Office of Emergency Operations

Abstract In March 2018, the US Food and Drug Administration (FDA), US Centers for Disease Control and Prevention, California Department of Public Health, Los Angeles County Department of Public Health and Pennsylvania Department of Health initiated an investigation of an outbreak of Burkholderia cepacia complex ( Bcc ) infections. Sixty infections were identified in California, New Jersey, Pennsylvania, Maine, Nevada and Ohio. The infections were linked to a no-rinse cleansing foam product (NRCFP), produced by Manufacturer A, used for skin care of patients in healthcare settings. FDA inspected Manufacturer A's production facility (manufacturing site of over-the-counter drugs and cosmetics), reviewed production records and collected product and environmental samples for analysis. FDA's inspection found poor manufacturing practices. Analysis by pulsed-field gel electrophoresis confirmed a match between NRCFP samples and clinical isolates. Manufacturer A conducted extensive recalls, FDA issued a warning letter citing the manufacturer's inadequate manufacturing practices, and federal, state and local partners issued public communications to advise patients, pharmacies, other healthcare providers and healthcare facilities to stop using the recalled NRCFP. This investigation highlighted the importance of following appropriate manufacturing practices to minimize microbial contamination of cosmetic products, especially if intended for use in healthcare settings.

Abstract Over the last decade, social and behaviour change strategies have increasingly been used to address human rights and child protection concerns, including harmful practices such as child marriage, female genital mutilation and violent discipline. Social and gender norms have also been recognized as key drivers of child recruitment. Nonetheless, the use of social and behaviour change strategies to prevent and respond to the recruitment and use of children in armed conflict has not yet been systematically explored or applied. Building on academic and practical sources, including findings from studies by the International Committee of the Red Cross and United Nations University, social and behavioural science theory, experiences from the Monitoring and Reporting Mechanism on grave violations against children, and academic literature, this article explores how social and behaviour change approaches can inform prevention of and response to the recruitment and use of children in armed conflict. The article concludes that social and behaviour change approaches can effectively inform prevention and reintegration efforts and can facilitate responses that bridge the humanitarian, development and peace nexus. Using social and behaviour change approaches can help to reveal why children are recruited from the perspective of key actors and entities across the socio-ecological framework in order to prevent the practice from becoming more accepted.