World Health Organization

World Pharmacopoeias support public health during COVID-19 pandemic

WHO news - Mon, 03/01/2021 - 19:04

Scientists and health professionals worldwide have rarely been under as much pressure as they have been these past few months. This has led to unprecedented collaborative efforts using exceptional means on a global scale, including amongst world pharmacopoeias.

A pharmacopoeia is a legally-binding collection of standards and quality specifications for medical products. The World Health Organization (WHO) organizes official meetings entitled International Meeting of World Pharmacopoeias for participation of all WHO Member States' pharmacopoeias worldwide, be they national, regional or international. During these meetings, the pharmacopoeias share important news and strengthen their co-operation to improve public health outcomes for patients.

The 12th International Meeting of World Pharmacopoeias (IMWP) was hosted by WHO and met virtually from 22-24 February 2021.  Sixty-one participants attended from 18 pharmacopoeias, representing 51 pharmacopoeias and pharmacopoeial authorities globally (out of the 60 listed in the Index of world pharmacopoeias and pharmacopoeial authorities compiled by WHO (Index of World Pharmacopoeias and Pharmacopoeial authorities). These pharmacopoeias work together to support the global public health response to the pandemic, providing support to manufacturers, regulators and stakeholders on medicines, all critical to the COVID-19 response. The availability and use of well-conceived international norms and standards - for performing clinical trials, producing a vaccine, a therapeutic, a medical device or diagnostics test or testing of their quality - are essential to ensure a successful outcome for a patient. 

A major outcome of the collaboration is the global pharmacopoeial alert system initiated by  the Brazilian, British, Chinese, European, Indian, International, Japanese, Mexican, United States and Vietnamese pharmacopoeias and other global pharmacopoeial partners. This has resulted in a dashboard listing of COVID-19 investigated medicines mapped to available monographs published in the various world pharmacopoeias. This listing is now available to allow easy identification of quality control specifications for therapeutics under consideration for COVID-19 treatment.  Link: Health product and policy standard.

In addition, a number of world pharmacopoeias have increased the accessibility of supportive pharmacopoeial texts by making these freely available via their websites (these website addresses are included within the list).

The collaborative efforts of this group of world pharmacopoeias have brought forth the development of a new type of test specification under the umbrella of this IMWP. The pilot (the first specifications of this type) will be the IMWP monographs for Favipiravir. All related information will be made available on the WHO IMWP website. This will be an excellent initiative, making sure that test specifications are available and free of charge for those who need them during an emergency situation, such as the current pandemic. It will allow for quality checks and will be a tool to help prevent substandard and falsified products circulating.   

In conclusion, the IMWP has again proven to be an invaluable forum and platform for world pharmacopoeias in their response to public health needs. 

 

First COVID-19 COVAX vaccine doses administered in Africa

WHO news - Mon, 03/01/2021 - 16:55

  • Today, the governments of Côte d’Ivoire and Ghana began COVID-19 vaccination campaigns aimed at protecting healthcare workers
  • This week’s first vaccinations happen as a further 11 million COVAX doses are expected to be delivered over the next seven days
  • Publication of the allocation of the AstraZeneca/Oxford vaccine to 142 of COVAX’s participating economies, to be delivered between now and the end of May, is anticipated tomorrow

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As the global rollout of COVAX vaccines accelerates, the first COVID-19 vaccination campaigns in Africa using COVAX doses began today in Ghana and Côte d'Ivoire. These campaigns are the among the first to use doses provided by the COVAX Facility’s Gavi COVAX Advanced Market Commitment (AMC). 

The AMC is the COVAX Facility’s mechanism to provide donor-funded vaccines to lower-income countries.

The campaigns in Ghana and Côte d’Ivoire follow deliveries to both countries last week with Ghana taking delivery of 600,000 doses on February 24 and Côte d’Ivoire 504,000 doses two days later. Both countries received the AstraZeneca/Oxford vaccine licensed and manufactured by the Serum Institute of India (SII). The vaccine, branded COVISHIELD, was granted Emergency Use Listing (EUL) by the World Health Organization on 15 February.

H.E. Nana Akufo-Addo, President of the Republic of Ghana said: "COVID-19 has changed the world. It has cost lives, battered health systems, and damaged livelihoods. But, through these challenges, we have seen the best of humanity exemplified through strong multilateral cooperation. Ghana welcomes the arrival of the first doses of COVID-19 vaccines through the COVAX AMC as a pathway to ending the acute phase of the pandemic. To maximise the public health benefit of the vaccine, the first doses will be prioritized for health and essential workers, and other at-risk groups. This important milestone will allow Ghana to get back to business, and build back our economy even stronger than before." 

The deliveries mark the start of what will be the largest, most rapid and complex global rollout of vaccines in history. In total, COVAX aims to deliver at least 2 billion doses of COVID-19 vaccines by the end of 2021, including at least 1.3 billion to the 92 economies eligible for support through the COVAX AMC.

Confirmation of first-round allocations, covering the majority of the COVAX Facility participants, will be published 2 March 2021. COVAX doses to date have been delivered by SII to India, Ghana, Cote d’Ivoire, while Pfizer-BioNTech has delivered doses to the Republic of Korea. More deliveries by these two manufacturers are planned in the coming days, with 11 million doses in total planned to be delivered over the next seven days. In addition, AstraZeneca is set to commence shipments this week.

COVAX, the overarching effort to accelerate development and access to COVID vaccines, is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance and the World Health Organization (WHO) working in partnership with UNICEF as well as the World Bank, manufacturers and civil society organizations, and others.

"This is a day many of us have been dreaming of and working for more than 12 months," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "It's gratifying to see the fruit of that labour. But success is still to come. This is only the beginning of what COVAX was set up to achieve. We have a lot left to do to realize our vision to start vaccination in all countries within the first 100 days of the year. There are just 40 days left."

“As vaccination begins in Côte D’Ivoire, less than a year after COVID-19 was characterized as a global pandemic, I am filled with confidence, and I am sure that through COVAX and international solidarity we will be able to reach the most at-risk everywhere. Global equitable access to life-saving vaccines is the surest way to save lives and rebuild economies. I would like to thank all donors and also the leadership of the G7 group of nations. Nowadays vaccine policy is the best economic policy,” said José Manuel Barroso, Chair of Gavi, the Vaccine Alliance.  

“The last year has been a dark one for families all over the world, but the rapid development of COVID-19 vaccines provided a hopeful light at the end of the tunnel. Today, the COVAX Facility begins to make good on its promise to make sure that light shines for all,” said Henrietta Fore, UNICEF Executive Director. “This unprecedented global effort has rallied the international community behind identifying acceptable vaccines, raising funds to procure them, and laying the groundwork for the world’s largest immunization campaign in history. Now, these vaccines are quickly reaching people in low and middle-income countries, many of which would have been left behind without the Facility’s work. This proves what we can accomplish when we all – the private sector, UN and development agencies, governments, donors, and other partners – work as one.”

“This is a historic day in the global fight against COVID-19. Today’s vaccinations in Cote d’Ivoire and Ghana are among the first to be delivered through COVAX, which will protect many hundreds of millions of those most at risk from COVID-19, wherever they are in the world.” said Dr Richard Hatchett, CEO of CEPI. “In the coming days and weeks, COVAX will begin to redress the global imbalance in vaccine deployment, but there is still much to do. The spread of new COVID-19 variants means global access to vaccines is more important than ever before, and the global community must remain firmly focused on this goal if we are to bring the pandemic to an end.”

The start of Africa’s biggest immunization drive in history through the COVAX Facility marks a step forward in the continent’s fight against COVID-19. It is a welcome shift towards bringing African countries off the sidelines and back into the vaccination race, correcting the glaring inequity which has been an unfortunate hallmark of the global vaccine rollout to date. For months WHO teams in the region and partners have been supporting countries to plan and prepare for the complex challenges of such a massive vaccination campaign. We now look forward to seeing these plans put into action with an effective and efficient vaccine rollout,” Dr Matshidiso Moeti, WHO Regional Director for Africa.

“The first COVAX vaccine deliveries in West and Central Africa were a huge first step towards equity and a demonstration of global solidarity,” said UNICEF Regional Director for West and Central Africa Marie-Pierre Poirier. “A few days after the vaccine doses landed, we are already celebrating the first COVID-19 vaccination campaigns, starting today in Ghana and Cote d’Ivoire, aimed at protecting the most vulnerable. We are proud that countries in West and Central Africa were ready from the get-go. UNICEF is active on the ground, together with WHO and other partners, to support the roll-out of the vaccination campaigns until everyone is safe.“

 

Quotes from partners and donors

President Ursula von der Leyen, European Commission said:  “To overcome coronavirus, vaccines must reach all corners of the planet, as soon as possible. I am delighted that we now have tangible results on the ground. I want to pay tribute to the tireless efforts of our partners, Gavi, CEPI, WHO and UNICEF. Team Europe is a proud supporter of COVAX and will continue to stand by the people of Africa."

Karina Gould, Minister of International Development, Government of Canada and Gavi COVAX AMC co-chair said: “Today is yet again proof of what can be achieved through international collaboration. We have reached another milestone in the global vaccination effort, with the first COVAX vaccines being administered in Cote d’Ivoire. Canada is committed to helping everyone, everywhere recover from the pandemic, and also, to strengthening health systems.”

Norwegian Minister of International Development and co-chair of ACT-A facilitation council Dag-Inge Ulstein said: “The progress on vaccines is impressive and, as a major funder to the ACT Accelerator, we believe in the need for the multilateral approach which is clearly working. As co-chair of the ACT Accelerator Facilitation Council, we urgently need to see the same traction in tests, treatments and health systems. Funding is needed to support this now; we have a small window of opportunity with the evolving context of the pandemic -new variants, limited vaccine supply, and underinvestment in global solutions means we cannot be complacent.”

HE Minister of Health in Saudi Arabia, Dr Tawfig AlRabiah said: “Saudi Arabia’s contribution to this historic moment reaffirms our commitment to the principles of ACT-A; equitable access to various pandemic tools, leaving no one behind.”

Adar Poonawalla, CEO, Serum Institute of India (SII) said: "We are delighted to play a part in vaccinating the world through COVAX. We will continue to work towards providing equitable access to vaccines."

Sai D. Prasad, President, Developing Countries Vaccine Manufacturer’s Network (DCVMN) said: “Developing Countries Vaccine Manufacturer’s Network has strongly stood with all stakeholders during this unprecedented time of COVID-19 pandemic and has strived hard to develop, manufacture and roll out COVID-19 vaccines in a record time span of 10-12 months as a part of global collaboration and solidarity. We stand together shoulder to shoulder in this endeavour.”

Thomas Cueni, Director General, International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) said: “Since the beginning of this pandemic, vaccine makers have spared no efforts to speed up development, production, registration, and equitable access to of high-quality vaccines. Pharmaceutical manufacturers are committed founding partners of ACT-Accelerator and COVAX, and we are excited that for the first time in the history of pandemics vaccines are rolled out in a coordinated manner quickly around the world. Another momentous effort, is the scaling up of the vaccine manufacturing from zero to millions in a matter of months. As producing vaccines is a complex process, so with such a scale up, there are inevitably going to be challenges ahead; we will continue working collaboratively to find solutions and join hands in making history.”

 

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Notes to Editors

List of donor pledges to the Gavi COVAX AMC is available here. 

About COVAX  

COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance Gavi) and the World Health Organization (WHO) – working in partnership with developed and developing country vaccine manufacturers, UNICEF, the World Bank, and others. It is the only global initiative that is working with governments and manufacturers to ensure COVID-19 vaccines are available worldwide to both higher-income and lower-income countries.  

CEPI is focused on the COVAX vaccine research and development portfolio: investing in R&D across a variety of promising candidates, with the goal to support development of three safe and effective vaccines which can be made available to countries participating in the COVAX Facility. As part of this work, CEPI has secured first right of refusal to potentially over one billion doses for the COVAX Facility to a number of candidates, and made strategic investments in vaccine manufacturing, which includes reserving capacity to manufacture doses of COVAX vaccines at a network of facilities, and securing glass vials to hold 2 billion doses of vaccine. CEPI is also investing in the ‘next generation’ of vaccine candidates, which will give the world additional options to control COVID-19 in the future.   

Gavi is focused on procurement and delivery for COVAX: coordinating the design, implementation and administration of the COVAX Facility and the Gavi COVAX AMC and working with its Alliance partners UNICEF and WHO, along with governments, on country readiness and delivery. The COVAX Facility is the global pooled procurement mechanism for COVID-19 vaccines through which COVAX will ensure fair and equitable access to vaccines for all 190 participating economies, using an allocation framework formulated by WHO. The COVAX Facility will do this by pooling buying power from participating economies and providing volume guarantees across a range of promising vaccine candidates. The Gavi COVAX AMC is the financing mechanism that will support the participation of 92 low- and middle-income countries in the Facility, enabling access to donor-funded doses of safe and effective vaccines. Gavi is fundraising for the COVAX AMC, and funding UNICEF procurement of vaccines as well as partners’ and governments work on readiness and delivery, including support cold chain equipment, technical assistance, syringes, vehicles, and other aspects of the vastly complex logistical operation for delivery. UNICEF and the Pan-American Health Organisation (PAHO) will be acting as procurement coordinators for the COVAX Facility, helping deliver vaccines to COVAX AMC participants and others. 

WHO has multiple roles within COVAX: It provides normative guidance on vaccine policy, regulation, safety, R&D, allocation, and country readiness and delivery. Its Strategic Advisory Group of Experts (SAGE) on Immunization develops evidence-based immunization policy recommendations. Its Emergency Use Listing (EUL) / prequalification programmes ensure harmonized review and authorization across member states. It provides global coordination and member state support on vaccine safety monitoring. It developed the target product profiles for COVID-19 vaccines and provides R&D technical coordination. WHO leads, together with UNICEF, the Country Readiness and Delivery workstream, which provides support to countries as they prepare to receive and administer vaccines. Along with Gavi and numerous other partners working at the global, regional, and country-level, the CRD workstream provides tools, guidance, monitoring, and on the ground technical assistance for the planning and roll-out of the vaccines. Along with COVAX partners, WHO has developed a no-fault compensation scheme as part of the time-limited indemnification and liability commitments. 

UNICEF is leveraging its experience as the largest single vaccine buyer in the world and working with manufacturers and partners on the procurement of COVID-19 vaccine doses, as well as freight, logistics and storage. UNICEF already procures more than 2 billion doses of vaccines annually for routine immunization and outbreak response on behalf of nearly 100 countries. In collaboration with the PAHO Revolving Fund, UNICEF is leading efforts to procure and supply doses of COVID-19 vaccines for COVAX. In addition, UNICEF, Gavi and WHO are working with governments around the clock to ensure that countries are ready to receive the vaccines, with appropriate cold chain equipment in place and health workers trained to dispense them. UNICEF is also playing a lead role in efforts to foster trust in vaccines, delivering vaccine confidence communications and tracking and addressing misinformation around the world. 

About CEPI 

CEPI is an innovative partnership between public, private, philanthropic, and civil organisations, launched at Davos in 2017, to develop vaccines to stop future epidemics. CEPI has moved with great urgency and in coordination with WHO in response to the emergence of COVID-19. CEPI has initiated ten partnerships to develop vaccines against the novel coronavirus. The programmes are leveraging rapid response platforms already supported by CEPI as well as new partnerships.  

Before the emergence of COVID-19, CEPI’s priority diseases included Ebola virus, Lassa virus, Middle East Respiratory Syndrome coronavirus, Nipah virus, Rift Valley Fever and Chikungunya virus. CEPI also invested in platform technologies that can be used for rapid vaccine and immunoprophylactic development against unknown pathogens (Disease X). 

About Gavi 

Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate half the world’s children against some of the world’s deadliest diseases. Since its inception in 2000, Gavi has helped to immunise a whole generation – over 822 million children – and prevented more than 14 million deaths, helping to halve child mortality in 73 developing countries. Gavi also plays a key role in improving global health security by supporting health systems as well as funding global stockpiles for Ebola, cholera, meningitis and yellow fever vaccines. After two decades of progress, Gavi is now focused on protecting the next generation and reaching the unvaccinated children still being left behind, employing innovative finance and the latest technology – from drones to biometrics – to save millions more lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency. Learn more at www.gavi.org and connect with us on Facebook and Twitter
 
The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. View the full list of donor governments and other leading organizations that fund Gavi’s work here

About WHO 

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our 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 TwitterFacebookInstagramLinkedInTikTokPinterestSnapchatYouTube 

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 . Find out more about UNICEF’s work on the COVID-19 vaccines here, or about UNICEF’s work on immunization here.  

Follow UNICEF on Twitter and Facebook.  

About the ACT-Accelerator 

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

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

The ACT-Accelerator has four areas of work: diagnostics, therapeutics, vaccines and the health system connector. Cross-cutting all of these is the workstream on Access & Allocation. 

 

Human infection with avian influenza A (H5N8) – the Russian Federation

Disease outbreak news - Fri, 02/26/2021 - 02:00
On 18 February 2021, the National IHR Focal Point for the Russian Federation notified WHO of detection of avian influenza A(H5N8) in seven human clinical specimens. These are the first reported detection of avian influenza A(H5N8) in humans. Positive clinical specimens were collected from poultry farm workers who participated in a response operation to contain an avian influenza A(H5N8) outbreak detected in a poultry farm in Astrakhan Oblast in the Russian Federation. The laboratory confirmation of the seven specimens were performed by the State Research Centre for Virology and Biotechnology VECTOR (WHO H5 Reference Laboratory). The age of seven positive cases ranged between 29 to 60 years and five were female.

Between 3 and 11 December, a total of 101 000 of 900 000 egg laying hens on the farm died. This high mortality rate prompted an investigation. Samples were collected from these birds and an initial detection of avian influenza A(H5N8) was performed by the Russian regional veterinary laboratory. On 11 December, the outbreak was confirmed by the World Organisation for Animal Health (OIE) Reference laboratory, and the Federal Centre for Animal Health (FGBI-ARRIAH), in Vladimir, the Russian Federation. Outbreak containment operations started immediately and continued for several days due to the large size of the poultry farm.

WHO: 1 in 4 people projected to have hearing problems by 2050

WHO news - Thu, 02/25/2021 - 20:17

Nearly 2.5 billion people worldwide ─ or 1 in 4 people ─ will be living with some degree of hearing loss by 2050, warns the World Health Organization’s (WHO) first World Report on Hearing, released today. At least 700 million of these people will require access to ear and hearing care and other rehabilitation services unless action is taken.

"Our ability to hear is precious. Untreated hearing loss can have a devastating impact on people’s ability to communicate, to study and to earn a living. It can also impact on people’s mental health and their ability to sustain relationships," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new report outlines the scale of the problem, but also offers solutions in the form of evidence-based interventions that we encourage all countries to integrate into their health systems as part of their journey towards universal health coverage.”

The report, launched ahead of World Hearing Day on 3 March, underlines the need to rapidly step up efforts to prevent and address hearing loss by investing and expanding access to ear and hearing care services. Investment in ear and hearing care has been shown to be cost-effective: WHO calculates that governments can expect a return of nearly US$ 16 for every US$ 1 invested.

Main findings of the report

Lack of accurate information and stigmatizing attitudes to ear diseases and hearing loss often limit people from accessing care for these conditions. Even among health-care providers, there’s often a shortage of knowledge about prevention, early identification and management of hearing loss and ear diseases, hampering their ability to provide the care required.

In most countries, ear and hearing care is still not integrated into national health systems and accessing care services is challenging for those with ear diseases and hearing loss. Moreover, access to ear and hearing care is poorly measured and documented, and relevant indicators are lacking in the health information system.

But the most glaring gap in health system capacity is in human resources. Among low-income countries, about 78% have fewer than one ear, nose and throat (ENT) specialist per million population; 93% have fewer than one audiologist per million; only 17% have one or more speech therapist per million; and 50% have one or more teacher for the deaf per million. This gap can be closed through integration of ear and hearing care into primary health care through strategies such as task sharing and training, outlined in the report.

Even in countries with relatively high proportions of ear and hearing care professionals, there is unequal distribution of specialists. This not only poses challenges for people in need of care, but also places unreasonable demands on the cadres providing these services.

Main causes of hearing loss

In children, almost 60% of hearing loss can be prevented through measures such as immunization for prevention of rubella and meningitis, improved maternal and neonatal care, and screening for, and early management of, otitis media - inflammatory diseases of the middle ear. In adults, noise control, safe listening and surveillance of ototoxic medicines together with good ear hygiene can help maintain good hearing and reduce the potential for hearing loss.

Identification is the first step in addressing hearing loss and related ear diseases. Clinical screening at strategic points in life ensure that any loss of hearing and ear diseases can be identified as early as possible.

Recent technological advances, including accurate and easy-to-use tools, can identify ear disease and hearing loss at any age, in clinical or community settings, and with limited training and resources. Screening can even take place in challenging situations such as those encountered during the COVID-19 pandemic and those living in underserved and remote areas of the world.

Access to timely and appropriate care

Once diagnosed, early intervention is key. Medical and surgical treatment can cure most ear diseases, potentially reversing the associated hearing loss. However, where hearing loss is irreversible, rehabilitation can ensure that those affected avoid the adverse consequences of hearing loss. A range of effective options are available.

Hearing technology, such as hearing aids and cochlear implants, when accompanied by appropriate support services and rehabilitative therapy are effective and cost-effective and can benefit children and adults alike.

The report notes that the use of sign language and other means of sensory substitution such as speech reading are important options for many deaf people; hearing assistive technology and services such as captioning and sign language interpretation can further improve access to communication and education for those with hearing loss.

 “To ensure that the benefit of these technological advances and solutions is equitably accessible to all, countries must adopt an integrated people-centered approach,” said Dr Bente Mikkelsen, Director of the WHO Department of Noncommunicable Diseases. “Integrating ear and hearing care interventions within national health plans and delivering these through strengthened health systems, as part of universal health coverage, is essential to meet the needs of those at risk of or living with hearing loss.”

 

Note to Editors

 

WHO and ITU launch new guide on introduction of dementia risk reduction and carer support programmes using mobile technology

WHO news - Thu, 02/25/2021 - 16:17
WHO’s new mDementia handbook[SF1] [BAR2] , launched today, will help countries to introduce and scale up dementia mHealth programmes (delivered through mobile devices, such as phones and tablets). The handbook and accompanying mHealth programme content includes a module on reducing the risk of dementia and another on support for carers of people with dementia. The handbook was developed by the WHO Mental Health and Substance Use Department and Be He@lthy Be Mobile (BHBM), a joint initiative between the World Health Organization and the International Telecommunications Union.

COVID-19 oxygen emergency impacting more than half a million people in low- and middle-income countries every day, as demand surges

WHO news - Thu, 02/25/2021 - 13:57
  • More than half a million COVID-19 patients in LMICs estimated to need oxygen treatment every day.
  • New assessments show US$90 million immediate funding required to meet urgent need in up to 20 low- and middle-income countries (LMICs). Unitaid and Wellcome will make an immediate contribution of up to US$20 million in total for the emergency response.
  • COVID-19 Oxygen Emergency Taskforce brings together key organisations working on oxygen access under ACT-Accelerator Therapeutics pillar, as COVID-19 surges and preventable deaths occur
  • Taskforce partners will work together to measure oxygen demand, work with financing partners, and secure oxygen supplies and technical support for worst-affected countries

Since the start of the pandemic, affordable and sustainable access to oxygen has been a growing challenge in low- and middle-income countries. 

COVID-19 has put huge pressure on health systems, with hospitals in many LMICs running out of oxygen, resulting in preventable deaths and families of hospitalised patients paying a premium for scarce oxygen supplies.

Oxygen is an essential medicine, and despite being vital for the effective treatment of hospitalised COVID-19 patients, access in LMICs is limited due to cost, infrastructure and logistical barriers. Health facilities often cannot access the oxygen they require, resulting in the unnecessary loss of lives.

Recognising the central importance of sustainable oxygen supply – alongside therapeutic products such as dexamethasone – for the treatment of COVID-19, the Access to COVID Tools Accelerator Therapeutics pillar (co-led by Unitaid and Wellcome), is taking a new role to coordinate and advocate for increased supply of oxygen, and, in partnership with a WHO-led consortium[1], is today announcing the launch of a COVID-19 Oxygen Emergency Taskforce.

It is estimated that more than half a million people in LMICs currently need 1.1 million cylinders of oxygen per day[2], with 25 countries currently reporting surges in demand, the majority in Africa. This supply was constrained prior to COVID-19 and has been exacerbated by the pandemic.

Dr Philippe Duneton, Executive Director of Unitaid, said: “This is a global emergency that needs a truly global response, both from international organisations and donors. Many of the countries seeing this demand struggled before the pandemic to meet their daily oxygen needs. Now it’s more vital than ever that we come together to build on the work that has already been done, with a firm commitment to helping the worst-affected countries as quickly as possible.”

The taskforce has determined an immediate funding need of US$90 million to address key challenges in oxygen access and delivery in up to 20 countries, including Malawi, Nigeria and Afghanistan. This first set of countries has been identified based on assessments coordinated by WHO’s Health Emergencies Programme, in order to match in-country need with potential financing, such as through the World Bank[3] and the Global Fund. Unitaid and Wellcome will make an immediate contribution of up to US$20 million in total for the emergency response. The urgent, short-term requirements of additional countries will be measured and costed in the coming weeks, with the overall funding need over the next 12 months estimated by ACT-A to be US$1.6 billion - a figure that will be regularly reviewed by the taskforce.

Dr Mike Ryan, Executive Director of the WHO Health Emergencies Programme, said: “Oxygen is life-saving and it is imperative to move faster to scale-up holistically with patient-centred, end-to-end solutions that improve clinical outcomes. WHO has been working through the Biomedical Consortium to bring the technical, clinical and procurement partners together with about US$80 million of biomedical equipment procured for low and middle-income countries. The Oxygen Taskforce will help drive oxygen scale-up through further innovation, financing and capacitation.”

Paul Schreier, Chief Operating Officer at Wellcome, said: “We have made critical advances in providing lifesaving clinical care and treatments to COVID-19 patients over the last year. The impact of the combination of oxygen and dexamethasone to treat severely ill patients has, in particular, been incredible. But global access to advances remains unequal. We need to urgently increase access to medical oxygen to ensure patients are benefiting regardless of where they live and ability to pay. International solidarity is the quickest - and only - way out of this pandemic. It is a public health, scientific, economic and moral imperative that all tools are made available globally.”

The taskforce brings together key organisations[4] that have been working to improve access to oxygen since the start of the pandemic including Unitaid, Wellcome, WHO, Unicef, the Global Fund, World Bank, the Clinton Health Access Initiative (CHAI), PATH, the Every Breath Counts coalition and Save the Children. Building on these efforts, partners will focus on four key objectives as a part of an emergency response plan: measuring acute and longer-term oxygen needs in LMICs; connecting countries to financing partners for their assessed oxygen requirements; and supporting the procurement and supply of oxygen, along with related products and services. Other areas in the scope of the taskforce include addressing the need for innovative market-shaping interventions, as well as reinforcing advocacy efforts to highlight the importance of oxygen access in the COVID-19 response. 

Henrietta Fore, Executive Director of UNICEF, said: “Oxygen is a simple medical intervention that remains in short supply for far too many around the world. The COVID-19 pandemic has taken this acute shortage and made it a full-blown emergency. But addressing the oxygen gap will not only help with COVID-19 treatment in countries that are losing far too many saveable lives. It will also help to improve health systems and health outcomes beyond COVID-19 in the long term, including for the many newborns and children who require oxygen to survive.”

 

Editor’s notes and background

Even before COVID-19, pneumonia was the world’s biggest infectious killer of adults and children, claiming the lives of 2.5 million people in 2019. The pandemic has exacerbated this problem, particularly in ‘double-burden’ countries which are contending with high levels of pneumonia and COVID-19. As well as meeting the immediate needs of the pandemic, the taskforce would look to leverage gains in this area to help with long-term pneumonia control.

About Unitaid

Unitaid is a global health agency engaged in finding innovative solutions to prevent, diagnose and treat diseases more quickly, cheaply and effectively, in low- and middle-income countries. Its work includes funding initiatives to address major diseases such as HIV/AIDS, malaria and tuberculosis, as well as HIV co-infections and co-morbidities such as cervical cancer and hepatitis C, and cross-cutting areas, such as fever management. Unitaid is now applying its expertise to address challenges in advancing new therapies and diagnostics for the COVID-19 pandemic, serving as a key member of the Access to COVID Tools Accelerator. Unitaid is hosted by the World Health Organization.

About Wellcome 

Wellcome supports science to solve the urgent health challenges facing everyone. We support discovery research into life, health and wellbeing, and we’re taking on three worldwide health challenges: mental health, global heating and infectious diseases. 

About WHO 

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our 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.

About the ACT-Accelerator

The Access to COVID-19 Tools (ACT) Accelerator, is a new global collaboration to accelerate the development, production and equitable access to COVID-19 tests, treatments, and vaccines. It was set up in response to a call from G20 leaders in March 2020 and launched by WHO, the European Commission, France and the Bill & Melinda Gates Foundation in April 2020. The ACT-Accelerator but works to speed up collaborative efforts among existing organizations to end the pandemic. It draws on the experience of leading global health organizations which are tackling the world’s toughest health challenges, and who, by working together, can unlock new and more ambitious results against COVID-19. Its members share a commitment to ensure all people have access to all the tools needed to defeat COVID-19 and to work with unprecedented levels of partnership to achieve it. The ACT-Accelerator has four areas of work: diagnostics, therapeutics, vaccines and the health system connector.


[1] As part of the UN COVID-19 Supply Chain System, a technical biomedical procurement consortium was set up under the coordination of WHO, including ALIMA, BMGF, IMC, MSF, UNDP, UNHCR, Unicef, UNOPS, USAID and WFP. Approximately US$150m of oxygen related biomedical products and consumables have been delivered to 149 countries over the last year.

[2]  https://www.path.org/programs/market-dynamics/covid-19-oxygen-needs-tracker/

[3] Governments can apply for financing through the World Bank’s COVID-19 emergency health response

[4] Partners joining the taskforce include Unitaid, Wellcome, WHO (and the broader biomedical consortium WHO coordinates), Unicef, The Global Fund, the World Bank, UNOPS, Save the Children, Every Breath Counts (coalition), CHAI and PATH.

 

El Salvador certified as malaria-free by WHO

WHO news - Thu, 02/25/2021 - 13:46

El Salvador is first Central American country to achieve this status, third in all of the Americas in recent years

El Salvador today became the first country in Central America to be awarded a certification of malaria elimination by the World Health Organization (WHO). The certification follows more than 50 years of commitment by the Salvadoran government and people to ending the disease in a country with dense population and geography hospitable to malaria.

“Malaria has afflicted humankind for millennia, but countries like El Salvador are living proof and inspiration for all countries that we can dare to dream of a malaria-free future,” said Dr.Tedros Adhanom Ghebreyesus, WHO Director-General.

Certification of malaria elimination is granted by WHO when a country has proven, beyond reasonable doubt, that the chain of indigenous transmission has been interrupted nationwide for at least the previous three consecutive years.

With the exception of one outbreak in 1996, El Salvador steadily reduced its malaria burden over the last three decades. Between 1990 and 2010, the number of malaria cases declined from more than 9000 to 26. The country has reported zero indigenous cases of the disease since 2017.

“For decades, El Salvador has worked hard to wipe out malaria and the human suffering that it generates,” said Dr. Carissa F. Etienne, Director of the Pan American Health Organization (PAHO), WHO’s regional office for the Americas. “Over the years, El Salvador has dedicated both the human and financial resources needed to succeed. This certification today is a life-saving achievement for the Americas.”

El Salvador is the third country to have achieved malaria-free status in recent years in the WHO Region of the Americas, following Argentina in 2019 and Paraguay in 2018. Seven countries in the region were certified from 1962 to 1973. Globally, a total of 38 countries and territories have reached this milestone.

El Salvador’s Minister of Health, Dr Francisco José Alabi Montoya, said: “The people and the government of El Salvador, together with its health workers, have fought for decades against malaria. Today we celebrate this historical achievement of having El Salvador certified malaria free.” 

El Salvador’s road to elimination

El Salvador’s anti-malaria efforts began in the 1940s with mechanical control of the malaria vector – the mosquito – through construction of the first permanent drains in swamps, followed by indoor spraying with the pesticide DDT. In the mid-1950s, El Salvador established a National Malaria Program (CNAP) and recruited a network of community health workers to detect and treat malaria across the country. The volunteers, known as “Col Vol,” registered malaria cases and interventions. The data, entered into health information systems by vector control personnel, allowed for strategic and targeted responses across the country.

By the late 1960s, progress had slowed as mosquitoes developed resistance to DDT. An expansion in the country’s cotton industry is thought to have fueled a further rise in malaria cases. Throughout the 1970s, there was a surge of migrant laborers on cotton estates in coastal areas near mosquito breeding sites, in addition to discontinued use of DDT. El Salvador experienced a resurgence of malaria, reaching a peak of nearly 96 000 cases in 1980.

With the support of PAHO, the US Centers for Disease Control and Prevention (CDC), and the US Agency for International Development (USAID), El Salvador successfully reoriented its malaria program, which led to improved targeting of resources and interventions based on geographic distribution of cases. The government also decentralized its network of diagnostic laboratories in 1987, allowing for cases to be detected and treated more rapidly. These factors and the collapse of the cotton industry led to a rapid decline of cases in the 1980s.

The 2009 health reform, which included important improvements on budget and coverage of primary health care, as well as maintenance of the vector control program as the technical leader in malaria interventions, contributed to El Salvador’s success.

Country leadership and consistent funding

El Salvador’s government recognized early on that consistent and adequate domestic financing would be crucial to achieve and maintain its health-related goals, including for malaria. This commitment has been reflected for more than 50 years in national budget lines.

Despite reporting its last malaria-related death in 1984, El Salvador has maintained its domestic investments for malaria. In 2020, the country continued to rely on 276 vector control personnel, 247 laboratories, nurses and doctors involved in case detection, epidemiologists, management teams and personnel, and more than 3000 community health workers. As part of El Salvador’s commitment to maintain zero cases, national budgeting for malaria has been and will be preserved, even through the pandemic. 

Global and regional initiatives

El Salvador is a member of the WHO global “E-2020” initiative – a group of 21 countries identified in 2016 as having potential to eliminate malaria by 2020. With support from WHO and PAHO, national program staff from El Salvador have participated in global meetings that bring together malaria-eliminating countries to share innovations and best practices.

Although the majority of financing for malaria has come from domestic resources, El Salvador’s elimination effort benefited from external grants provided by the Global Fund.

In 2019, El Salvador joined the Regional Malaria Elimination Initiative (RMEI), which was organized by the Inter-American Development Bank with technical leadership from PAHO and the participation of the Council of Health Ministers of Central America (COMISCA).The initiative supports Central American countries, the Dominican Republic, Mexico and Colombia in a collaborative effort to eliminate malaria.

PAHO has provided technical support throughout El Salvador’s anti-malaria campaign, from control to elimination to prevention of reestablishment of the disease. El Salvador’s success is an important contribution to the PAHO Elimination Initiative, a collaborative effort between governments, civil society, academia, the private sector and communities to eliminate more than 30 communicable diseases and related conditions in the Americas, including malaria, by 2030.

 

Note to the editor

Global and regional trends

Contracted through the bites of infected mosquitos, malaria remains one of the world’s leading killers, with more than 200 million cases and 400 000 malaria-related deaths reported each year. Approximately two-thirds of fatalities are among children under the age of five.

As of 2019, the Americas reported 723 000 confirmed cases of malaria, compared to almost 1.2 million cases in 2000. The total number of malaria deaths fell by 52% in the same period of time – from 410 to 197. Since 2015, the Region has seen a 66% rise in cases largely due to increased malaria transmission in some countries. Despite the increase, advances against malaria continue. In 2020, Belize completed two years without indigenous malaria transmission and, by the end of 2020, 10 countries and territories reported fewer than 2000 cases in 2019.

Facebook Live

Experts from El Salvador’s Ministry of Health, PAHO, and WHO experts will comment on El Salvador’s path to certification during a Facebook Live session on Friday, Feb. 26 at 11 EST. Simultaneous translation in English will be provided. To participate, go to Facebook   

 

Consultation on discussion paper on Global Action Plan on Epilepsy and Other Neurological Disorders

WHO news - Thu, 02/25/2021 - 13:23
Neurological disorders are the leading cause of disability-adjusted-life-years and the second leading cause of death globally. Despite the global burden that neurological conditions impose, access to both services and support for such conditions is insufficient, especially in low- and middle-income countries.

COVID-19 vaccine doses shipped by the COVAX Facility head to Ghana, marking beginning of global rollout

WHO news - Wed, 02/24/2021 - 14:18
  • COVAX announces 600,000 doses of the AstraZeneca/Oxford vaccine licensed to Serum Institute of India have arrived in Accra, Ghana; further deliveries to Abidjan, Cote d’Ivoire are expected this week
  • Final first round of allocations for doses of AstraZeneca/Oxford and Pfizer-BioNTech vaccines, to the majority of countries and economies participating in the COVAX Facility, anticipated to be published in coming days
  • Beginning of global rollout means that, as readiness criteria are met and doses produced, vaccines will be shipped to Facility participants on a rolling basis

Today, Ghana became the first country outside India to receive COVID-19 vaccine doses shipped via the COVAX Facility. This is a historic step towards our goal to ensure equitable distribution of COVID-19 vaccines globally, in what will be the largest vaccine procurement and supply operation in history. The delivery is part of a first wave of arrivals that will continue in the coming days and weeks.

On 23 February, COVAX shipped 600,000 doses of the AstraZeneca/ Oxford vaccine, from the Serum Institute of India (SII) from Pune, India to Accra, Ghana, arriving on the morning of 24 February.  The arrival in Accra is the first batch shipped and delivered in Africa by the COVAX Facility as part of an unprecedented effort to deliver at least 2 billion doses of COVID-19 vaccines by the end of 2021.

COVAX is co-led by Gavi, the Vaccine Alliance, the World Health Organization (WHO) and the Coalition for Epidemic Preparedness Innovations (CEPI), working in partnership with UNICEF as well as the World Bank, civil society organisations, manufacturers, and others.

“COVAX’s mission is to help end the acute phase of the pandemic as quickly as possible by enabling global equitable access to COVID-19 vaccines. Today’s delivery takes us another step closer to this goal and is something the whole world can be proud of. Over the coming weeks, COVAX must deliver vaccines to all participating economies to ensure that those most at risk are protected, wherever they live. We need governments and businesses now to recommit their support for COVAX and help us defeat this virus as quickly as possible,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance.

"We will not end the pandemic anywhere unless we end it everywhere," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "Today is a major first step towards realizing our shared vision of vaccine equity, but it's just the beginning. We still have a lot of work to do with governments and manufacturers to ensure that vaccination of health workers and older people is underway in all countries within the first 100 days of this year."

Dr Richard Hatchett, CEO of CEPI said: “This is a landmark moment in our efforts to get life-saving vaccine to the world.  The fact that we now have multiple safe and effective vaccines against COVID-19 developed in record time is testament to the scientific community and industry rising to the challenge of this pandemic. With this shipment we also see the global community, through COVAX, responding to the challenge of delivering these vaccines to those who need them most. Let us celebrate this as a moment of global solidarity in the struggle against the pandemic. But there is still much to do. With the increased spread of COVID-19 variants, we have entered a new and less predictable phase of the pandemic. It is crucial that the vaccines we have developed are shared globally, as a matter of the greatest urgency, to reduce the prevalence of disease, slow down viral mutation, and bring the pandemic to an end.”

“Today marks the historic moment for which we have been planning and working so hard. With the first shipment of doses, we can make good on the promise of the COVAX Facility to ensure people from less wealthy countries are not left behind in the race for life-saving vaccines,” said Henrietta Fore, UNICEF Executive Director. “In the days ahead, frontline workers will begin to receive vaccines, and the next phase in the fight against this disease can begin – the ramping up of the largest immunization campaign in history. Each step on this journey brings us further along the path to recovery for the billions of children and families affected around the world.”

The vaccines arrived on a flight from Mumbai, via Dubai, where the flight also collected a shipment of syringes from a Gavi-funded stockpile at UNICEF’s regional Supply Hub.

Over the past several months, COVAX partners have been supporting governments and partners, particularly for AMC-eligible participants, in readiness efforts, in preparation for this moment. This includes assisting with the development of national vaccination plans, support for cold chain infrastructure, as well as stockpiling of half a billion syringes and safety boxes for their disposal, masks, gloves and other equipment to ensure that there is enough equipment for health workers to start vaccinating priority groups as soon as possible.

In order for doses to be delivered to Facility participants via this first allocation round, several critical pieces must be in place, including confirmation of national regulatory authorisation criteria related to the vaccines delivered, indemnification agreements, national vaccination plans from AMC participants, as well as other logistical factors such as export and import licenses.

As participants fulfil the above criteria and finalise readiness preparations, COVAX will issue purchase orders to the manufacturer and ship and deliver doses via an iterative process. This means deliveries for this first round of allocation will take place on a rolling basis and in tranches.  

Building on the interim distribution forecast published earlier this month, final information on the first round allocations, covering the majority of Facility participants, is expected to be communicated in the coming days.

COVAX has built a diverse portfolio of vaccines suitable for a range of settings and populations, and is on track to meet its goal of delivering at least 2 billion doses of vaccine to participating countries around the globe in 2021, including at least 1.3 billion donor-funded doses to the 92 lower-income Facility participants supported by the Gavi COVAX AMC. said

Quotes from partners and donors

President Ursula von der Leyen, European Commission said: “I am delighted that today we have the first delivery of COVAX Vaccines in Accra, Ghana. This is the moment when the long days and nights of hard work finally show with tangible results on the ground. I want to pay tribute to the tireless efforts of our partners, Gavi, WHO and UNICEF. Team Europe will continue to stand by the people of Africa”. 

Prime Minister Jacinda Arden, New Zealand said: “Working towards broad global coverage of Covid-19 vaccines is both the right thing to do and the path to ending the pandemic. New Zealand acknowledges the remarkable work of GAVI, CEPI, the WHO and the COVAX Facility to get to this point”.

President Pedro Sánchez, Spain said: ““Spain has been from the beginning at the core of the ACT Accelerator and other international initiatives to fight the virus, because only by stepping up can we be successful. No one will be safe until everyone is safe.”

Senator the Hon Marise Payne, Minister for Foreign Affairs Minister for Women, Australia said: “In this pandemic we know no-one is safe until we all are, and to achieve that everyone must have access to safe and effective COVID 19 vaccines. With the first doses now distributed, Australia is proud to support the COVAX Advance Market Commitment as it delivers access to vaccines that will protect the world’s most vulnerable.”

Belgian Minister of Development Cooperation Meryame Kitir welcomes the delivery of the first vaccine doses with the Covax Facility in Africa: “This is great news. Belgium supports COVAX AMC because it will allow a number of countries to get access to COVID-19 vaccines. I hope this is the beginning of a fast roll-out to reach the goal of 2 billion doses delivered this year to the participating countries all over the world.”

Karina Gould, Minister of International Development, Government of Canada and Gavi COVAX AMC co-chair said: “Canada has supported the COVAX Facility from the start. It will bring countries together, regardless of their income levels, to speed up the development, manufacture and distribution of COVID-19 vaccines. Today, we celebrate as COVAX kick starts its delivery of the first vaccines to Ghana. This brings us one step closer to achieving coverage for all high-risk populations, including health care workers, around the world. This is truly a milestone for us all.”

French Minister for Europe and Foreign Affairs, Jean-Yves Le Drian said: “France welcomes the first deliveries of Covid-19 vaccine doses in Africa thanks to the COVAX facility, today in Ghana and on Friday in Cote d'Ivoire. This is a first concrete result that confirms the central importance of ACT-A, the key international platform for equitable and universal access to vaccines against Covid-19, which France helped launch together with the European Commission and WHO in spring 2020 in order to coordinate the global response to the pandemic. We must continue this effort of international solidarity by establishing, as proposed by the President of the Republic, dose sharing mechanisms that could speed up the distribution of vaccines in Africa."  

Retno Marsudi, Minister of Foreign Affairs for Indonesia and Gavi COVAX AMC co-chair said: "I am encouraged by the significant progress made by the COVAX Facility for equitable access to vaccines. This first arrival of vaccines shows that global solidarity and multilateralism work and deliver results. As one of the co-chairs of the AMC Group, I welcome this milestone achievement. I urge all countries to ensure greater access and ascertain that no one is left behind" 

Alessandro Rivera, Director General of the Treasury, Ministry of Economy and Finance, Italy said: “Italy is glad to see that COVAX will begin its vaccine rollout in AMC-eligible Countries in the coming days. This represents a landmark event, since we successfully allowed poorest Countries to get access to safe and effective vaccine within months from their approval in High Income Countries. Italy has supported the COVAX AMC since its inception in June 2020, and has pledged to date more than US$ 100 million. Our aim is to keep investing in multilateralism, international cooperation and solidarity, and as the current G20 Presidency we will ensure that these themes will remain at the heart of the global debate.”

Keiichi ONO, Ambassador of Japan for Global Issues said: “We welcome the commencement of the delivery of vaccines through the COVAX Facility as an important first step. Since the launch of the COVAX Facility last June, Japan has been contributing to the designing of unprecedented mechanism and the funding to the AMC. Japan is committed to supporting to ensure equitable access to safe, effective and quality-assured vaccines.”

Per Olsson Fridh, Swedish Minister for International Development Cooperation, Sweden said: “Today is a hopeful day in the fight against the devastating pandemic, and a hopeful day for multilateral collaboration. Sweden remains firmly committed to equitable global access to safe and effective vaccines.”

Foreign Secretary Dominic Raab, United Kingdom said: “Today’s rollout of vaccines to the world’s most vulnerable countries is a huge step forward in ending this pandemic. As one of the biggest donors to COVAX the UK is ensuring that more than one billion vaccine doses will be sent to 92 countries so that no one is left behind in this global fight. We will only save lives and reduce the risk of future infections if we prevent the virus spreading in the world’s developing countries.”

Dr John Nkengasong, Director, Africa Centres for Disease Control and Prevention said: "These first deliveries of COVID-19 vaccines through COVAX are a critical moment in Africa's fight against the virus. Thanks to this global collaboration, additional members of key groups such as health workers and other vulnerable groups will have access to COVID-19 vaccines in the weeks to come. This is an important step towards our continental goal of immunising at least 60% of Africa's population with safe and efficacious vaccines against COVID-19, to ease the strain on our health systems and economies and continue our work towards our continental development agenda."

Thomas Cueni, Director General, International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) said: “It is the first time in the history of pandemics that you will have vaccines rolled out in a coordinated manner to LMICs in less than three months of the very first Covid vaccine being granted the go ahead by the WHO.  Just as the scaling up of the manufacturing from zero to millions in a matter of months is a historic achievement, the roll out to the last mile is an important milestone to mark.  Manufacturers were among the founding partners of ACT-A and COVAX.  We have fully played our role in not only scaling up manufacturing through an amazing number of collaborations but also in delivering on the shared goal of fair and equitable access to vaccines.  But there are going to be challenges, whether in manufacturing or in delivery.  We must work together to find solutions. This is how we have gotten so far in such a short time.  Finger pointing and singling out manufacturers as not delivering will be counter productive.”

Notes to Editors

List of donor pledges to the Gavi COVAX AMC is available here.

About COVAX

COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance Gavi) and the World Health Organization (WHO) – working in partnership with developed and developing country vaccine manufacturers, UNICEF, the World Bank, and others. It is the only global initiative that is working with governments and manufacturers to ensure COVID-19 vaccines are available worldwide to both higher-income and lower-income countries.

CEPI is focused on the COVAX vaccine research and development portfolio: investing in R&D across a variety of promising candidates, with the goal to support development of three safe and effective vaccines which can be made available to countries participating in the COVAX Facility. As part of this work, CEPI has secured first right of refusal to potentially over one billion doses for the COVAX Facility to a number of candidates, and made strategic investments in vaccine manufacturing, which includes reserving capacity to manufacture doses of COVAX vaccines at a network of facilities, and securing glass vials to hold 2 billion doses of vaccine. CEPI is also investing in the ‘next generation’ of vaccine candidates, which will give the world additional options to control COVID-19 in the future.  

Gavi is focused on procurement and delivery for COVAX: coordinating the design, implementation and administration of the COVAX Facility and the Gavi COVAX AMC and working with its Alliance partners UNICEF and WHO, along with governments, on country readiness and delivery. The COVAX Facility is the global pooled procurement mechanism for COVID-19 vaccines through which COVAX will ensure fair and equitable access to vaccines for all 190 participating economies, using an allocation framework formulated by WHO. The COVAX Facility will do this by pooling buying power from participating economies and providing volume guarantees across a range of promising vaccine candidates. The Gavi COVAX AMC is the financing mechanism that will support the participation of 92 low- and middle-income countries in the Facility, enabling access to donor-funded doses of safe and effective vaccines. Gavi is fundraising for the COVAX AMC, and funding UNICEF procurement of vaccines as well as partners’ and governments work on readiness and delivery, including support cold chain equipment, technical assistance, syringes, vehicles, and other aspects of the vastly complex logistical operation for delivery. UNICEF and the Pan-American Health Organisation (PAHO) will be acting as procurement coordinators for the COVAX Facility, helping deliver vaccines to COVAX AMC participants and others.

WHO has multiple roles within COVAX: It provides normative guidance on vaccine policy, regulation, safety, R&D, allocation, and country readiness and delivery. Its Strategic Advisory Group of Experts (SAGE) on Immunization develops evidence-based immunization policy recommendations. Its Emergency Use Listing (EUL)/prequalification programmes ensure harmonized review and authorization across member states. It provides global coordination and member state support on vaccine safety monitoring. It developed the target product profiles for COVID-19 vaccines and provides R&D technical coordination.  WHO leads, along with UNICEF, the support to countries as they prepare to receive and administer vaccines. The Country Readiness and Delivery (CRD) workstream includes Gavi and numerous other partners working at the global, regional, and country-level to provide tools, guidance, monitoring, and on the ground technical assistance for the planning and roll-out of the vaccines.  Along with COVAX partners, WHO is also developing a no-fault compensation scheme as part of the time-limited indemnification and liability commitments.

UNICEF is leveraging its experience as the largest single vaccine buyer in the world and working with manufacturers and partners on the procurement of COVID-19 vaccine doses, as well as freight, logistics and storage. UNICEF already procures more than 2 billion doses of vaccines annually for routine immunization and outbreak response on behalf of nearly 100 countries. In collaboration with the PAHO Revolving Fund, UNICEF is leading efforts to procure and supply doses of COVID-19 vaccines for COVAX. In addition, UNICEF, Gavi and WHO are working with governments around the clock to ensure that countries are ready to receive the vaccines, with appropriate cold chain equipment in place and health workers trained to dispense them. UNICEF is also playing a lead role in efforts to foster trust in vaccines, delivering vaccine confidence communications and tracking and addressing misinformation around the world.

About CEPI

CEPI is an innovative partnership between public, private, philanthropic, and civil organisations, launched at Davos in 2017, to develop vaccines to stop future epidemics. CEPI has moved with great urgency and in coordination with WHO in response to the emergence of COVID-19. CEPI has initiated ten partnerships to develop vaccines against the novel coronavirus. The programmes are leveraging rapid response platforms already supported by CEPI as well as new partnerships.

Before the emergence of COVID-19, CEPI’s priority diseases included Ebola virus, Lassa virus, Middle East Respiratory Syndrome coronavirus, Nipah virus, Rift Valley Fever and Chikungunya virus. CEPI also invested in platform technologies that can be used for rapid vaccine and immunoprophylactic development against unknown pathogens (Disease X).

About Gavi

Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate half the world’s children against some of the world’s deadliest diseases. Since its inception in 2000, Gavi has helped to immunise a whole generation – over 822 million children – and prevented more than 14 million deaths, helping to halve child mortality in 73 developing countries. Gavi also plays a key role in improving global health security by supporting health systems as well as funding global stockpiles for Ebola, cholera, meningitis and yellow fever vaccines. After two decades of progress, Gavi is now focused on protecting the next generation and reaching the unvaccinated children still being left behind, employing innovative finance and the latest technology – from drones to biometrics – to save millions more lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency. Learn more at www.gavi.org and connect with us on Facebook and Twitter.

The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. View the full list of donor governments and other leading organizations that fund Gavi’s work here.

About WHO

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our 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 TwitterFacebookInstagramLinkedInTikTokPinterestSnapchatYouTube

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 . Find out more about UNICEF’s work on the COVID-19 vaccines here, or about UNICEF’s work on immunization here.

Follow UNICEF on Twitter and Facebook.

About the ACT-Accelerator

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

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

The ACT-Accelerator has four areas of work: diagnostics, therapeutics, vaccines and the health system connector. Cross-cutting all of these is the workstream on Access & Allocation.

Improving understanding of and response to infodemics during public health emergencies

WHO news - Tue, 02/23/2021 - 10:21

Following the first global infodemiology conference held in July 2020, WHO and partners coordinated a joint call for papers  with 5 academic journals representing different scientific fields, all related to components of the science behind managing infodemics. This week the first of these academic journals published its special infodemic feature. The research findings contribute to filling the knowledge gap identified through the WHO public health research agenda for managing infodemics released earlier this month.

In the issue published by Health Security, you’ll find original peer-reviewed articles that address practice- and research-based analysis of misinformation during epidemics, characteristics of successful online messaging, disinformation and epidemics in the context of biowarfare, understanding the impact of different news sources on risk perception, and use of community listening and feedback to respond to false information. The commentaries focus on the COVID-19 pandemic in the context of crisis and emergency risk communication, scientific situational awareness, and approaches to social media messaging.

Through research being published, the science of infodemic management will be built on solid and scientifically tested methods and analytics, all of which can contribute to the design of policies and interventions that will help health authorities monitor, evaluate and respond to the current and future infodemics. 

No-fault compensation programme for COVID-19 vaccines is a world first

WHO news - Mon, 02/22/2021 - 17:25
  • New programme makes compensation available to eligible individuals in 92 low- and middle-income countries without need to resort to law courts
  • This is the first and only global vaccine injury compensation mechanism
  • The programme is funded by a small levy on each dose supported by the Gavi COVAX AMC  

 

The World Health Organization (WHO) and Chubb Limited (NYSE: CB), through ESIS Inc., a Chubb company, signed an agreement on behalf of the COVAX Facility on 17 February 2021 for the administration of a no-fault compensation programme for the 92 low- and middle-income countries and economies eligible for support via the Gavi COVAX Advance Market Commitment (AMC) of the COVAX Facility.

As the first and only vaccine injury compensation mechanism operating on an international scale, the programme will offer eligible individuals in AMC-eligible countries and economies a fast, fair, robust and transparent process to receive compensation for rare but serious adverse events associated with COVAX-distributed vaccines until 30 June 2022.

By providing a no-fault lump-sum compensation in full and final settlement of any claims, the COVAX programme aims to significantly reduce the need for recourse to the law courts, a potentially lengthy and costly process.

ESIS, as the independent administrator of the programme, was selected in accordance with WHO’s procurement rules and procedures, and charges no fees to applicants.

All vaccines procured or distributed through the COVAX Facility receive regulatory approval or an emergency use authorization to confirm their safety and efficacy.

But, as with all medicines, even vaccines that are approved for general use may, in rare cases, cause serious adverse reactions.

 “The unprecedented nature of the COVID-19 pandemic has been matched by the largest ever rollout of new vaccines under the ACT-Accelerator and its vaccines pillar, COVAX. This no-fault compensation mechanism helps to ensure that people in AMC-eligible countries and economies can benefit from the cutting-edge science that has delivered COVID-19 vaccines in record time,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We are pleased to be collaborating with Chubb, which has the capabilities to support the COVAX facility through its global network and claims handling ability. WHO’s agreement with Chubb offers further protection and confidence in the life-saving power of vaccines.”

“The No-Fault Compensation fund is a massive boost for COVAX’s goal of equitable global access to vaccines: by providing a robust, transparent and independent mechanism to settle serious adverse events it helps those in countries who might have such effects, manufacturers to roll out vaccines to countries faster, and is a key benefit for lower-income governments procuring vaccines through the Gavi COVAX AMC,” said Dr Seth Berkley, CEO of Gavi.

The COVAX no-fault compensation programme will be operationalized through its web portal (www.covaxclaims.com) by 31 March 2021, which will include resources such as the programme’s protocol, Frequently Asked Questions (FAQs) and information on how to submit an application.

Eligible individuals may apply for compensation under the programme once the portal becomes operational, even if a COVAX-distributed vaccine is administered to them before 31 March 2021.

The programme is financed initially through Gavi COVAX AMC donor funding, calculated as a levy charged on all doses of COVID-19 vaccines distributed through the COVAX Facility to the AMC eligible economies until 30 June 2022.

WHO is working with Chubb to secure insurance coverage for the programme with Chubb as lead insurer.

Chubb is proud and honoured to work with the World Health Organization and its partners on the critically important COVAX programme,” said Evan G. Greenberg, Chairman and Chief Executive Officer of Chubb. “The COVID-19 pandemic has had a devastating effect on people and economies around the globe, and the development and deployment of efficacious vaccines is a crucial step toward ending this crisis. However, a vaccination strategy is only as effective as the number of people it reaches, which is why the COVAX facility is so critical. Access to the protection offered by a vaccine should not be limited or restricted. All countries, regardless of income levels, should have equal access to these life-saving vaccines.”

The delivery of COVID-19 vaccines during 2021 will be the fastest and largest global deployment of novel vaccines in history. The COVAX Facility aims, by the end of 2021, to deliver at least 2 billion doses of safe, effective and quality-assured vaccines to all participating countries, including at least 1.3 billion doses to the 92 AMC-eligible countries and economies, at the same time as wealthier nations.

***

ABOUT the COVAX Facility

The Gavi-administered COVAX Facility forms a key part of the COVAX pillar (COVAX) of the Access to COVID-19 Tools (ACT) Accelerator, a ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. COVAX is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO, working in partnership with developed and developing country vaccine manufacturers. 
 

ABOUT WHO

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 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, visit www.who.int and follow WHO on TwitterFacebookInstagramLinkedInTikTokPinterestSnapchatYouTubeTwitch 


 ABOUT Gavi, the Vaccine Alliance

Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate half the world’s children against some of the world’s deadliest diseases. Since its inception in 2000, Gavi has helped to immunise a whole generation – over 822 million children – and prevented more than 14 million deaths, helping to halve child mortality in 73 developing countries. Gavi also plays a key role in improving global health security by supporting health systems as well as funding global stockpiles for Ebola, cholera, meningitis and yellow fever vaccines. After two decades of progress, Gavi is now focused on protecting the next generation and reaching the unvaccinated children still being left behind, employing innovative finance and the latest technology – from drones to biometrics – to save millions more lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency. Learn more at www.gavi.org and connect with us on Facebook and Twitter.

The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. View the full list of donor governments and other leading organizations that fund Gavi’s work here.

 ABOUT CHUBB

Chubb is the world's largest publicly traded property and casualty insurance company. With operations in 54 countries and territories, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients. As an underwriting company, we assess, assume and manage risk with insight and discipline. We service and pay our claims fairly and promptly. The company is also defined by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength and local operations globally. Parent company Chubb Limited is listed on the New York Stock Exchange (NYSE: CB) and is a component of the S&P 500 index. Chubb maintains executive offices in Zurich, New York, London, Paris and other locations, and employs approximately 31,000 people worldwide. Additional information can be found at: www.chubb.com .


 ABOUT ESIS, A CHUBB COMPANY

ESIS, Inc. provides claim and risk management services to a wide variety of commercial clients. Our innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients' unique risk management needs. With more than 66 years of experience and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.

 

 

PMNCH Call to Action on COVID-19

Maternal, newborn and child health - Mon, 02/22/2021 - 06:20
The world is facing a global health pandemic without a clear end in sight. Covid-19 presents a massive shock to already struggling health systems globally and the world economy. Countries are grappling with how best to address mortality and morbidity due to the virus. At the same time, the pandemic is disrupting the provision of life-saving maternal, newborn, child, and adolescent health (MNCAH) services, contributing to the erosion of sexual and reproductive health and rights (SRHR) of women and adolescents, and further exposing and exacerbating systematic and structural racial, ethnic and gender inequities everywhere.

As the 1,000 partners of PMNCH, we are coming together to advocate urgent action to respond to the devastating effects of the pandemic on the health of women, children, and adolescents, as well as the societies and economies that support them. Our call to action can prevent the Covid-19 pandemic from becoming a lasting crisis, while forging stronger primary healthcare systems as a pathway to Universal Health Coverage and fostering a more equitable world. There is no time to lose.

WHO Director-General's statement on Tanzania and COVID-19

WHO news - Sat, 02/20/2021 - 22:02

We extend our condolences to our Tanzanian sisters and brothers on the recent passing of a senior Tanzanian leader as well as the government’s Chief Secretary.

In late January, I joined Dr Matshidiso Moeti, the WHO Director for the African Region, in urging Tanzania to scale public health measures against COVID-19 and to prepare for vaccination. I also encouraged the sharing of data in light of reports of COVID-19 cases among travellers.

Since then I have spoken with several authorities in Tanzania but WHO is yet to receive any information regarding what measures Tanzania is taking to respond to the pandemic.

This situation remains very concerning. I renew my call for Tanzania to start reporting COVID-19 cases and share data. I also call on Tanzania to implement the public health measures that we know work in breaking the chains of transmission, and to prepare for vaccination.

A number of Tanzanians travelling to neighbouring countries and beyond have tested positive for COVID-19. This underscores the need for Tanzania to take robust action both to safeguard their own people and protect populations in these countries and beyond.

COVID-19 is a serious disease that can cause severe illness and even death. National authorities everywhere must do all they can to protect people and save lives and WHO stands ready to support them in the response against this deadly virus.

 

 

G7 leaders commit US$ 4.3 billion to finance global equitable access to tests, treatments and vaccines in 2021

WHO news - Fri, 02/19/2021 - 21:06
  • The ACT Accelerator partnership welcomes over US$ 4.3 billion of new investments from the USA, Germany, the European Commission, Japan, and Canada to fund the development and equitable rollout of the tests, treatments and vaccines needed to end the acute phase of the COVID-19 pandemic.
  • Today’s commitments bring the amount committed to date to US$ 10.3 billion, leaving a funding gap of US$ 22.9 billion to fully fund the ACT Accelerator’s work in 2021. 
  • The UK’s commitment to share vaccine surplus with developing countries is also welcomed and joins similar commitments made by Canada, France, Norway and the European Union. 
  • Global Health leaders reiterated, however, that without further significant financial commitments, access to COVID-19 tools would be delayed, risking further mutations and prolonging the pandemic everywhere. 

 

Commitments made at today’s Virtual G7 leaders meeting hosted by UK Prime Minister Boris Johnson, and at the Munich Security Conference later in the day, signaled significant progress in the global response to the COVID-19 pandemic with an important underscoring of the need for global equity in access to test, treatments, and vaccines. 

Leaders recognised that no country can be safe until every country is safe and collectively committed over US $4.3 billion to the ACT Accelerator partnership to develop and distribute effective tests, treatments, and vaccines around the world.

Contributions were made up as follows:

  • The USA committed initial $2 billion to Gavi, the Vaccine Alliance for the COVAX Advance Market Commitment and a further $2 billion through 2021 and 2022, of which the first $500 million will be made available when existing donor pledges are fulfilled and initial doses are delivered to AMC countries.
  • Germany committed US$ 1.8 billion[i] with contributions to all pillars and partners of the ACT Accelerator across tests, treatments, vaccines, and health systems strengthening. 
  • The European Commission committed US$ 363 million[ii] for the COVAX Advance Market Commitment. 
  • Japan committed US$ 79 million for the COVAX Advance Market Commitment and UNITAID.
  • Canada committed US$ 59 million to the ACT Accelerator.[iii]

In addition, the European Investment Bank is providing a further US$ 242 million[iv] in loan guarantees which will help the ACT Accelerator partnership to frontload future payments to speed up the response.

The UK’s commitment to join Canada, France, Norway and the European Union in sharing its additional vaccine doses with developing countries is a vital step to increase volume of vaccines available worldwide and support rapid reduction of virus transmission amongst some of the world’s most vulnerable and exposed populations.

The ACT Accelerator initial needs for 2020-2021 were US $38.1 billion. Prior to today, an unprecedented mobilization of sovereign donors, private sectors, philanthropic and multilateral contributors had already committed  US $ 6 billion. Considering those pledges, and costs adjustments, today’s new contributions bring the total committed to the ACT Accelerator partnership to US$ 10.3 billion and reduce the funding gap to US $22.9 billion

The next few weeks will be critical for the global COVID-19 response. Further commitments are needed to fully fund the work of the ACT Accelerator and enable the delivery of more than 2 billion doses of vaccine; medical oxygen and millions of treatment doses including dexamethasone and new products, as and when they become available; and over 900 million diagnostic tests including high-quality, lower-cost molecular tests, antigen detection RDTs (Ag-RDTs) and self-tests. This work will also support the urgent need for rapid R&D, product evaluation, and regulatory pathways for new and modified tests, treatments and vaccines to meet the needs of global response programmes and the threat of new and emerging variants. 

Global health leaders responded to today’s announcements: 

Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, said: “I thank the US, Germany, the European Commission, the European Investment Bank, Japan, and Canada for their significant funding commitments. Today’s news shows us solidarity prevails; we can turn a corner on this pandemic by funding the only global solution to end it. History will judge us collectively and I welcome the words of support from today’s G7 Leaders and the Munich Security Council for again highlighting to the world that we have to solve this together.”

Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance, said: “This support for the Gavi COVAX AMC shows great commitment to equitable, global access to COVID-19 vaccines and is a major boost to our efforts to end the acute phase of the pandemic. We thank G7 countries, and particularly Germany and the United States, as well as the EU, for this strong leadership in the fields of global health and global health security.”  

Dr Catharina Boehme, CEO of FIND, said: “Today’s new commitment is gladly welcomed. Over a year into the pandemic, inequality in testing remains across the globe, meaning that many countries are still flying blind in their pandemic response even as new variants emerge. For every test conducted in Africa, Europe is conducting 33. The pandemic will not be defeated until every country can access the tests, treatments and vaccines it needs to keep everyone safe.”

Peter Sands, Executive Director of Global Fund, said: “The Global Fund welcomes these significant contributions to the ACT-Accelerator.  As the virus evolves, it is important to ensure equitable access to tests, treatments, vaccines and PPE to defeat COVID-19 and save lives. Galvanizing a bolder, faster  and more unified response should be a top priority for everyone. The longer COVID-19 is left unchecked in some parts of the world, the more the risk of new variants and the greater the knock-on impact on economies and other deadly diseases. We must act together now.”

Dr Philippe Duneton, Executive Director of Unitaid, said: "Unitaid welcomes such strong commitment to the vital work of the ACT-Accelerator. Treatments for COVID-19 are needed to save lives and provide a second line of defense against a mutating virus. This investment will aid our work to ensure promising treatments reach people everywhere."

Dr Richard Hatchett, CEO of CEPI, said: “We are entering a new and more complex phase of the pandemic. The emergence of novel variants that threaten to impact the safe and effective vaccines we have developed means that now, more than ever, we are in a race against this virus. It is paramount that we take this opportunity to not only push forward with our plan to end the acute phase of this devastating crisis, but also continue to focus on ensuring we invest in R&D, work for globally fair distribution, and build on our scientific achievements to meet the continued challenge of this pandemic. We welcome the G7’s leadership and focus on advancing COVID-19 vaccine development and deployment, in addition to their commitments to increase manufacturing capacity and share genomic sequencing information so that we can accelerate our work and continue to provide the tools the world so urgently needs. There is a moment of opportunity that we must now seize to collaborate in our efforts to stop the devastation of this pandemic.

 

 

Notes to Editors 

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

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

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

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

 

Since April 2020, the ACT Accelerator has supported the fastest, most coordinated, and successful global effort in history to develop tools to fight a disease. With significant advances in research and development by academia, private sector, multilateral organizations and government initiatives, the ACT Accelerator has advanced our understanding of what works to fight the disease. It has transformed our ability to tackle COVID-19 on a global scale: vaccines are poised to roll-out worldwide, low-cost high-performing antigen rapid diagnostic tests can now detect transmission anywhere, affordable therapy for severe disease can save lives in any setting, and health systems are being prepared for the roll out of tools. 

Find out more: https://www.who.int/initiatives/act-accelerator


[i] €1.5 billion

[ii] €300 million

[iii] Canadian $75 million

[iv] €200 million

World Waking Up To Vaccine Equity

WHO news - Fri, 02/19/2021 - 15:44

At the halfway point in the World Health Organization and Director-General Tedros Adhanom Ghebreyesus’ 100-day challenge, a movement of people and organizations is now uniting together under the banner of vaccine equity. WHO welcomes the new commitments made by France, Germany, the United Kingdom of Great Britain and Northern Ireland and the United States of America to COVAX and equitable allocation of vaccines. Backed by 190 countries and economies, COVAX is the global mechanism best positioned to deliver vaccines to the world and end the COVID-19 pandemic.

“There is a growing movement behind vaccine equity and I welcome that world leaders are stepping up to the challenge by making new commitments to effectively end this pandemic by sharing doses and increasing funds to COVAX,” said Dr Tedros, Director-General of the World Health Organization. “This can’t be business as usual and there is an urgent need for countries to share doses and technology, scale up manufacturing and ensure that there is a sustainable supply of vaccines so that everyone, everywhere can receive a vaccine."

Close to 7000 people and hundreds of organizations have already signed on to a vaccine equity declaration that directly calls on governments and manufacturers to speed up regulatory processes, boost manufacturing by sharing know-how and technology, and ensure that doses are shared equitably. There is a specific call to start with all health and care workers, who have been on the frontlines of this pandemic for more than a year. 

Heads of state and sports stars like Romain Grosjean; international agencies including UNICEF, UN Development Programme, UN Women and the World Food Programme; sporting organizations like the International Olympic Committee, World Rugby and FIFA; networks focused on faith, gender and youth, and civil society groups like the Elders, Global Health Council, Nursing Now, Pandemic Action Network, UHC2030 and Women in Global Health,*-- these and many more have signed on to the broad based movement, which recognizes the moral, economic and global security imperative of equitable vaccine distribution.

Dr Keith C Rowley, Prime Minister of Trinidad and Tobago, and Chairman of the Caribbean Community and Common Market (CARICOM) said, “Today, thankfully we are at that place where we now have tested and proven vaccines. A brightening light is shining on our way towards a more successful response to the still marauding virus.”

The movement for vaccine equity is growing, and to prevent virus variants from undermining our health technologies and hampering an already sluggish global economic recovery, it is critical that leaders continue to step up to ensure that we end this pandemic as quickly as possible. Individuals and organizations everywhere are encouraged to join in this crucial effort.

 

Note to editors: Please find the declaration at who.int/vaccinequity

*A list of declaration supporters will be added to the WHO website and updated regularly.  

 

Statement of the Twenty-Seventh Polio IHR Emergency Committee

WHO news - Fri, 02/19/2021 - 14:49

The twenty-seventh meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened by the WHO Director-General on 1 February 2021 with committee members and advisers attending via video conference, supported by the WHO Secretariat.  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 on the current situation in their respective countries: Afghanistan, Burkina Faso, the Republic of the Congo, Côte d’Ivoire, Egypt, the Islamic Republic of Iran, Liberia, Madagascar, Mali, Sierra Leone and Pakistan and Tajikistan.

Wild poliovirus

The committee noted that the rising incidence of global WPV1 cases seen since 2019 may have peaked with 140 cases with onset of illness in 2020 as at 21 January 2021 compared to the 137 cases that had occurred in 2019 as reported at 21 January 2020.  While in Pakistan the number fell from 111 cases to 84, it is not clear that this is going to be sustained, while the number in Afghanistan had more than doubled from 26 to 56.  Transmission persists in the core reservoirs of Karachi and Quetta Block in Pakistan and in Southern Afghanistan and has expanded to previously polio-free areas such as North Sindh and South Punjab in Pakistan and the Western and Northern regions in Afghanistan. The increase in Afghanistan is likely due to the growing cohort of missed children throughout the country due to local vaccination bans and the effect of COVID-19. The number of positive environmental samples has increased from 463 in 2019 to 503 so far in 2020. 

The Committee noted that based on results from sequencing of WPV1 since the last committee meeting in October 2020, 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.

Circulating vaccine derived poliovirus (cVDPV) 

The committee was very concerned that cVDPV2 continues to spread rapidly.  The number of cases in 2020 is 1009 (year to date), 254% higher than the total for 2019.  As in all the years following 2016 when OPV2 was withdrawn, the number of cVDPV2 cases globally has been greater than the number of WPV1 cases. The Global Polio Laboratory Network routinely analyzes and tracks vaccine derived polioviruses just as it does wild polioviruses, to assist the polio program identify the patterns of spread and thereby provide opportunities to limit or prevent the circulation.  In the most recent quarterly routine analysis (July to September 2020) there has been evidence of exportation of cVDPV2 from:


  • Pakistan to Afghanistan
  • Sudan to Egypt
  • Afghanistan to Iran
  • Côte D’Ivoire to Mali
  • Benin to Nigeria
  • Afghanistan to Pakistan
  • Chad to Sudan
  • Chad into Cameroon
    • Côte D’Ivoire and Togo to Burkina Faso
    • Somalia to Ethiopia
    • Burkina Faso to Mali
    • Angola to Republic of Congo
    • Chad and Sudan to Republic of South Sudan
    • Ethiopia to Somalia


More recently, in addition to the exportation of cVDPV2 to Egypt and the Republic of the Congo mentioned above, in West Africa, cVDPV2 that has been circulating in Côte d’Ivoire has now been found in sewage in Liberia, and similarly cVDPV2 previously found in Guinea has now caused an outbreak with at least three cases so far in Sierra Leone.  Following the earlier event in September 2020 where virus circulating in Darfur in Sudan was detected in sewage in Giza, Cairo, a second exportation has been detected in sewage in Alexandria in Egypt with links to the cVDPV2 found in the River Nile state in Sudan, and one detection in each of Anwan and Qena in southern Egypt linked to Alexandria.  The cVDPV2 virus causing the large outbreak in Afghanistan has now been detected in Sistan and Baluchistan province of the Islamic Republic of Iran, where it has been found in sewage in two districts on three separate occasions.  It has also been detected in two AFP cases in Tajikistan.

However, the number of lineages detected so far in 2020 is 35, compared to 44 for the whole of 2019, and the number of newly emerged viruses is only 13 so far in 2020, compared to 38 during 2019.  This reduction may reflect refinement and modification of cVDPV2 outbreak management to lessen the risk of seeding new emergences. 

The committee noted that novel OPV2 (nOPV2) has received an interim recommendation for use under WHO’s Emergency Use Listing procedure (EUL) to enable rapid field availability, and potential wider rollout of the vaccine.  The EUL involves careful and rigorous analysis of existing data to enable early, targeted use of unlicensed products for a Public Health Emergency of International Concern.  WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) endorsed accelerated clinical development of novel OPV2 and its assessment in October 2019.

COVID-19

The committee was concerned that COVID-19 continues to have an impact on polio eradication at many levels.  Many of the polio affected countries are currently experiencing a second wave of COVID-19, notably Malaysia, Pakistan and Nigeria. Although resumption of SIAs is now a major focus of the polio program the effect of the pause in 2020 and the current second wave will hamper this resumption. There are ongoing signs of the impact of COVID-19 on surveillance, particularly with slow shipment and handling and reporting of samples for polio testing.   All these factors serve to heighten the risk of polio transmission.

The committee noted that since the beginning of the pandemic, the value of polio-funded staff and assets contributed to the COVID-19 response in more than 50 countries is estimated at USD $104 million. In view of the overwhelming public health imperative to end the COVID-19 pandemic, the POB has committed to the polio program’s continued support for the next phase of COVID-19 response, COVID-19 vaccine introduction and delivery, through existing assets, infrastructure and expertise in key geographies.

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:

  • transmission in Pakistan and Afghanistan remains high noting that the small decrease in Pakistan is yet to be sustained, and in Afghanistan case numbers have doubled;
  • expansion of WPV1 transmission into previously polio free areas in both countries and rising positive environmental samples in both endemic countries;
  • the ongoing inaccessibility in many provinces of Afghanistan leading increasingly to highly susceptible populations which are and will continue to drive higher transmission; over 3 million children were missed in the October and November NIDs, and the cohort of missed children continues to grow quickly;
  • ongoing vaccine hesitancy in Pakistan leading to higher numbers of missed children particularly in high risk districts;
  • the fall in population immunity consequent on the four months 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 second wave of COVID-19 that appears to be currently under way in many polio affected countries making interventions more difficult;
  • the difficulties in supplying vaccines due to the pandemic (as is being seen in Yemen, for example). 

Rising risk of cVDPV2 international spread:

Based on the following factors, the risk of international spread of cVDPV2 appears to be currently very high:

  • The increasingly large number of cases, environmental detections and documented exportations across borders to both new countries and already infected countries;
  • The ever widening gap in population intestinal mucosal immunity in young children since the withdrawal of OPV2 in 2016;
  • The same factors regarding the COVID-19 pandemic as mentioned above;
  • The population of inaccessible children in Afghanistan that appears to be driving intense transmission there.

Other factors include

  • 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. 

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:

  1. States infected with WPV1, cVDPV1 or cVDPV3.
  2. States infected with cVDPV2, with or without evidence of local transmission:
  3. 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 1 Jan 2021)              

Pakistan                            (most recent detection 13 Jan 2021)

 

cVDPV1

Malaysia                            (most recent detection 13 March 2020)

Philippines                         (most recent detection 28 November 2019)

Yemen                               (most recent detection 6 Aug 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 cVDPV2, with or without evidence of local transmission:

Afghanistan           (most recent detection 1 Jan 2020)

Angola                   (most recent detection 9 February 2020)

Benin                     (most recent detection 30 Nov 2020)

Burkina Faso          (most recent detection 14 Nov 2020)

Cameroon             (most recent detection 29 Septr 2020)

CAR                       (most recent detection 2 Oct 2020)

Chad                     (most recent detection25 Nov 2020)

Rep Congo             (most recent detection 8 Sept  2020)

DR Congo              (most recent detection 28 Oct 2020)

Côte d’Ivoire          (most recent detection 9 Oct 2020)

Egypt                     (most recent detection 23 January 2021)

Ethiopia              (most recent detection 30 Aug 2020)

Ghana                   (most recent detection 9 March 2020)

Guinea                  (most recent detection 26 Oct 2020)

Iran                       (most recent detection 25 December 2020)

(Islamic Republic of)

Liberia                   (most recent detection 3 Nov 2020)

Malaysia             (most recent detection 13 March 2020)

Mali                      (most recent detection 31 Oct June 2020)

Niger                     (most recent detection 25 August 2020)

Nigeria               (most recent detection 13 Nov 2020)

Pakistan                (most recent detection 28 Dec 2020)

Philippines             (most recent detection 16 January 2020)

Sierra Leone          (most recent detection 19 Nov 2020

Somalia                 (most recent detection 25Oct 2020)

South Sudan          (most recent detection 6 Nov 2020)

Sudan                    (most recent detection 3 Dec 2020)

Tajikistan               (most recent detection 15 Jan 2021)

Togo                      (most recent detection 3 May 2020)

States that have had an importation of cVDPV2 but without evidence of local transmission should:

  • Officially declare, if not already done, at the level of head of state or government, that the prevention or interruption of poliovirus transmission is a national public health emergency
  • Undertake urgent and intensive investigations to determine if there has been local transmission of the imported cVDPV2
  • 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.
  • Further intensify efforts to increase IPV immunization coverage, including sharing coverage data.
  • Intensify national and international surveillance regional cooperation and cross­border coordination to enhance surveillance for prompt detection of poliovirus.

States with local transmission of cVDPV2, with risk of international spread should in addition to the above measures should:

  • Encourage residents and long­term visitors to receive a dose of IPV four weeks to 12 months prior to international travel.
  • 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.

For both sub-categories:

  • 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)

Indonesia              (most recent cVDPV1 detection 13 February 2019)

Myanmar              (most recent cVDPV1 detection 9 August 2019)

China                    (most recent cVDPV2 detection 18 August 2019)

Zambia                  (most recent cVDPV2 detection 25 November 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 welcomed the Emergency Use Listing of novel OPV2 but cautioned there was much to be done before the new vacccine could be expected to have a significant impact globally on the spread of cVDPV2. 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 novel OPV2 use under Emergency Use Listing procedure.

The committee welcomed the progress being made in individual countries that were facing huge challenges with both polio and COVID-19.  COVID-19 is also likely to continue to have a significant adverse impact on stopping polio transmission throughout 2021, with diversion of resources, barriers to successful polio campaign implementation and the consequential growing immunity gap.  However, the committee urged countries to look for where synergies can be built between polio and COVID -19 control, such as countering vaccine hesitancy, expanding and sharing testing resources, and vaccine management.  Countries also needed to make sure that local lockdowns and border restrictions were implemented in such a way as to avoid hampering specimen shipment and testing, particularly in West Africa where there are already constraints in lab capacity.  As testing for COVID-19 is strengthened, this should be done so as to strengthen lab capacity for other infectious diseases such as polio.  The committee urges affected countries to strengthen cross border cooperation as this appeared to be inconsistently carried out.

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 OPV use could adversely affect any future COVID-19 vaccine deployment.  The committee urged countries with particular issues 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 was also very concerned about the polio program funding gap which is developing in 2021 and beyond, noting several countries in Africa had been adversely affected by funding constraints.  The committee called on 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. 

Noting the serious situation in Afghanistan, the committee welcomed the recent agreement regarding mosque to mosque vaccination campaign activities but urged using multiple vaccines to avoid outbreaks of other vaccine preventable diseases such as measles.

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 February 2021 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 February 2021.

From paper to digital pathway: WHO launches first ‘SMART Guidelines’

WHO news - Thu, 02/18/2021 - 17:29

WHO has launched its first SMART Guideline, a landmark effort to accelerate the availability and impact of WHO health and data recommendations within digital systems at the country level, starting with antenatal care.

What are SMART guidelines?

As countries increasingly invest in digital technologies for health system strengthening, SMART Guidelines constitute a practical approach to making global guidance more effective across all areas of health and wellbeing.

They will support guideline developers, policy makers, technology teams, and health workers through the process of adapting and applying WHO global health and data recommendations to countries’ existing – and evolving – digital systems.

‘SMART’ stands for Standards-based, Machine-readable, Adaptive, Requirements-based, and Testable. The SMART Guideline approach includes documentation, procedures, and digital health tools, introduced in a new comment published in The Lancet Digital Health.

“In this day and age, the rigorous process of developing WHO guidance is only one part of improving health outcomes for people around the world,” said Dr Soumya Swaminathan, WHO Chief Scientist.

“Recommendations become meaningful when they are lifted off the page and effectively applied to local systems at the country level; when they are aligned with an evolving evidence base. SMART Guidelines are a pioneering approach to digital health systems transformation.”

Why are SMART Guidelines needed?

Digital tools have huge potential to improve the reach and accessibility of WHO guidelines in every country, strengthening quality of care and accelerating progress towards national and Sustainable Development Goals.

However, adapting recommendations in line with existing digital systems, as well as local policies, procedures, is a well-documented challenge.

“Every country’s digital health landscape is different, from the software that has been selected to the data that is available and the priorities that have been defined. To reduce error, ensure transparency and adhere to technical standards, a systematic approach to understanding and adapting WHO recommendations is essential,” said Dr Nancy Kidula, Medical Officer in the WHO Regional Office for Africa. 

The SMART Guidelines approach recognizes the complexity of this digital adaptation journey for health systems, facilities and providers. It is divided into five ‘knowledge layers’ which provide a systematic, transparent and testable structure for countries to work through. This ensures guidance is translated  into effective and interoperable digital systems – systems which are fully able to connect, communicate and share with any other device or digital platform, for maximum benefit.

All SMART Guidelines content is software-neutral, meaning it can be adapted into whichever software platform a country has elected to use. The approach is rooted in respect for the privacy and security of patient health information.

Applying SMART Guidelines to maternal health and rights

The new WHO SMART Antenatal Care Guidelines support a key WHO priority: improving maternal health and well-being.

WHO advocates for health planning where women’s values and preferences are at the centre of their care. Localized adaptation of global recommendations is essential to ensure quality antenatal care, leading to the best possible physical, emotional, and psychological outcomes for all.

Applying the SMART approach to the WHO recommendations on antenatal care for a positive pregnancy experience is a dynamic way of repackaging existing, evidence-based guidance, making it easier to implement with digital solutions.  

The WHO Antenatal Care SMART Guidelines build on groundwork laid by the Antenatal care recommendations adaptation toolkit for policymakers, and the WHO monitoring framework for antenatal care. They include a Digital Adaptation Kit, an implementation guide for machine-readable recommendations, and a WHO digital ANC module for health care providers.

Partnership and transparent process are key

SMART Guidelines are not a standalone solution. Good planning and governance on digital health by investors, governments, and technical bodies is needed when working to integrate digital approaches and investments into health systems.

“Digital health can transform health outcomes – but only if it is supported by sufficient resources for governance, people and processes,” said Dr Dan Rosen, Chief of Health Informatics Data Management and Statistics at the U.S. Centers for Disease Control and Prevention Division of Global HIV & TB.

“At this exciting moment in the history of digital development, we are committed to working with WHO and partners across all sectors to support equitable and universal access to quality health services for all.”

 SMART Guidelines for HIV, STIs, immunization, family planning, child health and humanitarian emergencies are in development and will be released later this year. SMART guidelines will be vital to digital health systems transformation, and attainment of universal health coverage and UN Sustainable Development Goals.

WHO calls for partners to help build and sustain effective digital health systems and support the SMART Guideline approach.

 

Ebola virus disease – Guinea

Disease outbreak news - Thu, 02/18/2021 - 01:50
On 14 February 2021, the Ministry of Health (MoH) of Guinea informed WHO of a cluster of Ebola Virus

WHO announces updates on new molecular assays for the diagnosis of tuberculosis (TB) and drug resistance

WHO news - Wed, 02/17/2021 - 18:38

Significant advances to the diagnosis of tuberculosis (TB) and drug resistance in adults, adolescents and children are expected, following key updates on new molecular assays, announced by the World Health Organization (WHO) in a Rapid Communication released today.

Diagnosis of TB and drug-resistant TB remains a challenge with a third of people with TB and more than a half of people with drug-resistant TB not receiving quality diagnosis and care globally. To address this challenge, WHO convened a meeting of a Guideline Development Group in December 2020, to update WHO policies on molecular assays used for the diagnosis of TB and drug resistance.

Highlights from the evidence reviewed and presented in the Rapid Communication show high diagnostic accuracy for 3 new classes of technologies:

  1. Moderate complexity automated Nucleic Acid Amplification Tests (NAATs), for detection of TB and resistance to rifampicin and isoniazid;
  2. Low complexity automated NAATs for detection of resistance to isoniazid and second-line anti-TB agents;
  3. High complexity hybridization-based NAATs for detection of resistance to pyrazinamide.
The Rapid Communication has been released in advance of updated WHO guidelines expected later in 2021, to inform national TB programmes and other stakeholders about these new developments for the diagnosis of TB and drug resistance in order to allow for rapid transition and planning at country level.

“The diagnostic options for people with TB and drug-resistant TB are increasing thanks to the engagement of manufacturers and to research that is generating new evidence. Ensuring that everyone can obtain a rapid and accurate diagnosis, followed by treatment according to the latest WHO guidelines, will save lives and reduce suffering” said Dr Tereza Kasaeva, Director of the WHO Global TB Programme. “We ask for renewed political commitment and stakeholder support in ensuring these updates are rapidly implemented.”

COVAX Statement on WHO Emergency Use Listing for AstraZeneca/Oxford COVID-19 Vaccine

WHO news - Tue, 02/16/2021 - 21:55

The Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance (Gavi) and the World Health Organization (WHO), as co-leads of the COVAX initiative for equitable global access to COVID-19 vaccines, alongside key delivery partner UNICEF, are pleased to welcome the news that two versions of the AstraZeneca/Oxford COVID-19 vaccine have been given WHO Emergency Use Listing (EUL). Yesterday’s announcement means that two versions of the AstraZeneca/Oxford vaccine, produced by AstraZeneca-SK Bioscience (AZ-SKBio) and the Serum Institute of India (AZ-SII), are now available for global rollout through the COVAX Facility.

Building on the early information provided in the interim distribution forecast published on 3 February 2021, COVAX will now complete the process of final Q1/Q2 allocations of the AstraZeneca/Oxford vaccine to Facility participants. Information on these final allocations will be communicated to all participants and published online the week of February 22nd.

In order for doses to be delivered via this first allocation round, several critical pieces must be in place:

  • All Facility participants must have given national regulatory authorisation for the vaccines in question, a process which can be expedited by issuing special authorisations for use based on granting of WHO EUL. 
  • All Facility participants must have signed indemnity agreements with the manufacturers in question in order to receive doses through COVAX. The COVAX Facility is helping to facilitate the process of getting these agreements in place. In particular, COVAX is supporting AMC-eligible participants by negotiating a template indemnity agreement on their behalf – saving time and resources – and establishing a no-fault compensation mechanism and fund.
  • AMC-eligible economies must have submitted National Deployment and Vaccination Plans (NDVPs) through the COVID-19 Partners Platform, that have then been reviewed and validated by COVAX.

In preparation for this unprecedented global rollout, COVAX partners have been working closely with all Facility participants for many months, providing support for regulatory and indemnity and liability issues as well as the submission of completed NDVPs. Throughout this process, Facility participants have been moving at speed to ensure all preparations are in place for the first deliveries.

As participants fulfil the above criteria and finalise readiness preparations, COVAX will issue purchase orders to the manufacturer and ship and deliver doses via an iterative process. This means deliveries for this first round of allocation will take place on a rolling basis and in tranches.

Due the high number of doses available as well as the high number of countries getting ready for delivery in Q1 2021, the capacity of supplier and freight forwarders will be under considerable pressure. Shipment timelines will be impacted by logistical preparedness and delivery lead times, which may vary depending on the location of the receiving participant.

Based on this, COVAX anticipates the bulk of the first round of deliveries taking place in March, with some early shipments to those that have already fulfilled the above criteria, occurring in late February. More information related to these first deliveries will be shared in the coming days.

 

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