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Rural populations across the globe continue to face health, economic and social inequities. A major contributor to pervasive health inequalities in rural and remote areas is a shortage of available, appropriate and motivated health workers. Compounding this, the COVID-19 pandemic’s health, health systems and socio-economic impacts threaten to worsen the health outcomes of the more vulnerable rural populations. 

Owing to partnership and the commitment and contributions of 35 reviewers with expertise in rural health workforce as researchers or practitioners. And to dialogue, notably at the Global Forum on Human Resources for Health in Dublin in 2017 and the WONCA World Rural Health Conference in India in 2018. WHO is able to launch a synthesis of recent evidence to see what has worked, and what has not, to attract, develop, recruit and retain health workers in rural and remote areas. 

This review “The Retention of the health workforce in rural and remote areas: a systematic review assesses the evolution of evidence in the decade that has passed since the global policy recommendations were released and builds on the work previously undertaken to develop the WHO’s 2010 Global policy recommendations: Increasing access to health workers in remote and rural areas through improved retention.

The context and research base has greatly evolved since 2010 - over 100 new studies – across a wider array of health worker occupations and countries now form the evidence base. This larger evidence is critical to informing effective policy approaches to redress rural health workforce gaps.

The review also examines the recurring factors that influence attraction, development, recruitment, and retention of health workers in rural areas, emphasizing important considerations such context, occupation and career stage of workers which influence the outcomes of interventions. Also highlighted are the impacts of an optimally engaged community and sustainable health systems, or lack thereof on the outcomes of interest. The review also underscores the need for an appropriate bundle of interventions to address the factors that influence the availability and performance of health workers.

It reiterates that for rural populations, the universal truths: no health without a health workforce and achieving universal health coverage implies leaving no one behind, call to attention the need to rapidly increase efforts to close the gap to in access to health workers and has direct and indirect implications on the timely achievement of the Sustainable Development Goals. 

The overall objective of the meeting was to engage in a political dialogue and exchange views on strategies, policies and activities of WHO, the current WHO transformation process and COVID-response, review the key areas financed by Luxembourg and explore new areas of collaboration.

On 27 November 2020, Iceland signed a new contribution agreement to support work towards integrated brain health, that will be led by a newly established unit within the Department of Mental Health and Substance Use.

The first G20 report in area of digital health, Report on Digital Health Implementation Approach to Pandemic Management, was announced in advent of the G20 Summit. This report promptly outlines digital health emergency responses landscape and proposed actions and implementation recommendations. WHO assumes leadership in multiple strategic recommendation areas in this report, and is committed to support countries to enhance capacity in leveraging digital intervention for emergency response through strengthened international collaboration.  

Creation of G20 Digital Health Taskforce

During the Saudi Arabian G20 presidency, a G20 Digital Health Taskforce was created by endorsement of the Health Ministers. The aim of the Taskforce is to strengthen international collaboration on leveraging digital health interventions, addressing challenges in access to foundational requirements and supporting policy making. In response to the Covid-19 emergency, in April 2020, the taskforce started to tackle the pandemic challenge by bringing together 17 countries, international organization, including WHO, ITU, OECD, Global Digital Health Partnership (GDPH), Global Fund, and UNICEF to explore mechanisms to harness the digital health interventions for Covid-19 emergency response.  ‘The pandemic has revealed our vulnerability, but the Digital Health Taskforce confirms that today sharing resources, utilities and expertise can go across national borders and beyond.’  Dr Mona AlMehaid, Saudi Arabia G20 Digital Health Lead, Ministry of Health Saudi Arabia, stated.

Launch of G20 Report on Digital Health Implementation Approach to Pandemic Management

The first G20 report in the area of digital health, G20 Report on Digital Health Implementation Approach to Pandemic Management, was launched by the Taskforce. 'This report provides the basis of a blueprint for countries to use digital health interventions for emergencies and in future, and it supports countries to select information and tools relevant to each country’s health situation, regulatory environment, and digital maturity.' Colleen Brooks, from the G20 Digital Health Taskforce Secretariat explains the objectives of the report. Based on data collected by the Saudi G20 Digital Health Secretariat, this report provides timely information to facilitate countries’ digital health emergency responses with proposed actions and implementation resources/recommendations. The information covered the whole circle of emergency response, including preparation and initiation, prevention and triage, tracking, tracing and testing, treatment and vaccine, and post-pandemic preparation. 11 recommendations have been raised for future work, among which WHO takes leadership in multiple areas:

1. Support countries documenting digital health maturity in key ‘building blocks’ areas including: leadership and governance; strategy and investment; legislation, policy, and compliance; workforce; standards and interoperability; and infrastructure;
2. Support international collaboration of countries in developing data standards and interoperability specifications for all types of surveillance; (co-lead with ITU);
3. Support international collaboration in determining the best process for supplementing the available information;
4. Support open source digital health applications to be compliant with interoperability  standards and specifications;
5. Support sharing telemedicine tools and platforms for free/open source during a state of emergency, where these tools are not available.

WHO is committed to take leadership to strengthen international cooperation and digital health  capacity building of countries' response to emergencies, and will continue this effort together with G20, to enhance global health system strengthening, building on  lessons learnt from the Covid-19 pandemic, and will continue this dialogue in G20 2021 hosted by Italy, stated Bernardo Mariano Junior, Chief Information Officer, Director of Department of Digital Health and Innovation, World Health Organization.  

The report can be downloaded from digitalhealthtaskforce.org.

Noncommunicable diseases now make up 7 of the world’s top 10 causes of death, according to WHO’s 2019 Global Health Estimates, published today. This is an increase from 4 of the 10 leading causes in 2000. The new data cover the period from 2000 to 2019 inclusive.

WHO today launches a year-long global campaign for World No Tobacco Day 2021 - “Commit to Quit."  The new WHO Quit Challenge on WhatsApp and publication “More than 100 reasons to quit tobacco" are being released today to mark the start of the campaign.

The COVID-19 pandemic has led to millions of tobacco users saying they want to quit. The campaign will support at least 100 million people as they try to give up tobacco through communities of quitters. 

“Commit to Quit”  will help create healthier environments that are conducive to quitting tobacco by advocating for strong tobacco cessation policies; increasing access to cessation services; raising awareness of tobacco industry tactics, and empowering tobacco users to make successful quit attempts through “quit & win” initiatives. 

WHO, together with partners, will create and build-up digital communities where people can find the social support they need to quit. The focus will be on high burden countries* where the majority of the world’s tobacco users live.

WHO welcomes new contributions from partners, including private sector companies that have offered support, including Allen Carr’s Easyway, Amazon Web Services, Cipla, Facebook and WhatsApp, Google, Johnson & Johnson, Praekelt, and Soul Machines. 

Quitting tobacco is challenging, especially with the added social and economic stresses that have come as a result of the pandemic. Worldwide around 780 million people say they want to quit, but only 30% of them have access to the tools that can help them do so. Together with partners, WHO will provide people with the tools and resources they need to make a successful quit attempt.

“Smoking kills 8 million people a year, but if users need more motivation to kick the habit, the pandemic provides the right incentive,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus.

WHO released a scientific brief earlier this year showing that smokers are at higher risk of developing severe disease and death from COVID-19. Tobacco is also a major risk factor for noncommunicable diseases like cardiovascular disease, cancer, respiratory disease and diabetes. Moreover, people living with these conditions are more vulnerable to severe COVID-19.

Both global and regional cessation tools will be rolled out as part of the campaign. WHO’s 24/7 digital health worker to help people quit tobacco is available in English and will soon be released to support people in Arabic, Chinese, French, Russian, and Spanish. 

“Millions of people worldwide want to quit tobacco – we must seize this opportunity and invest in services to help them be successful, while we urge everyone to divest from the tobacco industry and their interests,” said Dr Ruediger Krech, Director of Health Promotion. 

To create environments conducive to quitting tobacco, WHO has worked with partners and countries around the globe to implement tobacco control measures that effectively reduce the demand for tobacco. 

WHO calls on all governments to ensure their citizens have access to brief advice, toll-free quit lines, mobile and digital cessation services, nicotine replacement therapies and other tools that are proven to help people quit. Strong cessation services improve health, save lives and save money.  

Note to editors: 

*The campaign focus countries are:  

• Democratic Republic of Timor-Leste
• Federal Democratic Republic of Ethiopia
• Federal Republic of Germany                             
• Federal Republic of Nigeria
• Federative Republic of Brazil
• Hashemite Kingdom of Jordan
• Islamic Republic of Iran 
• Islamic Republic of Pakistan
• People’s Republic of Bangladesh
• People’s Republic of China, 
• Republic of India
• Republic of Indonesia
• Republic of the Philippines, 
• Republic of Poland
• Republic of South Africa
• Republic of Suriname
• Republic of Turkey
• Russian Federation
• Socialist Republic of Viet Nam
• United Mexican States
• United States of America
• Ukraine

Food insecurity is a continuing issue during COVID-19. Managers of food pantries and food distribution sites can take prevention measures to reduce the spread of COVID-19 while addressing gaps in food resources.

Advice on when and how long people should delay their domestic or international travel to avoid spreading COVID-19.

Stress and Coping

Over 300 representatives from countries, partners and civil society came together virtually at the Global Meeting of the Working Group Meeting on Public-Private Mix (PPM) on TB prevention and care on 23 and 25 November. The Meeting was convened by the World Health Organization (WHO) and the Stop TB Partnership with support from the US Agency for International Development (USAID) and the Global Fund. The meeting was opened by Dr Tereza Kasaeva, Director of WHO’s Global TB Programme and Dr Madhukar Pai, Chair of the Stop TB PPM Working Group and Associate Director of the McGill International TB Centre. Nigerian TB survivor and advocate Funke Dosumu shared her personal struggle against TB and made a passionate plea for stronger public-private collaboration to ensure access to quality care for those ill with TB without added financial burden. The meeting placed a spotlight on the impact of the COVID-19 pandemic on the TB response, which has been especially severe on private sector care delivery. A special talk was delivered by award-winning journalist Barkha Dutt. She issued a strong wake-up call on the tragic impact of COVID-19 on the poor and vulnerable, especially those struggling with TB and other infectious diseases in accessing affordable care.

The European Centre for Disease Prevention and Control (ECDC) and the Africa Centres for Disease Control and Prevention (Africa CDC) is today launching a new four-year partnership initiative in order to enhance mutual engagement and contribute to durably strengthening Africa CDC capacities in preparedness and response to health threats.

In a Rapid Communication issued today, the World Health Organization (WHO) is announcing a number of updates to its forthcoming guidance on the systematic screening of tuberculosis (TB) disease. This will help national TB programmes, public and private healthcare providers, funders and other stakeholders to prepare for the changes that will be introduced when the new guidelines are released in early 2021.

It is estimated that close to three million people with TB are not diagnosed or reported annually around the world. Improved TB screening using new tools and approaches to reach all people with care could help bridge this gap. Measures like screening need to be stepped up rapidly to reach the global target of treating at least 40 million people with TB by 2022.

The updated guidance will avail of the latest evidence and best available practices on, amongst others, new approaches to screening of people at risk, the role of new technologies such as computer-aided detection (CAD) to interpret chest radiography and the use of molecular rapid diagnostics for screening.

“Systematic screening is critical to ensure we can detect TB early in the people who need it, while also identifying people who could benefit from TB preventive treatment. This is important to break the chain of transmission and to ensure no one is left behind.” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “We need to maximize upon the synergies between the delivery of TB and COVID services during contact investigation and other situations, especially at these times of crisis when the demand on healthcare services is high.”

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If you are a close contact of someone with COVID-19 or you are a resident in a community where there is ongoing spread of COVID-19 and develop symptoms of COVID-19, call your healthcare provider and tell them about your symptoms and your exposure.

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CDC recommends a layered strategy to reduce exposures to SARS-CoV-2, the virus that causes COVID-19. This includes using multiple mitigation strategies with several layers of safeguards to reduce the spread of disease and lower the risk of exposure.

Proper interpretation of antigen test results is important for accurate clinical management of patients with suspected COVID-19. This guidance can help healthcare providers make the most effective use of antigen tests in different situations.

This document assesses the risk of SARS-CoV-2 transmission to the general population and medically vulnerable individuals in the EU/EEA and the UK, from the perspective of the upcoming end-of-year festive season.