Comparison of WHO versus national COVID-19 therapeutic guidelines across the world: not exactly a perfect match
Issued Date
2024-04-22
Resource Type
eISSN
20597908
Scopus ID
2-s2.0-85191361549
Journal Title
BMJ Global Health
Volume
9
Issue
4
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMJ Global Health Vol.9 No.4 (2024)
Suggested Citation
Cokljat M., Cruz C.V., Carrara V.I., Puttaraska K., Capriglioni C., Insaurralde S.M., Rousseau-Portalis M., Roldan A., Watson J.A., Tarning J., White N.J., Guerin P.J. Comparison of WHO versus national COVID-19 therapeutic guidelines across the world: not exactly a perfect match. BMJ Global Health Vol.9 No.4 (2024). doi:10.1136/bmjgh-2023-014188 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98217
Title
Comparison of WHO versus national COVID-19 therapeutic guidelines across the world: not exactly a perfect match
Corresponding Author(s)
Other Contributor(s)
Abstract
Background The COVID-19 pandemic affected all WHO member states. We compared and contrasted the COVID-19 treatment guidelines of each member state with the WHO COVID-19 therapeutic guidelines. Methods Ministries of Health or accessed National Infectious Disease websites and other relevant bodies and experts were contacted to obtain national guidelines (NGs) for COVID-19 treatment. NGs were included only if they delineated specific pharmacological treatments for COVID-19, which were stratified by disease severity. We conducted a retrospective review using the adapted Reporting Checklist for Public Versions of Guidelines (RIGHT-PVG) survey checklist and a derived comparative metric based on the WHO guidelines was performed. Results COVID-19 therapeutics NGs could be obtained from 109 of the 194 WHO member states. There was considerable variation in guidelines and in disease severity stratifications. Therapeutic recommendations in many NGs differed substantially from the WHO guidelines. Overall in late 2022, 93% of NGs were recommending at least one treatment which had proved to be ineffective in large randomised trials, and was not recommended by WHO. Corticosteroids were not recommended in severe disease in nearly 10% of NGs despite overwhelming evidence of their benefit. NGs from countries with low-resource settings showed the greatest divergence when stratified by gross domestic product per year, Human Development Index and the Global Health Security Index. Discussion Our study is limited to NGs that were readily accessible, and it does not reflect the availability of recommended medicines in the field. Three years after the start of the SARS-CoV-2 pandemic, available COVID-19 NGs vary substantially in their therapeutic recommendations, often differ from the WHO guidelines, and commonly recommend ineffective, unaffordable or unavailable medicines.