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Joint statement by UNICEF Executive Director Henrietta Fore and WHO Director-General Dr. Tedros Adhanom Ghebreyesus for the Pre-Summit of the UN Food Systems

Tue, 07/27/2021 - 11:28

The Pre-Summit of the UN Food Systems is an opportunity to set the agenda for how we will boldly and collectively strengthen food systems, promote healthy diets, and improve nutrition, especially for children and young people.

Even before the pandemic, children were bearing the brunt of broken food systems and poor diets, leading to an alarming nutrition and health crisis worldwide, and a triple burden of malnutrition: undernutrition, in the form of stunting and wasting, widespread micronutrient deficiencies, and a growing prevalence of overweight and obesity.

Globally, 1 in 3 children is not growing well due to malnutrition – a leading cause of child mortality worldwide – while 2 in 3 don’t have access to the minimum diverse diets they need to grow, develop and learn. We continue to see stubbornly high rates of wasting, and a worrying increase in overweight and obesity among young children.

In recent decades, changes in our global food systems – including the practices used to grow, distribute, market, consume, and dispose of our food – mean that the most nutritious and safe foods are too costly or inaccessible to millions of families. Many increasingly turn to processed foods that are affordable, widely available, and aggressively marketed, but often high in unhealthy sugar, fats and salt.

A toxic combination of rising poverty, inequality, conflict, climate change, and COVID-19 is further threatening food systems and children’s nutritional well-being, especially those from the poorest and most vulnerable communities and households.

A transformation of the food system that listens to the voices of children and young people, and unlocks nutritious, safe, affordable and sustainable diets for every child, everywhere, must be at the heart of strategies, policies and investments. UNICEF and WHO call on governments and decision-makers to scale up effective approaches that include:

  • Incentivizing healthy diets through price policies, including subsidies to reduce the price of nutritious foods such as eggs, dairy, fruits, vegetables and wholegrains, or taxes to increase the price of unhealthy options.
  • Improving the nutritional quality of food through mandatory fortification of staple foods with essential micronutrients, the reduction of sodium and sugar, and the elimination of industrially produced trans fats in processed foods.
  • Using public procurement of food as a lever to promote healthy diets and drive sustainable food systems, for example through schools, workplaces, hospitals, and social-protection programmes.
  • Protecting children from the harmful impacts of marketing of unhealthy foods and beverages through strengthened regulatory measures and better enforcement.
  • Protecting and supporting mothers and caregivers to optimally breastfeed their babies, including maternal protection and parental leave, and the implementation of the International Code of Marketing of Breast-milk Substitutes.
  • Putting in place mandatory, easy-to-understand nutrition labelling policies and practices to help children and families make healthier choices with the right information.
  • Supporting healthy feeding and dietary practices through the food, health, education, and social protection systems with easy to understand, coherent and memorable communication strategies.

Only then will we improve the quality, safety and affordability of the foods that children and young people have access to; the environments in which they grow, learn, play and eat, and the sustainability of the planet they live in.

By joining forces with governments, civil society, families, development and humanitarian partners, private sector stakeholders, and children and young people themselves, we can uphold our promise to deliver good nutrition and a healthier planet for every child and every adult, everywhere.

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About UNICEF

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across more than 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

Follow UNICEF on TwitterFacebookInstagram and YouTube

 

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 to protect yourself from coronavirus, visit www.who.int and follow WHO on TwitterFacebookInstagramLinkedInTikTokPinterestSnapchatYouTubeTwitch 

WHO reports progress in the fight against tobacco epidemic

Mon, 07/26/2021 - 15:57

Many countries are making progress in the fight against tobacco, but a new World Health Organization report shows some are not addressing emerging nicotine and tobacco products and failing to regulate them.

Increased adoption of WHO-recommended tobacco control measures

More than four times as many people are now covered by at least one WHO-recommended  tobacco control measure as compared with 2007. The six MPOWER measures are monitoring tobacco use and preventive measures; protecting people from tobacco smoke; offering help to quit; warning about the dangers of tobacco; enforcing bans on advertising, promotion and sponsorship; and raising taxes on tobacco.

Some 5.3 billion people are now covered by at least one of these measures - more than four times the 1 billion who were covered in 2007.

More than half of all countries and half the world’s population are now covered by at least two MPOWER measures at the highest level of achievement. This reflects an increase of 14 countries and almost one billion more people since the last report in 2019.

More than half of the world’s population are exposed to tobacco products with graphic health warnings.  However, progress has not been even across all MPOWER measures. Some measures like raising tobacco taxes have been slow to move and 49 countries remain without any MPOWER measures adopted.

Need to tackle threats posed by new nicotine and tobacco products.

For the first time, the 2021 report presents new data on electronic nicotine delivery systems, such as ‘e-cigarettes’. These products are often marketed to children and adolescents by the tobacco and related industries that manufacture them, using thousands of appealing flavours and misleading claims about the products..

WHO is concerned that children who use these products are up to three times more likely to use tobacco products in the future.  The Organization recommends governments to implement regulations to stop non-smokers from starting to use them, to prevent renormalization of smoking in the community, and to protect future generations..

“Nicotine is highly addictive. Electronic nicotine delivery systems are harmful, and must be better regulated,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, “Where they are not banned, governments should adopt appropriate policies to protect their populations from the harms of electronic nicotine delivery systems, and to prevent their uptake by children, adolescents and other vulnerable groups.”.

84 countries lack safe-guards to protect from unregulated proliferation of electronic nicotine delivery systems

Currently, 32 countries have banned the sale of electronic nicotine delivery systems (ENDS). A further 79 have adopted at least one partial measure to prohibit the use of these products in public places, prohibit their advertising, promotion and sponsorship or require the display of health warnings on packaging. This still leaves 84 countries where they are not regulated or restricted in any way.

Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases and Injuries and founder of Bloomberg Philanthropies, said “More than 1 billion people around the world still smoke. And as cigarette sales have fallen, tobacco companies have been aggressively marketing new products – like e-cigarettes and heated-tobacco products – and lobbied governments to limit their regulation. Their goal is simple: to hook another generation on nicotine. We can’t let that happen.”

Dr Rüdiger Krech, Director of the Health Promotion Department at WHO, highlighted the challenges associated with their regulation. “These products are hugely diverse and are evolving rapidly. Some are modifiable by the user so that nicotine concentration and risk levels are difficult to regulate. Others are marketed as ‘nicotine-free’ but, when tested, are often found to contain the addictive ingredient. Distinguishing the nicotine-containing products from the non-nicotine, or even from some tobacco-containing products, can be almost impossible. This is just one way the industry subverts and undermines tobacco control measures.”

The proportion of people using tobacco has declined in most countries, but population growth means the total number of people smoking has remained stubbornly high. Currently, of the estimated 1 billion smokers globally, around 80% of whom live in low- and middle-income countries (LMICs). Tobacco is responsible for the death of 8 million people a year, including 1 million from second-hand smoke.

While ENDS should be regulated to maximize protection of public health, tobacco control must remain focused on reducing tobacco use globally. MPOWER and other regulatory measures can be applied to ENDS.

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Editor’s note:

The eighth WHO Report on the global tobacco epidemic launched today summarizes national efforts to implement the most effective demand reduction measures from the WHO Framework Convention on Tobacco Control (WHO FCTC) that are proven to reduce tobacco use. These measures are known collectively as “MPOWER”.

The MPOWER interventions, have been shown to save lives and reduce costs from averted healthcare expenditure. The first MPOWER report was launched in 2008 to promote government action on six tobacco control strategies in-line with the WHO FCTC to:

  • Monitor tobacco use and prevention policies.
  • Protect people from tobacco smoke.
  • Offer help to quit tobacco use.
  • Warn people about the dangers of tobacco.
  • Enforce bans on tobacco advertising, promotion and sponsorship.
  • Raise taxes on tobacco.

 

The WHO report on the global tobacco epidemic, 2021, finds that:

  • Since 2007, 102 countries have introduced one or more MPOWER measures at the highest level of achievement.
  • More than half of all countries are now covered by graphic health warnings on tobacco packaging at best-practice level
  • While being the most effective way to reduce tobacco use, taxation is still the MPOWER policy with the lowest population coverage and has not increased from the 13% achieved in 2018.
  • Of the 5.3 billion people protected by at least one MPOWER measure, over 4 billion live in low- and middle-income countries (LMICs) (or 65% of all people in LMICs).
  • 49 countries have yet to adopt a single MPOWER measure at the highest level of achievement – 41 are LMICs.
  • In the world’s 29 low-income countries, 15 today have at least one MPOWER policy in place at best-practice level compared to three in 2007, showing that income level is not a barrier to best-practice tobacco control
  • Most high income countries (HICs) (78%) regulate ENDS, and 7% have a ban on sales without any other regulation. Among MICs, 40% regulate ENDS, and 10% have a ban on sales without any other regulation, leaving half of middle income countries (MICs) neither regulating ENDS nor banning their sale. In contrast, 76% of LICs neither regulate ENDS nor ban their sale.

 

 

For each MPOWER measure, there have been new countries that have implemented some of the measures at the best practice level since the last report:

  • Five countries (Bolivia, Ethiopia, Jordan, Paraguay, Saint Lucia) newly adopted complete smoke-free laws covering all indoor public places, workplaces and public transport.
  • Five countries (Austria, Cook Islands, Jordan, Philippines, Tonga) advanced to best-practice level with their tobacco use cessation services. However, during the same period, three other countries dropped from the highest group, resulting in a net gain of only two countries.543
  • Eight countries (Ethiopia, Gambia, Mauritania, Montenegro, Niger, Nigeria, Qatar, United States of America) adopted large graphic pack warnings.
  • Five countries (Cote d’Ivoire, Ethiopia, Iraq, Jordan, Venezuela (Bolivarian Republic of)) introduced comprehensive bans on tobacco advertising, promotion and sponsorship (TAPS), including at point-of-sale.
  • Six countries (Denmark, Georgia, Morocco, Netherlands, Portugal, Sri Lanka) moved to the best-practice group by levying taxes that comprise at least 75% of retail prices.

 

 

Together to #ENDviolence: Leaders' Statement. Six game-changing actions to End Violence Against Children

Fri, 07/23/2021 - 14:13

One billion children experience violence and abuse every year. That shocking figure has risen even higher during the COVID-19 pandemic. Violence prevention and response services have been disrupted for 1.8 billion children living in more than 100 countries. 1.5 billion young people affected by school closures lost the protection and support that schools often provide.

Measures to contain the virus, along with economic hardship and family stress, have combined to create ‘perfect storm’ conditions for children vulnerable to observing or experiencing physical, emotional and sexual abuse. Despite the benefits of digital connectivity, a life lived more online for learning, socialising and gaming has significantly increased children’s exposure to those who wish to harm them.

Today, we stand at a critical moment for the world’s children. Unless we act now and with urgency, we risk losing a generation of children to the long-term impacts of violence and abuse that will undermine child safety, health, learning and development long after the pandemic subsides. We cannot let that happen.

As the world starts to emerge from the pandemic, we have an opportunity to reimagine and create more peaceful, just and inclusive societies. Now is the time to redouble our collective efforts and translate what we know works into accelerated progress towards the goal of a world where every child grows-up safe, secure and in a nurturing environment.

We must create a world: where every child can grow up and thrive with dignity; where violence and abuse of children is legally outlawed and socially unacceptable; where the relationship between parents and children prevents the intergenerational transmission of violence; where children in every community can safely take advantage of the digital world for learning, playing and socialising; where girls and boys experience stronger developmental and educational outcomes because schools and other learning environments are safe, gender-sensitive, inclusive and supportive; where sport is safe for children; where every effort is made to protect the most vulnerable children from all forms of violence, exploitation and abuse, including those living in situations of conflict and fragility (including climate-related fragility); and where all children can access safe and child-friendly help when they need it.

The moral imperative and economic case for action to end violence against children are compelling. Action today will not only prevent the devastating intergenerational social and economic impacts of violence on children, families and societies; it will also help to address the wider impacts of COVID-19 and support progress towards multiple Sustainable Development Goals.

Together, as leaders of organisations committed to ending violence against children, we urge leaders in government, the private sector, faith communities, multilateral organisations, civil society and sports bodies to seize the moment and be champions of this agenda in their countries, organisations, networks and communities. We call on these leaders to prioritise protecting children in their policies, planning, budgets and communications, and to work together to deliver six game-changing actions to end violence against children:

  • Ban all forms of violence against children by 2030
  • Equip parents and caregivers to keep children safe
  • Make the internet safe for children
  • Make schools safe, non-violent and inclusive
  • Protect children from violence in humanitarian settings
  • More investment, better spent

As global organisations working to end violence against children, we will continue to advocate for and invest in effective child protection, promoting solutions that recognise the different ways in which girls and boys experience violence and abuse. We will collectively develop and share technical resources and guidance for policymakers, practitioners, parents, caregivers and children themselves. And we will support the courageous health, education, child protection and humanitarian professionals working alongside faith leaders, community volunteers, parents and young people to keep children safe during these unprecedented times.

In recent years, we have made significant gains in protecting children from violence. We must do all we can to keep children safe during the current turmoil, and work together to build back better — to end all forms of violence, abuse and exploitation of children.

Signatories

  • Alice Albright, CEO, Global Partnership for Education
  • Niklas Andréen, President and Chief Operating Officer, Carlson Wagonlit Travel
  • Inger Ashing, CEO, Save the Children International
  • Audrey Azoulay, Director-General, UNESCO
  • Irakli Beridze, Head of the Centre for Artificial Intelligence and Robotics, UNICRI
  • Scott Berkowitz, President and Founder, RAINN
  • Anna Borgstrom, CEO, NetClean
  • Professor Lucle Cluver, Universities of Oxford and Cape Town
  • Julie Cordua, CEO, Thorn
  • Bob Cunningham, CEO, International Centre for Missing and Exploited Children
  • Professor Jennifer Davidson, Executive Director, Inspiring Children’s Futures, Uni. of Strathclyde
  • Michelle DeLaune, Chief Operating Officer, National Center for Missing & Exploited Children
  • Iain Drennan, Executive Director, WeProtect Global Alliance
  • Suzanne Ehlers, CEO, Malala Fund
  • Helga Fogstad,, Executive-Director, PMNCH
  • Henrietta H. Fore, Executive Director, UNICEF
  • Dr. Debi Fry, Co-Director, End Violence Lab, University of Edinburgh
  • Virginia Gamba, UN Special Representative of the Secretary-General for Children and Armed Conflict
  • Meg Gardinier, Secretary General, ChildFund Alliance
  • Dr. Tedros Adhanom Ghebreyesus, Director-General, WHO
  • Filippo Grandi, UN High Commissioner for Refugees
  • Paula Guillet de Monthoux, Secretary General, World Childhood Foundation
  • Susie Hargreaves, CEO, Internet Watch Foundation
  • Mary Harvey, CEO, Centre for Sport and Human Rights
  • Denton Howard, Executive Director, INHOPE
  • Ingrid Johansen, CEO, SOS Children’s Villages International
  • Eylah Kadjar, Secretary General ad Interim, Terre des Hommes International Federation
  • Baroness Beeban Kidron OBE, Founder and Chair, 5Rights Foundation
  • Patrick Krens, Executive Director, Child Helpline International
  • Dr. A.K. Shiva Kumar, Global Co-Chair, Know Violence in Childhood
  • Dr. Daniela Ligiero, Executive Director and CEO, Together for Girls
  • Elizabeth Lule, Executive Director, Early Childhood Development Action Network
  • Dr. Najat Maalla M’jid, UN Special Representative of the Secretary-General on Violence Against Children
  • Rev. Keishi Miyamoto, President, Arigatou International
  • Phumzile Mlambo-Ngcuka, Executive Director, UN Women
  • Andrew Morley, President and CEO, World Vision International
  • Thomas Muller, Acting Executive Director, ECPAT International
  • Raj Nooyi, Interim CEO, Plan International
  • Dr. Joan Nyanyuki, Executive Director, African Child Policy Forum
  • Mabel van Oranje, Founder and Board Chair, Girls Not Brides
  • Pramila Patten, UN Special Representative of the Secretary-General on Sexual Violence in Conflict
  • Joy Phumaphi, Board Co-Chair, Global Partnership to End Violence Against Children
  • Rev. Prof. Dr. Ioan Sauca, Acting General Secretary, World Council of Churches
  • Dr. Rajeev Seth, Chair of the Board, IPSCAN
  • Yasmine Sherif, Director, Education Cannot Wait
  • Dr. Howard Taylor, Executive Director, Global Partnership to End Violence Against Children
  • Helle Thorning-Schmidt, Board Co-Chair, Global Partnership to End Violence Against Children
  • Liv Tørres, Director, Pathfinders for Peaceful, Just and Inclusive Societies, New York University
  • Dr. Jennifer Wortham, Chair, World Day Global Collaborative

New report reveals stark inequalities in access to HIV prevention and treatment services for children—partners call for urgent action

Wed, 07/21/2021 - 23:39

Almost half (46%) of the world’s 1.7 million children living with HIV were not on treatment in 2020 and 150 000 children were newly infected with HIV, four times more than the 2020 target of 40 000

In the final report from the Start Free, Stay Free, AIDS Free initiative, UNAIDS and partners* warn that progress towards ending AIDS among children, adolescents and young women has stalled and none of the targets for 2020 were met.

The report shows that the total number of children on treatment declined for the first time, despite the fact that nearly 800 000 children living with HIV are not currently on treatment. It also shows that opportunities to identify infants and young children living with HIV early are being missed—more than one third of children born to mothers living with HIV were not tested. If untreated, around 50% of children living with HIV die before they reach their second birthday. 

“Over 20 years ago, initiatives for families and children to prevent vertical transmission and to eliminate children dying of AIDS truly kick-started what has now become our global AIDS response. This stemmed from an unprecedented activation of all partners, yet, despite early and dramatic progress, despite more tools and knowledge than ever before, children are falling way behind adults and way behind our goals,” said Shannon Hader, UNAIDS Deputy Executive Director, Programme. “The inequalities are striking—children are nearly 40% less likely than adults to be on life-saving treatment (54% of children versus 74% of adults), and account for a disproportionate number of deaths (just 5% of all people living with HIV are children, but children account for 15% of all AIDS-related deaths). This is about children’s right to health and healthy lives, their value in our societies.  It’s time to reactivate on all fronts—we need the leadership, activism, and investments to do what’s right for kids.”

Start Free, Stay Free, AIDS Free is a five-year framework that began in 2015, following on from the hugely successful Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. It called for a super Fast-Track approach to ensure that every child has an HIV-free beginning, that they stay HIV-free through adolescence and that every child and adolescent living with HIV has access to antiretroviral therapy. The approach intensified focus on 23 countries, 21 of which were in Africa, that accounted for 83% of the global number of pregnant women living with HIV, 80% of children living with HIV and 78% of young women aged 15–24 years newly infected with HIV.

“The HIV community has a long history of tackling unprecedented challenges, today we need that same energy and perseverance to address the needs of the most vulnerable—our children. African leaders have the power to help us change the pace of care and should act and lead until no child living with HIV is left behind,” said Ren Minghui, Assistant Director-General of the Universal Health Coverage/Communicable and Noncommunicable Diseases Division of the World Health Organization.

Although the 2020 targets were missed, the 21 focus countries in Africa made better progress than the non-focus countries. However, there were major disparities between countries, and these countries still bear the highest burden of disease: 11 countries account for nearly 70% of the “missing children”—those living with HIV but not on treatment. There was a 24% decline in new HIV infections among children from 2015 to 2020 in focus countries versus a 20% decline globally. Focus countries also achieved 89% treatment coverage for pregnant women living with HIV, compared to 85% globally, but still short of the target of 95%, and there were huge differences between countries. For example, Botswana achieved 100% treatment coverage, yet the Democratic Republic of the Congo only reached 39%.

“While we are deeply distressed by the global paediatric HIV shortfalls, we are also encouraged by the fact that we largely have the tools we need to change this,” said Angeli Achrekar, Acting United States Global AIDS Coordinator. “So, let this report be a call to action to challenge complacency and to work tirelessly to close the gap.”

The report outlines three actions necessary to end new HIV infections among children in the focus countries. First, reach pregnant women with testing and treatment as early as possible—66 000 new HIV infections occurred among children because their mothers did not receive treatment at all during pregnancy or breastfeeding. Second, ensure the continuity of treatment and viral suppression during pregnancy, breastfeeding and for life—38 000 children became newly infected with HIV because their mothers were not continued in care during pregnancy and breastfeeding. Third, prevent new HIV infections among women who are pregnant and breastfeeding—35 000 new infections among children occurred because a woman became newly infected with HIV during pregnancy or breastfeeding.

There has been some progress in preventing adolescent girls and young women from acquiring HIV. In the focus countries, the number of adolescent girls and young women acquiring HIV declined by 27% from 2015 to 2020. However, the number of adolescent girls and young women acquiring HIV in the 21 focus countries was 200 000, twice the global target for 2020 (100 000). In addition, COVID-19 and school closures are now disrupting many educational and sexual and reproductive health services for adolescent girls and young women, highlighting the urgent need to redouble HIV prevention efforts to reach young women and adolescent girls.

“The lives of the most vulnerable girls and young women hang in the balance, locked into deeply entrenched cycles of vulnerability and neglect that must urgently be interrupted. With the endorsement of United Nations Member States, the new global AIDS strategy recommits us all to address these intersecting vulnerabilities to halt and reverse the effects of HIV by 2030. We know that rapid gains can be achieved for girls and young women; what is needed is the courage to apply the solutions, and the discipline to implement these with rigor and scale,” said Chewe Luo, United Nations Children’s Fund Chief of HIV and Associate Director of Health Programmes.

UNAIDS and partners will continue to work together to develop new frameworks to address the unfinished agenda. New targets for 2025 were officially adopted by United Nations Member States in the 2021 Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030 in June this year, providing a road map for the next five years.

“It is clear that ending mother-to-child transmission requires innovative approaches that support the whole woman throughout the life course, including intensified primary prevention efforts, such as pre-exposure prophylaxis (PrEP), access to comprehensive reproductive care, and focused attention on adolescent girls and young women. The Start Free, Stay Free, AIDS Free report includes new the new targets for 2025 that, if met, will propel a new era of HIV prevention and treatment for women, children and families. This is not the time for complacency, but rather an opportunity to redouble investments to reduce and eliminate mother-to-child transmission,” said Chip Lyons, President and Chief Executive Officer of the Elizabeth Glaser Pediatric AIDS Foundation.

*The United States President’s Emergency Plan for AIDS Relief, UNAIDS, the United Nations Children’s Fund and the World Health Organization, with support from the Elizabeth Glaser Pediatric AIDS Foundation.

UNAIDS
The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

PEPFAR
PEPFAR is the largest commitment by any nation to address a single disease in history. Managed and overseen by the U.S. Department of State, and supported through the compassion and generosity of the American people, PEPFAR has saved 20 million lives, prevented millions of infections, and helped transform the global AIDS response.

UNICEF
UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across more than 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. Follow UNICEF on Twitter, Facebook, Instagram and YouTube

WHO
Dedicated to the well-being of all people and guided by science, the World Health Organization (WHO) leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life. We are the UN agency for heath that connects nations, partners and people on the front lines in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to promote health, keep the world safe and serve the vulnerable. www.who.int

Elizabeth Glaser Pediatric AIDS Foundation
EGPAF is a proven leader in the fight for an AIDS-free generation and has reached over 31 million pregnant women with services to prevent transmission of HIV to their babies. Founded in 1988, EGPAF has supported over 15,000 sites and currently works in 17 countries to offer HIV counseling, prevention, diagnosis, and treatment services alongside high-quality family health care. Each stage of life—from infancy to adulthood—brings new and different challenges, and EGPAF is driven to see a world where no other mother, child, or family is devastated by this disease. For more information, visit www.pedaids.org.

Vaccine inequity undermining global economic recovery

Wed, 07/21/2021 - 20:45
New Global Dashboard on COVID-19 Vaccine Equity finds low-income countries would add $38 billion to their GDP forecast for 2021 if they had the same vaccination rate as high-income countries. Global economic recovery at risk if vaccines are not equitably manufactured, scaled up and distributed.

International Paralympic Committee, World Health Organization sign memorandum of understanding to cooperate in the promotion of diversity and equity in health and sports

Wed, 07/21/2021 - 13:58
The World Health Organization (WHO) and the International Paralympic Committee (IPC) today signed an agreement to work together to foster diversity and equity through global initiatives promoting health and sport for everybody, everywhere.

WFP and WHO launch innovative project on Emergency Health Facilities

Mon, 07/19/2021 - 15:10

Following the recent G20 side event co-hosted by the Italian Government and the United Nations World Food Programme (WFP) focusing on the role of logistics in current and future health emergencies, WFP and the World Health Organization (WHO) are launching INITIATE2, a joint project to bring together emergency actors, research and academic institutions, and international and national partners to promote knowledge sharing and skills transfer for improved emergency response to health crises.

INITIATE² will develop standardized, innovative solutions such as disease-specific field facilities and kits and test these solutions in real-life scenarios. The agencies will also train logistics and health responders on their installation and use, contributing to their capacity to respond in health crises. The project will be developed and replicated in countries for relevant personnel, building on past experiences in emergency response.

“Health emergencies like the West Africa Ebola response and the current COVID-19 pandemic have shown just how crucial working together as a humanitarian community is, and so we’re extremely pleased to be able to further cement our role as an enabler of humanitarian response through this collaboration with WHO,” said Alex Marianelli, WFP Director of Supply Chain.

“The WHO-WFP-led COVID-19 Supply Chain System has already illustrated an end-to-end integration of technical and operational capacities for impact,” said Dr Ibrahima Soce-Fall, Assistant Director-General for Emergencies Response, WHO. “With INITIATE2, WFP and WHO are now extending the collaboration to build synergies among different actors and foster innovation in this critical field, to quickly respond to health emergencies and create a conducive environment for knowledge sharing and skills transfer. This is an excellent example of how we can scale and harmonize emergency preparedness, readiness, and response.”

The United Nations World Food Programme is the 2020 Nobel Peace Prize Laureate. We are the world’s largest humanitarian organization, saving lives in emergencies and using food assistance to build a pathway to peace, stability and prosperity for people recovering from conflict, disasters and the impact of climate change.

Follow us on Twitter @wfp_media @wfplogistics

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, 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 well-being.

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

The initiative will combine WFP and WHO’s technical expertise and will leverage the existing infrastructure of the United Nations Humanitarian Response Depot in Brindisi, the first in a network of six strategically located hubs around the world which store and dispatch relief items on behalf of the humanitarian community. INITIATE2 will capitalise on these facilities and experience: the Brindisi hub is regularly used to organize large-scale emergency simulations and hosts the UNHRD Lab, where innovative emergency response products are developed and tested.

 

 

Updated WHO SAGE Roadmap for prioritizing uses of COVID-19 vaccines in the context of limited supply

Fri, 07/16/2021 - 16:10

This interim guidance was initially issued in October 2020, based on advice from the Strategic Advisory Group of Experts (SAGE) on Immunization; it has been updated following the discussions at an extraordinary meeting of SAGE on 29 June 2021.  A summary of the major revisions appears in Annex 3 (page 20), including evolving key assumptions and epidemiological considerations.

For further information, see below:

WHO SAGE Roadmap For Prioritizing Uses Of COVID-19 Vaccines In The Context Of Limited Supply

Statement on the eighth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic

Thu, 07/15/2021 - 15:54

The eighth meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the coronavirus disease (COVID-19) took place on Wednesday, 14 July 2021 from 11:30 to 16:00 Geneva time (CEST).

Proceedings of the meeting

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

The Director-General welcomed the Committee and reiterated his global call for action to scale up vaccination and implement rationale use of public health and social measures (PHSM). He thanked the Committee for their continued support in identifying key challenges and solutions that countries can use to overcome the issues posed by the pandemic.  

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

The Secretariat turned the meeting over to the Chair, Professor Didier Houssin. Professor Houssin also expressed concern over the current trends with the COVID-19 pandemic and reviewed the objectives and agenda of the meeting. 

The Secretariat presented on the global epidemiological context, shared updates on travel guidance and measures taken by countries and provided an overview of the World Health Assembly 74’s decisions and resolutions that relate to the role and functioning of the IHR Emergency Committee. The Secretariat also highlighted factors driving the current situation including:

  • variants of concern,
  • inconsistent application of public health and social measures,
  • increased social mobility, and
  • highly susceptible populations due to lack of equitable vaccine distribution.


The Committee discussed key themes including:

  • global inequitable access to COVID-19 vaccines which is compounded by use of the available vaccines beyond SAGE recommended priority populations and the administration of booster doses while many countries do not have sufficient access to initial doses;
  • the need for technology transfer to enhance global vaccination production capacity,
  • the importance of adapting PHSM to epidemiological and socio-economic contexts and to diverse types of gatherings,
  • challenges posed by the lack of harmonization in documentation requirements for vaccination and recovery status for international travel, 
  • threats posed by current and future SARS CoV-2 variants of concern, and
  • efforts made by some States Parties to apply a risk-management approach to religious or sports-based mass gathering events.

The pandemic remains a challenge globally with countries navigating different health, economic and social demands. The Committee noted that regional and economic differences are affecting access to vaccines, therapeutics, and diagnostics. Countries with advanced access to vaccines and well-resourced health systems are under pressure to fully reopen their societies and relax the PHSM. Countries with limited access to vaccines are experiencing new waves of infections, seeing erosion of public trust and growing resistance to PHSM, growing economic hardship, and, in some instances, increasing social unrest.

As a result, governments are making increasingly divergent policy decisions that address narrow national needs which inhibit a harmonized approach to the global response. In this regard, the Committee was highly concerned about the inadequate funding of WHO’s Strategic Preparedness and Response Plan and called for  more flexible and predictable funding to support WHO’s leadership role in the global pandemic response.

The Committee noted that, despite national, regional, and global efforts, the pandemic is nowhere near finished. The pandemic continues to evolve with four variants of concern dominating global epidemiology. The Committee recognised the strong likelihood for the emergence and global spread of new and possibly more dangerous variants of concern that may be even more challenging to control.

The Committee expressed appreciation for States Parties engaging in research to increase understanding of COVID-19 vaccines and requested that clinical trial volunteers not be disadvantaged in travel arrangements due to their participation in research studies. At the same time, the risk of emergence of new zoonotic diseases while still responding to the current pandemic has been emphasised by the Committee.  The Committee noted the importance of States Parties’ continued vigilance for detection and mitigation of new zoonotic diseases.

The Committee unanimously agreed that the COVID-19 pandemic still constitutes an extraordinary event that continues to adversely affect the health of populations around the world, poses a risk of international spread and interference with international traffic, and requires a coordinated international response. As such, the Committee concurred that the COVID-19 pandemic remains a public health emergency of international concern (PHEIC) and offered the following advice to the Director-General.

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

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

Advice to the WHO Secretariat

  1. Continue to work with States Parties to implement PHSM to control transmission, taking into account the acceptability, feasibility, costs, effects, and the balance between benefits and harms in each epidemiological and socio-economic context.
  2. Continue to advocate for equitable vaccine access and distribution by encouraging sharing of available vaccine doses, expanded local production capacity in low- and middle-income countries, waiving intellectual property rights, leveraging technology transfer, scale up of manufacturing, and calling for the necessary global funding. Update and disseminate guidance related to appropriate use of vaccines (including topics such as booster doses and heterologous use of vaccines).
  3. Expedite the work to establish updated means for documenting COVID-19 status of travelers, including vaccination, history of SARS-CoV-2 infection, and SARS-CoV-2 test results. This includes both an interim update to the WHO booklet containing the International Certificate of Vaccination and Prophylaxis and digital solutions which allow for verification of relevant information. 
  4. Continue to strengthen the global monitoring and assessment framework for SARS CoV-2 variants and provide updated guidance to support States Parties in establishing, leveraging, and expanding genomic sequencing capacities as well as timely sharing of information, data, and samples.
  5. Strengthen communication strategies at national, regional and global levels to reduce COVID-19 transmission and counter misinformation, including rumours that fuel vaccine hesitancy. This will require reinforcing messages that a comprehensive public health response continues to be needed, including the continued use of PHSM regardless of vaccination coverage.
  6. Collect information from States Parties on their uptake and progress made in implementing the Temporary Recommendations.

Temporary Recommendations to States Parties

While the Committee noted that there are nuances associated with diverse regional contexts related to the implementation of the Temporary Recommendations, they identified the following as critical for all countries:                  

  1. Continue to use evidence-informed PHSM based on real time monitoring of the epidemiologic situation and health system capacities, taking into account the potential cumulative effects of these measures. The use of masks, physical distancing, hand hygiene, and improved ventilation of indoor spaces remains key to reducing transmission of SARS CoV-2. The use of established public health measures in response to individual cases or clusters of cases, including contact tracing, quarantine and isolation, must continue to be adapted to the epidemiological and social context and enforced. Link to WHO guidance
  2. Implement a risk-management approach for mass gathering events by evaluating, mitigating, and communicating risks. Recognizing that there are different drivers and risk tolerance for mass gatherings, it is critical to consider the epidemiological context (including the prevalence of variants of concern, the strength of transmission, as well as contract tracing and testing capacity) when conducting this risk assessment in line with WHO guidance. Link to WHO guidance.
  3. Achieve the WHO call to action to have at least 10% of all countries’ populations vaccinated by September 2021. Increased global solidarity is needed to protect vulnerable populations from the emergence and spread of SARS CoV-2 variants. Noting that many countries have now vaccinated their priority populations, it is recommended that doses should be shared with countries that have limited access before expanding national vaccination programmes into lower risk groups. Vaccination programmes should include vulnerable populations, including sea farers and air crews. Link to WHO guidance.
  4. Enhance surveillance of SARS-CoV-2 and continue to report to WHO to enable rapid identification, tracking, and evaluation of variants and continued monitoring of the pandemic’s evolution. To achieve this recommendation, States Parties may need to strengthen their epidemiological and virologic (including genomic) surveillance and reporting systems or share samples with countries that have this capacity. Link to WHO guidance.
  5. Improve access to and safe administration of WHO recommended therapeutics, including oxygen, to treat COVID-19. In addition, it is important for States Parties to conduct clinical research on and support access to care for patients suffering from post COVID-19 condition (also known as long COVID). States Parties should also continue research on therapeutics for the prevention of COVID-19 infections where feasible. Link to WHO resource.
  6. Continue a risk-based approach to facilitate international travel and share information with WHO on use of travel measures and their public health rationale. In accordance with the IHR, measures (e.g. masking, testing, isolation/quarantine, and vaccination) should be based on risk assessments, consider local circumstances, and avoid placing the financial burden on international travellers in accordance with Article 40 of the IHR. Link to WHO guidance.
  7. Do NOT require proof of vaccination against COVID-19 for international travel as the only pathway or condition permitting international travel, given limited global access and inequitable distribution of COVID-19 vaccines.  Link to WHO interim position paper. State Parties should consider a risk-based approach to the facilitation of international travel by lifting measures, such as testing and/or quarantine requirements, when appropriate, in accordance with the WHO guidance. Link to WHO guidance.
  8. Recognize all COVID-19 vaccines that have received WHO Emergency Use Listing in the context of international travel. In addition, States Parties are encouraged to include information on COVID-19 status, in accordance with WHO guidance, within the WHO booklet containing the International Certificate of Vaccination and Prophylaxis; and to use the digitized version when available.
  9. Address community engagement and communications gaps at national and local levels to reduce COVID-19 transmission, counter misinformation, and improve COVID-19 vaccine acceptance, where applicable. This will require reinforcing messages that a comprehensive public health response is needed, including the continued use of PHSM alongside increasing vaccination coverage. Link to WHO risk communications resources.

COVID-19 pandemic leads to major backsliding on childhood vaccinations, new WHO, UNICEF data shows

Wed, 07/14/2021 - 14:19

23 million children missed out on basic vaccines through routine immunization services in 2020 – 3.7 million more than in 2019 - according to official data published today by WHO and UNICEF. This latest set of comprehensive worldwide childhood immunization figures, the first official figures to reflect global service disruptions due to COVID-19, show a majority of countries last year experienced drops in childhood vaccination rates.

Concerningly, most of these – up to 17 million children – likely did not receive a single vaccine during the year, widening already immense inequities in vaccine access. Most of these children live in communities affected by conflict, in under-served remote places, or in informal or slum settings where they face multiple deprivations including limited access to basic health and key social services.

“Even as countries clamour to get their hands on COVID-19 vaccines, we have gone backwards on other vaccinations, leaving children at risk from devastating but preventable diseases like measles, polio or meningitis,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Multiple disease outbreaks would be catastrophic for communities and health systems already battling COVID-19, making it more urgent than ever to invest in childhood vaccination and ensure every child is reached.”

In all regions, rising numbers of children miss vital first vaccine doses in 2020; millions more miss later vaccines

Disruptions in immunization services were widespread in 2020, with the WHO Southeast Asian and Eastern Mediterranean Regions most affected.  As access to health services and immunization outreach were curtailed, the number of children not receiving even their very first vaccinations increased in all regions. As compared with 2019, 3.5 million more children missed their first dose of diphtheria, tetanus and pertussis vaccine (DTP-1) while 3 million more children missed their first measles dose. 

“This evidence should be a clear warning – the COVID-19 pandemic and related disruptions cost us valuable ground we cannot afford to lose – and the consequences will be paid in the lives and wellbeing of the most vulnerable,” said Henrietta Fore, UNICEF Executive Director. “Even before the pandemic, there were worrying signs that we were beginning to lose ground in the fight to immunize children against preventable child illness, including with the widespread measles outbreaks two years ago. The pandemic has made a bad situation worse. With the equitable distribution of COVID-19 vaccines at the forefront of everyone’s minds, we must remember that vaccine distribution has always been inequitable, but it does not have to be.”

Table 1: Countries with the greatest increase in children not receiving a first dose of diphtheria-tetanus-pertussis combined vaccine (DTP-1)

 20192020India1'403'0003'038'000Pakistan567'000968'000Indonesia472'000797'000Philippines450'000557'000Mexico348000454'000Mozambique97'000186'000Angola399'000482'000United Republic of Tanzania183'000249'000Argentina97'000156'000Venezuela (Bolivarian Republic of)75'000134'000Mali136'000193'000

 

The data shows that middle-income countries now account for an increasing share of unprotected children – that is, children missing out on at least some vaccine doses. India is experiencing a particularly large drop, with DTP-3 coverage falling from 91% to 85%.

Fuelled by funding shortfalls, vaccine misinformation, instability and other factors, a troubling picture is also emerging in WHO’s Region of the Americas, where vaccination coverage continues to fall. Just 82% of children are fully vaccinated with DTP, down from 91% in 2016.

Countries risk resurgence of measles, other vaccine-preventable diseases

Even prior to the COVID-19 pandemic, global childhood vaccination rates against diphtheria, tetanus, pertussis, measles and polio had stalled for several years at around 86%. This rate is well below the 95% recommended by WHO to protect against measles –often the first disease to resurge when children are not reached with vaccines - and insufficient to stop other vaccine-preventable diseases.

With many resources and personnel diverted to support the COVID-19 response, there have been significant disruptions to immunization service provision in many parts of the world. In some countries, clinics have been closed or hours reduced, while people may have been reluctant to seek healthcare because of fear of transmission or have experienced challenges reaching services due to lockdown measures and transportation disruptions.

“These are alarming numbers, suggesting the pandemic is unravelling years of progress in routine immunization and exposing millions of children to deadly, preventable diseases”, said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “This is a wake-up call – we cannot allow a legacy of COVID-19 to be the resurgence of measles, polio and other killers. We all need to work together to help countries both defeat COVID-19, by ensuring global, equitable access to vaccines, and get routine immunization programmes back on track. The future health and wellbeing of millions of children and their communities across the globe depends on it.” 

Concerns are not just for outbreak-prone diseases. Already at low rates, vaccinations against human papillomavirus (HPV) - which protect girls against cervical cancer later in life - have been highly affected by school closures. As a result, across countries that have introduced HPV vaccine to date, approximately 1.6 million more girls missed out in 2020. Globally only 13% girls were vaccinated against HPV, falling from 15% in 2019.

Agencies call for urgent recovery and investment in routine immunization

As countries work to recover lost ground due to COVID-19 related disruptions, UNICEF, WHO and partners like Gavi, the Vaccine Alliance are supporting efforts to strengthen immunization systems by:

  • Restoring services and vaccination campaigns so countries can safely deliver routine immunization programmes during the COVID-19 pandemic;
  • Helping health workers and community leaders communicate actively with caregivers to explain the importance of vaccinations;
  • Rectifying gaps in immunization coverage, including identifying communities and people who have been missed during the pandemic.
  • Ensuring that COVID-19 vaccine delivery is independently planned for and financed and that it occurs alongside, and not at the cost of childhood vaccination services.
  • Implementing country plans to prevent and respond to outbreaks of vaccine-preventable diseases, and strengthen immunization systems as part of COVID-19 recovery efforts

The agencies are working with countries and partners to deliver the ambitious targets of the global Immunization Agenda 2030, which aims to achieve 90% coverage for essential childhood vaccines; halve the number of entirely unvaccinated, or ‘zero dose’ children, and increase the uptake of newer lifesaving vaccines such as rotavirus or pneumococcus in low and middle-income countries.

###

Notes for editors

Access the full data set here (from 15th July 2021): https://www.who.int/data/immunization

Multimedia: https://who.canto.global/b/PLVSO  https://weshare.unicef.org/Package/2AMZIFH25X95

Vaccines For All campaign page: https://www.unicef.org/vaccines

About the data

Based on country-reported data, the official WHO and UNICEF estimates of national immunization coverage (WUENIC) provide the world’s largest data-set on immunization trends for vaccinations against 13 diseases given through regular health systems - normally at clinics or community centres or health worker visits. For 2020, data was provided from 160 countries.

Globally, the vaccination rate for three doses of diphtheria-tetanus and pertussis (DTP-3) vaccine fell from around 86% in 2019 to 83% in 2020, meaning 22.7 million children missed out, and for measles first dose, from 86 to 84%, meaning 22.3 million children missed out. Vaccination rates for measles second dose were at 71% (from 70% in 2019).  To control measles, 95% uptake of two vaccine doses is required; countries that cannot reach that level rely on periodic nationwide vaccination campaigns to fill the gap. 

In addition to routine immunization disruptions, there are currently 57 postponed mass vaccination campaigns in 66 countries, for measles, polio, yellow fever and other diseases, affecting millions more people.

New modelling also shows significant declines in DTP, measles vaccination coverage

New modelling, also published today in The Lancet by researchers at the Washington-based Institute for Health Metrics and Evaluation (IHME), similarly shows that childhood vaccination declined globally in 2020 due to COVID-19 disruptions. The IHME-led modelling is based on country-reported administrative data for DTP and measles vaccines, supplemented by reports on electronic medical records and human movement data captured through anonymized tracking of mobile phones.

Both analyses show that countries and the broader health community must ensure that new waves of COVID-19 and the massive roll out of COVID 19 vaccines don’t derail routine immunization and that catch-up activities continue to be enhanced.

 

UN report: Pandemic year marked by spike in world hunger

Fri, 07/09/2021 - 11:28

There was a dramatic worsening of world hunger in 2020, the United Nations said today – much of it likely related to the fallout of COVID-19. While the pandemic’s impact has yet to be fully mapped, a multi-agency report estimates that around a tenth of the global population – up to 811 million people – were undernourished last year. The number suggests it will take a tremendous effort for the world to honour its pledge to end hunger by 2030.  

This year’s edition ofThe State of Food Security and Nutrition in the World is the first global assessment of its kind in the pandemic era. The report is jointly published by the Food and Agriculture Organization of the United Nations (FAO), the International Fund for Agricultural Development (IFAD), the United Nations Children’s Fund (UNICEF), the UN World Food Programme (WFP) and the World Health Organization (WHO).

Previous editions had already put the world on notice that the food security of millions – many children among them – was at stake. “Unfortunately, the pandemic continues to expose weaknesses in our food systems, which threaten the lives and livelihoods of people around the world,” the heads of the five UN agencies write in this year’s Foreword.

They go on to warn of a “critical juncture,” even as they pin fresh hopes on increased diplomatic momentum. “This year offers a unique opportunity for advancing food security and nutrition through transforming food systems with the upcoming UN Food Systems Summit, the Nutrition for Growth Summit and the COP26 on climate change.” “The outcome of these events,” the five add, “will go on to shape the […] second half of the UN Decade of Action on Nutrition” – a global policy commitment yet to hit its stride.

The numbers in detail

Already in the mid-2010s, hunger had started creeping upwards, dashing hopes of irreversible decline. Disturbingly, in 2020 hunger shot up in both absolute and proportional terms, outpacing population growth: some 9.9 percent of all people are estimated to have been undernourished last year, up from 8.4 percent in 2019.

More than half of all undernourished people (418 million) live in Asia; more than a third (282 million) in Africa; and a smaller proportion (60 million) in Latin America and the Caribbean. But the sharpest rise in hunger was in Africa, where the estimated prevalence of undernourishment – at 21 percent of the population – is more than double that of any other region.

On other measurements too, the year 2020 was sombre. Overall, more than 2.3 billion people (or 30 percent of the global population) lacked year-round access to adequate food: this indicator – known as the prevalence of moderate or severe food insecurity – leapt in one year as much in as the preceding five combined. Gender inequality deepened: for every 10 food-insecure men, there were 11 food-insecure women in 2020 (up from 10.6 in 2019).

Malnutrition persisted in all its forms, with children paying a high price: in 2020, over 149 million under-fives are estimated to have been stunted, or too short for their age; more than 45 million – wasted, or too thin for their height; and nearly 39 million – overweight. A full three-billion adults and children remained locked out of healthy diets, largely due to excessive costs. Nearly a third of women of reproductive age suffer from anaemia. Globally, despite progress in some areas – more infants, for example, are being fed exclusively on breast milk – the world is not on track to achieve targets for any nutrition indicators by 2030.

Other hunger and malnutrition drivers

In many parts of the world, the pandemic has triggered brutal recessions and jeopardized access to food. Yet even before the pandemic, hunger was spreading; progress on malnutrition lagged. This was all the more so in nations affected by conflict, climate extremes or other economic downturns, or battling high inequality – all of which the report identifies as major drivers of food insecurity, which in turn interact.

On current trends, The State of Food Security and Nutrition in the World estimates that Sustainable Development Goal 2 (Zero Hunger by 2030) will be missed by a margin of nearly 660 million people. Of these 660 million, some 30 million may be linked to the pandemic’s lasting effects.

What can (still) be done

As outlined in last year’s report, transforming food systems is essential to achieve food security, improve nutrition and put healthy diets within reach of all. This year’s edition goes further to outline six “transformation pathways”. These, the authors say, rely on a “coherent set of policy and investment portfolios” to counteract the hunger and malnutrition drivers.

Depending on the particular driver (or combination of drivers) confronting each country, the report urges policymakers to:

  • Integrate humanitarian, development and peacebuilding policies in conflict areas – for example, through social protection measures to prevent families from selling meagre assets in exchange for food;
  • Scale up climate resilience across food systems – for example, by offering smallholder farmers wide access to climate risk insurance and forecast-based financing;
  • Strengthen the resilience of the most vulnerable to economic adversity – for example, through in-kind or cash support programmes to lessen the impact of pandemic-style shocks or food price volatility;
  • Intervene along supply chains to lower the cost of nutritious foods – for example, by encouraging the planting of biofortified crops or making it easier for fruit and vegetable growers to access markets;
  • Tackle poverty and structural inequalities – for example, by boosting food value chains in poor communities through technology transfers and certification programmes;
  • Strengthen food environments and changing consumer behaviour – for example, by eliminating industrial trans fats and reducing the salt and sugar content in the food supply, or protecting children from the negative impact of food marketing.

The report also calls for an “enabling environment of governance mechanisms and institutions” to make transformation possible. It enjoins policymakers to consult widely; to empower women and youth; and to expand the availability of data and new technologies. Above all, the authors urge, the world must act now – or watch the drivers of hunger and malnutrition recur with growing intensity in coming years, long after the shock of the pandemic has passed.

 

Read the full report here and the In-Brief report here.

 

GLOSSARY

Hunger: an uncomfortable or painful sensation caused by insufficient energy from diet. Food deprivation; not eating enough calories. Used here interchangeably with (chronic) undernourishment. Measured by the prevalence of undernourishment (PoU).

Moderate food insecurity: a state of uncertainty about the ability to get food; a risk of skipping meals or seeing food run out; being forced to compromise on the nutritional quality and/or quantity of food consumed.

Severe food insecurity: running out of food; experienced hunger; at the most extreme, having to go without food for a day or more.

Malnutrition: the condition associated with deficiencies, excesses or imbalances in the consumption of macro- and/or micronutrients. For example, undernutrition and obesity are both forms of malnutrition. Child stunting or wasting are both indicators for undernutrition.

WHO recommends life-saving interleukin-6 receptor blockers for COVID-19 and urges producers to join efforts to rapidly increase access

Tue, 07/06/2021 - 22:28

The World Health Organization (WHO) has updated its patient care guidelines to include interleukin-6 receptor blockers, a class of medicines that are lifesaving in patients who are severely or critically ill with COVID-19, especially when administered alongside corticosteroids. 

These were the findings from a prospective and a living network meta-analysis initiated by WHO, the largest such analysis on the drugs to date. Data from over 10 000 patients enrolled in 27 clinical trials were considered. 

These are the first drugs found to be effective against COVID-19 since corticosteroids were recommended by WHO in September 2020. 

Patients severely or critically ill with COVID-19 often suffer from an overreaction of the immune system, which can be very harmful to the patient’s health. Interleukin-6 blocking drugs – tocilizumab and sarilumab – act to suppress this overreaction.  

The prospective and living network meta-analyses showed that in severely or critically ill patients, administering these drugs reduce the odds of death by 13%, compared to standard care. This means that there will be 15 fewer deaths per thousand patients, and as many as 28 fewer deaths for every thousand critically ill patients. The odds of mechanical ventilation among severe and critical patients are reduced by 28%, compared with standard care. This translates to 23 fewer patients out of a thousand needing mechanical ventilation. 

Clinical trial investigators in 28 countries shared data with WHO, including pre-publication data. Researchers worldwide compiled and analyzed the data. With the support of these critical partnerships, WHO has been able to issue a rapid and trustworthy recommendation for the use of interleukin-6 receptor blockers in severe and critical COVID-19 patients.

“These drugs offer hope for patients and families who are suffering from the devastating impact of severe and critical COVID-19. But IL-6 receptor blockers remain inaccessible and unaffordable for the majority of the world,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

“The inequitable distribution of vaccines means that people in low- and middle-income countries are most susceptible to severe forms of COVID-19. So, the greatest need for these drugs is in countries that currently have the least access. We must urgently change this.” 

To increase access and affordability of these life-saving products, WHO calls on manufacturers to reduce prices and make supplies available to low- and middle-income countries, especially where COVID-19 is surging. 

WHO also encourages companies to agree to transparent, non-exclusive voluntary licensing agreements using the C-TAP platform and the Medicines Patent Pool, or to waive exclusivity rights.

In addition, WHO has launched an expression of interest for prequalification of manufacturers of interleukin-6 receptor blockers. Prequalification of innovator and biosimilar products aims to expand the availability of quality-assured products and to increase access through market competition and reduce prices to meet urgent public health needs.

WHO pledges extensive commitments towards women’s empowerment and health

Mon, 07/05/2021 - 18:07

The World Health Organization announced multiple commitments to drive change for gender equality and the empowerment of women and girls in all their diversity at the Generation Equality Forum, held last week in Paris. The WHO commitments focused on ending gender-based violence; advancing sexual and reproductive health and rights; and supporting health workers as well as feminist movements and leadership. These commitments shape a progressive and transformative blueprint for advancing gender equality, health equity, human rights and the empowerment of women and girls globally.

The Forum, marking the twenty-fifth anniversary of the Beijing Declaration and Platform for Action on Women, came at a critical moment, with COVID-19 having exacerbated existing gender inequalities. WHO led in two key areas of the Forum: the Action Coalition on Gender-Based Violence (co-led with UN Women and other partners) and the Gender Equal Health and Care Workforce Initiative between France, Women in Global Health and WHO.

Recognizing the health sector has an important role to play in preventing and responding to gender-based violence against women and girls, WHO committed to:

WHO will partner with Wellspring, Ford Foundation, UN Women and the Government of the United Kingdom, in the launch of the Shared Agenda Advocacy Accelerator (the Accelerator) to advocate for increasing resources for preventing violence against women and girls. WHO will support the implementation of the International Labour Organization Convention No. 190 on Eliminating Violence and Harassment in the World of Work including by providing training to staff on a new internal policy, Preventing and Addressing Abusive Conduct. 

WHO also committed to investing in the evidence base for sexual and reproductive health and rights, including delivering comprehensive sexuality education outside school settings; improving access to quality and rights-based family planning in 14 middle-income countries ; supporting 25 countries in increasing adolescents’ access to and use of contraception; disseminating updated guidelines on safe abortion; and building knowledge among adolescents of their entitlements and ability to advocate for their needs. 

Together with UNFPA and UNICEF, WHO committed to work to end harmful practices like female genital mutilation and child, early and forced marriages. The health sector will be supported to end medicalization of female genital mutilation and provide quality health services to women and girls living with female genital mutilation and married girls.  

At a high-level event focusing on the Gender Equal Health and Care Workforce Initiative, WHO Director-General Dr Tedros Adhanom Ghebreyesus reiterated WHO’s commitment to advocating for decent and safe work conditions for all health and care workers, especially women. Several countries and organizations announced commitments towards the four pillars of the Initiative: gender equal leadership; equal pay; protection against sexual harassment and violence; decent and safe working conditions. The Gender Equal Health and Care Workforce Initiative will convene again during the United Nations General Assembly in September 2021.

WHO along with other UN agencies declared solidarity with and support to feminist movements and women human rights defenders, committing to expand an open, safe and inclusive civic space for their work. This commitment is closely linked to the UN Secretary-General's Call to Action for Human Rights and the recently published UN Guidance on Promoting and Protecting Civic Space. WHO will:

  • Update its gender policy, strategy and roadmap;
  • Open specific internship opportunities for individuals with feminist leadership experience;
  • Promote civil society participation in health systems, COVID-19 response and recovery activities;
  • Promote and encourage gender parity in World Health Assembly delegations, WHO panels and advisory groups; and
  • Facilitate menstrual hygiene and promote awareness.

WHO, as part of the Global Polio Eradication Initiative, also committed to  support countries to address gender-related barriers to polio vaccination, collect and analyse sex-disaggregated data to ensure girls and boys are reached equally, and to increase women’s meaningful participation and decision-making across all levels of the programme.

WHO has committed to accelerating and scaling up its efforts to prevent and respond to sexual exploitation, abuse and harassment. An organization-wide task team, headed by a Director reporting to the Director-General, will bring together WHO’s accountability functions that deal with these issues within WHO programmes and operations the field. The aim is to increase policy coherence, address gaps, and ensure that implementation of policy and procedures has sufficient impact to protect women, their families and communities.

There will be a priority focus on how allegations and cases are managed, and practical measures on how emergency and programmatic operations can safeguard people more effectively from sexual exploitation, abuse and harassment.

The Task Team will work with partners on the ground to empower communities to prevent and respond to sexual exploitation, abuse and harassment. They will also prioritize engagement with the UN systems, international partners and external experts to move this important work forward. Some of the activities currently being scaled up include awareness raising in communities; engaging female and male community focal points to empower women to be alert to and use community-based complaint mechanisms safely; and measures to strengthen survivor-based services for women through the health system and in the community.

 

New recommendations for screening and treatment to prevent cervical cancer

Mon, 07/05/2021 - 17:45

Too many women worldwide – particularly the poorest women – continue to die from cervical cancer; a disease which is both preventable and treatable. Today, WHO and HRP have launched a new guideline to help countries make faster progress, more equitably, on the screening and treatment of this devastating disease.

Ending suffering from cervical cancer

Last year, in 2020, more than half a million women contracted cervical cancer, and about 342 000 women died as a result – most in the poorest countries. Quick and accurate screening programmes are critical so that every woman with cervical disease gets the treatment she needs, and avoidable deaths are prevented.

WHO’s global strategy for cervical cancer elimination– endorsed by the World Health Assembly in 2020 –  calls for 70% of women globally to be screened regularly for cervical disease with a high-performance test, and for 90% of those needing it to receive appropriate treatment. Alongside vaccination of girls against the human papillomavirus (HPV), implementing this global strategy could prevent more than  62 million deaths from cervical cancer in the next 100 years.

Effective and accessible cervical screening and treatment programmes in every country are non-negotiable if we are going to end the unimaginable suffering caused by cervical cancer,” says Dr Princess Nono Simelela, Assistant Director-General for Strategic Programmatic Priorities: Cervical Cancer Elimination. “This new WHO guideline will guide public health investment in better diagnostic tools, stronger implementation processes and more acceptable options for screening to reach more women –  and save more lives.”

A shift in care

The new guideline include some important shifts in WHO’s recommended approaches to cervical screening. 

In particular, it recommends an HPV DNA based test as the preferred method, rather than visual inspection with acetic acid (VIA) or cytology (commonly known as a ‘Pap smear’), currently the most commonly used methods globally to detect pre-cancer lesions.

HPV-DNA testing detects high-risk strains of HPV which cause almost all cervical cancers. Unlike tests that rely on visual inspection, HPV-DNA testing is an objective diagnostic, leaving no space for interpretation of results.

Although the process for a healthcare provider obtaining a cervical sample is similar with both cytology or HPV DNA testing, HPV DNA testing is simpler, prevents more pre-cancers and cancer, and saves more lives than VIA or cytology. In addition, it is more cost-effective.

More access to commodities and self-sampling is another route to consider for reaching the global strategy target of 70% testing by 2030. 

WHO suggests that self-collected samples can be used when providing HPV DNA testing. Studies show that women often feel more comfortable taking their own samples, for instance in the comfort of their own home, rather than going to see a provider for screening. However, women need to receive appropriate support to feel confident in managing the process.

Recommendations respond to the link between HPV and HIV

Women who are immunocompromised, such as those living with HIV, are particularly vulnerable to cervical disease; they are more likely to have persistent HPV infections and more rapid progression to pre-cancer and cancer. This results in a six-fold higher risk of cervical cancer among women living with HIV.

In recognition of this, the new guideline include recommendations which are specific for women living with HIV. This includes using an HPV DNA primary screening test followed by a triage test if results are positive for HPV, to evaluate the results for risk of cervical cancer and need for treatment. The global recommendations also advise that screening start at an earlier age (25 years of age) than for the general population of women (30 years of age). Women living with HIV also need to be retested after a shorter time interval following a positive test and following treatment than women without HIV. 

With these new guidelines, we must leverage the platforms already developed for HIV care and treatment to better integrate cervical cancer screening and treatment to meet the health needs and rights of the diverse group of women living with HIV to increase access, improve coverage, and save lives” Dr. Meg Doherty, Director, WHO Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes.

Every intervention counts to eliminate cervical cancer

Data showing where countries around the world currently stand in relation to their burden of cervical cancer and coverage for screening and treatment, are due to be published by the end of 2021. These country profiles can help ministries of health identify where their programmes need strengthening and measure progress towards the 2030 targets.

For a cervical cancer prevention and control programme to have impact, strengthening patient retention and ensuring rapid treatment of women who screen positive for HPV or cervical pre-cancer is a fundamental priority.

Cost-effectiveness of screening tests is important for scaling up programmes, but other aspects of the public health approach to eliminating cervical cancer are also vital,” said Dr Nathalie Broutet, WHO Department of Sexual and Reproductive Health and Research and HRP. “What matters most is the coherence of every country’s programme in ensuring the continuum of care: that all women have access to screening, health care providers are informed in a timely manner about the results of the screening test and can in turn share this information with their client, and that women can access appropriate treatment or referral if needed.” 

WHO calls for all women to ensure they get regular cervical cancer screening tests in line with the recommendations of their local health authority.

Summary recommendation for the general population of womenSummary recommendation for women living with HIV

WHO suggests using either of the following strategies for cervical cancer prevention:

  • HPV DNA detection in a screen-and-treat approach starting at the age of 30 years with regular screening every 5 to 10 years.
  • HPV DNA detection in a screen, triage and treat approach starting at the age of 30 years with regular screening every 5 to 10 years.

WHO suggests using the following strategy for cervical cancer prevention among women living with HIV:

  • HPV DNA detection in a screen, triage and treat approach starting at the age of 25 with regular screening every 3 to 5 years.

 

 

Joint COVAX Statement on the Equal Recognition of Vaccines

Thu, 07/01/2021 - 13:57

COVAX was built on the principle of equitable access to COVID-19 vaccines to protect the health of people all across the globe. That means protecting their lives and livelihoods, including their ability to travel and conduct trade. As travel and other possibilities begin to open up in some parts of the world, COVAX urges all regional, national and local government authorities to recognise as fully vaccinated all people who have received COVID-19 vaccines that have been deemed safe and effective by the World Health Organization and/or the 11 Stringent Regulatory Authorities (SRAs) approved for COVID-19 vaccines, when making decisions on who is able to travel or attend events.

Any measure that only allows people protected by a subset of WHO-approved vaccines to benefit from the re-opening of travel into and with that region would effectively create a two-tier system, further widening the global vaccine divide and exacerbating the inequities we have already seen in the distribution of COVID-19 vaccines. It would negatively impact the growth of economies that are already suffering the most.

Such moves are already undermining confidence in life-saving vaccines that have already been shown to be safe and effective, affecting uptake of vaccines and potentially putting billions of people at risk. At a time when the world is trying to resume trade, commerce and travel, this is counter-effective, both in spirit and outcome.

COVAX commends countries that have already shown commitment to equity as well as safety by accepting travelers protected by all vaccines validated by WHO Emergency Use Listing (EUL) and/or the 11 Stringent Regulatory Authorities (SRAs) approved for COVID-19 vaccines. We call on other nations and regions to do the same.  

 

Notes to editors

About COVAX

COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, is co-convened by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance Gavi) and the World Health Organization (WHO) – working in partnership with UNICEF as key implementing partner, developed and developing country vaccine manufacturers, 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’s role in COVAX

CEPI is leading 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’s role in COVAX

Gavi leads on procurement and delivery at scale for COVAX: designing and managing the COVAX Facility and the Gavi COVAX AMC and working with its traditional Alliance partners UNICEF and WHO, along with governments, on country readiness and delivery. As part of this role, Gavi hosts the Office of the COVAX Facility to coordinate the operation and governance of the mechanism as a whole, holds financial and legal relationships with 193 Facility participants, and manages the COVAX Facility deals portfolio: negotiating advance purchase agreements with manufacturers of promising vaccine candidates to secure doses on behalf of all COVAX Facility participants. Gavi also coordinates design, operationalisation and fundraising for the Gavi COVAX AMC, the mechanism that provides access to donor-funded doses of vaccine to 92 lower-income economies. As part of this work, Gavi provides funding and oversight for UNICEF procurement and delivery of vaccines to all AMC participants – operationalising the advance purchase agreements between Gavi and manufacturers – as well as support for partners’ and governments work on readiness and delivery. This includes tailored support to governments, UNICEF, WHO and other partners for cold chain equipment, technical assistance, syringes, vehicles, and other aspects of the vastly complex logistical operation for delivery. Gavi also co-designed, raises funds for and supports the operationalisation of the AMC’s no fault compensation mechanism as well as the COVAX Humanitarian Buffer.

WHO’s role in COVAX

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’s role in COVAX

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 immunisation 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 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.

 

First Meeting of the Task Force on COVID-19 Vaccines, Therapeutics and Diagnostics for Developing Countries

Wed, 06/30/2021 - 22:42

The Heads of the World Bank Group, International Monetary Fund, World Health Organization, and World Trade Organization today convened for the first meeting of the Task Force on COVID-19 Vaccines, Therapeutics and Diagnostics for Developing Countries. They issued the following joint statement:

“As many countries are struggling with new variants and a third wave of COVID-19 infections, accelerating access to vaccines becomes even more critical to ending the pandemic everywhere and achieving broad-based growth. We are deeply concerned about the limited vaccines, therapeutics, diagnostics, and support for deliveries available to developing countries. Urgent action is needed now to arrest the rising human toll due to the pandemic, and to halt further divergence in the economic recovery between advanced economies and the rest.

We have formed a Task Force, as a “war room” to help track, coordinate and advance delivery of COVID-19 health tools to developing countries and to mobilize relevant stakeholders and national leaders to remove critical roadblocks—in support of the priorities set out by World Bank Group, IMF, WHO, and WTO including in the joint statements of June 1 and June 3, and in the IMF staff’s $50 billion proposal.

At today’s first meeting, we discussed the urgency of increasing supplies of vaccines, therapeutics, and diagnostics for developing countries. We also looked at practical and effective ways to track, coordinate and advance delivery of COVID-19 vaccines to developing countries.

As an urgent first step, we are calling on G20 countries to (1) embrace the target of at least 40 percent in every country by end-2021, and at least 60 percent by the first half of 2022, (2) share more vaccine doses now, including by ensuring at least  1 billion doses are shared with developing countries in 2021 starting immediately, (3) provide financing, including grants and concessional financing, to close the residual gaps, including for the ACT-Accelerator, and (4) remove all barriers to export of inputs and finished vaccines, and other barriers to supply chain operations.

In addition, to enhance transparency we agreed to compile data on dose requests (by type and quantity), contracts, deliveries (including through donations), and deployments of COVID-19 vaccines to low and middle-income countries—and make it available as part of a shared country-level dashboard. We also agreed to take steps to address hesitancy, and to coordinate efforts to address gaps in readiness, so countries are positioned to receive, deploy and administer vaccines.” 

Joint Statement by the Heads of the World Bank Group, International Monetary Fund, World Health Organization, and World Trade Organization on the First Meeting of the Task Force on COVID-19 Vaccines, Therapeutics and Diagnostics for Developing Countries

Wed, 06/30/2021 - 22:23

The Heads of the World Bank Group, International Monetary Fund, World Health Organization, and World Trade Organization today convened for the first meeting of the Task Force on COVID-19 Vaccines, Therapeutics and Diagnostics for Developing Countries. They issued the following joint statement:

“As many countries are struggling with new variants and a third wave of COVID-19 infections, accelerating access to vaccines becomes even more critical to ending the pandemic everywhere and achieving broad-based growth. We are deeply concerned about the limited vaccines, therapeutics, diagnostics, and support for deliveries available to developing countries. Urgent action is needed now to arrest the rising human toll due to the pandemic, and to halt further divergence in the economic recovery between advanced economies and the rest.

We have formed a Task Force, as a “war room” to help track, coordinate and advance delivery of COVID-19 health tools to developing countries and to mobilize relevant stakeholders and national leaders to remove critical roadblocks—in support of the priorities set out by World Bank Group, IMF, WHO, and WTO including in the joint statements of June 1 and June 3, and in the IMF staff’s $50 billion proposal.

At today’s first meeting, we discussed the urgency of increasing supplies of vaccines, therapeutics, and diagnostics for developing countries. We also looked at practical and effective ways to track, coordinate and advance delivery of COVID-19 vaccines to developing countries.

As an urgent first step, we are calling on G20 countries to (1) embrace the target of at least 40 percent in every country by end-2021, and at least 60 percent by the first half of 2022, (2) share more vaccine doses now, including by ensuring at least  1 billion doses are shared with developing countries in 2021 starting immediately, (3) provide financing, including grants and concessional financing, to close the residual gaps, including for the ACT-Accelerator, and (4) remove all barriers to export of inputs and finished vaccines, and other barriers to supply chain operations.

In addition, to enhance transparency we agreed to compile data on dose requests (by type and quantity), contracts, deliveries (including through donations), and deployments of COVID-19 vaccines to low and middle-income countries—and make it available as part of a shared country-level dashboard. We also agreed to take steps to address hesitancy, and to coordinate efforts to address gaps in readiness, so countries are positioned to receive, deploy and administer vaccines.” 

WHO and Global Fund Sign Cooperation Agreement to Scale Up HIV, TB and Malaria Interventions and Strengthen Health Systems

Wed, 06/30/2021 - 10:15

The World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria signed a cooperation and financing agreement to implement 10 strategic initiatives to accelerate the end of AIDS, tuberculosis and malaria as epidemics and strengthen systems for health. This new agreement, which will cover the 2021-2023 implementation period, aims to address some of the persistent challenges that impede progress against the three diseases and protect hard-won gains from new pandemics like COVID-19.

In 2019, a total of 1.4 million people died from tuberculosis and an estimated 409,000 people died from malaria. In 2020, 690,000 people died from AIDS-related illnesses.

Through the new agreement, the strategic initiatives seek to:

  • Expand TB preventive treatment for people living with HIV in 9 countries across Africa;
  • Strengthen efforts to provide differentiated HIV service delivery;
  • Accelerate efforts to find people with TB missed by health systems in 20 countries;
  • Accelerate introduction of innovation for multi-drug resistant TB treatment through regional operational research in Eastern and Central Europe;
  • Support 26 countries and territories to eliminate malaria by 2025;
  • Improve country data collection and use to develop evidence-informed policy;
  • Foster the rapid uptake of service delivery innovations with South to South Learning;
  • Improve quality of care;
  • Encourage rapid uptake of procurement and supply chain management innovation; and
  • Increase program sustainability, facilitate the transition to domestic financing and improve program efficiency.


WHO and the Global Fund have a long and successful partnership working together to scale up HIV, TB and malaria interventions and strengthen health systems in many countries. Through focused efforts and catalytic investments, this collaboration has contributed to significantly reduce the disease burdens of HIV, TB and malaria worldwide, saving millions of lives since 2002.

“The COVID-19 pandemic, more than ever, reinforces the need to strengthen our partnership to achieve our shared goals of ending the epidemics,” said Dr Mubashar Sheikh, Director, Deputy Director-General’s Office, WHO. “This agreement supports countries to develop more effective responses to the HIV, tuberculosis and malaria epidemics and build the resilient health systems they need to reach the most vulnerable.”

“Together, WHO and the Global Fund have proven to be a powerful force that builds on strong in-country support and regional presence, technical leadership and financial resources to strengthen systems for health and accelerate the end of AIDS, TB and malaria as epidemics,” said Michael Byrne, Head of Technical Advice and Partnerships at the Global Fund. “This new agreement will help overcome the multiple challenges caused by the COVID-19 pandemic, safeguard and expand HIV, TB and malaria programs.”

 

 

 

WHO issues first global report on Artificial Intelligence (AI) in health and six guiding principles for its design and use

Mon, 06/28/2021 - 09:53

Artificial Intelligence (AI) holds great promise for improving the delivery of healthcare and medicine worldwide, but only if ethics and human rights are put at the heart of its design, deployment, and use, according to new WHO guidance published today.

The report, Ethics and governance of artificial intelligence for health, is the result of 2 years of consultations held by a panel of international experts appointed by WHO.

“Like all new technology, artificial intelligence holds enormous potential for improving the health of millions of people around the world, but like all technology it can also be misused and cause harm,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This important new report provides a valuable guide for countries on how to maximize the benefits of AI, while minimizing its risks and avoiding its pitfalls.”

Artificial intelligence can be, and in some wealthy countries is already being used to improve the speed and accuracy of diagnosis and screening for diseases; to assist with clinical care; strengthen health research and drug development, and support diverse public health interventions, such as disease surveillance, outbreak response, and health systems management.

AI could also empower patients to take greater control of their own health care and better understand their evolving needs. It could also enable resource-poor countries and rural communities, where patients often have restricted access to health-care workers or medical professionals, to bridge gaps in access to health services.

However, WHO’s new report cautions against overestimating the benefits of AI for health, especially when this occurs at the expense of core investments and strategies required to achieve universal health coverage.

It also points out that opportunities are linked to challenges and risks, including unethical collection and use of health data; biases encoded in algorithms, and risks of AI to patient safety, cybersecurity, and the environment.      

For example, while private and public sector investment in the development and deployment of AI is critical, the unregulated use of AI could subordinate the rights and interests of patients and communities to the powerful commercial interests of technology companies or the interests of governments in surveillance and social control.

The report also emphasizes that systems trained primarily on data collected from individuals in high-income countries may not perform well for individuals in low- and middle-income settings.

AI systems should therefore be carefully designed to reflect the diversity of socio-economic and health-care settings. They should be accompanied by training in digital skills, community engagement and awareness-raising, especially for millions of healthcare workers who will require digital literacy or retraining if their roles and functions are automated, and who must contend with machines that could challenge the decision-making and autonomy of providers and patients.

Ultimately, guided by existing laws and human rights obligations, and new laws and policies that enshrine ethical principles, governments, providers, and designers must work together to address ethics and human rights concerns at every stage of an AI technology’s design, development, and deployment. 

 

Six principles to ensure AI works for the public interest in all countries

To limit the risks and maximize the opportunities intrinsic to the use of AI for health, WHO provides the following principles as the basis for AI regulation and governance:

Protecting human autonomy: In the context of health care, this means that humans should remain in control of health-care systems and medical decisions; privacy and confidentiality should be protected, and patients must give valid informed consent through appropriate legal frameworks for data protection.

Promoting human well-being and safety and the public interest. The designers of AI technologies should satisfy regulatory requirements for safety, accuracy and efficacy for well-defined use cases or indications. Measures of quality control in practice and quality improvement in the use of AI must be available.

Ensuring transparency, explainability and intelligibility. Transparency requires that sufficient information be published or documented before the design or deployment of an AI technology. Such information must be easily accessible and facilitate meaningful public consultation and debate on how the technology is designed and how it should or should not be used.

Fostering responsibility and accountability. Although AI technologies perform specific tasks, it is the responsibility of stakeholders to ensure that they are used under appropriate conditions and by appropriately trained people. Effective mechanisms should be available for questioning and for redress for individuals and groups that are adversely affected by decisions based on algorithms.

Ensuring inclusiveness and equity. Inclusiveness requires that AI for health be designed to encourage the widest possible equitable use and access, irrespective of age, sex, gender, income, race, ethnicity, sexual orientation, ability or other characteristics protected under human rights codes.

Promoting AI that is responsive and sustainable. Designers, developers and users should continuously and transparently assess AI applications during actual use to determine whether AI responds adequately and appropriately to expectations and requirements. AI systems should also be designed to minimize their environmental consequences and increase energy efficiency. Governments and companies should address anticipated disruptions in the workplace, including training for health-care workers to adapt to the use of AI systems, and potential job losses due to use of automated systems.         

These principles will guide future WHO work to support efforts to ensure that the full potential of AI for healthcare and public health will be used for the benefits of all.

At Local Production Forum, WHO and partners highlight key steps to improve access to health technologies

Fri, 06/25/2021 - 18:23

The first WHO World Local Production Forum ended today after five days of discussions centered on promoting quality and sustainable local production to improve access to medicines and other health technologies.

  • Delegates from over 100 countries, international partners, civil society groups, industry associations, and major investors joined WHO, WTO, UNIDO, UNICEF and UNCTAD to highlight the challenges facing local production and the steps required to address them, as well as the range of opportunities for the sector. 

Looking ahead, the Forum will provide a platform to drive forward efforts to support and enhance local production of health products in low- and middle-income countries.

Forum conclusions, recommendations and next steps

Increasing manufacturing capacity for global security - The COVID-19 pandemic has highlighted the importance of local manufacturing as a key component of pandemic response by reducing reliance on global markets and imported products.

Vaccine production was a central theme at the Forum, as were the role of new technologies and generation of flexible manufacturing strategies to develop sustained production capacity in low- and middle-income countries.

Technology transfer and licensing were seen as key to scaling up production. Sharing intellectual property and know-how will be essential, along with facilitation of voluntary licensing and effective technology transfer. It will also be vital to create a favourable environment for technology transfer. Key elements will include good governance; a skilled workforce; good access to market information and careful assessment of local capacity to receive and absorb the transferred technology.

Governmentsrole is key in creating an enabling political environment and a supportive business eco-system. Such efforts must be coordinated with relevant stakeholders at national, regional and global levels.

National regulators and local manufacturers can drive quality-compliant local production and facilitate faster access to health technologies during pandemics and beyond.  To do that, they need continued training, support and resources.

Low access to capital is a key limiting factor for local manufacturers in low- and middle-income countries. The greater interest expressed by key development banks and other financial institutions towards investing in the sector indicates improvement in this area, whilst the need to develop strong investment cases, including demonstration of a long term economically viable business case, were highlighted as key components of successful manufacturing projects.

A mechanism to stimulate industry engagement was recommended for strengthened collaboration with and among industry bodies with the aim of transferring priority technologies to low- and middle-income countries.

A strategic advisory group should be established by WHO in collaboration with Member States and partners to address current and future global challenges and trends in local production and technology transfer.

The next Forum will be held in The Netherlands as announced by Deputy Prime Minister and Minister of Health, Welfare and Sport, Hugo De Jonge. The Local Production Forum is now established as a long-term mechanism to promote dialogue and decision-making to strengthen local manufacturing capacity and move towards the shared goal of universal access to health technologies.

 

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