International public health strategies in dermatology

Structured strategies to tackle skin diseases and related infections provide a framework and direct actions against their burden. The World Health Organization (WHO) develops, updates, advocates, and disseminates international public health strategies and implementation tools including guidelines. The 2016–2021 strategy to end sexually transmitted infections (STI) epidemic as a major public health concern, targets the 90:90:90 reduction of the global STI prevalence and national human papillomavirus (HPV) vaccine coverage. Standardized protocols and guidance which are people centered are needed to reach the targets, and interventions are mainly focused on prevention, management of asymptomatic patients, reaching sex partners and their treatment, access to STI services of adequate quality, and reducing the vulnerability and risks while meeting the needs of the general population with appropriate services. Vector-borne infectious protozoa causing dermal complications such as lymphatic filariasis (LF) and leishmaniasis are to be targeted for elimination. The intervention and prevention strategies set up by the WHO for both of these protozoal infections overlap by interrupting the chain of transmission, monitoring the burden of disease, vector control of sandflies and mosquitoes, environmental management and protection, and control of animal reservoirs. The HIV Global Health Strategy for 2016–2020 is a priority for the WHO and is based on accelerating actions and fast-tracking their responses. The WHO goal for HIV is the elimination of AIDS as a public health threat by 2030. The Strategy 2020 global targets are to reduce new HIV-infections and HIV-related deaths to fewer than 500,000 each and zero new infections among infants. The Five Strategic Directions are information for action, interventions for impact, delivering for equity, financing for sustainability, and innovation for acceleration. Once leprosy was eliminated as a public health problem globally in 2000, the WHO global leprosy strategy focused on reducing leprosy-related disabilities. The 2016–2020 WHO Global Leprosy Strategy focuses on promoting early diagnosis to reduce the leprosy burden. The Strategy 2020 targets are zero new children diagnosed with leprosy and visible deformities, <1 per million newly diagnosed leprosy patients with visible deformities, and zero countries with legislation allowing discrimination on leprosy. The program five key operational strategies are focused on early and increased detection and coverage, universal contacts screening, uniform leprosy treatment, and interventions against stigma and discrimination. Some non-governmental organizations, such as the International Society of Dermatology, have developed public health task forces and programs to promote skin health. Although the WHO has no specific public health strategies for general skin diseases in primary care, it has issued simple and practical clinical guidelines in the Integrated Management of Adolescent and Adult Illness for such diseases.