GENEVA – The resumed 73rd World Health Assembly (WHA73) opened to the tune of the classic hit song “We are Family” by Sister Sledge, the Kingdom of Tonga’ Nurses’ Choir and a powerful speech by the WHO Director-General calling for predictable and sustainable WHO funding, the launch of a Universal Health and Preparedness Review and the need to “reimagine” global leadership and “forge a new era of cooperation” reflecting the lessons of the COVID-19 pandemic.  

Dr Tedros called on Member States to “address the shocking and expanding imbalance between assessed contributions and voluntary, largely earmarked funds,” observing that WHO’s annual budget is equivalent to what the world spends on tobacco products in a single day.

He warned that “a vaccine cannot address the global under-investment in essential public health functions and resilient health systems, nor the urgent need for a “One Health” approach that encompasses the health of humans, animals and the planet we share. There is no vaccine for poverty, hunger, climate change or inequality.”

He called for “leadership built on mutual trust and mutual accountability – to end the pandemic and address the fundamental inequalities that lie at the root of so many of the world’s problems.”

“It’s time for the world to heal – from the ravages of this pandemic, and the geopolitical divisions that only drive us further into the chasm of an unhealthier, un-safer and unfairer future” he said. “Today and every day, we must choose health. We’re one big family.”

Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme (WHE), gave an epidemiological update on the COVID-19 pandemic, noting “the grim milestone” of 50 million cases globally.

The Chair of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme (IOAC), Dr Felicity Harvey, presented the IOAC report, which makes several recommendations and concludes that: “Over the last four years, the WHE Programme has demonstrated its capacity to manage multiple emergencies and has helped affirm WHO’s position as a global health leader, but the COVID-19 pandemic has thrown the challenges faced by WHO in handling a global pandemic into stark relief and has placed the WHE Programme under global public scrutiny.”

The Chair of the Review Committee on the functioning of the International Health Regulations (2005) during COVID-19 response, Professor Lothar H. Wieler, President of the Robert Koch Institute, Germany provided an update on the work of the Committee and its preliminary findings.

Senior Advisor to the Director-General, Dr Bruce Aylward, briefed Member States on the progress of the Access to COVID-19 Tools (ACT) Accelerator, noting key achievements with regard to rapid tests, life-saving treatments, and the COVAX Facility with its equitable allocation framework.

He remarked that access to these critical tools differs widely across countries and could worsen without urgent action to close the ACT-Accelerator’s US$4.5 billion financing gap.

The WHO Director-General’s Health Leaders Award for outstanding leadership in global health was awarded to Her Royal Highness Princess Muna Al-Hussein of Jordan, the Honourable Minister for Health of the Kingdom of Tonga, Dr Amelia Afuhaamango Tuipulotu, and the Kingdom of Tonga’s Nurses’ Choir.

The WHA73 considered a proposal for a supplementary agenda item entitled “Inviting Taiwan to participate in the World Health Assembly as an observer”.

The proposal was considered in accordance with an agreed process for a structured debate, known as a “two plus two” arrangement. Following this process, the WHA73 decided not to include this item on its agenda.

This is the 15th time since 1997 that such a proposal has been submitted.

In line with an analogous decision of the UN General Assembly, the World Health Assembly though resolution WHA 25.1, of 1972,  decided “(…) to recognize the representatives of its Government as the only legitimate representatives of China to the World Health Organization (…)”. This decision still applies, 48 years later.

Although the question of Taiwanese membership in WHO and its participation in the World Health Assembly remains a question for Member States, WHO works with all health authorities who are facing the current coronavirus pandemic, including Taiwanese health experts

 

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  • Re-recorded by Kim Sledge, part of the legendary multi-Gold and Platinum recording music group Sister Sledge, and presented by Natasha Mudhar, Founder of the global social impact enterprise The World We Want, a special edition cover of the classic We Are Family song will be accompanied by a crowdsourced music video, with members of the public joining frontline health heroes and a host of A-list celebrities, such as global superstar Rita Ora, in a spectacular sing-along video, out in December. 
  • Individuals and families can submit their sing-along video clips for a chance to star in the official music video until 30 November.
  • Proceeds from the download of the new cover are being donated to the WHO Foundation, with the support of the World Health Organization, to address global health challenges such as COVID-19.

9 November 2020, LONDON/GENEVA: The special edition cover of the timeless hit We Are Family, re-recorded by one member of the iconic multi-Gold and Platinum recording music group Sister Sledge, Kim Sledge, presented by Natasha Mudhar, Founder of the global social impact enterprise The World We Want, and supported by the  World Health Organization, is now officially available for download worldwide from leading digital music stores such as iTunes, Spotify and Amazon Music.

The song, an upbeat cover of the classic anthem that saw the group rise to stardom in 1979, is being released as an inspiring call for global solidarity to respond to the COVID-19 pandemic and to generate proceeds in benefit of the WHO Foundation to address the most pressing global health challenges of our time, such as COVID-19.

Global icons such as multi-award winning critically-acclaimed artist Rita Ora, soul-singing legend Heather Small (singer of 2000’s hit Proud) and Formula One hero Romain Grosjean are just some of the big name supporters of the sing-along music video for the new cover, which is also open to the global public to submit their videos up until 30 November, to officially release worldwide this December. Short video platform TikTok is supporting the campaign, offering users the chance to sing along to, record and share their own videos there as well.

The special edition cover was officially released online for download in conjunction with today’s opening of the resumed 73rd World Health Assembly, at which Kim Sledge performed the track with the support of the Tongan Nurses Choir

 The special re-recorded cover, star-studded music video, social media campaign and fundraising initiative has been conceptualised by Natasha Mudhar, Founder, The World We Want, and supported by WHO. The inspiration to release a special edition of the classic track initially came early this year as communities around the world were left reeling from the impact of COVID-19.

 

Join the We Are Family video campaign

In support of the song’s release, people from around the world can submit videos of themselves singing along to We Are Family for inclusion in a unique and inspiring compilation video for release in December 2020. This video will feature members of the global public, celebrities, leaders and health heroes, to honour the incredible work of the frontline workforces risking their lives around to save ours, and all those around the world who have been affected by the pandemic.

 

Download the Special Edition Cover of We Are Family

For a list of all major digital music stores where you can download the song, visit www.unitystrong.com

 

Steps to be part of the We Are Family video:

To submit sing-along videos of the Special Edition Cover Version of the We Are Family song, the key steps are:

  • Download the Special Edition Cover of We Are Family, in benefit of the WHO Foundation. 
  • Record yourself singing to the Special Edition Cover of We Are Family either alone, or with friends and family, whilst observing physical distancing guidelines. 
  • Share the video on your favourite social media channel, with the hashtag #WeAreFamily #COVID19 #HealthforAll and tag @WHO, @The_WorldWeWant and @thewhof.
  • Upload your video to https://unitystrong.com
  • If you want your video to be considered for inclusion in the global, We Are Family video; you will need to share your video by Monday, 30 November 2020.
  • Video clips will be selected based on age, geographical diversity, and appropriate physical distancing if the video includes groups of people beyond immediate family members and correct handwashing if singing along to the song while washing hands. 
  • More details, including Terms & Conditions, can be found here www.unitystrong.com.

For further information, please contact:

The World We Want:
WAFmedia@theworldwewant.global

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Editors notes

Official quotes for the We Are Family Campaign:

Dr Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization:
We Are Family is more than a song. It is a call to action for collaboration and kindness, and a reminder of the strength of family and the importance of coming together to help others in times of need.

“Now more than ever, communities and individuals all over the world need to heed this message and come together, as a global family, to support each other through this COVID-19 challenge, and to remember that our health and wellbeing is our most precious gift. I am grateful to Kim Sledge and The World We Want for sharing this masterpiece and message of hope with us all. It is only through national unity and global solidarity that we will overcome COVID-19 and ensure people all over the world attain the highest level of health and well-being.

Kim Sledge, vocalist, philanthropist, novelist, songwriter, producer and Minister: “From the doctors and nurses on the front lines, to the paramedics and police, from the midwives and scientists to the carers for the vulnerable, the We Are Family campaign will salute each and every one with a feeling of unity, strength and solidarity in response to the unprecedented challenges the world faces as a result of the coronavirus outbreak.

Natasha Mudhar, founder of The World We Want and the driving force behind the #WeAreFamily campaign:
We Are Family is one of the most instantly recognizable anthems in the world. The song carries such an inspiring message of unity and solidarity and brings about a real sense of togetherness when sung aloud! We hope everybody loves the song, supports the campaign and sends in their videos to be part of a spectacular music video for a great cause. This is a rallying cry for togetherness, for the strength of our global family. We are all together during these times.”

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The HIV Prevention Trials Network study (HPTN 084) on the safety and efficacy of the long-acting injectable antiretroviral drug cabotegravir (CAB LA), for pre-exposure prophylaxis (PrEP) in HIV-uninfected women, was stopped early by the trial Data and Safety Monitoring Board (DSMB) as results showed CAB LA to be highly effective in preventing HIV acquisition.Selengkapnya

The International Coalition of Medicines Regulatory Authorities (ICMRA) and the World Health Organization (WHO) have committed to working together to ensure that patients have access to safe and effective health products against COVID-19 as early as possible, while the existing rigorous scientific standards for the evaluation and safety monitoring of treatments and vaccines are maintained at all times.

In their joint statement, international medicines regulators and WHO reiterate that therapeutics and vaccines against COVID-19 can only be rapidly approved if applications are supported by robust and sound scientific evidence that allows medicine regulators to conclude on a positive benefit-risk balance for these products. ICMRA and WHO also pledge to take concrete actions to ensure equitable access to safe, effective and quality-assured medicines for the treatment or prevention of COVID-19 around the world.

In view of the large number of COVID-19 vaccines and treatments under development, and their potentially imminent roll-out, the World Health Organization (WHO) and the International Coalition of Medicines Regulatory Authorities (ICMRA) have joined forces
to uphold and promote the most rigorous, evidence-based regulatory practices by supporting the alignment of regulatory processes across all countries. As in other areas of the pandemic response, multilateral cooperation between regulatory authorities
will be critical in ensuring there is a level playing field, that COVID-19 vaccines and medicines are safe, effective and quality-assured, and that all countries may benefit from such products equitably and at the same time. This joint statement commits
each organization to a series of actions to make this happen. 

  • ICMRA and WHO continue to join forces in collaborating to address the unprecedented global health challenges related to COVID-19 pandemic, affecting so many people in the world. 
  • These challenges are best addressed by working together to ensure existing rigorous scientific standards of review and oversight are maintained, while still giving patients access to safe and effective medical products at the earliest time possible
  • Regulatory authorities for medical products, including medicines and vaccines, have the responsibility to approve quality assured, safe and effective products based on robust and reliable data.
  • The regulatory approval should be based on an independent scientific assessment of the balance of benefits and risks.
  • Robust and reliable data on efficacy and safety to support market approval of medicines and vaccines are best collected through randomized controlled clinical trials which control for bias, meet Good Clinical Practice standards, respect the rights,
    autonomy and safety of clinical trial participants, and can be audited.
  • To ensure patients have fast access to safe and effective medicines and vaccines, WHO and ICMRA, together with other stakeholders including public health institutions, are committed to the following actions:
  • Working to prioritise well-designed clinical trials that will provide robust and reliable results.
  • Ensuring that there are meaningful and scientifically sound endpoints and safety data of sufficient duration in clinical trials;
  • Sharing data between regulators in real time to facilitate multi-country approvals;
  • Putting in place processes and policies utilizing the principles of regulatory agility by ICMRA members and WHO member states, providing an agile and rapid response to the global emergency;
  • Committing to full transparency of clinical trial results to support regulatory decisions, as well as ensuring public trust in authorities and confidence in vaccines
  • Working together to prevent and/or mitigate shortages of critical medicines and vaccines;
  • Continue working together once these COVID-19 therapies and vaccines are authorized and used to monitor their use, and identify, communicate and mitigate any safety or efficacy issues which may arise;
  • Reduce the risks associated with unproven treatments, potentially fraudulent and false claims, which endanger patients’ lives.

 

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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

UNICEF and the World Health Organization (WHO) today issued an urgent call to action to avert major measles and polio epidemics as COVID-19 continues to disrupt immunization services worldwide, leaving millions of vulnerable children at heightened risk of preventable childhood diseases. 

The two organizations estimate that US$655 million (US$400 million for polio and US$255 million for measles) are needed to address dangerous immunity gaps in non-Gavi eligible countries and target age groups.    

“COVID-19 has had a devastating effect on health services and in particular

immunization services, worldwide,” commented Dr Tedros Adhanom Ghebreyesus,

WHO Director-General. “But unlike with COVID, we have the tools and knowledge to

stop diseases such as polio and measles. What we need are the resources and

commitments to put these tools and knowledge into action. If we do that, children’s lives

will be saved.”

“We cannot allow the fight against one deadly disease to cause us to lose ground in the

fight against other diseases,” said Henrietta Fore, UNICEF Executive Director. “Addressing the global COVID-19 pandemic is critical. However, other deadly diseases also threaten

the lives of millions of children in some of the poorest areas of the world. That is why

today we are urgently calling for global action from country leaders, donors and

partners. We need additional financial resources to safely resume vaccination campaigns

and prioritize immunization systems that are critical to protect children and avert other

epidemics besides COVID-19.”

In recent years, there has been a global resurgence of measles with ongoing outbreaks in all parts of the world.  Vaccination coverage gaps have been further exacerbated in 2020 by COVID-19. In 2019, measles climbed to the highest number of new infections in more than two decades. Annual measles mortality data for 2019 to be released next week will show the continued negative toll that sustained outbreaks are having in many countries around the world.

At the same time, poliovirus transmission is expected to increase in Pakistan and  Afghanistan and in many under-immunized areas of Africa. Failure to eradicate polio now would lead to global resurgence of the disease, resulting in as many as 200,000 new cases annually, within 10 years.  

New tools, including a next-generation novel oral polio vaccine and the forthcoming Measles Outbreak Strategic Response Plan are expected to be deployed over the coming months to help tackle these growing threats in a more effective and sustainable manner, and ultimately save lives. The Plan is a worldwide strategy to quickly and effectively prevent, detect and respond to measles outbreaks.

Notes to editors:

Download photos and broll on vaccinations, including polio and measles vaccinations here

Generous support from Gavi, the Vaccine Alliance, has enabled previous access to funding for outbreak response, preventive campaigns and routine immunization strengthening, including additional support for catch-up vaccination for children who were missed due to COVID-19 disruptions in Gavi-eligible countries.  However, significant financing gaps remain in middle-income countries which are not Gavi-eligible.  This call for emergency action will go to support those middle-income countries that are not eligible for support from Gavi.

About UNICEF

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children, visit www.unicef.org. For more information about COVID-19, visit www.unicef.org/coronavirus. To know more about UNICEF’s work on immunization, visit https://www.unicef.org/immunization

Follow UNICEF on Twitter and Facebook

About the Global Polio Eradication Initiative

The Global Polio Eradication Initiative is spearheaded by WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance.

About the Measles & Rubella Initiative

The Measles & Rubella Initiative (M&RI) is a partnership between the American Red Cross, the U.S. Centers for Disease Control and Prevention (CDC), UNICEF, the United Nations Foundation and the World Health Organization. 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 23 million lives by increasing vaccination coverage, responding to outbreaks, monitoring and evaluation, and supporting demand for vaccine.   

 

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Portrait photo of director

Ian Askew, Director, Department of Sexual and Reproductive Health and Research including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction


Finding ways to connect with each other has felt more important than ever during the COVID-19 pandemic, as public health measures ask us to maintain physical distance where possible. 

Our work at HRP over the last few months has shown, despite the challenges, just how much collaboration, creativity, research and meaningful connection our community is capable of. We are so proud to continue
our work with you on such a broad range of sexual and reproductive health and rights issues – across disciplines, platforms and generations.  

A good place to start this month’s newsletter is with the 25th anniversary of the Beijing Declaration and Platform for Action. HRP is working with WHO and a wide range of partners to celebrate progress made on this ambitious framework for realizing
the human rights of all women and girls. We are also committed to highlighting challenges, gaps, and concrete actions needed to advance health equity and gender equality: now, and in a post-COVID-19
world. Please do spend some time reading “Women’s Health and Gender Inequalities,” a special series of papers commissioned by The British Medical Journal (BMJ) with support from HRP, WHO and the
UNU-IIGH. 

No matter where you live, there are unique health needs which digital technologies can help to meet. The Digital implementation investment guide: integrating digital interventions into health systems, (also known as the DIIG), launched early in
October, is a landmark publication from WHO, HRP and many other partners. It supports step-by-step planning, costing and implementing of digital health investments. 

Digital technologies have of course played a bigger role in many of our lives over the last few months, but this was already the case for many adolescents and young people, who are accessing the internet at earlier stages of life. 
Youth-centred digital health interventions
, another WHO, HRP and partner-led digital health publication launched last month, has a very clear message for all of us: when designing effective digital health solutions for young people, young
people should be making decisions at every stage of the design process. 

The fundamental importance of quality of care for every pregnant woman and newborn is another message repeated and received loud and clear across HRP’s work. This month, the WHO ACTION-I trial resolved an ongoing controversy about the efficacy
of antenatal steroids for improving preterm newborn survival in low-income countries, showing a significant impact: for every 25 pregnant women treated with dexamethasone, 
one premature baby’s life was saved.  

Such data can and must inform our global approach to improving maternal and newborn health. For premature babies, the ACTION trial shows that pregnancy dating and quality care, combined with the steroids, are key to survival. Similarly, data from the recent 
Global Maternal Sepsis Study (GLOSS)
 – which showed that infection has a much larger impact on global maternal mortality and morbidity than previously thought – is an opportunity to mobilize, improve evidence-based practice, and save lives.  

Understanding more about the specific impact of COVID-19 on pregnant women and their babies is an ongoing priority at HRP. We are helping to lead a ‘living systematic review’ into clinical manifestations, risk factors, and maternal and perinatal outcomes of COVID-19 in pregnancy. 
New findings were recently published, and this global research will continue to collect and synthesize data, as more is learned.  

As we move forward in one area, it is equally important not to slip back in others. COVID-19 clearly threatens recent gains in women’s and adolescent’s health, rights and gender equality.  

HRP is now collaborating with several partners to prevent unsafe abortion
 and support women’s and girls’ health, well-being and rights in the context of the current pandemic We recently launched the updated 
Companion of choice during labour and childbirth for improved quality of care
 alongside the WHO Clinical management of COVID-19: interim guidance
, emphasizing that the pandemic is no exception to every woman’s right to high-quality, respectful maternity care – including labour companionship.  

With all this in mind, the final word this month belongs to Rea, a 17-year old advocate from Kosovo who took part in the virtual intergenerational dialogue WHO and HRP co-organized on the International Day of The Girl. Organised around the 2020 theme of “My voice, our equal future,” the event was a striking call to recognize girls’ inheritance of the still-unfinished Beijing Agenda, their expertise on the challenges they face especially for their sexual and reproductive health and rights, and their limitless capacity as change-makers.  

As Rea said, “While
there are girls and young women reaching out for the stars and opening doors and opportunities, there are still a lot of doors that need keys to be opened.”     

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As health leaders prepare to gather for a virtual session of the resumed 73rd World Health Assembly (WHA), WHO has three messages to share.

First, we can beat COVID-19 with science, solutions and solidarity.

More than 47 million COVID-19 cases have now been reported to WHO, and more than 1.2 million people have lost their lives.

Although this is a global crisis, many countries and cities have successfully prevented or controlled transmission with a comprehensive, evidence-based approach.

For the first time, the world has rallied behind a plan to accelerate the development of the vaccines, diagnostics and therapeutics we need, and to ensure they are available to all countries on the basis of equity. The Access to COVID-19 Tools (ACT) Accelerator is delivering real results.

Second, we must not backslide on our critical health goals.

The COVID-19 pandemic is a sobering reminder that health is the foundation of social, economic and political stability.

It reminds us why WHO’s ‘triple billion’ targets are so important, and why countries must pursue them with even more determination, collaboration and innovation.

Since May, Member States have adopted a number of decisions – the Immunization Agenda 2030, the Decade of Healthy Ageing 2020-2030, as well as initiatives to tackle cervical cancer, tuberculosis, eye care, food safety, intellectual property and influenza preparedness.

The resumed session will discuss a 10-year-plan for addressing neglected tropical diseases, as well as efforts to address meningitis, epilepsy and other neurological disorders, maternal infant and young child nutrition, digital health, and the WHO Global Code of Practice on the International Recruitment of Health Personnel, adopted in 2010.

Third, we must prepare for the next pandemic now.

We’ve seen this past year that countries with robust health emergency preparedness infrastructure have been able to act quickly to contain and control the spread of the SARS-CoV-2 virus.

The WHA will consider a draft resolution (EB146.R10) that strengthens Member States’ preparedness for health emergencies, such as COVID-19, through more robust compliance with the International Health Regulations (2005).[1] ;

This resolution 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 dangerous infectious diseases.

 

 

NOTE TO EDITORS

The World Health Assembly (WHA) is the decision-making body of WHO, attended by delegations from all WHO Member States. The main functions of the World Health Assembly are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget.

The WHA usually takes place in May. This year, given the COVID-19 pandemic, a reduced (de minimis) WHA took place on 18-19 May. The resumed WHA73 will take place virtually from 9-14 November 2020.

The WHA open sessions are webcast: https://www.who.int/about/governance/world-health-assembly/seventy-third-world-health-assembly

WHA73 Agenda and all documents: https://apps.who.int/gb/e/e_wha73.html  

List of delegates and other participants: https://apps.who.int/gb/ebwha/pdf_files/WHA73/A73_DIV1REV1-en.pdf

The event will be followed by a resumed 147th session of the Executive Board  on Monday, 16 November 2020: https://apps.who.int/gb/e/e_eb147.html

 


[1] EB146.R10 Strengthening preparedness for health emergencies: implementation of the International Health Regulations (2005)

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The Global Programme to Eliminate Lymphatic Filariasis (GPELF) has delivered over 8.2 billion cumulative treatments to more than 923 million people since 2000. The treatments target the parasites in the blood of infected people and prevent the risk of transmission in the community. Infections have been brought to such low levels in some areas that 649.1 million people no longer require MDA for this debilitating parasitic disease.Selengkapnya

For medicines to work safely, it’s vital to have strong systems in place to report any undesired side effects or “adverse drug reactions“.

The most important aspect of drug safety monitoring is reliable, real-time information. Health-care professionals (physicians, pharmacists, nurses, dentists) are best placed to report suspected adverse reactions as part of patient care. Patients also
have a critical role in getting the right information to authorities and should refer to their medical practitioner as soon as they detect unwanted symptoms or reactions. Both health professionals and patients should report these even if they are
doubtful about the precise relationship between the given drug and the reaction.

Most adverse reactions are preventable

Many undesired drug reactions may be due to factors independent of the medicine. For example:

  • incorrect diagnosis of the patient’s medical condition;
  • prescription of an inappropriate drug or incorrect dosage of the appropriate drug;
  • an undetected medical, genetic or allergic condition that may cause a patient reaction;
  • self-medication with prescription medicines;
  • not following instructions for taking the medication;
  • interactions with other drugs (including traditional medicines) and certain foods.

But s risks may also occur because a medicine’s composition and ingredients do not meet required standards, causing them to be ineffective and even hazardous; or because the medicine is counterfeit, with no active ingredients or inappropriate ingredients.

Assessing medicines before and after they reach patients

Before medicines or vaccines are made widely available in countries, they are rigorously tested in patient and healthy volunteers respectively to discover how well they work for a defined disease and how safe they are. But to get a comprehensive picture
of a product’s safety, it is important to keep watching how it works once it is widely used in a population.

This requires careful patient monitoring and further scientific data collection by organized local, national and international agencies.

Drug safety during the COVID-19 pandemic

International drug safety monitoring is particularly important during global epidemics such as the current COVID-19 pandemic, and even more so when there are no proven vaccines or medicines for the disease. As new COVID-19 vaccines and treatments become
available, health-care professionals and patients will need to be actively engaged in monitoring the effects of these novel products and reporting any potential adverse reaction. By analyzing reported reactions, national medicines authorities can
take the necessary measures for safer use of the drugs, scientists can assess the data and, if needed, international networks can be activated to address the problem.

WHO’s role in making medicines safer

WHO promotes global drug safety through its Programme for International Drug Monitoring, which supports countries to develop sound pharmacovigilance policies, organizes hands-on training and workshops, and establishes networks for information sharing.

An important role of the programme is to strengthen national reporting systems and their contribution to VigiBase, the global WHO database for adverse drug reactions, managed by Uppsala Monitoring Centre in Sweden, and to identify possible links between
the use of a drug and adverse reactions. When signals of drug safety problems emerge through the database or other sources, WHO and Uppsala Monitoring Centre share new information on serious adverse reactions with all WHO Member States.

A recent key WHO development is the introduction of a mobile application called “Med Safety”, jointly launched in nine countries* with Uppsala Monitoring Centre and the UK Medicines and Healthcare products Regulatory Agency. The app enables
health-care professionals and patients to report suspected adverse reactions directly to the national authorities’ data base. WHO is preparing to roll out the app in more countries once a COVID-19 vaccine becomes available.

*Armenia, Botswana, Burkina Faso, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Uganda, Zambia.

 

 

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The Emergency Committee on COVID-19 met on 29 October to review the situation and progress made on the temporary recommendations.  They advised that the pandemic still constituted a public health emergency of international concern, and urged a focus on response efforts based on lessons learned and strong science.

WHO Director-General Dr Tedros Adhanom Ghebreyesus accepted the advice of the committee, stating that “WHO will continue to work in partnership across the world to drive science, solutions and solidarity.”

The committee expressed appreciation for WHO’s leadership and activities throughout the global response, including its critical role in developing evidence-based guidance, providing countries with technical assistance and critical supplies and equipment, communicating clear information and addressing misinformation, and convening the Solidarity Trials and the Access to COVID-19 Tools (ACT) Accelerator.

The committee provided concrete and targeted advice for WHO and countries to focus on in the coming months. It emphasized the importance of evidence-informed, risk-based and coherent measures in relation to international traffic, surveillance and contract tracing efforts, maintaining essential health services including mental health services, and preparing plans for future COVID-19 vaccines. The committee urged countries to avoid politicization of the pandemic response, seen as a major detriment to global efforts. Read the full statement.

As the committee convened for the fifth time, global reported cases had reached 44 million, with over 1.1 million people having lost their lives to COVID-19.

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The fifth meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the coronavirus disease (COVID-19) took place on Thursday, 29 October 2020 from 12:30 to 16:05 Geneva time (CEST).

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by videoconference. 

The Director-General welcomed the Committee, highlighted global advances and challenges in addressing the COVID-19 pandemic, and expressed his appreciation to the Committee for their continued support and advice. 

Representatives of the legal department and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities. The Ethics Officer from CRE provided the Members and Advisers with an overview of the WHO Declaration of Interest process. The Members and Advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the committee. Each member who was present was surveyed and no conflicts of interest were identified. 

The Secretariat turned the meeting over to the Chair, Professor Didier Houssin. Professor Houssin also welcomed the Committee and reviewed the objectives and agenda of the meeting. 

The WHO Assistant Directors-General for Emergency Response and for Emergency Preparedness and International Health Regulations provided an overview of the current context and an update on the implementation of the 1 August 2020 Temporary Recommendation. WHO continues to assess the global risk level of the COVID-19 pandemic as very high.

The Committee expressed strong appreciation for WHO’s leadership and activities throughout the global response. In particular, the Committee appreciated WHO’s critical role in developing evidence-based guidance and recommendations; providing countries with technical assistance and operational support; communicating clear information and addressing misinformation; and convening the Solidarity Trials and the Access to COVID-19 Tools (ACT) Accelerator. The Committee commended WHO’s sustained efforts to strengthen national, regional, and global responses to the COVID-19 pandemic. 

After ensuing discussion, the Committee unanimously agreed that the pandemic still constitutes an extraordinary event, a public health risk to other States through international spread, and continues to require a coordinated international response. As such, the Committee considered the COVID-19 pandemic to remain a public health emergency of international concern and offered advice to the Director-General.

The Director-General determined that the COVID-19 pandemic continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR (2005). 

The Emergency Committee will be reconvened within three months, at the discretion of the Director-General. The Director-General thanked the Committee for its work.

Advice to the WHO Secretariat

Leadership and Coordination 
1. Continue to coordinate global and regional multilateral organizations, partners, and networks and share best practices for responding to the pandemic. 

2. Provide States Parties with a mechanism including templates and processes to report on national progress in implementing the temporary recommendations; collect, analyze, and provide regular updates to the IHR emergency Committee on this progress. 

Evidence-Based Response Strategies
3. Continue to provide evidence-based guidance for COVID-19 readiness and response. This guidance should include sustainable long-term response strategies, mitigation approaches for different levels of transmission, refined indicators for risk management and pandemic response, a meta-analysis of the effectiveness of public health and social measures for COVID-19 response, and lessons learned including from intra-action reviews. 

Research 
4. Continue to convene multi-disciplinary experts to agree on consistent language for and to further explain: all potential modes of transmission and virulence of SARS-CoV-2; severity risk factors and epidemiology of COVID-19; and the striking diversity of the pandemic dynamics globally.

5. Continue intersectoral collaborations to understand the origin of SARS-CoV-2, the role/impact of animals, and provide regular updates on international research findings. 

6. Continue to work with partners to refine mathematical models that can inform policy decisions on how best to mitigate the effects of the pandemic.

Surveillance and Contact Tracing  
7. Continue to work with partners and networks to provide guidance, tools, and trainings to support countries in strengthening their robust public health surveillance, comprehensive contact tracing, and cluster investigation. 

8. Encourage and support countries to understand and report on their epidemiological situation and relevant indicators including through leveraging existing influenza sentinel surveillance systems for COVID-19. 

Risk communications and community engagement
9. Continue to work with partners to counter the ongoing infodemic and provide guidance on community mobilization to support effective public health and social measures.  

Diagnostics, therapeutics, and vaccines
10. Continue to support development of and equitable access to diagnostics, safe and effective therapeutics and vaccines, through the Access to COVID-19 Tools (ACT) Accelerator; continue to work with all ACT Accelerator partners to provide countries with additional clarity on the processes to enable equitable and timely access to diagnostics, therapeutics, and vaccines, including in humanitarian settings. 

11. Accelerate support to enhance countries’ readiness for COVID-19 vaccine introduction by providing guidance, tools, and technical assistance for critical areas such as vaccination strategies, vaccine acceptance and demand, training, supply and logistics with a focus on cold chain, and monitoring uptake and vaccine safety. 

Health Measures in Relation to International Traffic
12. Continue to work with partners to update and review evidence-based guidance for international travel consistent with IHR (2005) provisions. This guidance should focus on effective, risk-based, and coherent approaches (including targeted use of diagnostics and quarantine) that consider transmission levels, response capacities in origin and destination countries, and relevant travel-specific considerations.

Essential Health Services
13. Work with partners to support countries in strengthening their essential health services, with a particular focus on mental health, public health prevention and control systems, and other societal impacts, as well as preparing for and responding to concurrent outbreaks, such as seasonal influenza. Special attention should continue to be provided to vulnerable settings. 

Temporary Recommendations to State Parties

Leadership and coordination 
1. Continue to share with WHO best practices, including from intra-action reviews, and apply lessons learned for mitigating resurgence of COVID-19. Invest in implementing National Action Plans for sustainable preparedness and response capacities in compliance with the IHR requirements. 

2. Report to WHO on progress in implementing the Temporary Recommendations, particularly major achievements, milestones, and obstacles. This information will empower countries, WHO, partners, and the Committee to continue to make informed decisions as the pandemic evolves.   

Evidence-Based Response Strategies
3. Avoid politicization or complacency with regards to the pandemic response which negatively impact local, national, regional, and global response efforts. National strategies and localized readiness and response activities should be driven by science, data, and experience and should engage and enable all sectors using a whole-of-society approach. 

4. Implement a dynamic risk management approach using appropriate indicators to inform time-limited, evidence-based public health and social measures. 

Research 
5. Conduct research and share information on transmission, including role of aerosols; presence and potential impact of SARS-CoV-2 in animal populations; and potential sources of contamination (such as frozen products) to mitigate potential risks through preventative measures and international cooperation.

Surveillance and Contact Tracing 
6. Sustain efforts to strengthen public health surveillance systems and investments in a trained workforce for active case finding, comprehensive contact tracing, and cluster investigations. 

7. Continue timely and consistent reporting to WHO, including through platforms such as GISRS, on all recommended indicators for COVID-19 epidemiology and severity, response measures, and concurrent outbreaks, to enhance global understanding of the pandemic’s evolution. 

Risk Communications and Community Engagement
8. Engage and empower individuals and communities to strengthen confidence in the COVID-19 response and promote sustained adherence to public health and social measures underpinned by the principles of solidarity and human rights; monitor and address rumours and misinformation.   

Diagnostics, Therapeutics, and Vaccines
9. Establish national multi-disciplinary taskforce, assess progress using the COVID-19 Vaccine Introduction Readiness Assessment Tool (VIRAT), and prepare the National Deployment and Vaccination Plan, which can serve as the holistic operational plan for COVID-19 vaccine introduction. A strong emphasis should be placed on communication with communities to prepare for COVID-19 vaccination.  

Health Measures in Relation to International Traffic
10. Regularly re-consider measures applied to international travel in compliance with Article 43 of the IHR (2005) and continue to provide information and rationales to WHO on measures that significantly interfere with international traffic. Ensure that measures affecting international traffic (including targeted use of diagnostics and quarantine) are risk-based, evidence-based, coherent, proportionate and time limited. 

11. Continue to strengthen capacity at points of entry to manage potential risks of cross-border transmission and to facilitate international contact tracing. 

Essential Health Services
12. Maintain essential health services with sufficient funding, supplies, and human resources; strengthen health systems to cope with mental health impacts of the pandemic, concurrent disease outbreaks, and other emergencies.

 

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The 1st WHO Infodemic Management Training programme kicks off next week, and participants will come together during 8 sessions that will take place over the course of the next four weeks.The training programme received over 650 applications from 83 countries, and this very competitive selection process resulted in a cohort of 270 trainees. 

The training has been co-sponsored by the US Centers for Disease Control and Prevention, Africa Centres for Disease Control and Prevention and RCCE collective service. Technical expertise is being provided by First Draft, a non-profit that works globally to tackle misinformation. 

Organizing the training programme has been a complicated logistical exercise. The number and location of this first cohort means the sessions will be repeated twice per day to allow everyone to join the sessions live to ask questions and to interact with their fellow learners. During the 34 hours of programming, there will be 46 different speakers sharing their expertise with the participants.

The training programme has been driven by a recognition of the harm being caused by false and misleading health information circulating in online spaces, low quality news outlets and in peer to peer discussions. By the end of the training, participants will have a thorough grounding in infodemic management. This includes an understanding that public health professionals need to share accurate, engaging, sharable content as well as using techniques to counter misinformation when it starts to cause harm to communities. 

The course includes practical training on tools for monitoring rumors, fact-checking and verification, as well as learning how to respond effectively and testing interventions to slow down the spread of misinformation. There are also guest speakers from UNICEF, Google and Facebook and most importantly representatives from country based Ministries of Health who will be talking about their current challenges with the infodemic and the lessons they have learned.

At the first welcome event, 188 learners interacted over Zoom sharing experiences and hopes for the upcoming weeks. The session included an information ‘crisis’ simulation, where participants played the role of a public health communications officer in a major North American city and had to make decisions based on a fictional public health incident, where rumors were swirling all over social media. Would they hold a press conference? Or debunk rumors directly on the different social media platforms? Or would they wait for more information? The simulation was designed to highlight the different challenges involved in infodemic management today, and to preview some of the key elements of the training programme.

As one of the participants posted during the simulation: “This feels like a ‘choose your own adventure game.” The training has been designed to be interactive, engaging and practical. By the end of the training, participants who will successfully pass the assessment will join the WHO roster of infodemic managers to be deployed to countries, where they will be thrust into real-life situations that will feel far from an adventure game.

The training team are very excited to work with these experienced professionals from the fields of epidemiology, risk communication, health service delivery/health care workers, digital health, policy making, and others who are responding to the current COVID-19 and overlapping infodemics at country level. 

 

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WHO organized a webinar series of public financial management (PFM) in health issues in 2019. The series included six sessions on key PFM topics – from budget formulation, to budget execution and monitoring . WHO has made available the recorded sessions of the webinar series, and have transformed them into video podcasts.Selengkapnya

Scaling up efforts on the prevention and control of non-communicable diseases (NCDs) can avert over 4.3 million deaths and yield RUB 8.1 trillion (USD 105 billion) in economic benefits in Russia over the next 15 years – suggest the results of a recent analysis by WHO and UNDP under the United Nations Interagency Task Force on NCDs. These immense benefits can be achieved through investment in five proven and cost-effective intervention packages recommended by WHO to address the major NCD risk factors.  

The analysis, presented at the 4th All-Russia Forum on Public Health, highlighted that NCDs exert a significant economic, social, and sustainable development toll on the Russian Federation every year. NCDs are the leading cause of mortality and disability and are accountable for 87% of all deaths in the country. It is estimated that an average person in Russia has a 25% risk of dying prematurely (i.e. before the age of 70) from one of the four main NCDs – cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. In 2016, 1 635 000 people in Russia died from NCDs while still in their prime productive years. The effects of such losses go far beyond the health sector and hinder Russia’s broader development priorities of increasing human capital, reducing poverty and inequality and strengthening inclusive economic growth. The investment case report shows that in 2018 alone, NCDs cost the Russian economy around 3.9% of GDP, with 86% of all costs stemming from indirect losses linked to premature mortality and reduced productivity of workers.

However, most of the socio-economic damage from NCDs is preventable. The results of the analysis show that by scaling up the national NCD response, the Russian Government can continue to improve the situation in the country. 

The analysis assessed five cost-effective intervention packages within the Russian Federation: four policy packages to reduce the prevalence of behavioural risk factors for NCDs – tobacco use, harmful use of alcohol, physicalinactivity, and excessive salt consumption – and one clinical intervention package to address cardiovascular diseases and diabetes. The results show that implementation of these packages can significantly reduce the burden of NCDs and increase people’s well-being and quality of life while also accelerating economic growth. The return on investment is expected to far exceed the required costs and be as high as 50-fold over a 15-year period in the case of some interventions. In addition to these returns, the Government can expect to receive revenues from increasing taxes on health harming products – tobacco, sugar-sweetened beverages, and alcohol – which is part of the recommended intervention packages.

“Economic growth, equity, demographic security – nearly all facets of sustainable development are affected by the NCD burden in Russia. These investment case findings – and the real progress made to date – confirm that Russia is on the right path, but the pace needs to be increased to meet the 2030 targets.” Dudley Tarlton, Programme Specialist, Health and Development, UNDP

The analysis conducted by the WHO/UNDP joint programme under the UN NCD Task Force can be used to facilitate multi-stakeholder engagement and promote a whole-of-government, comprehensive approach to tackling NCDs in Russia. It takes into account the country’s institutional and social context and contains a diverse range of compelling evidence-based arguments that could be used to appeal to a broad range of stakeholders, both in the public and the private space.

The Government of Russia has already demonstrated strong commitment to strengthening the prevention and control of NCDs, and the Ministry of Health’s strategic goals under Presidential Decree No. 204 of 2018 include several NCD-related priorities. The Russian Federation also supports other countries in their efforts to tackle NCDs, for example through the WHO/UNDP joint programme on catalyzing multisectoral action on NCDs.

“The Russian Federation continues to demonstrate outstanding leadership on the prevention and control of NCDs at national, regional, and global levels. We are happy that the comprehensive analysis conducted by UNIATF can inform Russia’s continued multisectoral and multistakeholder efforts to address NCDs and other health-related SDGs.”  Dr Svetlana Akselrod, Director, Global NCD Platform, WHO

The analysis prepared by the Task Force confirms the importance of such commitment and advocates for further scale up of Russia’s national NCD response to improve health and wellbeing of millions of Russian people while enhancing economic growth and prosperity for millions more.

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WHO and partners launch new guidance on designing digital health interventions with and for young people.  

Digital tools are an increasingly popular approach to improving health worldwide – particularly among adolescents and young people, who are accessing the internet at earlier stages of life.  

Youth-centred digital health interventions is a new framework developed by WHO, HRP, UNESCO, UNICEF and UNFPA. It provides guidance on effective planning, development and implementation of digital solutions with and for young people to address the many health challenges they may face as they grow into adulthood. 

Meaningful youth engagement at every step  

The 2019 WHO Guideline for recommendations on digital interventions for health system strengthening advises that digital health interventions adapt the way they transmit information to specific audiences in order to improve the health and well-being of the people they were designed to reach.  

This is critical when working with young people, who still encounter considerable resistance to being viewed as equal and valuable partners in programme design and delivery. This is true even when it comes to programmes, strategies, policies, funding mechanisms and organizations that directly affect their lives.  

The new framework includes a list of “do’s and don’ts” for engaging young people in the process of digital health design and delivery, based on consultation with young social media influencers, health content and intervention developers, health advocates, educators, and current or future health professionals.  

Young people are the experts on their own health needs, the technologies they use and how they access information,” said Dr Lianne Gonsalves, technical officer in the WHO Department of Sexual and Reproductive Health and Research, who led the development of this guidance. 

Youth-centred digital interventions is a pathway to collaboration: trusting young people, learning from them and paying them for their work. As well as being essential for successful solutions, meaningful youth engagement empowers young people to evolve from beneficiaries, to partners, to leaders.” 

Learning lessons from the first generation of youth-centred interventions 

Aligning with a growing body of WHO digital health guidance, the new framework builds on important lessons learned from the first generation of youth-focused digital health interventions.  

Instead of standalone websites and SMS-based pilot programmes that are not integrated into existing health infrastructure, the new guidance notes that solutions should complement and enhance existing digital and non-digital tools already in the health system.  

The next generation of digital health designers, developers, researchers and funders can use the framework to learn from the experiences of experts in the field – missteps, course corrections and successes – and better meet young people’s diverse health needs.  

WHO and the future of digital health 

With the right approach and effective investment, digital health tools have the potential to transform health services and help to achieve universal health coverage. 

WHO has a growing suite of digital health tools which can help countries effectively put into place, scale-up, maintain, and evaluate the impact of digital health interventions. 

Youth-centred digital health interventions is a companion to the recent Digital Implementation investment guide: integrating digital interventions into health systems (also known as the DIIG). This step-by-step tool from WHO and partners was developed to help ensure that investments in digital health are effective, sustainable, and equitable, and implemented in ways that are appropriate for the local context. 

The DIIG and the youth-centred framework are underpinned by the same core steps for digital health intervention development,” said Dr Garrett Mehl, scientist in digital innovations and research at the WHO Department of Sexual and Reproductive Health and Research including HRP. 

Used together, these tools can enable meaningful youth engagement, responsible investment and long-term good governance for digital health interventions – ultimately ensuring that every young person has access to the health care, information and education that is right for them.” 

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Special series aims to advance women’s health and gender equality.

Progress on gender equality has been made in all 12 key areas identified in the 1995 Beijing Declaration and Platform for Action on Women – but for millions of girls and women
around the world today, this visionary agenda is still far from reality.

The British Medical Journal (BMJ) has commissioned a special series of papers on “Women’s Health and Gender Inequalities” with support from the World Health Organization (WHO), the Human Reproduction Programme (HRP) and the United Nations
University International Institute for Global Health (UNU-IIGH).

Launched at the World Health Summit, the series reflects on priorities articulated twenty-five years ago for improving women’s health, and asks: what has been learned, and what still needs to change?

Critical areas of concern for women’s health and gender equality

The Beijing Declaration affirmed that women’s rights are human rights and that gender equality is an essential building block for health, well-being, development and peace.

The topics covered in the BMJ series, include a broad range of social and medical factors influencing women’s health, such as sexual and reproductive health; violence against women, mental health, noncommunicable diseases, climate change, limited
inclusion of women’s specific health needs in clinical research and the role of the feminist movement in women’s health.

This series also includes a co-authored opinion piece by WHO Director-General Dr Tedros Adhanom Ghebreyesus.

Uneven progress and emerging threats to women’s health

Progress in women’s health remains fragile and uneven. While progress has been made in reducing maternal mortality and harmful gender practices such as female genital mutilation, millions of women still continue to have an unmet need for contraception.

Rising rates of reproductive cancers, mental ill-health, non-communicable diseases and new disease outbreaks including Ebola, Zika and COVID-19, are highlighting the need to have a comprehensive approach to women’s health throughout their life-course.

While there is a greater recognition of women as providers of healthcare, many face an unacceptable level of harassment, violence and abuse in the workplace.

Access to health services for millions of women remains limited even as countries are moving to a progressive realization of universal health coverage. In part, this is linked to an emphasis on employment-based health financing, which excludes women,
who tend to work in informal sectors.

The impact of COVID-19

In the midst of tracking progress on the Beijing Declaration, the COVID-19 pandemic is limiting or reversing gains made towards gender equality. While women and men seem to be infected by COVID-19 in roughly equal numbers, women health workers, who are the majority of frontline providers, are at increased risk of infection.

COVID-19 has brought rising economic insecurity, driving millions, especially women who work in informal sectors, into unemployment. Lockdown measures have increased the already high burden of unpaid care work shouldered by women, including caring for
children, the sick, and the elderly. And distancing measures have increased violence against women and children – a widespread issue even before the pandemic.

Many governments are reprioritizing what health services are provided in the context of COVID-19 and unfortunately scaling back access to essential services for women – including comprehensive sexual and reproductive health care, which includes services
for survivors of violence.

An urgent call to action: Invest in women’s health

WHO Director-General Tedros Adhanom Ghebreyesus, Executive Director of UN Women Phumzile Mlambo-Ngcuka, and Rector of UN University David Malone, argue in their opinion piece that, “Covid-19 provides an opportunity to re-imagine a future where women’s
health and rights are non-negotiable, gender equality is achievable and working towards it is the norm.”

The health, well-being and needs of half the world’s population cannot be treated as an afterthought. Investing in women’s health is a moral and smart imperative. It saves lives, reduces poverty, increases productivity and stimulates economic
growth with up to a nine-fold return on investment.

WHO is committed to the Beijing Declaration and is marking the 25th anniversary with a number of activities.

Learn more about our involvement in Beijing+25.

Read the BMJ series. Additional papers will be added in March 202

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On 13 October 2020, the French health authorities officially reported 13 laboratory-confirmed cases of Mayaro fever in French Guiana, France.

In September 2020, the Institut Pasteur de la Guyane (IPG) (member of the French National Reference Laboratory for arboviruses) identified two cases of Mayaro virus infection (MAYV) confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) and one probable case found positive for Mayaro antibodies. The case-patients presented dengue-like symptoms and joint pains, and tested negative for dengue by RT-PCR.Selengkapnya

Accurate pregnancy dating and quality care combined with the steroids are key to survival

The results of a new clinical trial, published today in the New England Journal of Medicine, show that dexamethasone—a glucocorticoid used to treat many conditions, including rheumatic problems and severe COVID-19— can boost survival of premature babies when given to pregnant women at risk of preterm birth in low-resource settings.

The WHO ACTION-I trial resolves an ongoing controversy about the efficacy of antenatal steroids for improving preterm newborn survival in low-income countries. Dexamethasone and similar drugs have long shown to be effective in saving preterm babies lives in high-income countries, where high-quality newborn care is more accessible. This is the first time a clinical trial has proven that the drugs are also effective in low-income settings.

The impact is significant: for every 25 pregnant women treated with dexamethasone, one premature baby’s life was saved. When administered to mothers at risk of preterm birth, dexamethasone crosses the placenta and accelerates lung development, making it less likely for preterm babies to have respiratory problems at birth.

“Dexamethasone is now a proven drug to save babies born too soon in low-income settings,” says Dr Olufemi Oladapo, head of maternal and perinatal health unit at WHO and HRP, and one of the coordinators of the study. “But it is only effective when administered by health-care providers who can make timely and accurate decisions, and provide a minimum package of high-quality care for both pregnant women and their babies.”

Globally, prematurity is the leading cause of death in children under the age of 5. Every year, an estimated 15 million babies are born too early, and 1 million die due to complications resulting from their early birth. In low-income settings, half of the babies born at or below 32 weeks die due to a lack of feasible, cost-effective care.

The study notes, healthcare providers must have the means to select the women most likely to benefit from the drug and to correctly initiate the treatment at the right time – ideally 48 hours before giving birth to give enough time to complete steroid injections for maximal effect. Women who are in weeks 26-34 of their pregnancy are most likely to benefit from the steroid, so healthcare providers must also have access to ultrasound to accurately date their pregnancies. In addition, babies must receive sufficiently good-quality care when they are born.

“When a minimal package of care for newborn babies – including management of infection, feeding support, thermal care and access to a CPAP machine to support respiration – is in place in low-income countries, antenatal steroids such as dexamethasone can help to save preterm babies’ lives,” says Dr Rajiv Bahl, head of the newborn health unit at WHO and one of the study coordinators.

Conducted from December 2017–November 2019, the randomized trial recruited 2852 women and their 3070 babies from 29 secondary and tertiary level hospitals in Bangladesh, India, Kenya, Nigeria, and Pakistan. Beyond finding a significantly lower risk of neonatal death and stillbirth, the study also found there was no increase in possible maternal bacterial infections when treating pregnant women with dexamethasone in low-resource settings.


Note to editors

WHO includes dexamethasone in its Essential Medicines List. The drug has also recently been shown to be effective in helping to relieve the symptoms caused by severe COVID-19. It is therefore crucial that countries, health systems, and pharmaceutical companies across the world ensure quality, as well as effective supply chains and pricing to prevent hoarding or stock-outs of this drug, which has many uses; including for helping to save preterm babies lives.

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At the occasion of the World Health Summit 2020 and the 75th anniversary of the United Nations, a new book has been launched that calls on world leaders and politicians to unite in their response to the COVID-19 pandemic and other threats to health and the global economy.

Health: A Political Choice – Act Now, Together is the latest in a series of titles published by the Global Governance Project in collaboration with WHO.  

This year’s edition features another prestigious line-up of authors, including Amina J Mohammed, deputy secretary-general of the UN, Dr Tedros Adhanom Ghebreyesus, Director-General of WHO and President of South Africa Cyril Ramaphosa. Calling for coordinated action in response to COVID-19 and on other pressing health-related issues, the publication focuses on five key areas:

  1. Inclusive economics, defined by a new social contract and the pursuit of progress for all
  2. The fundamental requirements for a healthy life and equitable health care
  3. Equitable investments and how to make universal health coverage a reality
  4. Health in the digital age and how technology can help reshape the human rights agenda
  5. The long-term outlook on global health

Dr Tedros, WHO Director-General, said: “It has never been clearer that health is a political and economic choice. In the past 20 years, countries have invested heavily in preparing for terrorist attacks, but relatively little in preparing for the attack of a virus – which, as the COVID-19 pandemic has proven, can be far more deadly, disruptive and costly.” 

The first book in the series Health: A Political Choice. Delivering Universal Health Coverage 2030 was launched in 2019. 

 

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The World Health Organization (WHO) and the Wikimedia Foundation, the nonprofit that administers Wikipedia, announced today a collaboration to expand the public’s access to the latest and most reliable information about COVID-19. 

The collaboration will make trusted, public health information available under the Creative Commons Attribution-ShareAlike license at a time when countries face continuing resurgences of COVID-19 and social stability increasingly depends on the public’s shared understanding of the facts. 

Through the collaboration, people everywhere will be able to access and share WHO infographics, videos, and other public health assets on Wikimedia Commons, a digital library of free images and other multimedia. 

With these new freely-licensed resources, Wikipedia’s more than 250,000 volunteer editors can also build on and expand the site’s COVID-19 coverage, which currently offers more than 5,200 coronavirus-related articles in 175 languages. This WHO content will also be translated across national and regional languages through Wikipedia’s vast network of global volunteers.

“Equitable access to trusted health information is critical to keeping people safe and informed during the COVID-19 pandemic,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Our new collaboration with the Wikimedia Foundation will increase access to reliable health information from WHO across multiple countries, languages, and devices.”

Since the beginning of the pandemic, WHO has taken steps to prevent an “infodemic”— defined by the organization as “an overabundance of information and the rapid spread of misleading or fabricated news, images, and videos.” 

Wikipedia editors have similarly been on the frontlines of preventing the spread of misinformation surrounding the coronavirus, ensuring information about the pandemic is based on reliable sources and updated regularly on Wikipedia. 

By making verified information about the pandemic available to more people on one of the world’s most-visited knowledge resources, the organizations aim to help curb this infodemic and ensure everyone can access critical public health information.

“Access to information is essential to healthy communities and should be treated as such,” said Katherine Maher, CEO at the Wikimedia Foundation. “This becomes even more clear in times of global health crises when information can have life-changing consequences. All institutions, from governments to international health agencies, scientific bodies to Wikipedia, must do our part to ensure everyone has equitable and trusted access to knowledge about public health, regardless of where you live or the language you speak.”

WHO has served as the leading international health agency spearheading the global response to the coronavirus outbreak. Since the beginning, WHO has worked to rapidly establish international coordination, scale up country readiness and response, and accelerate research and innovation. Today, as information on the transmission and epidemiology of the virus evolves, WHO continues to provide essential guidance and public health recommendations to governments, communities and individuals everywhere.

At the same time, Wikipedia volunteer editors, many of whom are from the medical community, have been creating, updating, and translating Wikipedia articles with information from reliable sources about the pandemic. As one of the top ten sites in the world, studies have shown that Wikipedia is one of the most frequently viewed sources for health information. 

At the moment, readers can access WHO’s mythbusting series of infographics on Wikimedia Commons. The infographics, which focus on addressing common misconceptions about COVID-19, are also available for Wikipedia editors to incorporate into Wikipedia articles. 

In the coming months, the Wikimedia Foundation and WHO will continue uploading resources to Wikimedia Commons and collaborating with Wikipedia volunteer editors to better understand gaps in information needs on Wikipedia articles related to COVID-19 and how WHO resources can help fill these gaps. 

Additionally, under the Creative Commons Attribution-ShareAlike license, other organizations, individuals, and websites can more easily share these materials on their own platforms without having to address stricter copyright restrictions. 

About 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 149 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing.

For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube, and Twitch.

About the Wikimedia Foundation 

The Wikimedia Foundation is the nonprofit organization that operates Wikipedia and the other Wikimedia free knowledge projects. Our vision is a world in which every single human can freely share in the sum of all knowledge. We believe that everyone has the potential to contribute something to our shared knowledge, and that everyone should be able to access that knowledge freely. We host Wikipedia and the Wikimedia projects, build software experiences for reading, contributing, and sharing Wikimedia content, support the volunteer communities and partners who make Wikimedia possible, and advocate for policies that enable Wikimedia and free knowledge to thrive. The Wikimedia Foundation is a United States 501(c)(3) tax-exempt organization with offices in San Francisco, California, USA.

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The World Health Organization’s (WHO) Global TB Programme welcomes the results from a landmark study on the treatment of drug-susceptible TB presented at the 51st virtual Union World Conference on Lung Health. The study, named Study 31/A5349, was led by the U.S. Centers for Disease Control and Prevention’s (CDC) Tuberculosis Trials Consortium (TBTC) in collaboration with the AIDS Clinical Trials Group (ACTG) and funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

Study 31/A5349 is a phase 3, open-label randomized controlled clinical trial that examined the efficacy and safety of two four-month treatment regimens with high-dose rifapentine with or without moxifloxacin for the treatment of drug susceptible pulmonary TB, compared to the currently recommended six-month regimen composed of rifampicin, isoniazid, pyrazinamide and ethambutol (2RHZE/4RH). Thirteen countries contributed data to the study, from 34 clinical sites. Approximately 2 500 people aged 12 years and older participated in the study, including 214 people living with HIV infection.

One of the key findings from the study was that the four-month regimen which included a combination of high-dose rifapentine, isoniazid, pyrazinamide and moxifloxacin, was shown to be non-inferior in terms of efficacy to the currently recommended six-month regimen composed of rifampicin, isoniazid, ethambutol and pyrazinamide. In addition, this four-month regimen was safe and well-tolerated by patients.

New, shorter and effective treatment regimens for both drug-susceptible and drug-resistant TB are urgently needed to treat all patients with TB and achieve the WHO’s End TB Strategy targets. Therefore, the findings from this study have the potential to complement current options for the treatment of drug-susceptible TB with a new effective and safe 4-month regimen.

Robust and representative scientific data constitute the premise for WHO public health policy recommendations, which are developed using a rigorous, systematic and evidence-based approach. WHO regularly reviews the findings from key studies on TB treatment in order to offer patients the most effective and safe treatment regimens. The results from Study 31/A5349 mark an important step forward in this process and once the final data become available, WHO intends to initiate a policy development process to refine its current policy recommendations on the treatment of drug-susceptible TB.

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The twenty-sixth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened and opened by the WHO Deputy Director-General on 14 October 2020 with committee members attending via video conference, supported by the WHO Secretariat.  Dr Zsuzsana Jakab in opening remarks on behalf of Dr Tedros congratulated all those involved in eliminating wild polioviruses from the WHO African Region despite some very challenging obstacles.  The COVID-19 pandemic and the ongoing spread of cVDPV2 were both growing major challenges, which would require strenuous efforts to overcome in order to restart progress toward global polio eradication.

 

The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV).  The following IHR States Parties provided an update at the video conference or in writing on the current situation in their respective countries: Afghanistan, Chad, Egypt, Guinea, Pakistan, Somalia, South Sudan, Sudan and Yemen.

 

Wild poliovirus

 

The higher incidence of global WPV1 cases seen during 2020 continues, with 121 cases reported between 1 January – 5 October 2020 compared to 85 for the same period in 2019, a 42% increase.  Last year there were 176 WPV1 cases, the highest number reported since the PHEIC was declared in 2014, when there were 359 cases in nine countries.  The lowest number of WPV1 cases was reported in 2017, when only 22 cases were found.  No wild polio cases have been detected outside of Pakistan and Afghanistan since the last cases in Nigeria in 2016 four years ago.  The number of positive environmental samples has increased 70% to 375 compared to 221 for the same time last year.  Since the last meeting, exportation of WPV1 from Pakistan to Afghanistan has been documented.

 

The Committee noted that based on results from sequencing of WPV1 since the last committee meeting in June, there were further instances of international spread of viruses from Pakistan to Afghanistan.  The ongoing frequency of WPV1 international spread between the two countries and the increased vulnerability in other countries where routine immunization and polio prevention activities have both been adversely affected by the COVID-19 pandemic are two major factors that suggest the risk of international spread may be at the highest level since 2014.  While border closures and lockdowns may mitigate the risk in the short term while in force, this would be outweighed in the longer term by falling population immunity through disruption of vaccination and the resumption of normal population movements.

 

On the other hand the certification of the WHO African Region as wild polio free in August 2020 indicated a lessening of the global risk from this previous source.

 

Vaccine derived poliovirus (VDPV)

 

The committee was very concerned that the international spread of cVDPV2 continues, causing new outbreaks in Guinea, South Sudan and Sudan, the latter two due to importation of a cVDPV2 lineage that emerged in Chad in 2019.  The same virus has also been detected in sewage in Cairo, Egypt but with no evidence of local circulation. The number of cases in 2020 is 409 as at 5 October 2020, already exceeding the 378 cases reported for the whole of 2019.  As in all other years after 2016 when OPV2 was withdrawn, the number of cVDPV2 cases has been greater than the number of WPV1 cases in 2020.  However, the number of sub-types / lineages detected so far in 2020 is 27, compared to 42 for the whole of 2019, and the number of newly emerged viruses is only seven so far this year, compared to 38 during 2019. 

 

Cross border spread of cVDPV2 is now occurring regularly.  Based on analysis by the US CDC of isolates, in the three months from April to June 2020, there has been evidence of exportation of cVDPV2 from:

·     Pakistan to Afghanistan

·     Côte d’Ivoire to Mali

·     Guinea to Mali

·     Côte d’Ivoire to Ghana, and Ghana to Côte d’Ivoire

·     CAR to Cameroon

·     Chad to Sudan and South Sudan

·     Ghana to Burkina Faso

 

COVID-19

 

The committee heard that nearly all countries (90%) have experienced disruption to health services especially in low and middle income countries, according to a survey of 105 countries conducted March – June 2020.  Routine immunization particularly outreach services was the area most frequently reported as disrupted.

 

The committee was very concerned that most of the current outbreak countries have had to delay immunization responses in recent months, meaning that transmission is likely continuing unchecked.  Furthermore, there appear to be significant falls in surveillance indicators in many of the outbreak countries, such as drops in AFP reporting rates, and lesser drops in environmental sampling.  Vaccine management and supply has been significantly impacted.  More than 60 campaigns in 28 countries have been postponed since late February and early March. Vaccine supplies have been disrupted in many ways, with some quantities already in-country at risk of exceeding their expiry data and therefore unusable.  Some suppliers are reaching storage capacity and may well be forced to stop production.

 

Although the resumption of Supplementary Immunization Activities (SIAs) is now occurring, the waves of the pandemic are expected to fluctuate considerably from country to country and across the WHO Regions, so the program will need to adjust according to the COVID-19 situation for the foreseeable future.

 

Although in general surveillance processes are continuing, there are clear signs of a significant drop in AFP case reporting, including in endemic countries, some outbreak countries and some other non-infected high risk countries. 

 

The committee noted that GPEI modeling indicated there is a risk of an exponential rise in the number of cVDPV2 infected districts in the African Region, leading to a 200% increase if response SIAs had not resumed. In addition to the risk of WPV1 geographical spread and intensification, cVDPV2 cases could rise exponentially in Pakistan and Afghanistan potentially reaching more the 3,500 cases without a resumption of immunization response.   Consequently, both Pakistan and Afghanistan are now implementing large scale mOPV2 campaigns and will continue with tOPV/mOPV2 until controlled. While there has been rapid spread, particularly in Afghanistan, expected exponential rise has been curtailed by the resumption of campaigns in July.

 

 

Conclusion

 

The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months.  The Committee recognizes the concerns regarding the lengthy duration of the polio PHEIC, but concludes that the current situation is extraordinary, with clear ongoing and increasing risk of international spread and ongoing need for coordinated international response. The Committee considered the following factors in reaching this conclusion:

 

Rising risk of WPV1 international spread:  

Based on the following factors, the risk of international spread of WPV1 appears to be currently very high:

·     increasing transmission in Pakistan and Afghanistan as evidenced by higher case numbers and positive environmental samples;

·     greater geographical spread within the endemic countries, particularly Afghanistan;

·     the ongoing inaccessibility in many provinces of Afghanistan, leading increasingly to highly susceptible populations which are and will continue to drive higher transmission;

·     the drop in population immunity consequent on the pause in polio vaccination necessitated by the COVID-19 pandemic, leading to greater susceptibility to poliovirus importation and outbreaks in high risk countries; 

·     the complicated context of WPV eradication activities in Afghanistan and Pakistan created by the need to simultaneously respond to cVDPV2 and COVID-19;

·     the difficulties in supplying vaccines due to the pandemic (as is being seen in Yemen, for example);

·     the possible expiring of vaccines in country and stockpiles caused by delays in polio vaccination activities;

·     the results of modelling done by GPEI on the potential consequences for WPV1 of the pause on eradication activities.

 

Rising risk of cVDPV international spread:

The international spread of cVDPV2 is now established, with three newly infected countries being reported since June 2020.  While experience demonstrates the effectiveness of Sabin OPV2 in controlling outbreaks, and changes in the strategy and standard operating procedures for responding to cVDPV2 appear to be succeeding in reducing the risk of new emergences in outbreak zones and neighbouring areas, overall the problem continues to grow, affecting more countries and paralyzing more children. 

●    COVID-19:  This unprecedented pandemic is likely to continue to substantially negatively impact the polio eradication program and outbreak control efforts.  The need to take extra precautions to prevent COVID-19 transmission will probably have an impact on vaccination coverage, and also hamper polio surveillance activities leading to increased risk of missed transmission. 

●    Falling PV2 immunity:  Global population mucosal immunity to type 2 polioviruses (PV2) continues to fall, as the cohort of children born after OPV2 withdrawal grows, exacerbated by poor coverage with IPV particularly in some of the cVDPV infected countries.

●    Weak routine immunization: Many countries have weak immunization systems that can be further impacted by various humanitarian emergencies including COVID19, and the number of countries in which immunization systems have been weakened or disrupted by conflict and complex emergencies poses a growing risk, leaving populations in these fragile states vulnerable to outbreaks of polio.

●    Lack of access: Inaccessibility continues to be a major risk, particularly in several countries currently infected with WPV or cVDPV, i.e. Afghanistan, Nigeria, Niger, Somalia and Myanmar, which all have sizable populations that have been unreached with polio vaccine for prolonged periods.

●    Population movement: While border closures may have mitigated the short term risk, conversely the risk once borders begin to be re-opened is likely to be higher. 

●    The results of cVDPV2 modelling, done by GPEI in June 2020 which had indicated that there was a risk of an exponential rise in the number of cVDPV2 infected districts in the African Region and in Pakistan and Afghanistan.

●    New cVDPV1 outbreak: The new outbreak of cVDPV1 in Yemen in an area of conflict is a further example of the risks anywhere that conflict can contribute to lower immunization rates and therefore new emergences of other cVDPV.

 

 

Risk categories

 

The Committee provided the Director-General with the following advice aimed at reducing the risk of international spread of WPV1 and cVDPVs, based on the risk stratification as follows:

 

●    States infected with WPV1, cVDPV1 or cVDPV3, with potential risk of international spread.

●    States infected with cVDPV2, with potential risk of international spread.

●    States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV.

 

Criteria to assess States as no longer infected by WPV1 or cVDPV:

 

●    Poliovirus Case: 12 months after the onset date of the most recent case PLUS one month to account for case detection, investigation, laboratory testing and reporting period OR when all reported AFP cases with onset within 12 months of last case have been tested for polio and excluded for WPV1 or cVDPV, and environmental or other samples collected within 12 months of the last case have also tested negative, whichever is the longer.

●    Environmental or other isolation of WPV1 or cVDPV (no poliovirus case): 12 months after collection of the most recent positive environmental or other sample (such as from a healthy child) PLUS one month to account for the laboratory testing and reporting period

●    These criteria may be varied for the endemic countries, where more rigorous assessment is needed in reference to surveillance gaps.

 

Once a country meets these criteria as no longer infected, the country will be considered vulnerable for a further 12 months.  After this period, the country will no longer be subject to Temporary Recommendations, unless the Committee has concerns based on the final report.

 

TEMPORARY RECOMMENDATIONS

 

States infected with WPV1, cVDPV1 or cVDPV3 with potential risk of international spread

 

WPV1                                                                                                       

Afghanistan                       (most recent detection 7 Sep 2020)             

Pakistan                            (most recent detection 16 Sep 2020)

 

cVDPV1

Malaysia                            (most recent detection 13 March 2020)

Philippines                         (most recent detection 28 November 2019)

Yemen                               (most recent detection 5 June 2020)

 

These countries should:

●    Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency and implement all required measures to support polio eradication; where such declaration has already been made, this emergency status should be maintained as long as the response is required.

●    Ensure that all residents and long­term visitors (i.e. > four weeks) of all ages, receive a dose of bivalent oral poliovirus vaccine (bOPV) or inactivated poliovirus vaccine (IPV) between four weeks and 12 months prior to international travel.

●    Ensure that those undertaking urgent travel (i.e. within four weeks), who have not received a dose of bOPV or IPV in the previous four weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travelers.

●    Ensure that such travelers are provided with an International Certificate of Vaccination or Prophylaxis in the form specified in Annex 6 of the IHR to record their polio vaccination and serve as proof of vaccination.

●    Restrict at the point of departure the international travel of any resident lacking documentation of appropriate polio vaccination. These recommendations apply to international travelers from all points of departure, irrespective of the means of conveyance (e.g. road, air, sea).

●    Further intensify cross­border efforts by significantly improving coordination at the national, regional and local levels to substantially increase vaccination coverage of travelers crossing the border and of high risk cross­border populations. Improved coordination of cross­border efforts should include closer supervision and monitoring of the quality of vaccination at border transit points, as well as tracking of the proportion of travelers that are identified as unvaccinated after they have crossed the border.

●    Further intensify efforts to increase routine immunization coverage, including sharing coverage data, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication.

●    Maintain these measures until the following criteria have been met: (i) at least six months have passed without new infections and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until the state meets the above assessment criteria for being no longer infected.

●    Provide to the Director-General a regular report on the implementation of the Temporary Recommendations on international travel.

 


 

States infected with cVDPV2s, with potential or demonstrated risk of international spread

Afghanistan           (most recent detection 5 September 2020)

Angola                   (most recent detection 9 February 2020)

Benin                     (most recent detection 12 June 2020)

Burkina Faso          (most recent detection 11 June 2020)

Cameroon             (most recent detection 1 September 2020)

CAR                       (most recent detection 28 July 2020)

Chad                     (most recent detection 22 August 2020)

Cote d’Ivoire          (most recent detection 20 June 2020)

DR Congo              (most recent detection 4 August 2020)

Ethiopia                 (most recent detection 13 June 2020)

Ghana                   (most recent detection 16 June 2020)

Guinea                  (most recent detection 21 July 2020)

Malaysia                (most recent detection 13 March 2020)

Mali                      (most recent detection 23 June 2020)

Niger                     (most recent detection 25 August 2020)

Nigeria                  (most recent detection 18 June 2020)

Pakistan                (most recent detection 24 September 2020)

Philippines             (most recent detection 16 January 2020)

Somalia                 (most recent detection 29 August 2020)

South Sudan          (most recent detection 8 July 2020)

Sudan                    (most recent detection 18 August 2020)

Togo                      (most recent detection 3 May 2020)

Zambia                  (most recent detection 25 November 2019)

 

These countries should:

●    Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency and implement all required measures to support polio eradication; where such declaration has already been made, this emergency status should be maintained.

●    Noting the existence of a separate mechanism for responding to type 2 poliovirus infections, consider requesting vaccines from the global mOPV2 stockpile based on the recommendations of the Advisory Group on mOPV2.

●    Encourage residents and long­term visitors to receive a dose of IPV four weeks to 12 months prior to international travel; those undertaking urgent travel (i.e. within four weeks) should be encouraged to receive a dose at least by the time of departure.

●    Ensure that travelers who receive such vaccination have access to an appropriate document to record their polio vaccination status.

●    Intensify regional cooperation and cross­border coordination to enhance surveillance for prompt detection of poliovirus, and vaccinate refugees, travelers and cross­border populations, according to the advice of the Advisory Group.

●    Further intensify efforts to increase routine immunization coverage, including sharing coverage data, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication.

●    Maintain these measures until the following criteria have been met: (i) at least six months have passed without the detection of circulation of VDPV2 in the country from any source, and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until the state meets the criteria of a ‘state no longer infected’.

●    At the end of 12 months without evidence of transmission, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.

 

 


 

States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV

 

WPV1

none                    

cVDPV

Mozambique         (most recent cVDPV2 detection 17 December 2018)

PNG                      (most recent cVDPV1 detection 6 November 2018)

Indonesia              (most recent cVDPV1 detection 13 February 2019)

Myanmar              (most recent cVDPV1detection 9 August 2019)

China                    (most recentcVDPV2 detection 18 August 2019)

 

These countries should:

●    Urgently strengthen routine immunization to boost population immunity.

●    Enhance surveillance quality, including considering introducing supplementary methods such as environmental surveillance, to reduce the risk of undetected WPV1 and cVDPV transmission, particularly among high risk mobile and vulnerable populations.

●    Intensify efforts to ensure vaccination of mobile and cross­border populations, Internally Displaced Persons, refugees and other vulnerable groups.

●    Enhance regional cooperation and cross border coordination to ensure prompt detection of WPV1 and cVDPV, and vaccination of high risk population groups.

●    Maintain these measures with documentation of full application of high quality surveillance and vaccination activities.

●    At the end of 12 months without evidence of reintroduction of WPV1 or new emergence and circulation of cVDPV, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.

 

 

Additional considerations

 

The committee noted with concern the drop in the number of SIAs due to the problems caused by COVID-19, including preventive SIAs in high risk countries that are done to maintain population immunity in places where routine immunization is weak or disrupted.  This indicates a very dangerous situation could arise: not only is there increasing WPV1 in the two potential source countries, but the susceptibility in potential outbreak prone countries could significantly and relatively rapidly increase.  Furthermore, importations leading to outbreaks may be detected late due to the pandemic’s effect on surveillance.  The committee urges all at-risk countries to pay careful attention to managing these risks, ensuring population immunity for polio is maintained throughout the course of the pandemic whether through SIAs or improvements to routine immunization, and attention is also given to enhancement of surveillance, especially environmental surveillance where it remains limited in some high risk areas.

 

The committee also noted the risk of vaccine hesitancy could be exacerbated during the pandemic, so that adverse events during the development or future deployment of any COVID-19 vaccine could compound the existing issues around polio vaccines, particularly but not only in Pakistan.  Conversely, vaccine issues arising out of novel OPV2 or trivalent OPV2 use could adversely affect any future COVID-19 vaccine deployment.  The committee urged countries with particular problems around vaccine hesitancy to make preparations now to avert situations of greater vaccine refusals through education campaigns, activities to counter misinformation and rumors and wherever possible provide incentives to target populations such as multi-antigen campaigns and offering other health and wellbeing services (vitamins, anti-worming medication, soap etc).

 

The committee commended Egypt for its thorough investigation of the finding in Cairo of the VDPV2 poliovirus genetically closely linked to that which is circulating in Sudan and noted there was no evidence that it was circulating in Egypt.  However, given recent experience in other countries where such findings often heralded the beginning of an outbreak, the committee requests Egyptian health authorities to continue to monitor the situation carefully and provide a detailed update to the committee at its next meeting.  The committee urged any country that detects importation of a VDPV2 known to be circulating in another country prepare for a rapid response should local circulation be identified.

 

The committee was also very concerned about the polio program funding gap which is developing in 2021 and beyond and urged countries and donors to maintain funding of polio eradication activities, as the potential for reversal of progress appears high, with many years of work undone easily and swiftly if WPV1 spreads outside the endemic countries.  The committee was saddened to learn of several deaths of polio workers due to COVID-19, which serves as a reminder that both the polio PHEIC and the COVID-19 PHEIC are at dangerous crossroads and need equal attention.  The Committee recommends that in countries with strong polio programs to intensify efforts to link polio eradication and COVID-19 activities including surveillance to provide greater mutual benefits to both initiatives.

 

 

The phased replacement during 2021 of Sabin OPV2 with novel OPV2 is expected to substantially reduce the source of cVDPV2 emergence, transmission and subsequent risk of international spread.  Full licensure and pre-qualification of nOPV2 is not expected before 2022; therefore all countries at risk of cVDPV2 outbreak should consider preparing for nOPV2 use under Emergency Use Listing procedure. 

 

Based on the current situation regarding WPV1 and cVDPV, and the reports provided by affected countries, the Director-General accepted the Committee’s assessment and on 19 October 2020 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV.  The Director-General endorsed the Committee’s recommendations for countries meeting the definition for ‘States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread’, ‘States infected with cVDPV2 with potential risk for international spread’ and for ‘States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV’ and extended the Temporary Recommendations under the IHR to reduce the risk of the international spread of poliovirus, effective 19 October 2020.

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In recognition of World Sight Day 2020, the UN Friends of Vision, the Permanent Missions of Antigua and Barbuda, Bangladesh and Ireland to the United Nations, organized a high-Level event entitled ‘2020 and Beyond: Accelerating Vision for Everyone’. The event was aimed at bringing awareness and global attention to blindness and vision impairment, as well as discussion with Member States the way forward towards a UN General Assembly resolution on Vision Care and a preview of the forthcoming report of The Lancet Global Health Commission on Global Eye Health.

 

WHO ADG Stewart Simonson gave key remarks, presenting WHO’s work on the issue and emphasizing the importance of multi-sectoral approach to scale up integrated people-centred eye care for all. He expressed appreciation of the Member States’ support in implementing the recommendations included in the WHO World Report on Vision fortified by the recent adoption of the WHA resolution 73.4 – ‘Integrated people-cantered eye care, including preventable vision impairment and blindness’. Dr. Alarcos Cieza: Unit Head, Sensory Functions, Disability and Rehabilitation in WHO, also participated in the technical panel discussion and provided further details on the WHO Report as well as its work on prevention of blindness and promoting eye care. Participants voiced their concerns of disrupted services for eye care, particularly in the context of the COVID-19 pandemic, and stressed the need to strengthen health systems so that eye care becomes an integral part of health care service delivery to ensure all people obtain the eye care services they need without hindrance or financial hardship.

Click here to watch the event.Selengkapnya

During such international food safety events, the INFOSAN Secretariat relies on the swift action of national INFOSAN Emergency Contact Points (ECP) to respond to requests for information. Rapid sharing of information through INFOSAN enables members to implement appropriate risk management measures to prevent illness.Selengkapnya

The World Health Organization invites independent film-makers, production companies, NGOs, communities, students, and film schools from around the world to submit their original short films to the 2nd Health for All Film Festival.

Launched in 2020, the festival aims to recruit a new generation of film and video innovators to champion global health issues. 

The inaugural Health for All Film Festival in 2019/2020 accepted 1,300 short film submissions from more than 110 countries. 

“Telling stories is as old as human civilization. It helps us understand our problems and heal ourselves. WHO is proud to announce the second Health for All Film Festival, to cultivate visual storytelling about public health,” said Dr Tedros
Adhanom Ghebreyesus, WHO Director-General. “We look forward to receiving creative entries inspired by WHO’s mission to promote health, keep the world safe, and serve the vulnerable.” 

The competition categories this year will align with WHO’s global goals for public health.

  • Universal health coverage (UHC): films about mental health, noncommunicable diseases  and other UHC stories linked to communicable diseases not part of emergencies;
  • Health emergencies: films about health emergencies, such as COVID-19, Ebola, as well as health responses in the context of humanitarian crises and in conflict-affected settings;
  • Better health and well-being: films about environmental and social determinants of health, such as nutrition, sanitation, pollution, and/or films about health promotion or health education.

For each of these three grand prix categories, judges will accept short documentaries or fiction films (3 to 8 minutes in length), short videos for social media or animation films (1 to 5 minutes in length).

Three other prizes will be awarded for a student-produced film, a health educational film aimed at youth, and a short video designed exclusively for social media platforms.

Submissions are open from 24 October 2020 to 30 January 2021.

After the close of submissions, critically-acclaimed artists from the film and music industries will review the shortlisted films with WHO experts and recommend winners to WHO’s Director-General, who will make the final decision. The jury composition
will be announced in by January 2021.

For further information, visit https://www.who.int/film-festival

Contact Gilles Reboux, Film Festival Lead: rebouxg@who.int

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The new version of the World Health Organization (WHO) 2020 Global TB Report app is now available for your smartphone and tablet. The game-changing app brings to the users’ fingertips the latest TB statistics and trends, country and region comparisons and quick search for indicators.

The app is now updated with latest data from the WHO 2020 Global Tuberculosis Report.

In addition to allowing users to explore and interact with data from 215 countries and areas, this update includes new features, such as:

·       the ability to create your own groups of countries for which the app will automatically calculate values for key indicators;

·       an expanded ‘favourites’ functionality where you can make specific countries, regions, personalized groups, as well as profile comparisons easily available;

·       the app is now available in English, French and Russian – switch between languages at any time.

Other languages and more features will be available in future updates of the app.

The app is available for free download on the Google Play and Apple App stores. It works both online and offline.

Copy of TB DATA AT YOUR FINGERTIPS copy

*The data in the app are from WHO’s Global TB Report, which provides a comprehensive and up-to-date assessment of the TB epidemic, and progress in the response at global, regional and country levels. TB remains one of the top 10 causes of death worldwide and is the world’s top infectious killer.Selengkapnya