Leading through example: Norway paves the way to ensure equal access to COVID-19 treatments and develops trailblazing flagship initiative on noncommunicable diseases
On 1 December 2020, the Government of Norway and WHO met virtually for their annual strategic dialogue. This year’s meeting was particularly crucial, with the overall objective of reviewing strategic challenges for WHO’s Thirteenth General Programme of Work in view of the COVID-19 pandemic. Key issues discussed included universal health coverage, care management and risk reduction for noncommunicable diseases (NCDs), and health emergencies preparedness and country readiness.
“Norway has been a stalwart supporter of global health issues for decades, paving the way to strengthen health systems in lower- and middle-income countries, as shown by the country’s leadership of the Global Action Plan for Healthy Lives and Well-being for All framework,” said Ms Jane Ellison, WHO Executive Director for External Relations and Governance. “And now within the context of the COVID-19 pandemic, Norway is playing a key role in ensuring equitable access to COVID-19 tools. WHO is deeply grateful to the Government of Norway for its leadership and pioneer work, acting as an example during the pandemic.”
Norway is one of WHO’s top 10 core voluntary donors. Its flexible funding support helps WHO address pockets of poverty, makes it possible for WHO to fill critical gaps to provide health interventions to the most vulnerable populations. It also allows WHO to act quickly by allocating funds when and where they are needed most.
Norway is also a pioneer in the area of NCDs and has initiated the development of a flagship initiative on NCDs in the context of development cooperation. A first of its kind, it sets out a trailblazing model of engagement across WHO divisions and the three levels of the Organization. More in-depth discussions on this new strategy will take place in the first quarter of 2021.
The World Health Organization and the International Federation of Red Cross and Red Crescent Societies (IFRC) today launched a new collaboration to strengthen the delivery of emergency medical and health services during humanitarian crises.
WHO Director-General Dr Tedros Adhanom Ghebreyesus and IFRC Secretary-General Mr Jagan Chapagain signed a memorandum of understanding to cooperate on implementing the Emergency Medical Team (EMT) initiative.
“We thank the IFRC for their support from the onset of the EMT Initiative and we look forward to this continued partnership in improving the quality of care in emergencies,” said Dr Tedros. “With the COVID-19 pandemic and the significant increase in emergencies around the world, this agreement could not come at a better time.”
Mr Chapagain said IFRC was committed to working side-by-side with WHO in providing life-saving health services to communities affected by humanitarian emergencies.
“This MoU will allow us to standardize our emergency health response work and provide increased support for National Red Cross and Red Crescent Societies which play such a crucial role in emergency response,” Mr Chapagain said. “We are very committed to working together with WHO to provide quality emergency health services that communities desperately need in times of crisis.”
The MoU, also known as the Red Channel Agreement, is the culmination of years of collaboration between IFRC and the WHO Emergency Medical Team Initiative.
The new agreement will bring more synergies to health emergency response between the two international organizations, particularly in technical standards, accountability, and coordination.
It aligns the IFRC’s system with that of the WHO Emergency Medical Teams global classification system, in doing so recognizing the IFRC’s Emergency Response Units as EMTs and heightens the involvement of IFRC teams and National Red Cross and Red Crescent Societies in the capacity building efforts of the EMT network.
Lack of water puts health care workers and patients at higher risk of COVID-19 infection
Around 1.8 billion people are at heightened risk of COVID-19 and other diseases because they use or work in health care facilities without basic water services, warn WHO and UNICEF.
“Working in a health care facility without water, sanitation and hygiene is akin to sending nurses and doctors to work without personal protective equipment” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Water supply, sanitation and hygiene in health care facilities are fundamental to stopping COVID-19. But there are still major gaps to overcome, particularly in least developed countries.”
The report, Fundamentals first: Universal water, sanitation, and hygiene services in health care facilities for safe, quality care, comes as COVID-19 is exposing key vulnerabilities within health systems, including inadequate infection prevention and control.
Water, sanitation and hygiene (WASH) are vital to the safety of health workers and patients yet provision of these services is not prioritized. Worldwide, 1 in 4 health care facilities has no water services, 1 in 3 does not have access to hand hygiene where care is provided, 1 in 10 has no sanitation services*, and 1 in 3 does not segregate waste safely.
“Sending healthcare workers and people in need of treatment to facilities without clean water, safe toilets, or even soap puts their lives at risk,” said UNICEF Executive Director Henrietta Fore. “This was certainly true before the COVID-19 pandemic, but this year has made these disparities impossible to ignore. As we reimagine and shape a post-COVID world, making sure we are sending children and mothers to places of care equipped with adequate water, sanitation and hygiene services is not merely something we can and should do. It is an absolute must.”
The situation is worst of all in the world’s 47 Least Developed Countries (LDCs): 1 in 2 health care facilities does not have basic drinking water, 1 in 4 health care facilities has no hand hygiene facilities at points of care; and 3 in 5 lack basic sanitation services.
But this can be fixed. The report’s preliminary estimates indicate that it would cost roughly USD 1 per capita to enable all 47 LDCs to establish basic water service in health facilities. On average, USD 0.20 per capita is needed each year to operate and maintain services.
According to the report, immediate, incremental investments in WASH have big returns: improving hygiene in health care facilities is a “best buy” for tackling antimicrobial resistance. It reduces health care costs because it reduces health-care associated infections (which are costly to treat). It saves time as health workers do not have to search for water for hand hygiene. Better hygiene also increases uptake of services. This all adds up to a return of USD 1.5 for every dollar invested.
These services are especially critical for vulnerable populations, including pregnant mothers, newborns and children. Improving WASH services in health care facilities is particularly important around childbirth when far too many mothers and newborns suffer and die, including from preventable conditions like sepsis. Better WASH services could save a million pregnant women and newborns’ lives and reduce still-births.
The report provides four main recommendations:
- Implement costed national roadmaps with appropriate financing;
- Monitor and regularly review progress in improving WASH services, practices and the enabling environment;
- Develop capacities of health workforce to sustain WASH services and promote and practice good hygiene;
- Integrate WASH into regular health sector planning, budgeting, and programming, including COVID-19 response and recovery efforts to deliver quality services.
Global WASH and health partners have shown their support for meeting global and country WASH in health care facility targets. By 2020, over 130 partners have committed resources, of which 34 have made dedicated financial commitments totalling USD125 million.
Nevertheless, implementation of the 2019 World Health Assembly Resolution on WASH in health care facilities is uneven. Of the nearly 50 countries for which WHO and UNICEF have data, 86 per cent have updated standards and 70 per cent have conducted initial assessments which show that these areas are generally on track. Yet just a third of countries have costed national WASH in health care facility roadmaps and only 10 per cent have included WASH indicators in national health systems monitoring.
More catalytic global funding, technical support, and domestic resourcing is needed to keep health care workers and patients safe and protected. Now, an opportunity exists to build on existing efforts and commitments and integrate WASH in health care facilities in all national COVID-19 plans, vaccine distribution and economic recovery packages.
“For millions of healthcare workers across the world, water is PPE”, said Jennifer Sara, Global Director for Water at the World Bank Group. “It is essential that financing keeps flowing to bring water and sanitation services to those battling the COVID crisis on the frontlines. Funding WASH in healthcare facilities is among the most cost-effective investments that governments can make.”
Data published by WHO in October indicates that COVID-19 infections among health care workers are far greater than those in the general population: Health care workers represent less than 3 per cent of the population, but account for 14 per cent of global COVID-19 cases reported to WHO. Ensuring health care workers have the basic WASH necessities to keep themselves, their patients, their families and children safe - is imperative.
“Millions have no option but to seek care from the 50% of health care facilities in the developing world which don’t have clean water on the premises. This cannot continue. Every day both healthcare workers’ and patients’ lives are being put at risk,” saidTim Wainwright, Chief Executive at international charity WaterAid. “Without frontline health workers being able to wash their hands; provide their patients with clean water; or have somewhere decent to go to the toilet, a hospital is not a hospital at all - it’s a breeding ground for disease.”
Note to Editors:
The data in this year’s report include statistics for 165 countries, from surveys representing 760,000 facilities. Compared to last year’s baseline report, estimates were available for 125 countries with data from surveys representing 560,000 facilities. The data on county progress in implementing the World Health Assembly Resolution represent 47 countries. It is the first time these data have been compiled and analyzed.
Sanitation services are measures taken to ensure the hygienic management of excreta along all stages of the sanitation chain: capture, containment, emptying, transport, treatment and safe disposal.
About the World Health Organization
The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For updates on COVID-19 and public health advice to protect yourself from coronavirus.
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.
A new WHO Checklist to support schools re-opening and preparation for COVID-19 resurgences or similar public health crises , lists 38 essential actions to be considered by different stakeholders as they work together to agree school reopening plans.
According to data collected by UNESCO, classrooms for nearly 1 in 5 schoolchildren globally – or 320 million – are closed as of 1 December, an increase of nearly 90 million from 232 million on 1 November.
In some places, children have been out of school for 9 months or more. Prolonged school closures in response to the COVID-19 pandemic are presenting an unprecedented challenge to children’s education, health and well-being worldwide. The longer a student stays out of school, the higher their risk of dropping out.
As school closure numbers continue to soar and many schools break for holidays, a new WHO checklist aims to support the different levels of decision-making (national, local, and the schools themselves) that are needed in order to reopen schools safely.
The checklist also aims to help improve adherence to existing COVID-19-related public health and social measures designed to protect children under the age of 18 years in educational settings.
“Schools can reopen safely,” says Dr Ruediger Krech, WHO Director of Health Promotion. “Decisions to reopen schools should be driven by data and the safety measures in place, but also address the concerns of students, parents, caregivers and teachers. These concerns are best addressed if reopening approaches are co-designed with students, parents, caregivers and teachers.”
Developed in accordance with the health-promoting schools principles, the checklist aims to enhance compliance and adherence to the public health measures outlined in the recently updated Considerations for school-related public health measures in the context of COVID19. It focuses on protective measures such as, hand hygiene and respiratory etiquette; physical distancing; use of masks in schools; environmental cleaning and ventilation; and respecting procedures for isolation of all people with symptoms.
Of the 38 essential actions, 21 focus on individual school-level measures to ensure the school returns to equitable and high-quality education while safeguarding the health and well-being of all students. Some of these school-level actions include reorganizing school layouts to space desks or changing school schedules to stagger recesses and breaks, depending on the local context.
There is one set of actions to prepare to reopen schools and another to prepare schools for COVID-19 resurgences.
WHO encourages active engagement with concerned stakeholders – including students, parents and caregivers – in all decisions that impact their lives, families, safety and education. Students can be strong allies in strengthening efforts and reinforcing or amplifying public health messages.
The actions specific to preparing for COVID-19 resurgences aim to support schools to design plans, protocols, and trainings in anticipation of potential resurgences that might result in a reclosure, such as increased transmission and/or prevalence of COVID-19-related illness or hospitalizations following a period of cessation or interruption.
The checklist is not intended to suggest either uniform or all-or-nothing approaches. Users are urged to constantly adapt the checklist and specific actions – or combinations of actions – in accordance with the changing local social, epidemiological, economic and cultural contexts.
The checklist was developed by WHO, in collaboration with UNESCO, the World Food Programme, UNICEF and members from the health-promoting schools expert working group.
Virtual summit marking Universal Health Coverage Day 2020, echoes its theme of “Health for All: Protect Everyone” with a series of commitments by global leaders to improve the health of women, children and adolescents during the COVID-19 pandemic and...
They will take stock of how the COVID-19 has affected progress towards achieving Universal Health Coverage (UHC), launch new commitments towards improving the health of women, children and adolescents, and galvanize a participatory approach from all stakeholders to ensure we can ‘do better’ during the COVID-19 pandemic and beyond.