The heads of the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), and the World Health Organization (WHO) today launched the new One Health Global Leaders Group on Antimicrobial Resistance.

Group members include heads of government, government ministers, leaders from private sector and civil society. The group is co-chaired by their Excellencies Mia Mottley, Prime Minister of Barbados, and Sheikh Hasina Wazed, Prime Minister of Bangladesh. 

The full list of the members of the One Health Global Leaders Group is available here.

The group will harness the leadership and influence of these world-renowned figures to catalyze global attention and action to preserve antimicrobial medicines and avert the disastrous consequences of antimicrobial resistance.

The Tripartite organizations launched the group during World Antimicrobial Awareness Week 2020 (18-24 November), as part of their shared call for united action to preserve and protect antimicrobial medicines. The group was created in response to a recommendation from the Interagency Coordination Group on Antimicrobial Resistance and supported by the Secretary-General of the United Nations.

The Directors General described the rapid rise of antimicrobial resistance as one of the world’s most urgent threats to human, animal, plant and environmental health – endangering food security, international trade, economic development and undermining progress towards the Sustainable Development Goals (SDGs). Antimicrobial resistance also leads to increased health care costs, hospital admissions, treatment failure, severe illness and death. 

Preventing the most severe outcomes of antimicrobial resistance

Antimicrobial resistance is making many infections harder to treat worldwide. WHO’s latest reporting shows that the world is running out of effective treatments for several common infections.

“Antimicrobial resistance is one of the greatest health challenges of our time, and we cannot leave it for our children to solve,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Now is the time to forge new, cross-sector partnerships that will protect the medicines we have and revitalize the pipeline for new ones.” 

A common agenda across human, animal and plant health

Misuse and overuse of antimicrobials in humans, animals and agriculture are the main drivers of antimicrobial resistance. Resistant micro-organisms can spread between humans, animals or the environment, and the antimicrobial medicines used to treat various infectious diseases in animals and humans are often the same.

“No single sector can solve this problem alone,” said QU Dongyu, Director-General of FAO. “Collective action is required to address the threat of antimicrobial resistance – across different economic sectors and country borders.”

Elevating political leadership for good governance

The group will provide political leadership to address this critical global challenge.

It will elevate the need to prioritize best practices to address antimicrobial resistance at global, regional, and national levels. And it will advise and advocate for  the development and implementation of polices and legislation to govern the importation, manufacture, distribution and use of quality antimicrobial drugs across all sectors.

“Antimicrobial resistance is a current problem affecting  animal health, human health, and the environment, we need to act today to protect their efficacy,” said Dr Monique Eloit, Director General of OIE. “I am confident that this group will advocate powerfully to implement legislation and mobilize key stakeholders to change antimicrobial use practices to protect our collective health and welfare.”

More information on the work of the Tripartite (FAO/OIE/WHO) is available here.

For more information on World Antimicrobial Awareness Week, visit WHO’s campaign page. A full calendar of World Antimicrobial Awareness Week events can be found here.

Note to Editors:

The Interagency Coordination Group (IACG) on Antimicrobial Resistance was convened by the Secretary-General of the United Nations after the UN High-Level Meeting on Antimicrobial Resistance in 2017 following the request of the 2016 Political Declaration of the High Level Meeting on Antimicrobial Resistance contained in resolution A/RES/71/3. The IACG brought together partners across the UN, international organizations and individuals with expertise across human, animal and plant health, as well as the food, animal feed, trade, development and environment sectors, to formulate a blueprint for the fight against antimicrobial resistance. The Secretariat for the IACG was provided by WHO, with contributions from FAO and OIE. The IACG completed its mandate on 29 April 2019 upon the handover of its report to the UN Secretary-General.

The World Health Organization

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goals for 2019-2023 are to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and to provide a further billion people with better health and well-being.

The Food and Agriculture Organization

The Food and Agriculture Organization (FAO) is a specialized agency of the United Nations that leads international efforts to defeat hunger. Our goal is to achieve food security for all and make sure that people have regular access to enough high-quality food to lead active, healthy lives. We believe that everyone can play a part in ending hunger.

The World Organisation for Animal Health

The OIE is the intergovernmental organisation responsible for improving animal health worldwide. Founded in 1924, it is recognised as a reference organisation for international standards relating to animal health and zoonoses by the World Trade Organization (WTO) and has a total of 182 Member Countries. The OIE maintains permanent relations with international and regional organisations and has Regional and Sub-regional Offices on every continent.

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On World Children’s Day, WHO is pleased to issue a call urging stakeholders to accelerate access to effective paediatric HIV and tuberculosis (TB) diagnostics and medicines.

The Action Plan, which is launched today, has been developed by a wide group of stakeholders under the auspices of the Fifth Vatican High-Level Dialogue on Paediatric HIV and TB in Children Living with HIV which was held earlier this month.     

Children are one of the most disadvantaged populations in the HIV and AIDS and TB response. In 2019, 95 000 AIDS-related deaths occurred in children, two-thirds of those deaths in 21 focus countries. 850 000 children living with HIV were not
accessing treatment, 65% of which were aged 5-14 years. These children are also particularly susceptible to co-infection with tuberculosis, a major cause of AIDS-related deaths in this population. In 2019, an estimated 36 000 children who were
living with HIV died from TB.

There are several challenges that hamper the rapid development of paediatric formulations, including lack of paediatric data for new drugs, delay in completion of clinical studies, challenges with taste, and slow market uptake among others. In addition,
high prices of diagnostic products, limited availability and accessibility to novel technical and case-finding interventions as well as fragmented and delayed regulatory approvals are some of the challenges faced in finding appropriate diagnostics
for children. All in all these delay and affect uptake of essential services to diagnose and treat children with HIV and TB.

The plan agreed upon by participants of the High Level Dialogue includes pledges to accelerate development of new pediatric HIV and TB formulations; improved diagnostic devices and assays for children with TB; and lower prices for early infant HIV diagnosis.

Researchers and pharmaceutical companies have committed to continue and expand their collaborations to investigate and develop better medicines for children. Regulators committed to work towards facilitating the regulatory pathways for priority TB and HIV paediatric medicines. Government representatives confirmed their support for advancing widespread availability of new tests and optimal paediatric medicines.
Policymakers committed to continue updating their normative work to capture new developments and support prioritization of research and development for medicines and diagnostics. Finally, key donors expressed their commitment by continuing and expanding
their investments to support development of better formulations for children.

Organizers of the High-Level Dialogue included WHO and the Elizabeth Glaser Paediatric Aids Foundation, in their capacity as co-chairs of the AIDS Free Working Group of the Start Free, Stay Free, AIDS Free framework, as well as The US President’s Emergency
Plan for AIDS Relief (PEPFAR), UNAIDS, representatives of faith-based organizations, and the Stop TB partnership. Participants included leaders of major diagnostic and pharmaceutical companies, multilateral organizations, governments, regulators,
faith-based organizations, and services providers for children and adolescents living with HIV and TB.

The 2020 High-Level Dialogue serves as a reminder of the challenges that exist, but also highlights the opportunities we can capitalize on when we work together.  WHO remains committed in working with its partners in ensuring progress towards a Start
Free, Stay Free and AIDS Free generation and to reaching the targets as included in the political declaration of the UN General Assembly High Level Meeting on TB and the WHO End TB Strategy

“The impact of the COVID-19 pandemic has laid bare the power of collaboration and partnership to accelerate action. The WHO Global HIV programme recognizes this Action Plan as the roadmap to reset the speed at which innovations in drugs and diagnostics
can lead to child-centered impact. We are proud to commit to developing the norms and standards, policies and research agendas on this pathway to success” said Dr Meg Doherty, Director the WHO Global HIV, Hepatitis and STI Programmes.

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The United Nations, IOM, ITU, OCHA, OHCHR, UNDP, UNEP, UNESCO, UNHCR, UNICEF, UNOPS, UPU, UN Volunteers, UN Women, WFP and WHO support the adoption of the following joint statement, in line with the UN Personal Data Protection and Privacy Principles  adopted by the UN System Organizations to support its use of data and technology in the COVID-19 response in a way that respects the right to privacy and other human rights and promotes economic and social development.

The COVID-19 pandemic has become a global emergency, with devastating consequences in terms of loss of life and economic decline, and significantly hampering progress toward achieving the United Nations Sustainable Development Goals. Poor and vulnerable communities are particularly imperiled by this deadly disease and its economic ramifications.

Mounting evidence demonstrates that the collection, use, sharing and further processing of data can help limit the spread of the virus and aid in accelerating the recovery, especially through digital contact tracing. Mobility data derived from people’s usage of mobile phones, emails, banking, social media, postal services, for instance, can assist in monitoring the spread of the virus and support the implementation of the UN System Organizations’ mandated activities.[1]

Such data collection and processing, including for digital contact tracing and general health surveillance, may include the collection of vast amounts of personal and non-personal sensitive data. This could have significant effects beyond the initial crisis response phase, including, if such measures are applied for purposes not directly or specifically related to the COVID-19 response, potentially leading to the infringement of fundamental human rights and freedoms. This concern is especially pressing if some emergency measures introduced to address the pandemic, such as digital contact tracing, are turned into standard practice.

The UN Secretary-General highlighted in his policy brief on human rights and COVID-19 that “Human rights are key in shaping the pandemic response, both for the public health emergency and the broader impact on people’s lives and livelihoods. Human rights put people centre-stage. Responses that are shaped by and respect human rights result in better outcomes in beating the pandemic, ensuring healthcare for everyone and preserving human dignity.”

Any data collection, use and processing by UN System Organizations in the context of the COVID-19 pandemic should be rooted in human rights and implemented with due regard to applicable international law, data protection and privacy principles, including the UN Personal Data Protection and Privacy Principles. Any measures taken to address the COVID-19 pandemic should also be consistent with the mandates of the respective UN System Organizations and take into account the balancing of relevant rights, including the right to health and life and the right to economic and social development.

Taking into account the UN Personal Data Protection and Privacy Principles, the UN Secretary-General’s policy brief on human rights and COVID-19, and relevant health and humanitarian standards, data collection, use and processing by  UN System Organizations in their operations should, at a minimum:

  • Be lawful, limited in scope and time, and necessary and proportionate to specified and legitimate purposes in response to the COVID-19 pandemic;
  • Ensure appropriate confidentiality, security, time-bound retention and proper destruction or deletion of data in accordance with the aforementioned purposes;
  • Ensure that any data exchange adheres to applicable international law, data protection and privacy principles, and is evaluated based on proper due diligence and risks assessments;
  • Be subject to any applicable mechanisms and procedures to ensure that measures taken with regard to data use are justified by and in accordance with the aforementioned principles and purposes, and cease as soon as the need for such measures is no longer present; and
  • Be transparent in order to build trust in the deployment of current and future efforts alike.

A coordinated and inclusive global UN-wide response rooted in solidarity is necessary to contain the pandemic and minimize its negative impact across the world. Although the statement is aimed to address the challenges of the current COVID-19 pandemic, it may serve as a precedent for using data to respond to any future crises of a similar scale quickly and while respecting data protection and privacy.


[1] WHO issued “Ethical considerations to guide the use of digital proximity tracking technologies for COVID-19 contact tracing”. More information can be found at https://www.who.int/publications/i/item/WHO-2019-nCoV-Ethics_Contact_tracing_apps-2020.1

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This story accompanies the UNICEF-WHO State of the World’s Sanitaton report launched on 19 November 2020. This report, aims to draw attention to the sanitation crisis, bring together lessons from high-achieving countries, and presenting a vision of what is needed to deliver universal access to safe sanitation.Selengkapnya

Yvonne Magawa (ESAWAS), Batsirai Majuru (WHO), Bisi Agberemi (UNICEF), Jan-Willem Rosenboom

& Alyse Schrecongost (BMGF)

Two sanitation workers

Faecal sludge transport workers in Kenya – UNICEF/UN0348903/Modola

This blog is part of a series for World Toilet Day highlighting issues within the WHO-UNICEF State of the Worlds Sanitation report.  The topic of sanitation regulation is also covered in ‘Catalysing Citywide Sanitation For All Through Regulating Service Providers‘ by IWA’s Regulation for Citywide Inclusive Sanitation initiative’s advisory and taskforce members – Yvonne Magawa (ESAWAS), Diego Polania (CRA), and Gustavo Saltiel (World Bank).

For too long sanitation, specifically on-site sanitation systems such as septic tanks and pit latrines, have been left in the realm of household responsibility.

The scant investments available for urban sanitation gravitate towards sewered infrastructure, reaching small proportions of large urban areas, primarily wealthier populations.  Urban populations continue to grow rapidly, often in dense settlements with limited basic public services or infrastructure.  Particularly for sanitation, households are forced to make do, covering the costs of basic access for themselves.  The very nature of safe sanitation, however, means that the decisions and priorities of individuals are largely decoupled from what would be required to protect public health, the environment, and reach the poorest. Services for safely containing, emptying, transporting and treating human waste, and preventing pits and septic tanks from contaminating groundwater and open drains are needed, but without regulation, investments will not prioritize public health outcomes.

This situation is both unfair to the households and ineffective in achieving a primary purpose of sanitation: protecting public health.  Sanitation is fundamentally a public good.  Individuals’ decisions maximize their own best interest – they do not necessarily serve the best interests of society at large.

Investments in sanitation need to be planned, regulated and financed to align the priorities of individual households with those of service providers.  This alignment is required to address the broader social goals of public health protection, cleaner environments, and stronger economies.  Among the countries that have made extraordinary gains in a generation, a common factor among them has been strong political leadership that clarified public goals, gave clear mandates to the responsible authorities to achieve those goals, regulated authorities’ delivery of services, and mobilized the corresponding investments needed.

Where utilities manage sewers, generally those utilities have a defined, public service-oriented mandate, performance accountability, and financing strategies.  Over two thirds of countries have environmental standards for wastewater treatment.

Beyond sewered areas, urban sanitation remains a public good, but it is largely delivered by unorganized and unregulated private or informal actors.  Few countries have standards for faecal sludge treatment or safe reuse of wastewater or sludge.  Individual providers of emptying and transport services may or may not be subject to a smattering of on-paper regulatory codes or standards.  Where standards exist, they are almost universally decoupled from efforts to monitor, incentivize or enforce compliance.  As a result, less than a third of mandated oversight agencies are able to carry out the basic functions of monitoring and enforcement.

Robust regulatory systems can address the market failures of urban sanitation to protect public health and incentivize delivery of safe, inclusive, and viable services.  We highlight three issues critical to pursuit of this outcome that merit case studies, discussion, and sector learning and evolution.

First, regulations can help to better link sanitation services to public health protections.  Simple statement but not a simple task. Regulation of sanitation services has long lagged behind that of water services: only 1 in 5 countries have any indicators for sanitation service quality.  If sanitation services are to protect public health, then public health-aligned guidance and oversight must become the expected norm in all countries, for sewered and non-sewered sanitation systems alike.  Health outcomes must be designed into simple, transparent and effective by-laws, codes and standards; actionable and funded monitoring and enforcement systems are required to make those standards meaningful.  To achieve this, systems must be designed in collaboration with public health authorities.  Public health risk assessment and risk management priorities must underpin product and service standards along the full sanitation service chain.  This includes measures to address the specific health risks, stigma and marginalization faced by sanitation workers in unregulated settings.

Second, as with public health regulation, the focus of economic and performance regulation of sanitation services must be on safe, inclusive services, irrespective of the infrastructure used.  Failure to focus mandates and regulatory frameworks on service outcomes instead of infrastructure inputs exacerbates systemic inequity and exclusion. In most cases, providers of non-sewered products and services remain unregulated and unorganized retail actors.  They deliver services with wide variability in price and quality, with little accountability for the quality of their service to households or for public health. Market structuring – particularly economic and performance regulation of services – is required if public or private providers are to be incentivized to protect public health, to reach low income communities, and to mobilize investment and innovation.  Economic regulatory tools can help align customer inclusion and affordability goals with providers’ financial interests.

Finally, if the public sector is well-structured and regulated, it can increase business opportunity, available finance, and incentivize investment in innovation to meet health and inclusivity goals.  Recognizing sanitation as a public good does not imply that the public sector has sole responsibility for delivering public services.  Indeed, without structuring sanitation as a public service, opportunities for private sector engagement are more restricted, higher risk, less effective, less profitable, and less aligned with the public good.  Tools and business models that align public, customer, and provider interests have not always been clear, but promising innovations are emerging in urban markets in Kenya, Malaysia, Zambia, and other countries.  In these areas, regulators are insisting on improved sector outcomes.  They are also supporting utilities and the private sector to learn and grow as the sector transforms and more is expected of everyone.

Significant challenges remain.  In many countries sanitation is entirely managed by municipalities.  Municipal service systems tend to be subject to individuals’ short term political interests, missing accountability mechanisms, and with limited flexibility to generate or ringfence revenue effectively. Treatment compliance or the relationship between customer-based revenue mechanisms and service quality can be opaque.

We have good reason to believe that well-designed regulatory systems can accelerate global progress toward SDG 6.2 and 6.3, and improve public health.  The WHO Guidelines on Sanitation and Health provide a useful point of departure in addressing public health criteria in sanitation regulations, and articulating the role of the health sector in sanitation authorities’ service provision.

In addition, a new publication – the WHO-UNICEF State of the Worlds Sanitation – launching today draws attention to the role of regulators in solving the sanitation crisis.  The report brings together lessons from high-achieving countries, and presents a vision of what is needed to deliver universal access to safe sanitation.  It calls for urgent action around five areas: governance; financing; capacity development; data; and innovation, and highlights leadership, effective coordination and regulation as effective pathways for achieving safe sanitation for all.  Building on the directions outlined in the report, WHO and other partners working with regulators’ networks such as the East and Southern Africa Water and Sanitation (ESAWAS) Regulators Association and the WHO International Network of Drinking-water and Sanitation Regulators (RegNet), will work to create concrete and contextualized changes in regulation of sanitation services that can inform future updates of the report.

 

 

 

 

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Over the past decade, the world has witnessed unprecedented scale-up of antiretroviral therapy, which has saved the lives of tens of millions of people. An increased use of HIV medicines has been accompanied by the emergence of HIV drug resistance, which has also steadily increased in recent years.Selengkapnya

 

Health is a human right, and tactics learned from the human rights movement can help ensure every person access to the highest standard of sexual and reproductive health. 

WHO, HRP and partners present a new documentary series about the power of people to change the world. 

Every individual on the planet has the right to the highest standard of health and well-being in all aspects of their sexuality, their body and their reproductive choices – but there is no ‘one size fits all’ strategy for making
this a reality.  

Right To A Better World is a documentary video series produced by WHO and HRP, in partnership with UN Human Rights (OHCHR) and the Oxford Human Rights Hub (OxHRH). It explores how tactics
developed by the human rights movement can be used to achieve sexual and reproductive health rights, and drive meaningful progress towards the fulfillment of the 2030 Agenda for Sustainable Development. 

A human rights-based approach to health is essential to achieving my top priority as DG – universal health coverage,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus, when he signed the 2017 WHO-OHCHR Framework of Cooperation.  

Right To A Better World builds on this major milestone for health and human rights, affirming that rights holders and their experiences belong at the centre of every discussion and decision
affecting them. 

“The achievement of the 2030 Agenda for Sustainable Development hinges on the realization of human rights, which necessitates action across sectors and disciplines,” said Veronica Birga, Chief of Women’s Human Rights and
Gender Section of UN Human Rights. “The lessons in this series created through a multi-disciplinary partnership are invaluable and make it clear that securing rights for all, is not only the right way, but the smart way to achieve truly
sustainable development.” 

There are four 20-minute thematic episodes in Right To A Better World, all free to access: 
contraception
comprehensive sexuality education
 maternal mortality and morbidity
, and violence against women
.   

“This powerful series creates a unique synergy between academic and practical human rights approaches, vividly demonstrating the key role human rights can play when advocating for sexual and reproductive health rights in political, legal, and international forums,” said Professor Sandra Fredman, Director of OxHRH. 

“The “Right to a Better World” series bridge the communicative divide between health and human rights practitioners, throwing the spotlight on the importance of addressing not only health outcomes but the underlying gender inequalities,
stereotypes and structures,” adds Dr Meghan Campbell, Deputy Director at OxHRH. 

Although health outcomes and the achievement of rights have improved for many across these core components of sexual and reproductive health, progress overall remains fragile and uneven.   

In each episode across the series, experts in health and human rights share their professional struggles and successes working on the frontline of communities worldwide. As advocates and activists, they represent a broad range of professional
fields, ages, levels and backgrounds.  

The episodes can be watched at home, in groups and in classroom settings. Viewers are encouraged to learn from the experiences shared, and consider how tactics could be adapted to their own contexts.  

Human rights are the key to ensuring every person has access to comprehensive sexual and reproductive health care, and WHO and HRP are committed to mainstreaming human rights into health policies and programmes. Our partnership with UN Human Rights and OxHRH affirms that in the changing landscape of sexual and reproductive health, human rights must be heard as loudly as clinical and scientific research,” said
Ian Askew, Director of the WHO Department of Sexual and Reproductive Health and Research including HRP.  

Join the conversation at #RightToABetterWorld.  

 


Right To A Better World VIDEOS 


Comprehensive sexuality education (episode 1 of 4) 

Building support and understanding of every young person’s right to education, health and well-being, in an inclusive and gender equal society. 

 

Contraception (episode 2 of 4) 

Ensuring each woman’s and adolescent’s right to make decisions about their reproductive health and future.

 

Maternal mortality and morbidity (episode 3 of 4) 

Ensuring every woman’s and adolescent’s right to not only survive pregnancy and childbirth, but have a positive experience of this profound life event. 

 

Violence against women (episode 4 of 4) 

Building a world in which women and girls are free from all forms of violence and discrimination.

 

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Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including disability, learning difficulties, and visual and hearing problems.

Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.

Today, on World Prematurity Day, WHO launched a new Roadmap on human resource strategies to improve newborn care in health facilities in low- and middle-income countries, aimed at improving quality of care for newborns, including small and sick babies, and supporting countries to achieve the SDG target to reduce neonatal mortality to less than 12 per 1000 live births by 2030.

As the COVID-19 pandemic overburdens already weak health systems in many countries, it is expected to increase the number of newborn deaths, particularly among babies born too soon. Disrupted essential health services, like family planning or antenatal check-ups, will leave women more at risk of preterm birth and vulnerable infants without the services they need.

“We have the power to prevent, diagnose and treat preterm birth, and save babies lives, if we invest in competent and specialized nurses and health workers to care for them,” Dr Anshu Banerjee, WHO Director for the Department of Maternal, Newborn, Child and Adolescent Health and Ageing. “As more pregnant women give birth in health facilities, we must also strengthen our health workforce to provide a positive pregnancy experience for each of them.”

Survival and health outcomes of preterm newborns can be enhanced by increasing access to interventions provided to the mother shortly before or during birth as well as interventions for the newborn baby. However, the highest burden of preterm birth, death and disability is concentrated in low- and middle-income countries, where competent and specialized health workers are in short supply.  

Of the 30 million newborns who require inpatient care every year, approximately half do not have access to neonatal care services and those who have access often receive care of suboptimal quality. Skilled birth attendants, including medical doctors and midwives, are critical to the provision of high-quality newborn care and to improving newborn outcomes, not only at the time of birth and for routine postnatal care but also in health facilities to which mothers and newborns with complications are referred.

The new WHO roadmap consists of 10 strategies to guide countries in developing their policies to improve the number and competence of health workers to deliver high-quality essential care for all newborns and specialized care for small and sick newborns. It also aims to fill the gap in the numbers of health workers with specialized neonatal skills in low- and middle-income countries required to provide high-quality inpatient care for small and sick newborns.

Over the past three decades countries that have invested in their nursing and midwifery workforces have achieved sustained reductions in maternal and newborn mortality. With continued investments in universal access to high-quality newborn care an estimated 1.7 million newborns could be saved each year. Almost half of the effect would result from providing special and intensive hospital care for preterm, low-birth-weight or sick newborns.

 

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The European Commission, France, Spain, The Republic of Korea and the Bill & Melinda Gates Foundation pledge US$ 360 million to Gavi’s COVID-19 Vaccines Advance Market Commitment (COVAX AMC)
Latest announcements mean over US$ 2 billion has been raised towards the effort to ensure equitable access to COVID-19 vaccines for low- and middle-income economies, with at least US$ 5 billion more needed in 2021
The Bill & Melinda Gates Foundation has also pledged an additional US$ 20 million to the Coalition for Epidemic Preparedness Innovations (CEPI) to support COVID-19 vaccine research and developmentSelengkapnya

WHO commissioned this systematic review and meta-analysis to summarise the global evidence on the prevalence and incidence of HCV infection among men who have sex with men and to examine associations with HIV and injecting drug use. The results are presented in this paper.Selengkapnya

WHO has developed the assistive technology capacity assessment (ATA-C) tool, a system-level tool to evaluate a country’s capacity to finance, regulate, procure and provide assistive technology. The ATA-C tool enables countries to better understand the current status and identify key actions to improve access to assistive technology: it can be used for awareness raising, policy and programme design and ongoing monitoring and evaluation. The ATA-C implementation process can also serve to bring diverse stakeholders together and build momentum for action.

The tool was developed by WHO, in collaboration with the Clinton Health Access Initiative and with support of many other in-country partners. Its development has been informed by implementation in Bahrain, Bolivia (Plurinational State of), Ethiopia, Indonesia, Iraq, Liberia, Malawi, Mongolia, Nigeria, Rwanda, Sierra Leone, Tajikistan, Uganda and Viet Nam. The tool development and country assessments were funded by UK aid under the AT2030 programme led by the Global Disability Innovation Hub, with contributions from the United States Agency for International Development.

To access the tool and supporting documents, WHO has created a dedicated portal. Through this portal, WHO will provide technical support and facilitate coordination and connections between the diverse stakeholders in countries. To access the portal, visit this link.

The ATA-C is part of the WHO Assistive Technology Assessment (ATA) Toolkit, helping countries to collect effective and relevant data on assistive technology. For more information on the toolkit, visit this link.

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The Ministry of Health in Lao People’s Democratic Republic (PDR) reported a human case of infection with an avian influenza A(H5N1) virus. The case is a one-year-old female who developed symptoms of fever, productive cough, difficulty breathing and runny nose on 13 October 2020. She was hospitalized for her illness on 16 October and discharged on 19 October. As part of severe acute respiratory infection (SARI) sentinel surveillance, a specimen was collected on the date of hospitalization and confirmed to be positive for avian influenza A(H5N1) on 28 October by reverse transcription polymerase chain reaction (RT-PCR) at the National Centre for Laboratory and Epidemiology (NCLE).

Among the close contacts of the patient, one contact developed fever and cough after the onset of illness in the case. Specimens collected from all household contacts, including the symptomatic contact, were negative for influenza A viruses.Selengkapnya

More than one year on across the pilot countries of Ghana, Kenya and Malawi, more than 1 million doses of the RTS,S/AS01 malaria vaccine have been administered, and an estimated 480,000 children have received their first dose of vaccine in childhood vaccination and should benefit from this additional malaria prevention.Selengkapnya

WHO‘s Global Strategy to Accelerate the Elimination of Cervical Cancer, launched today, outlines three key steps: vaccination, screening and treatment. Successful implementation of all three could reduce more than 40% of new cases of the disease and 5 million related deaths by 2050.

Today’s development represents a historic milestone because it marks the first time that 194 countries commit to eliminating cancer – following adoption of a resolution at this year’s World Health Assembly. 

Meeting the following targets by 2030 will place all countries on the path toward elimination:

  • 90% of girls fully vaccinated with the HPV vaccine by 15 years of age
  • 70% of women screened using a high-performance test by age 35 and again by 45
  • 90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated and 90% of women with invasive cancer managed).

The strategy also stresses that investing in the interventions to meet these targets can generate substantial economic and societal returns. An estimated US$ 3.20 will be returned to the economy for every dollar invested through 2050 and beyond, owing to increases in women’s workforce participation. The figure rises to US$ 26.00 when the benefits of women’s improved health on families, communities and societies are considered.

“Eliminating any cancer would have once seemed an impossible dream, but we now have the cost-effective, evidence-based tools to make that dream a reality,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “But we can only eliminate cervical cancer as a public health problem if we match the power of the tools we have with unrelenting determination to scale up their use globally.”

Cervical cancer is a preventable disease. It is also curable if detected early and adequately treated. Yet it is the fourth most common cancer among women globally. Without taking additional action, the annual number of new cases of cervical cancer is expected to increase from 570 000 to 700 000 between 2018 and 2030, while the annual number of deaths is projected to rise from 311 000 to 400 000. In low- and middle-income countries, its incidence is nearly twice as high and its death rates three times as high as those in high-income countries.

“The huge burden of mortality related to cervical cancer is a consequence of decades of neglect by the global health community. However, the script can be rewritten,” says WHO Assistant Director-General Dr Princess Nothemba (Nono) Simelela. “Critical developments include the availability of prophylactic vaccines; low-cost approaches to screening and treating cervical cancer precursors; and novel approaches to surgical training. Through a shared global commitment to the Sustainable Development Goals and leaving no-one behind, the countries of the world are forging a new path to ending cervical cancer. “

The strategy is launched at a challenging time, however.

The COVID-19 pandemic has posed challenges to preventing deaths due to cancer, including the interruption of vaccination, screening and treatment services; border closures that reduced the availability of supplies and that prevent the transit of skilled biomedical engineers to maintain equipment; new barriers preventing women in rural areas from travelling to referral centres for treatment; and school closures that interrupt school vaccine programmes. To the extent possible, however, WHO urges all countries to ensure that vaccination, screening and treatment can continue safely, with all necessary precautions. 

“The fight against cervical cancer is also a fight for women’s rights: the unnecessary suffering caused by this preventable disease reflects the injustices that uniquely affect women’s health around the world,” says Dr Princess Nothemba Simelela. “Together, we can make history to ensure a cervical cancer-free future.”

The launch is being celebrated with a day of action across the globe, as ministries of health, partners, and cancer advocates engage in activities to improve access to cancer prevention and treatment for girls and women. 

Around the world,  monuments are being illuminated in the cervical teal, from Niagara Falls in North America to The Dubai Frame, to city skylines across Australia.  (More information about the events in countries around the world and monument lightings will be posted on WHO’s event site: https://www.who.int/news-room/events/detail/2020/11/17/default-calendar/launch-of-the-global-strategy-to-accelerate-the-elimination-of-cervical-cancer).

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Measles surged worldwide in 2019 reaching highest number of reported cases in 23 years. Highlighted in a publication by WHO and the United States Centers for Disease Control and Prevention (CDC),
measles cases worldwide increased to 869 770 in 2019, the highest number reported since 1996 with increases in all WHO regions. Global measles deaths climbed nearly 50 percent since 2016, claiming an estimated 207 500 lives in 2019 alone. 

After steady global progress from 2010 to 2016, the number of reported measles cases climbed progressively to 2019. Comparing 2019 data with the historic low in reported measles cases in 2016, authors cite a failure to vaccinate children on time with
two doses of measles-containing vaccines (MCV1 and MCV2) as the main driver of these increases in cases and deaths.

“We know how to prevent measles outbreaks and deaths,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “These data send a clear message that we are failing to protect children from measles in every region of the world. We must collectively work to support countries and engage communities to reach everyone, everywhere with measles vaccine and stop this deadly virus.”

Measles outbreaks occur when people who are not protected from the virus are infected and spread the disease to unvaccinated or under-vaccinated populations. To control measles and prevent outbreaks and deaths, vaccination coverage rates with the
required MCV1 and MCV2 must reach 95 percent and be maintained at national and subnational levels.  MCV1 coverage has been stagnant globally for more than a decade at between 84 and 85 percent. MCV2 coverage has been steadily increasing
but is only now at 71 percent. Vaccination coverage against measles remains well below the 95 percent or higher needed with both doses to control measles and prevent outbreaks and deaths.

Global response to COVID-19 pandemic must not exacerbate the measles crisis

Although reported cases of measles are lower in 2020, necessary efforts to control COVID-19 have resulted in disruptions in vaccination and crippled efforts to prevent and minimize measles outbreaks. As of November, more than 94 million people were at
risk of missing vaccines due to paused measles campaigns in 26 countries. Many of these countries are experiencing ongoing outbreaks. Of countries with postponed planned 2020 campaigns, only eight (Brazil, Central African Republic, Democratic
Republic of Congo, Ethiopia, Nepal, Nigeria, Philippines and Somalia) resumed their campaigns after initial delays. 

“Before there was a coronavirus crisis, the world was grappling with a measles crisis, and it has not gone away,” said Henrietta Fore, UNICEF Executive Director. “While health systems are strained by the COVID-19 pandemic, we must not
allow our fight against one deadly disease to come at the expense of our fight against another. This means ensuring we have the resources to continue immunization campaigns for all vaccine-preventable diseases, even as we address the growing COVID-19
pandemic.”

Causes of failure to control measles are many and must be addressed

Global immunization partners are engaging leaders and public health professionals in affected and at-risk countries to ensure that measles vaccines are available and safely delivered, and that caregivers understand the life-saving benefit of the vaccine. On 6 November 2020, WHO and UNICEF issued an emergency call to action for measles and polio outbreak prevention and response.

“Measles virus easily finds unprotected children, adolescents and adults because it is so contagious,” said Dr. Robert Linkins, Measles & Rubella Initiative Management Team Chair and Accelerated Disease Control Branch Chief at U.S. CDC.
“Infections are not only a sign of poor measles vaccination coverage, but also a known marker, or ‘tracer,’ that vital health services may not be reaching populations most at-risk. Our collective efforts to reach children with vaccines
now, ahead of the possible easing of COVID-19 travel restrictions and increased population movement, will save lives.”

The Measles & Rubella Initiative (M&RI), which includes American Red Cross, the United Nations Foundation, the U.S. CDC, UNICEF and WHO, and global immunization partners
like Gavi, the Vaccine Alliance, the Bill and Melinda Gates Foundation and others, are working to address the current measles crisis and ensure that resources are positioned to address immunization delays – for measles and all vaccines –
in every region of the world. A bold strategy released by M&RI, Measles & Rubella Strategic Framework 2021 – 2030,
will help to address reversals in global progress toward measles elimination by bolstering strong, national immunization systems that can reach and protect children. This strategic shift by the partnership will focus on strengthening the routine delivery
of all vaccines, and quickly and effectively detecting and responding to measles outbreaks.

Quotes from our partners

“These alarming figures should act as a warning that, with the COVID-19 pandemic occupying health systems across the world, we cannot afford to take our eye off the ball when it comes to other deadly diseases. Measles is entirely preventable; in
a time in which we have a powerful, safe and cost-effective vaccine nobody should still be dying of this disease. COVID-19 has resulted in dangerous declines in immunization coverage, leading to increased risk of measles outbreaks. This is why countries
urgently need to prioritize measles catch-up immunization through routine services to mitigate the risk of outbreaks and ensure no child goes without this lifesaving vaccine.” – Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance.

“The fact that measles outbreaks are occurring at the highest levels we’ve seen in a generation is unthinkable when we have a safe, cost-effective, and proven vaccine. No child should die from a vaccine-preventable disease. We are proud to
chart a bold way forward with partners to close gaps in access to immunization and rapidly respond to outbreaks so everyone, everywhere can live healthy lives.” – Elizabeth Cousens, President & CEO, United Nations Foundation.

“We are concerned that COVID-19 will contribute to an increase in the number of measles cases and deaths. Measles knows no borders, and it is imperative we work together to vaccinate more children and continue the fight against this preventable
disease. “Around the globe, Red Cross and Red Crescent volunteers help families in chronically unvaccinated communities to protect their children. Join us in this effort.” – Gail McGovern, President & CEO of the American Red Cross.

###

Notes to editors

Download photos and broll on vaccines here: https://weshare.unicef.org/Package/2AM408X1UA6X

About M&RI:

The Measles & Rubella Initiative (M&RI) is a partnership between the American Red Cross, the United Nations Foundation, the U.S. CDC, UNICEF and WHO. Working
with Gavi, the Vaccine Alliance and other stakeholders, the Initiative is committed to achieving and maintaining a world without measles, rubella and congenital rubella syndrome. Since 2000, M&RI has helped deliver over USD 5.5 billion doses of measles
vaccine to children worldwide and saved over USD 25.5 million lives by increasing vaccination coverage, responding to outbreaks, monitoring and evaluation, and supporting demand for vaccine.  

More information on measles:

WHO factsheet; CDC measles updates; Latest WHO measles surveillance data; UNICEF’s immunization updates; and Latest WHO guidelines for immunization programme in context of COVID-19.

 

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Picture extracted from website https://hela100.org/

 

The family of Henrietta Lacks is celebrating the 100 year anniversary of her birth.  As part of their Centennial celebration, they are supporting the global movement to eliminate cervical cancer and hosting exciting events in the United States to mark the launch of the global strategy.

Watch Henrietta Lacks Centennial conversation with Dr Princess Nothemba Simelea on HELA100 website

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The Ministry of Health (MoH) notified WHO that between 13 September and 1 October 2020, eight cases of Rift Valley Fever (RVF) including seven deaths were confirmed in animal breeders. Districts affected include Tidjikja and Moudjéria (Tagant region), Guerou (Assaba region) and Chinguetty (Adrar region). Laboratory confirmation of RVF infection was performed using a reverse transcription polymerase chain reaction (RT-PCR) at the National Institute for Public Health Research (INRSP) in Nouakchott. The age of infected patients varied between 16 and 70 years old and included one woman and seven men. All seven deaths occurred among hospitalised patients with fever and haemorrhagic syndrome (petechia, gingivorrhagia) and vomiting.

Between 4 September to 7 November 2020, a total of 214 people were sampled and their samples have been sent to the INRSP for laboratory testing with a total of 75 testing positive for RVF (RT-PCR and serology by enzyme-linked immunosorbent assay (ELISA). Positive cases have been reported in 11 of 15 regions of the country: Brakna, Trarza, Gorgol, (on the border with Senegal), Adrar, Assaba, Hodh El Gharby, Hodh El Chargui, Guidimaka (on the border with Mali) and Nouakchott Sud, Nouakchott Ouest and Tagant. The Tagant region is the most affected (38/75, 51%) with principal hotspot districts being Tidjikja and Moudjeria. Thus far a total of 25 deaths have been reported from this outbreak.Selengkapnya

Donors commit to fund the scale up of the ACT-Accelerator but warn additional funding is critical to support its success

  • The European Commission, France, Spain, The Republic of Korea and the Bill & Melinda Gates Foundation pledge US$360 million to COVAX, the Vaccines Pillar of the ACT Accelerator
  • Emmanuel Macron, President of France; Erna Solberg, Prime Minister of Norway; Ursula von der Leyen, President of the European Commission; Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO; Melinda Gates, Co-Chair of The Bill & Melinda Gates Foundation discuss essential need for multilateral action and the ACT Accelerator’s role in ending the acute phase of the pandemic as quickly as possible
  • Leaders warn that the world’s capacity to fundamentally change the dynamic of the pandemic in the first half of 2021 is at risk if there are delays to urgent funding

Heads of state, global health leaders, scientists and the private sector have come together at the Paris Peace Forum this week to discuss how to meet the urgent funding needs of the ACT Accelerator. New contributions bring the total committed to over US$ 5.1 billion – but an additional US$ 4.2 billion is needed urgently this year, with a further US$ 23.9 billion required in 2021, if tools are to be deployed across the world as they become available.

Since April, the ACT Accelerator partnership, launched by WHO and partners, has supported the fastest, most coordinated, and successful global effort in history to develop tools to fight a disease. With significant advances in research and development by academia, private sector and government initiatives, the ACT Accelerator is on the cusp of securing a way to end the acute phase of the pandemic by deploying the tests, treatments and vaccines the world needs.

Speaking at the Paris Peace Forum, Emmanuel Macron, President of France, said: “Together, we have implemented the ACT-A system, with the ambition to be part of a “global public good” approach, that is, to allow access for all to these tools to fight this pandemic.”

Ursula von der Leyen, President of the European Commission reminded delegates that the US$ 28 billion needed to fund the ACT-Accelerator to fulfil its objectives is equivalent to “the same sum the transport sector and the global tourism sector lose in just two days of lockdown”. She added that “there is a very clear message behind it. It’s way better to invest now in the ACT Accelerator and to COVAX – for the distribution in every corner of the world of vaccines – than to struggle longer with all the confinement measures we have suffered during this pandemic.”

Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO, said: “This pandemic is unprecedented, and it has taken the whole world hostage. The only option we have is cooperation and solidarity. It is a must. The world is seeing it that way.”

Erna Solberg, Prime Minister of Norway and co-chair of the ACT Accelerator Facilitation Council, said: “We have to look beyond aid for financing. We need to look at private sector, innovative mechanisms, other ways to get this money, fast. We need to accelerate this faster than we are doing these days.”

Melinda Gates, co-chair of The Bill & Melinda Gates Foundation, said: “COVID-19 has made distinction completely irrelevant. In this pandemic, there’s no difference between helping yourself and helping others. The self-interested thing and the selfless thing are one and the same.”

In just 6 months the ACT Accelerator, through its partnership of the world’s leading international health organizations, has already delivered significant and concrete results: more than 50 diagnostic tests are being evaluated and new rapid antigen diagnostics are being made available for low and middle income countries; life-saving dexamethasone treatments are being used and rolled out; new monoclonal antibodies are being evaluated; 186 countries are working with COVAX, the world’s largest and most diverse portfolio of vaccines; a diverse research portfolio of nine vaccines candidates are in clinical trials and systems requirements for delivery of COVID-19 tools have been mapped in 4 of the world’s 6 regions.

The urgent funding need of US$ 4.2 billion will save lives, lay the groundwork for mass procurement and delivery of COVID-19 tools around the world, and provide an exit strategy out of this global economic and human crisis by:

  1. Massively expanding testing globally by immediately increasing the number & volumes of new high-quality rapid diagnostic tests and facilitating use in countries with fragile systems;
  2. Transforming treatment to save lives by hugely accelerating the availability and use of dexamethasone and oxygen, and securing production capacities for monoclonal antibodies;
  3. Rolling out mass vaccination by securing vaccines doses now to launch their worldwide rollout for at least 20% of the global population, while quickly investing in further R&D, technology transfer and scale-up of global manufacturing capacity; and
  4. Unblocking bottlenecks to COVID-19 tools supply chain management, logistics and delivery with rapid assessments, integrated delivery plans and key investments in countries with the most fragile systems.

Fully financing the ACT-Accelerator will position the world to fundamentally change the dynamic of the pandemic. Funding gaps mean delays in access to tools in 2021 and the world continuing to rely on non-pharmaceutical interventions like stay-at-home orders and physical distancing as the primary line of defense against the virus.

Against the ACT Accelerator’s US$ 38.1 billion budget, outlined in its newly published ‘Urgent Priorities & Financing Requirements’, US$ 5.1 billion has been committed to date, alongside down payments of US$ 4.8 billion through COVAX self-financing countries. The ACT Accelerator Commitment Tracker provides details on total commitments to date.

Fully financing the ACT Accelerator would shorten the pandemic, saving millions of lives with the investment paid back in as little as 36 hours as the global economy recovers.

 

Notes to Editors

The Access to COVID-19 Tools ACT Accelerator, is the proven, up-and-running global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. It was set up in response to a call from G20 leaders in March and launched by the WHO, European Commission, France and The Bill & Melinda Gates Foundation in April 2020.

The ACT Accelerator is not a decision-making body or a new organization but works to speed up collaborative efforts among existing organizations to end the pandemic. It is a framework for collaboration that has been designed to bring key players around the table with the goal of ending the pandemic as quickly as possible through the accelerated development, equitable allocation, and scaled up delivery of tests, treatments and vaccines, thereby protecting health systems and restoring societies and economies in the near term. It draws on the experience of leading global health organizations which are tackling the world’s toughest health challenges, and who, by working together, are able to unlock new and more ambitious results against COVID-19. Its members share a commitment to ensure all people have access to all the tools needed to defeat COVID-19 and to work with unprecedented levels of partnership to achieve it.

The ACT Accelerator comprises four pillars: diagnostics, therapeutics, vaccines and health system strengthening.

  • The diagnostics pillar co-convened by the Global Fund and FIND is focused on bringing to market 2–3 high-quality rapid tests, training 10,000 healthcare professionals across 50 countries and establishing testing for 500 million people in Low and Middle-Income countries by mid-2021.
  • The therapeutics pillar is led by Unitaid and Wellcome. Therapeutics can play a role in all stages of COVID-19 disease: to prevent infection; suppress symptoms and spread of infection to others; treat or prevent symptoms; as a life-saving treatment for severe symptoms; and as a treatment that can speed up recovery. The aim in the next 12 months is to develop, manufacture and distribute 245 million treatments, helping COVID-19 sufferers to recover from the disease.
  • The vaccines pillar, convened by CEPI, Gavi and WHO, is speeding up the search for an effective vaccine for all countries. At the same time, it is supporting the building of manufacturing capabilities, and buying supply, ahead of time so that 2 billion doses can be fairly distributed by the end of 2021.
  • The health systems connector pillar, led by the World Bank and the Global Fund, is working to ensure that these tools can reach the people who need them.
  • Cross-cutting all of these is the workstream on Access & Allocation, hosted by the World Health Organisation (WHO).

Find out more: https://www.who.int/initiatives/act-accelerator
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WHO today listed the nOPV2 vaccine (Bio Farma, Indonesia) for emergency use to address the rising cases of a vaccine-derived polio strain in a number of African and East Mediterranean countries. Countries in WHO’s Western Pacific and South-East Asia regions are also affected by these outbreaks. The emergency use listing, or EUL, is the first of its kind for a vaccine and paves the way for potential listing of COVID-19 vaccines.

The world has made incredible progress toward polio eradication, reducing polio cases by 99.9% in the last 30 years. But the last steps to ending this disease are proving the most difficult, particularly with continuing outbreaks of circulating vaccine-derived polio viruses (cVDPVs).

cVDPVs are rare and occur if the weakened strain of the poliovirus contained in the oral polio vaccine (OPV) circulates among under-immunized populations for a long time. If not enough children are immunized against polio, the weakened virus can pass between individuals and over time genetically revert to a form that can cause paralysis. Type 2 cVDPVs are currently the most prevalent form of the vaccine-derived virus.

The EUL procedure and how it could help to speed up access to a future COVID-19 vaccine

The EUL procedure assesses the suitability of yet to be licensed health products during public health emergencies, such as polio and COVID. The objective is to make these medicines, vaccines and diagnostics available faster to address the emergency. The assessment essentially weighs the threat posed by the emergency against the benefit that would accrue from the use of the product based on a robust body of evidence.

The procedure was introduced during the West Africa Ebola outbreak of 2014-2016, when multiple Ebola diagnostics received emergency use listing; since then, numerous COVID-19 diagnostics have also been listed. The nOPV2 is the first such listing for a vaccine.

EUL_Graphic_blue_21102020

The EUL pathway involves a rigorous assessment of phase II and phase III clinical trial data as well as substantial additional data on safety, efficacy and manufacturing quality. These data are reviewed by independent experts who consider the current body of evidence on the vaccine under consideration, the plans for monitoring its use, and the plans for further studies.

Experts from individual national authorities are invited to participate in the EUL review and are engaged to help facilitate the necessary country-level decision process for authorization of use. Once a vaccine has been listed for WHO emergency use, WHO engages its regional regulatory networks and partners to sensitize national health authorities on the vaccine and its anticipated benefits based on data from clinical studies to date.

In addition to deciding whether to use the vaccine, each country needs to complete a readiness process for the implementation of the vaccine under the EUL. The company producing the vaccine also commits to continue to generate data to enable full licensure and WHO prequalification of the vaccine. WHO prequalification will assess additional clinical data generated from vaccine trials and deployment on a rolling basis to ensure the vaccine continues to meet the necessary standards of quality, safety and efficacy for broader availability (i.e. through procurement by UN agencies and others).

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The World Health Organization has announced a new Council on the Economics of Health for All, staffed by leading economists and health experts, to put “Health for All” at the centre of how we think about value creation and economic growth.

“The COVID-19 pandemic has demonstrated the consequences of chronic under-investment in public health. But we don’t just need more investment; we must also rethink how we value health,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus, as he made the announcement on the final day of the resumed 73rd World Health Assembly on Friday.

Chaired by noted economist Professor Mazzucato, Professor of the Economics of Innovation and Public Value and Founding Director in the Institute for Innovation and Public Purpose at University College London, the Council will aim to create a body of work that sees investment in local and global health systems as an investment in the future, not as a short-term cost. Designing such investments makes our economies more healthy, inclusive and sustainable.

The COVID-19 pandemic, with 52 million reported cases and 1.3 million deaths, has shown the dire consequences of chronic under-investment in health on the global economy and on the lives and livelihoods of billions worldwide.

Over the past year, the pandemic has ignited a socio-economic crisis like no other; a crisis that has undermined global stability and solidarity. It has stressed how interdependent health and the economy are and served as a reminder that health is a human right.

“We are living through multiple crises: economic, climate and health related. If we continue to patch up the system each time, we will always be one step behind. I am thrilled to work closely with Dr Tedros on a proactive Health for All economic agenda, to shape our economies so they truly have wellbeing and inclusion at the centre of how we create value, measure it and distribute it,” Mazzucato said.  

Returning to the status quo following the pandemic will not be enough – we need an innovation-led transformation of our health systems to achieve economic well-being everywhere.

“The time has come for a new narrative that sees health not as a cost, but an investment that is the foundation of productive, resilient and stable economies,” Dr Tedros said.

The Council on the Economics of Health For All is expected to hold its first virtual session in the coming weeks, to discuss its work plan and mode of operation. The Council will produce thought leadership for implementing change, and help to inform the piloting of initiatives at country level.

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Member States recommended the adoption of two resolutions on meningitis control and epilepsy at the 73rd World Health Assembly on Thursday (November 12).

Committee A, which focuses on programme and budget matters, decided to recommend the adoption of the first-ever resolution on meningitis, which would approve a global roadmap to defeat meningitis by 2030 – a disease that kills 300,000 people annually and leaves one in five of those affected with devastating long-term consequences.

The Committee also recommended the adoption of a resolution calling for scaled-up and integrated action on epilepsy and other neurological disorders such as stroke, migraine and dementia. Neurological disorders are the leading cause of disability and the second leading cause of death worldwide.

The Committee further decided to recommend the adoption of a decision endorsing the new roadmap for neglected tropical diseases. The roadmap aims to achieve these targets by 2030: reduce by 90% the number of people requiring treatment for NTDs, eliminate at least one NTD in 100 countries, eradicate two diseases (dracunculiasis and yaws), and reduce by 75% the disability-adjusted life years (DALYs) related to NTDs.

Committee A noted the Operational Framework for Primary Health Care, which aligns with the Declaration of Astana and resolution WHA72.2 (2019). WHO has established a Special Programme on Primary Health Care to roll out the Operational Framework – supporting Member States to build people-centred, resilient and sustainable primary health care-based health systems.

Committee B – which deals predominantly with administrative, financial and legal matters – reviewed the Director-General’s report on “Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan”. The Committee also decided, by vote, to recommend the adoption of a decision requesting the Director-General, amongst others, to report on progress in the implementation of its recommendations to the next World Health Assembly.

All resolutions and decisions recommended by the Committees for adoption by the 73rd World Health Assembly will be included in the Committees’ reports to the Plenary and considered on Friday. 

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Measles surged worldwide in 2019 reaching highest number of reported cases in 23 years.  Highlighted in a publication by the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC), measles cases worldwide increased to 869,770 in 2019, the highest number reported since 1996 with increases in all WHO regions. Global measles deaths climbed nearly 50 percent since 2016, claiming an estimated 207,500 lives in 2019 alone. 

After steady global progress from 2010 to 2016, the number of reported measles cases climbed progressively to 2019. Comparing 2019 data with the historic low in reported measles cases in 2016, authors cite a failure to vaccinate children on time with two doses of measles-containing vaccines (MCV1 and MCV2) as the main driver of these increases in cases and deaths.

“We know how to prevent measles outbreaks and deaths,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “These data send a clear message that we are failing to protect children from measles in every region of the world.  We must collectively work to support countries and engage communities to reach everyone, everywhere with measles vaccine and stop this deadly virus.”

Measles outbreaks occur when people who are not protected from the virus are infected and spread the disease to unvaccinated or under-vaccinated populations.  To control measles and prevent outbreaks and deaths, vaccination coverage rates with the required MCV1 and MCV2 must reach 95 percent and be maintained at national and subnational levels.  MCV1 coverage has been stagnant globally for more than a decade at between 84 and 85 percent.  MCV2 coverage has been steadily increasing but is only now at 71 percent.   Vaccination coverage against measles remains well below the 95 percent or higher needed with both doses to control measles and prevent outbreaks and deaths.

Global response to COVID-19 pandemic must not exacerbate the measles crisis

Although reported cases of measles are lower in 2020, necessary efforts to control COVID-19 have resulted in disruptions in vaccination and crippled efforts to prevent and minimize measles outbreaks. As of November, more than 94 million people were at risk of missing vaccines due to paused measles campaigns in 26 countries.  Many of these countries are experiencing ongoing outbreaks.  Of countries with postponed planned 2020 campaigns, only eight (Brazil, Central African Republic, Democratic Republic of Congo, Ethiopia, Nepal, Nigeria, Philippines and Somalia) resumed their campaigns after initial delays. 

“Before there was a coronavirus crisis, the world was grappling with a measles crisis, and it has not gone away,” said Henrietta Fore, UNICEF Executive Director. “While health systems are strained by the COVID-19 pandemic, we must not allow our fight against one deadly disease to come at the expense of our fight against another. This means ensuring we have the resources to continue immunization campaigns for all vaccine-preventable diseases, even as we address the growing COVID-19 pandemic.”

Causes of failure to control measles are many and must be addressed

Global immunization partners are engaging leaders and public health professionals in affected and at-risk countries to ensure that measles vaccines are available and safely delivered, and that caregivers understand the life-saving benefit of the vaccine.  On 6 November 2020, WHO and UNICEF issued an emergency call to action for measles and polio outbreak prevention and response.

“Measles virus easily finds unprotected children, adolescents and adults because it is so contagious,” said Dr. Robert Linkins, Measles & Rubella Initiative Management Team Chair and Accelerated Disease Control Branch Chief at U.S. CDC. “Infections are not only a sign of poor measles vaccination coverage, but also a known marker, or ‘tracer,’ that vital health services may not be reaching populations most at-risk. Our collective efforts to reach children with vaccines now, ahead of the possible easing of COVID-19 travel restrictions and increased population movement, will save lives.”

The Measles & Rubella Initiative (M&RI), which includes American Red Cross, the United Nations Foundation, the U.S. CDC, UNICEF and WHO, and global immunization partners like Gavi, the Vaccine Alliance, the Bill and Melinda Gates Foundation and others, are working to address the current measles crisis and ensure that resources are positioned to address immunization delays – for measles and all vaccines – in every region of the world.  A bold strategy released by M&RI, Measles & Rubella Strategic Framework 2021 – 2030, will help to address reversals in global progress toward measles elimination by bolstering strong, national immunization systems that can reach and protect children. This strategic shift by the partnership will focus on strengthening the routine delivery of all vaccines, and quickly and effectively detecting and responding to measles outbreaks.

Quotes from Our Partners

“These alarming figures should act as a warning that, with the COVID-19 pandemic occupying health systems across the world, we cannot afford to take our eye off the ball when it comes to other deadly diseases. Measles is entirely preventable; in a time in which we have a powerful, safe and cost-effective vaccine nobody should still be dying of this disease. COVID-19 has resulted in dangerous declines in immunization coverage, leading to increased risk of measles outbreaks. This is why countries urgently need to prioritize measles catch-up immunization through routine services to mitigate the risk of outbreaks and ensure no child goes without this lifesaving vaccine.” – Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance.

“The fact that measles outbreaks are occurring at the highest levels we’ve seen in a generation is unthinkable when we have a safe, cost-effective, and proven vaccine. No child should die from a vaccine-preventable disease. We are proud to chart a bold way forward with partners to close gaps in access to immunization and rapidly respond to outbreaks so everyone, everywhere can live healthy lives.” – Elizabeth Cousens, President & CEO, United Nations Foundation.

“We are concerned that COVID-19 will contribute to an increase in the number of measles cases and deaths. Measles knows no borders, and it is imperative we work together to vaccinate more children and continue the fight against this preventable disease. “Around the globe, Red Cross and Red Crescent volunteers help families in chronically unvaccinated communities to protect their children. Join us in this effort.” – Gail McGovern, President & CEO of the American Red Cross.

###

Notes to editors

Download photos and broll on vaccines here: https://weshare.unicef.org/Package/2AM408X1UA6X

About M&RI:

The Measles & Rubella Initiative (M&RI) is a partnership between the American Red Cross, the United Nations Foundation, the U.S. CDC, UNICEF and WHO. Working with Gavi, the Vaccine Alliance and other stakeholders, the Initiative is committed to achieving and maintaining a world without measles, rubella and congenital rubella syndrome. Since 2000, M&RI has helped deliver over 5.5 billion doses of measles vaccine to children worldwide and saved over 25.5 million lives by increasing vaccination coverage, responding to outbreaks, monitoring and evaluation, and supporting demand for vaccine.  

More information on measles:

WHO factsheet; CDC measles updates; Latest WHO measles surveillance data; UNICEF’s immunization updates; and Latest WHO guidelines for immunization programme in context of COVID-19.

 

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Although medicines used for neglected tropical diseases (NTDs) continue to effective, antimicrobial resistance can compromise these global programmes. To ensure drug-efficacy, immediate measures – including monitoring and establishment of surveillance systems – need to be in place.
To mark this year’s World Antimicrobial Awareness Week from 18 -24 November, the NTD Department and the Department of Global Coordination and Partnership on AMR are hosting a webinar on 24 November.Selengkapnya

The interactive dashboard gives users a wide range of information on HIV testing from countries worldwide on, for example, HIV prevalence, the number of people testing positive for HIV and the number of people testing for HIV for the first time or repeating a test. Data are given in charts and tables and are differentiated by age, sex and other characteristics.Selengkapnya

Member States at the resumed virtual, 73rd World Health Assembly, recognizing the dedication and sacrifice of the millions of health and care workers at the forefront of the Covid-19 pandemic, unanimously designated 2021 as the International Year of Health and Care Workers (YHCW).

Member States and Non-State Actors in unison, spoke to the critical role of health and care workers in ensuring our health and prosperity. They emphasized the urgency and imperative to address persistent health worker challenges. 

As part of the ten-year anniversary and review of the WHO Global Code of Practice on the International Recruitment of Health Personnel (Code), the World Health Assembly discussed the increasing scale of international health worker migration.  Member States recognized the high relevance of the Code, particularly in the context of Covid-19, and called for its’ strengthened implementation. 

Further, Member States expressed commitment to the ethical principles and practices of the Code, urging prioritization of support and safeguards for the countries with the greatest vulnerability, including greater investment. 

The Code was identified as a leading and universally recognized regulatory instrument under WHOs stewardship, and as such, Member States called for WHO and development partners to strengthen its financing, implementation and monitoring.  

Earlier in the week, in her keynote address to the World Health Assembly, Her Royal Highness Princess Muna of Jordan reminded us that applause without action is no longer acceptable and urged member States to invest in health, health systems and in health and care workers.

The 73rd World Health Assembly, through its decision to strengthen Code implementation and to designate 2021 as the YHCWs reflects a collective vision on the health and care workforce. The Secretariat was also requested to update the Strategic Directions on Nursing and Midwifery and submit it to the 74th Assembly for its consideration.

Reflecting immediately after the decision of the Assembly, Jim Campbell, Director of the Health Workforce Department in WHO headquarters, stated:

“Today’s decision gives clear direction on consensus and the necessary actions on the health and care workforce.  WHO urges all Member States, International Financing Institutions, Global Health Initiatives and partners to invest in health workforce readiness, education and learning to manage the pandemic, maintain health services and prepare for a COVID-19 vaccine”.

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In a year that has seen more than 1.2 million lives lost to a deadly coronavirus pandemic, WHO’s 194 Member States are expected to adopt a resolution to strengthen preparedness for health emergencies EB146.R10, at the resumed 73rd World Health Assembly.

The draft resolution renews the commitment to better prepare for health emergencies such as COVID-19, through “full” compliance with the International Health Regulations (2005).

It urges Member States to “dedicate domestic investment and recurrent spending and public funding to health emergency preparedness,” and to “improve government and decision-making processes and enhance institutional capacity and infrastructure for public health.”

It calls on the global health community to ensure that all countries are better equipped to detect and respond to cases of COVID-19 and other infectious diseases.

Over the past two days, Committee A – which deals with predominantly programme and budget matters – has reviewed the findings of the reports of the Director-General on WHO’s work in health emergencies (A73/11) and on the implementation of the International Health Regulations (2005) (A73/14).

It has heard interventions by the Chair of the Independent Oversight and Advisory Committee (IOAC) for the WHO Health Emergencies Programme and the Co-Chairs of the Independent Panel for Pandemic Preparedness and Response (IPPR), which was established by the WHO Director-General pursuant to Health Assembly resolution WHA73.1 (2020).

On Tuesday, Committee A concluded with a recommendation to the Health Assembly to adopt the proposed Resolution.

Meanwhile Committee B – which deals predominantly with administrative, financial and legal matters – recommended that WHA73 adopt two draft decisions on endorsing the global strategy on digital health and accepting the report of the External Auditor (A73/27), as well as one draft resolution on revising the process for electing the WHO Director-General in relation to the transition period between the election of future Directors-General and their taking office.

All resolutions and decisions recommended by the Committees for adoption will be included in their reports to the plenary, and considered on Friday. 

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Honorable Minister, Excellencies, Director-General, Chair of the Committee A, Ladies and Gentlemen

  1. Thank you for the opportunity to provide you with an update on the work of the Review Committee on the functioning of the International Health Regulations (2005) during COVID-19.

     

  2. This Committee was convened by the Director-General on 8 September 2020, following up on the request of Member States in the World Health Assembly Resolution WHA73.1, and in line with Article 50 of the International Health Regulations (2005). The
    Committee is composed of 21 members selected and nominated by the Director-General from the IHR Roster of Experts, comprising a wide range of expertise and with adequate gender and geographical representation. I have the privilege and honour to
    be elected Chair of this Committee, and grateful to be supported by the elected Vice-Chair Professor Lucille Blumberg from South Africa and the elected Rapporteur Professor Preben Aavitsland from Norway.

     

  3. The mandate we were given is to review the functioning of the International Health Regulations (2005) during the COVID-19 response, to review the status of implementation of the relevant recommendations of previous IHR Review Committees, and ultimately
    to make technical recommendations to the Director-General regarding the functioning of the Regulations and possible needs for amendments.

     

  4. We convened for 9 closed meetings so far, and we also convened 3 open meetings, when we provided updates on our work and listened to the submissions and questions raised by Member States, international agencies and non-governmental organizations in
    official relation to WHO. These open meetings were attended by more than 100 designated representatives. I also reported on our initial work and progress to the Executive Board on 6 October.

     

  5. We currently work mainly through three sub-groups: preparedness, alert, and response. The sub-groups meet weekly for deliberations and interviews, and they report back to the weekly plenary meeting. Let me take the opportunity to thank the Committee
    members who act assub-group leads, Dr Okwo-Bele, Dr Salter and Professor LeDuc.

     

  6. Key questions we are addressing include:

    On preparedness:

    • Do the current tools for IHR core capacities assessment and monitoring – such as SPAR, the State Party Self-Assessment Annual Reporting Tool, and Joint External Evaluations – cover all the necessary capacities, including those
      required at subnational levels?
    • How can the current tools for preparedness assessment and monitoring better help countries to implement a more effective response? How can universal peer reviews be used to help improve IHR implementation?

      On alert:

    • How was information shared during the early days of the outbreak under the IHR? Does WHO need a stronger and clearer mandate to react if information is not provided by States Parties; if yes, how should this be implemented?
    • Is the determination of a Public Health Emergency of International Concern and the consequences of declaring it clearly understood? What would be the advantages/disadvantages of an intermediate level of alert?

      On response:

    • How did WHO and States Parties implement their obligations with regard to additional health measures in relation to international traffic?
    • How are the current mechanisms of collaboration and coordination for global outbreak response functioning and how can they be improved, especially with regard to timely and transparent data sharing?

       

  7. Preliminary findings include:
    • Preparedness assessment and monitoring as well as core capacities need to be further examined in light of the observed performance in the response of many Member States. A universal peer-review mechanism such as that used in human rights reviews
      may be useful.
    • Both official information as well as information through media, social media and rumors are useful surveillance information. IHR provisions for notification and verification of information for events need to be further examined to understand
      the reluctance of some countries for early reporting and the need for incentives or other approaches to ensure better compliance.
    • WHO-provided Rapid Risk Assessments for events that may pose a risk of international spread are of utmost importance.
    • The meaning and consequences of Public Health Emergencies of International Concern have to be fully understood by Member States and inter- as well as supranational institutions. The relevance of an intermediate level of alert to prevent a
      PHEIC from occurring, and options for its implementation, need to be also clearly examined.
    • Implementation of travel restrictions at the national level was widespread. The role of WHO in relation to travel recommendations as well as incentives for States Parties to comply with their obligations related to travel measures need to
      be further examined.
    • Strong support for the current mechanisms for global outbreak alert and response as well as adequate national legislation are key to strengthen the response to global public health risks. The authority of National IHR Focal Points is critical
      to ensure rapid communication and coordination.
    • What also became very clear during our work so far, and looking beyond just the IHR, both strong public health as well as health care systems are needed for effective response.

       

  8. Beside the work in the sub-groups we have started to organize our work around issues that are not addressed in the sub-groups or are relevant for more than one sub-group. These include:
    • The overarching question of whether the IHR are fit for purpose. Are there challenges in their design or in their implementation that raised concerns during the COVID-19 response?
    • Issues of financing at the national and international level, especially for preparedness, as well as the functions and effectiveness of IHR governance bodies and mechanisms.
    • Conducting an article-by-article analysis to ensure a systematic review and identify whether any amendments may be required.
    • And examining the progress made on implementing the recommendations of previous Review Committees to refine our own recommendations.

       

  9. In our work, we have considered closely the submissions of Member States and other representatives, and will continue to do so.

     

  10. So far, we have interviewed the Chairs of former Review Committees and Chairs of former or current Emergency Committees, WHO staff from Headquarters, some regional and country offices, some National IHR Focal Points, and a number of experts in the
    field. Many more interviews are planned. We have also requested our Secretariat to commission a number of analysis and literature reviews.

     

  11. We are also discussing on a regular basis with the Chair of the Independent Oversight Advisory Committee and the Co-Chairs of the Independent Panel for Pandemic Preparedness to exchange findings and align our respective scopes of work and mandates.

     

  12. Our next open meeting is planned for 8 December and we plan to have an interim report ready for the Executive Board session in January. The deadline for our final report is the 74th WHA in May 2021. However, as we all know this is an unusual
    process, since the review process is happening while the event under review is still unfolding, and we may not have a definite set of recommendations until the pandemic ends.

     

  13. Let me remind us, that we are a technical expert group. We make recommendations to the Director-General, and if we see that amendments may be required for the IHR to function more effectively, we will make such recommendations to the Director-General.
    But whether these amendments are made or not to the IHR is a prerogative that sits entirely with Member States.

     

  14. Lastly, let me emphasize one thing: we very much welcome the interactions with Member States during our open meetings and encourage all of you to share with us your ideas, suggestions and proposals at any time. The IHR are your instrument, our instrument,
    of international public health law. It is incumbent on us to make it work for all of us to better prepare and protect humanity against public health risks, through an effective, coordinated, multisectoral and evidence-based public health response,
    while being mindful of the potential consequences that such response may have on other sectors.

     

  15. Thank you again for the opportunity to speak to you today and let me also thank the Director-General for the excellent support provided by the WHO Secretariat to this Review Committee.

     

  16. And one last word of inspiration for us all, on a grey and misty day like today: “Believe that further a shore/ Is reachable from here”.

 

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