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This threat assessment addresses the implications of the ongoing Marburg virus disease (MVD) outbreak in Rwanda for the European Union/European Economic Area (EU/EEA).

A new report by the World Health Organization (WHO) finds that vaccines against 24 pathogens could reduce the number of antibiotics needed by 22% or 2.5 billion defined daily doses globally every year, supporting worldwide efforts to address antimicrobial resistance (AMR). While some of these vaccines are already available but underused, others would need to be developed and brought to the market as soon as possible.

AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to antimicrobial medicines, making people sicker and increasing the risk of illness, death and the spread of infections that are difficult to treat. AMR is driven largely by the misuse and overuse of antimicrobials, yet, at the same time, many people around the world do not have access to essential antimicrobials. Each year, nearly 5 million deaths are associated with AMR globally.

Vaccines are an essential part of the response to reduce AMR as they prevent infections, reduce the use and overuse of antimicrobials, and slow the emergence and spread of drug-resistant pathogens.

The new report expands on a WHO study published in BMJ Global Health last year. It estimates that vaccines already in use against pneumococcus pneumonia, Haemophilus influenzae type B (Hib, a bacteria causing pneumonia and meningitis) and typhoid could avert up to 106 000 of the deaths associated with AMR each year. An additional 543 000 deaths associated with AMR could be averted annually when new vaccines for tuberculosis (TB) and Klebsiella pneumoniae, are developed and rolled out globally. While new TB vaccines are in clinical trials, one against Klebsiella pneumoniae is in early stage of development.

“Addressing antimicrobial resistance starts with preventing infections, and vaccines are among the most powerful tools for doing that,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Prevention is better than cure, and increasing access to existing vaccines and developing new ones for critical diseases, like tuberculosis, is critical to saving lives and turning the tide on AMR.” 

Vaccines are key to preventing infection

Vaccinated people have fewer infections and are protected against potential complications from secondary infections that may need antimicrobial medicines or require admission to hospital. The report analyzed the impact of already licensed vaccines as well as vaccines in various stages of development.

Every year, vaccines against:

• Streptococcus pneumoniae could save 33 million antibiotic doses, if the Immunization Agenda 2030 target of 90% of the world’s children were vaccinated, as well as older adults;
• Typhoid could save 45 million antibiotic doses, if their introduction was accelerated in high-burden countries;
• Malaria caused by Plasmodium falciparum could save up to 25 million antibiotic doses, which are often misused to try to treat malaria;
• TB could have the highest impact once they are developed, saving between 1.2 to 1.9 billion antibiotic doses – a significant portion of the 11.3 billion doses used annually against the diseases covered in this report.

Vaccines could significantly reduce the substantial economic costs of AMR

Globally, the hospital costs of treating resistant pathogens evaluated in the report are estimated at US$ 730 billion each year. If vaccines could be rolled out against all the evaluated pathogens, they could save a third of the hospital costs associated with AMR.

A comprehensive, people-centred approach applied across health systems is needed to prevent, diagnose and treat infections. This approach recognizes vaccination as core to preventing AMR and especially impactful when combined with other interventions.

At the 79th United Nations General Assembly High-Level Meeting on AMR on 26 September, world leaders approved a political declaration committing to a clear set of targets and actions, including reducing the estimated 4.95 million human deaths associated with bacterial AMR annually by 10% by 2030. The declaration emphasizes key aspects, including the importance of access to vaccines, medicines, treatments and diagnostics, while calling for incentives and financing mechanisms to drive multisectoral health research, innovation and development in addressing AMR.

Notes to editors:

The report, “Estimating the impact of vaccines in reducing antimicrobial resistance and antibiotic use,” evaluates the role of vaccines in reducing AMR and provides key stakeholders with recommendations for enhancing the impact of vaccines on AMR. It evaluates 44 vaccines targeting 24 pathogens: 19 bacteria, four viruses and one parasite. Infections can result in multiple syndromes and vary across age groups; thus, in several cases more than one vaccine for a pathogen was evaluated for its impact on AMR.

The pathogens include: Acinetobacter baumannii, Campylobacter jejuni, Clostridioides difficile, Enterococcus faecium, Enterotoxigenic Escherichia coli (ETEC), Extraintestinal Pathogenic Escherichia coli (ExPEC), Group A Streptococcus (GAS), Haemophilus influenzae type B (Hib), Helicobacter pylori, Klebsiella pneumoniae, Mycobacterium tuberculosis, Neisseria gonorrhoeae, Nontyphoidal Salmonella, Pseudomonas aeruginosa, Salmonella Paratyphi A, Salmonella typhi, Shigella, Staphylococcus aureus, Streptococcus pneumoniae, Plasmodium falciparum (malaria), influenza, norovirus, rotavirus, respiratory syncytial virus (RSV).

A defined daily dose is the assumed average maintenance dose per day for an antibiotic used for its main indication in adults.

 

The World Health Organization (WHO) and the Kingdom of the Netherlands have renewed their strategic partnership in addressing the growing impacts of climate change on global health.

The Netherlands is providing a new allocation of €500 000 for 2024 to WHO, reinforcing its commitment to climate resilience and sustainable healthcare systems worldwide. This allocation supports WHO’s ongoing efforts to strengthen the Alliance for Transformative Action on Climate and Health Secretariat and advance climate change and health programmes globally.

This contribution builds on the partnership established in 2023 between the Netherlands and WHO to collaborate on climate change and health. Together, they have supported African, Asian and Eastern Mediterranean countries in advancing the implementation of integrated climate and health surveillance and early warning systems, enhancing capacity to deliver on COP26 health commitments, helping harmonize early warning systems for health-related climate risks, and empowering countries to advance climate-resilient health system readiness.

This partnership along with the support from other organizations is pivotal in assisting Member States in developing climate-resilient and low-carbon health systems. Engaging with relevant partners, including civil society, Multilateral Development Banks, UN Agencies, and health professionals in concerted action on climate change and health, is also a core activity.

The Netherlands has been at the forefront of advocating climate action in health, aligned with the Dutch Global Health Strategy 2023-2030 which emphasizes the intersection of climate change and health. In addition, the Netherlands, together with Peru, led the adoption in 2024 of the World Health Assembly 77 Resolution on Climate Change and Health at the to renew the current one from 2008. Recognizing the increasing urgency and the need for accelerated efforts, the resolution calls for a WHO global action plan, increased national efforts and mainstreaming of climate change and health in WHO’s new Fourteenth General Programme of Work.

The partnership’s renewal brings the total support from the Netherlands to WHO activities on climate change and health to over €1.1 Million since 2023 and comes at a crucial time as countries face increasing health challenges from climate change and as the global health community gears up for discussions on climate change and health at COP29 in Azerbaijan in 2024. Climate change will continue to be a key priority area in the new GPW, and where WHO’s work in collaboration with Member States and partners will result in 7.5 million lives saved in the next four years, as estimated in WHO’s latest Investment case.

The Netherlands and WHO will continue to leverage their partnership to ensure that health remains central to climate negotiations and actions. A focus on building resilience in vulnerable regions and empowering countries to implement sustainable, low-carbon healthcare solutions remains central.

WHO-trained Rapid Responders evaluating flash flood aftermath in Mai Mahiu region in Kenya 29 April. From March to May 2024, the country experienced exceptionally heavy rains, leading to widespread devastation, including fatalities, disease outbreaks, and severe infrastructure damage. Photo: WHO/Genna Print

Every month ECDC provides detailed epidemiological overview of the worldwide transmission of chikungunya in its weekly threat report (Communicable Diseases Threat Report).

Every month ECDC provides detailed epidemiological overview of the worldwide transmission of dengue in its weekly threat report (Communicable Diseases Threat Report).

The Heads of the International Monetary Fund (IMF), the World Bank Group (WBG), and the World Health Organization (WHO) have agreed on broad principles for cooperation on pandemic preparedness. This cooperation will allow a scaling up of support to countries to prevent, detect and respond to public health threats through the IMF’s Resilience and Sustainability Trust (RST), the WBG’s financial and technical support, and WHO’s technical expertise and in-country capabilities. The RST allows eligible member countries to access long-term financing at low interest rates to help implement reforms that address structural challenges to the stability of the economy, such as those posed by pandemics, and to enhance countries’ health systems resilience.

Operating within their respective mandates and policies, the IMF, the WBG, and WHO will leverage their expertise to enhance pandemic preparedness in their member countries, building on the synergies and complementarity of each institution’s in-country analysis and operations. This collaboration will strengthen the design and articulation of effective policy, institutional and public financial management reforms supported by the IMF’s Resilience and Sustainability Facility (RSF), the policy reforms and investments supported by the WBG, and the technical and operational support provided by WHO. In strengthening the pandemic preparedness framework, member countries will also work to improve the resilience of their health systems and their ability to respond better to all health emergencies.

Under the Broad Principles of Coordination:

• WHO and the WBG will continue to take the lead on health-related development policies and, with other multilateral development banks and The Pandemic Fund, on specific project investments for pandemic preparedness. RST financing will not be earmarked for specific projects.
• Pandemic preparedness policy reform measures supported by RSF arrangements will be informed by existing data, analytics and operational engagement of WHO, the WBG, and country authorities.
• Pandemic preparedness reforms will build on each institution’s area of expertise. RSF programs will focus on macro-critical policy reforms within the IMF’s expertise and complement the work carried out by the WBG and WHO to maximize both the financial resources and technical expertise available to countries. RSF Reform measures can include policy actions aimed at enhancing the readiness of finance and health systems to respond effectively to future health emergencies.

Thanks to this stepped-up cooperation between the IMF, the WBG, and WHO, the three institutions will better serve countries’ efforts on pandemic preparedness.

Kristalina Georgieva, Managing Director of the IMF, said: “The stepped-up collaboration with the World Bank Group and the World Health Organization will help our institutions complement and leverage each other’s expertise to help our members strengthen pandemic preparedness and enhance resilience of their health systems. The IMF’s Resilience and Sustainability Trust allows eligible member countries to access affordable, long-term financing to address structural challenges that threaten their macroeconomic stability.”

“The COVID-19 pandemic highlighted the need for new sources of financing to bolster health systems to make them more able to prevent and detect epidemics and pandemics, and to respond and withstand them when they strike,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO is proud to be working with the IMF and the World Bank to unlock financing from the Resilience and Sustainability Trust, and support countries to put it to work for a safer world.”

“We must aggressively be planning and preparing for the next global health crisis, so that when the battle comes – and we know it will – we will have the health workforce that can be rapidly deployed in the face of a crisis, laboratories that can quickly ramp up testing, and surge capacity that can be called upon to respond,” said World Bank Group President Ajay Banga. “This deepened collaboration focuses our response on helping countries better prepare and respond to public health threats.”

 

The 2024 Annual Meeting of National ECDC Correspondents in the Western Balkans and Türkiye was held on 2–3 October in a hybrid format at ECDC.

The World Health Organization (WHO) has listed the first mpox in vitro diagnostic (IVD) under its Emergency Use Listing (EUL) procedure, an important step in improving global access to mpox testing. The approval for emergency use of the Alinity m MPXV assay, manufactured by Abbott Molecular Inc., will be pivotal in expanding diagnostic capacity in countries facing mpox outbreaks, where the need for quick and accurate testing has risen sharply. Early diagnosis of mpox enables timely treatment and care, and control of the virus.

Limited testing capacity and delays in confirming mpox cases persist in Africa, contributing to the continued spread of the virus. In 2024, over 30 000 suspected cases have been reported across the region, with the highest numbers in the Democratic Republic of the Congo, Burundi, and Nigeria. In the Democratic Republic of the Congo, only 37% of suspected cases have been tested this year.

The presence of the monkeypox virus is confirmed by nucleic acid amplification testing (NAAT), such as real-time or conventional polymerase chain reaction (PCR), as stated in the WHO Interim Guidance on Diagnostic testing for the monkeypox virus (MPXV). And the recommended specimen type for diagnostic confirmation of monkeypox virus (MPXV) infection in suspected cases is lesion material.

The Alinity m MPXV assay is a real-time PCR test that enables detection of monkeypox virus (clade I/II) DNA from human skin lesion swabs. It is specifically designed for use by trained clinical laboratory personnel who are proficient in PCR techniques and IVD procedures. By detecting DNA from pustular or vesicular rash samples, laboratory and health workers can confirm suspected mpox cases efficiently and effectively.

"This first mpox diagnostic test listed under the Emergency Use Listing procedure represents a significant milestone in expanding testing availability in affected countries,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. “Increasing access to quality-assured medical products is central to our efforts in assisting countries to contain the spread of the virus and protect their people, especially in underserved regions."

The EUL process accelerates the availability of life-saving medical products, such as vaccines, tests and treatments, in the context of a Public Health Emergency of International Concern (PHEIC). On 28 August 2024, WHO called on mpox IVDs manufacturers to submit an expression of interest for EUL, recognizing the urgent need to bolster global testing capacities as the virus continued to spread. The EUL process assesses the quality, safety, and performance of essential health products, such as diagnostic tests, to guide procurement agencies and WHO Member States in making informed decisions for time-limited emergency procurement.

So far, WHO has received three additional submissions for EUL evaluation, and discussions are ongoing with other manufacturers of mpox IVDs to ensure a wider range of quality-assured diagnostic options. This will support countries which have not approved the medical products through their own approval processes to procure the critically needed tests through UN agencies and other procurement partners.

The EUL for Alinity m MPXV assay, allowing for its use, will remain valid as long as the PHEIC, justifying the emergency use of mpox in vitro diagnostics, is in effect.

Information on active EUL applications for mpox IVDs can be found on these WHO webpages.

On 2 October 2024, Germany reported that two travellers returning from Rwanda were isolated in Hamburg due to a history of exposure in a medical facility in Rwanda where Marburg virus disease patients were being treated. ECDC has been in close contact with German public health authorities. Negative test results were reported on 3 October 2024.

The European Centre for Disease Prevention and Control (ECDC) has released a new report addressing the risk factors associated with higher odds of carrying the parasite responsible for Chagas disease, in non-endemic regions such as Europe.

Today, the World Health Organization (WHO) launched the Global Strategic Preparedness, Readiness and Response Plan (SPRP) to tackle dengue and other Aedes-borne arboviruses.

Laura Paris, EPIET fellow at the Health Protection Surveillance Centre in Ireland (C2023), went on a GOARN deployment to support the health response in Gaza in 2024. This is her postcard from the field.

ECDC has released an assessment on tick-borne encephalitis (TBE), focusing on the transmission risks of the TBE virus (TBEV) through substances of human origin (SoHO) such as blood, organs, tissues, and cells.

The World Health Organization (WHO) congratulates Brazil for having eliminated lymphatic filariasis as a public health problem.

“Eliminating a disease is a momentous accomplishment that takes unwavering commitment,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “I congratulate Brazil for its efforts to free its people of the scourge of this painful, disfiguring, disabling and stigmatizing disease. This is another example of the incredible progress we have made against neglected tropical diseases and gives hope to many other nations still fighting against lymphatic filariasis that they too can eliminate this disease.”

Lymphatic filariasis, commonly known as elephantiasis, is a debilitating parasitic disease spread by mosquitoes. For centuries, this disease has afflicted millions worldwide, causing pain, chronic, severe swelling, serious disability, and social stigmatization.

Effective country-level investments

Over the past few decades, Brazil has implemented integrated actions to eliminate lymphatic filariasis, including the development of a national plan to fight this disease in 1997, the mass distribution of antiparasitic drugs, vector control activities, and strong surveillance, particularly in the most affected areas. With these efforts, the country achieved the end of disease transmission in 2017.

The elimination of lymphatic filariasis was also one of the goals of the Brasil Saudável program, a multisectoral initiative aimed at ending socially determined diseases with a whole-of-government approach and civil society participation, including the involvement of affected people in the implementation of disease control efforts. The programme was launched in February 2024 by President Luiz Inácio Lula da Silva in a ceremony with the participation of Dr Tedros Adhanom Ghebreyesus, WHO Director-General and Dr Jarbas Barbosa, Director of the Pan American Health Organization (PAHO) and WHO Regional Director for the Americas. In the post-elimination phase, Brazil, PAHO, and WHO will continue to closely monitor for possible resurgence of infections.

“This milestone is the result of years of dedication, hard work, and collaboration among health workers, researchers, and authorities in Brazil”, said Dr Jarbas Barbosa, PAHO Director and WHO Regional Director for the Americas. “Brazil’s extensive and unified health system, coupled with solid specialized laboratory expertise and robust surveillance were essential to interrupt the chain of transmission, inspiring other countries to advance towards the elimination of lymphatic filariasis and other neglected tropical diseases”.

Global progress

Globally, Brazil joins 19 other countries and territories that have been validated by WHO for having eliminated lymphatic filariasis as a public health problem. These are Malawi and Togo in the African Region; Egypt and Yemen in the Eastern Mediterranean Region; Bangladesh, Maldives, Sri Lanka and Thailand in the South-East Asia Region; and Cambodia, Cook Islands, Kiribati, Lao People’s Democratic Republic, Marshall Islands, Niue, Palau, Tonga, Vanuatu, Viet Nam and Wallis and Futuna in the Western Pacific Region.

In the Americas, three endemic countries (Dominican Republic, Guyana, and Haiti) still require mass drug administration to stop transmission and are working to achieve the elimination target.

In addition to being the 20th country to be validated for elimination of lymphatic filariasis as a public health problem, Brazil has also become the 53rd country to have eliminated at least one neglected tropical disease, globally.

Note to the editor

Lymphatic filariasis, commonly known as elephantiasis, is a neglected tropical disease. Infection occurs when filarial parasites are transmitted to humans through mosquitoes. Infection is usually acquired in childhood and causes hidden damage to the lymphatic system.

The painful and profoundly disfiguring visible manifestations of the disease – lymphoedema, elephantiasis and scrotal swelling – occur later in life and can lead to permanent disability. These patients are not only physically disabled, but suffer mental, social and financial losses contributing to stigma and poverty.

Elimination of lymphatic filariasis is possible by stopping the spread of the infection through preventive chemotherapy. The WHO-recommended preventive chemotherapy strategy for lymphatic filariasis elimination is mass drug administration (MDA). MDA involves administering an annual dose of medicines to the entire at-risk population. The medicines used have a limited effect on adult parasites but effectively reduce the density of microfilariae in the bloodstream and prevent the spread of parasites to mosquitoes.

In 2023, 657 million people in 39 countries and territories were living in areas that require preventive chemotherapy to stop the spread of infection. In the Americas, Costa Rica, Suriname, and Trinidad and Tobago were removed from the WHO list of lymphatic filariasis endemic countries in 2011. The 2021–2030 neglected tropical disease road map targets the prevention, control, elimination and eradication of 20 diseases and disease groups by 2030. Progress against lymphatic filariasis and other neglected tropical diseases alleviates the human and economic burden that they impose on the world’s most disadvantaged communities. 

 

An ECDC team visited Bosnia and Herzegovina from 24 to 26 September 2024 as part of ongoing efforts to support the Western Balkans and Türkiye in strengthening the surveillance of communicable diseases.

Two experts from the Africa Centres for Disease Control and Prevention (Africa CDC) successfully completed an exchange visit to ECDC in Stockholm, Sweden, from 16–27 September 2024.

On 25 and 26 September 2024, the European Centre for Disease Prevention and Control (ECDC) held a two-day workshop at the Carlos III Health Institute in Madrid.

As part of the EU Initiative on Health Security, four representatives from ECDC took part in the recently concluded eighth Eastern Mediterranean Public Health Network (EMPHNET) conference, which focused on public health preparedness and response.

The second meeting of the Cross-agency One Health Task Force was hosted by the European Medicines Agency (EMA) on 10-11 September 2024.

The World Health Organization (WHO) today announced the recommendations for the viral composition of influenza vaccines for the 2025 influenza season in the southern hemisphere. The announcement was made at an information session after a 4-day meeting on the Composition of Influenza Virus Vaccines. The meeting is held twice annually, once for the southern and once for the northern hemisphere.