Quality Assurance, Norms and Standards

Quality Assurance, Norms and Standards

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WHO is the world’s foremost public health agency. One of its key roles is bringing the best skills, science and evidence to inform practice through setting globally-applicable norms and standards. Norms and standards provide guidance on a broad range of thematic areas. These are based on the best available scientific evidence and advice from leading technical experts.

Member States look to WHO for guidance to address uncertainties in public health policy and practice. As such, norms and standards need to be high-quality, relevant, accessible, and able to keep pace with rapid change, even in times of unfolding health crisis, such as the COVID-19 pandemic.

 

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Putting processes in place for developing and updating public health and clinical guidance, normative and standard-setting products

All WHO public health and clinical guidance must be produced to a consistently high standard. It must be timely, scientifically evidence-based, ethically sound and driven by what Member States need. It must be designed and delivered for real impact on the health of people. The COVID-19 pandemic reinforced how vital it is for countries to have access to the latest information to inform clinical practice and public health decisions.

WHO has a clear, dynamic process for technical departments to use when developing public health and clinical normative guidance. This entails quality assurance procedures and guiding principles for the design, formulation, and dissemination of WHO products. This ensures every set of recommendations or guidance that WHO produces is based on agreed scientific and ethical standards and is independently reviewed. WHO is also using new tools, such as machine learning, to expedite the conduct of systematic reviews. WHO has established living guideline processes for flagship publications so that countries can benefit from digitalized guidelines with up-to-date content and a simple format that enables continuous updating.

Science in action: living guidelines for COVID-19 treatment

The COVID-19 pandemic led to an unprecedented level of information generation and a critical need for data sharing. To manage the flood of evidence that has been emerging in real time, WHO took an innovative approach: living guidelines for COVID-19 treatment, with recommendations revised as new evidence emerges. The pioneering process included new approaches for rapid review of evidence, standards for user-friendly interfaces for health professionals and policy makers, and immediate and widespread dissemination of updates. Thanks to access to digital tools and optimized approaches to guidelines development, this accelerated process has cut the average time from full data receipt to production of guidance from the typical six to nine months to as little as five to seven weeks.

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Vaccination research
WHO/Yoshi Shimizu
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Supporting WHO to deliver quality assured, relevant, and user-centered products

Within an organization as complex as WHO, everyone responsible for producing technical materials should be supported to ensure that their work is high quality, relevant, and based on user needs. This requires consistency, standardization and centralized quality assurance.

The Science Division provides functional support to technical departments responsible for developing all types of norms, standards, and knowledge products, including strategies, roadmaps, action plans, and technical guidance. These can only have impact if they are adopted by Member States, so the Science Division also engages with WHO’s regional and country offices to promote uptake and application of WHO norms and standards.

WHO frequently requires advice from external experts to review and make technical recommendations. It convenes expert committees and advisory groups composed of experts on specific areas, participating in an individual capacity. The Department of Quality Assurance, Norms and Standards coordinates WHO’s work with advisory groups.

 

Science in action: Global Accelerator for Paediatric Formulations.

The Global Accelerator for Paediatric Formulations, or GAP-f, was conceived to provide a sustainable mechanism that ensures that safer, more effective, and more durable paediatric drug formulations are developed and made available to children on an accelerated timeline. GAP f works across the life cycle of drug development to prioritize, evaluate, develop, and deliver optimal formulations for paediatric populations. Current priority areas include TB, HIV and Hepatitis C.

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Making accurate scientific information openly accessible

WHO’s huge multilingual institutional repository, IRIS, forms one of the most authoritative sources of strategic information on public health. Maintaining digital access to all WHO publications is key to ensuring this knowledge is accessible to all who need it.

The WHO Science Division promotes availability of scientific information in the six official WHO languages, as well as in accessible formats for those with visual impairments and other disabilities. WHO has an open access publication policy, so that all knowledge products produced by WHO are available to all.

Science in action: increased accessibility to clinical guidelines

To increase accessibility, WHO is now launching clinical guidelines in a range of digital formats, including through the WHO website in PDF, and through a mobile phone app. The platform used to support this includes user-friendly tools such as infographics, making it easier to navigate and to implement the guidelines, even during busy clinical practice. The online multi-layered formats are designed to allow users to find recommendations first and then drill down to find supporting evidence and other information pertinent to applying the recommendations in practice, including tools for shared decision-making.
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The Bulletin of the World Health Organization is the flagship periodical of the World Health Organization.

It is a monthly peer-reviewed journal of public health with a special focus on developing countries. Since it was first published in 1948, it has become one of the world’s leading public and environmental health journals with an impact factor of 9.408. The journal is fully open-access with no article-processing charges or author fees. All articles are available under the Creative Commons Attribution 3.0 IGO licence. To submit a manuscript go to http://submit.bwho.org

In biosafety level II laboratory setting, a medical scientist is working on RT-PCR method for the testing of the novel coronavirus at Department of Medical Sciences.
© WHO/Ploy Phutpheng - 2020
In biosafety level II laboratory setting, a medical scientist is working on RT-PCR method for the testing of the novel coronavirus at Department of Medical Sciences.
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WHO Collaborating Centres: vital partners in public health

Around the world, there are more than 800 WHO Collaborating Centres supporting our work. WHO’s technical departments manage the centres, and the whole system is coordinated and supported by the Science Division’s Quality Assurance for Norms and Standards department. Each Collaborating Centre is the result of a time-limited formal agreement between WHO and an existing institution, with specific activities and deliverables in support of WHO's programmes.

The network of Collaborating Centres is essential for WHO to fulfil its mandated activities and to harness resources for global health far exceeding its own. They are a cost-effective way for WHO to access centres of excellence worldwide and provide crucial institutional capacity to ensure the scientific validity of WHO’s global health work. Through these global networks, WHO is able exercise leadership in shaping the international health agenda.

The Collaborating Centres are WHO’s largest in-kind resource mobilization mechanism, and they support the work of most technical departments. For the optimal use of this extremely valuable resource, it is essential that each Collaborating Centre complies with WHO corporate rules, and that the collaboration strengthens and enhances WHO’s work priorities and programme objectives.

Designation as a WHO collaborating centre provides institutions with enhanced visibility and recognition by national authorities, calling public attention to the health issues on which they work. It opens up improved opportunities for them to exchange information and develop technical cooperation with other institutions, in particular at international level, and to mobilize additional resources from funding partners.

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A laboratory technician cuts a piece of gel
WHO / P. Phutpheng
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Fast, reliable guidance and normative products for COVID-19

As the COVID-19 pandemic rapidly evolved, the amount of emerging evidence and data threatened to be as overwhelming as the disease itself. WHO acted fast to establish the Evidence Collaborative for COVID-19 Network, and devised ways to rapidly review evidence and disseminate scientific information in real time.

There has been an unprecedented demand for reliable guidance on how to manage the COVID-19 pandemic at country level, and WHO harmonized its evidence review process to fast-track interim guidance during emergencies. The WHO COVID-19 Publications Review Committee reviewed over 750 WHO documents in 2020, typically providing feedback and recommendations in 24 to 48 hours, while the WHO Rapid Review Group supports rapid evidence briefs for key COVID-19 issues to support the WHO emergency response.

The WHO COVID-19 Health Literature Database offers global open access to over 240,000 citations, including pre-prints & clinical trials, in multiple languages.

With over 90 partners, the Evidence Collaborative for COVID-19 Network helps coordinate the efforts of organizations, individual experts, and WHO staff from offices around the globe. This promotes collaboration and the efficient use of limited resources. It helps minimize duplication of efforts and fosters alignment with the global research agenda priorities.

More information:

Publications   

COVID-19 page

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WHO calls for research and development proposals for medicines, diagnostics and health technologies

How WHO supports evidence driven norms and standards updated in real time

Countries also need guidance on how to convert these norms and standards into action to promote health for all and contribute to the WHO Triple Billion Targets: 1 billion more people benefitting from universal health coverage, 1 billion more people better protected from health emergencies, and 1 billion more people enjoying better health and well-being.

WHO is uniquely positioned to provide the global public health community with norms and standards, especially for Member States that do not have their own national organizations for normative guidance. The work of developing quality norms and standards is a continuous cycle of priority setting, product planning and development and publication, uptake and implementation, evaluation of impact, and monitoring of health outcomes, which then feeds back into the next set of priorities.

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