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After three years of the COVID-19 pandemic, health systems in countries have started showing the first major signs of health system recovery, according to the WHO interim report on the “Fourth round of the global pulse survey on continuity of essential health services during the COVID-19 pandemic: November 2022–January 2023”.  By early 2023, countries reported experiencing reduced disruptions in the delivery of routine health services, but highlighted the need to invest in recovery and stronger resilience for the future.

Among the 139 countries that responded to the fourth round of WHO’s pulse survey, countries reported continued disruptions in almost one-quarter of services on average. In 84 countries where trend analysis is possible, the percentage of disrupted services declined on average from 56% in July-September 2020 to 23% in November 2022- January 2023.  

Persisting disruptions are due to both demand- and supply-side factors, including low levels of health care-seeking in communities as well as limited availability of health workers and other health-care resources such as open clinics or available stocks of medicines and products. 

“It is welcome news that health systems in the majority of countries are starting to restore essential health services for millions of people who missed them during the pandemic,” said Dr Rudi Eggers, WHO Director for Integrated Health Services. “But we need to ensure that all countries continue to close this gap to recover health services, and apply lessons learnt to build more prepared and resilient health systems for the future”.

First notable signs of recovery

In this new survey, fewer countries reported intentionally scaling back access across all service delivery platforms and essential public health functions since 2020-2021 reporting, showing an important step to return to pre-pandemic levels of service delivery and broader system functioning. 

By the end of 2022, most countries reported partial signs of service recovery, including in services for sexual, reproductive, maternal, newborn, child and adolescent health; nutrition; immunization; communicable diseases (including malaria, HIV, TB, and other sexually-transmitted infections); neglected tropical diseases; noncommunicable diseases; management of mental, neurological and substance use disorders; care for older people; and traditional and/or complementary care.  

The number of countries reporting disruption to their national supply chain system reduced from nearly half (29 of 59 responding countries) to about a quarter (18 of 66 responding countries) within the last year. 

Despite signs of recovery, service disruptions persist across countries in all regions and income levels, and across most service delivery settings and tracer service areas. Countries are also dealing with increasing service backlogs – most frequently in services for screening, diagnosis and treatment of noncommunicable diseases – which can lead to negative consequences as people are delayed access to timely care.

Recovering essential health service delivery is critical because disruptions – including to services for health promotion, disease prevention, diagnosis, treatment, rehabilitation and palliation – may have even greater adverse health effects at population and individual level than the pandemic itself, especially among vulnerable populations. 

Integrating COVID-19 services into essential health services 

In another important step towards system recovery and transition, most countries have made progress in integrating COVID-19 services into routine health service delivery. About 80-90% of countries have fully integrated COVID-19 vaccination, diagnostic and case management services as well as services for post COVID-19 condition into routine service delivery. 

Still, most countries (80% of 83 responding countries) reported at least one bottleneck to scaling up access to essential COVID-19 tools (e.g. COVID-19 diagnostics, therapeutics, vaccines and personal protective equipment - PPE), with health workforce issues and lack of funding representing the most common barriers. 

Further support needed for recovery, resilience and preparedness 

Most countries have started to apply what they have learnt during the COVID-19 pandemic, including through the institutionalization of a number of innovative service disruption mitigation strategies into routine health service delivery. These include deployment of telemedicine approaches, promotion of home-based care or self-care interventions, approaches for strengthening health workers availability, capacities and support mechanisms, innovations in procuring and delivering medicines and supplies, more routine community communications, and partnerships with private sector providers. 

Three quarters of countries reported additional funding allocation towards longer term system recovery, resilience and preparedness. 

Countries expressed need for WHO support to address remaining challenges in the COVID-19 context and beyond, most frequently related to health workforce strengthening, building the monitoring capacities of health services, designing primary health care -- oriented models of care, governance, policy and planning and financial planning and funding.

 

Note to editors: 

In the fourth round of WHO’s global pulse survey, 222 countries, territories and areas were invited to respond to a standardized web-based survey between November 2022 and January 2023. The fourth survey followed up on WHO’s previous 2020 and 2021 pulse surveys: Round 1 (May-September 2020), Round 2 (January-March 2021), and Round 3 (November-December 2021) which showed the extent to which the pandemic was affecting the continuity of essential health services and how countries are taking action. While pulse surveys have limitations such as reporting bias and representativeness, the strength of this effort is that it is comprehensive and delivers information rapidly. The term “country” should be understood to include all countries, territories and areas. Trend analyses was completed based on responses from 84 countries, territories, or areas that responded to at least one survey section in all four pulse survey rounds.

 

The new Preparedness and Resilience for Emerging Threats Initiative, or PRET, incorporates the latest tools and approaches for shared learning and collective action established during the COVID-19 pandemic and other recent public health emergencies.

Marking World Malaria Day, the World Health Organization (WHO) is issuing a call for increased implementation of new and existing interventions to save lives from malaria. Nearly 1.5 million children at high risk of illness and death from malaria in Ghana, Kenya and Malawi have now received their first dose of the first malaria vaccine, RTS,S/AS01 (RTS,S), thanks to an ongoing pilot programme coordinated by WHO.

The malaria vaccine pilots, launched in 2019, are increasing equity in access to malaria prevention for the most vulnerable and are saving lives. If implemented broadly, WHO estimates that malaria vaccines could save the lives of tens of thousands of children each year.

“We have the tools to drive down malaria, a package of interventions that includes vector control, preventive medicines, testing, and treatment,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “These are joined by a safe and effective malaria vaccine, which could save the lives of tens of thousands children every year. With sustained investment and scaled-up efforts to reach those most at risk, malaria elimination in many countries is in reach."

World Malaria Day 2023 is being marked under the theme “Time to deliver zero malaria: invest, innovate, implement”. Within this theme, WHO is urging more effective implementation of available tools and strategies to prevent, diagnose and treat malaria, particularly among marginalized populations.

According to the latest World malaria report, published in December 2022, there were an estimated 247 million new cases of malaria in 2021. The WHO African Region continues to shoulder the heaviest burden of the disease – accounting for an estimated 95% of all malaria cases (234 million) and 96% of all deaths (593 000) in 2021. Nearly 80% of malaria deaths in the African Region were among children under the age of five.

New strategies and tools

Countries have made some progress in expanding access to malaria services for most-at-risk populations. Despite some progress, many people at high risk of malaria still lack access to services that can prevent, detect and treat the disease. Challenges in expanding access to malaria services have been compounded, particularly in sub-Saharan Africa, by the COVID-19 pandemic, converging humanitarian crises, restricted funding, weak surveillance systems, and declines in the effectiveness of core malaria-fighting tools.

To address these threats and support countries in building more resilient malaria programmes, WHO recently published new strategies and frameworks, including:

• a new strategy to contain antimalarial drug resistance in Africa;
• a new initiative to stop the spread of Anopheles stephensi in urban environments;
• a new framework, developed jointly by WHO and UN-Habitat, to guide city leaders in urban malaria control.
• a new toolkit to help countries assess their malaria surveillance systems and identify areas for investment

WHO has also increased the transparency, flexibility and access to its malaria recommendations. The consolidated WHO Guidelines for malaria are now available through two digital platforms: MAGICapp and the “Malaria Toolkit” app. WHO encourages countries to tailor the recommendations to local disease settings for maximum impact.

Prospects for new interventions

Continued investment in the development and deployment of new malaria vaccines and next-generation tools will be key to achieving the 2030 global malaria targets.

A second malaria vaccine, the R21/Matrix-M (R21) vaccine, if approved, could help close the sizable gap between supply and demand and further reduce child illness and death from malaria. It is a priority for WHO to continue the thorough and efficient expert review of the R21 malaria vaccine once additional key safety and efficacy data from the ongoing R21 phase 3 trial are available and provided to WHO.  

Phased introductions of the RTS,S malaria vaccine in additional countries in Africa are expected to begin in early 2024.

In the vector control space, there are 28 new products in the R&D pipeline. Tools under evaluation include, for example, new types of insecticide-treated nets, targeted baits that attract mosquitoes, spatial repellents, lethal house lures (eaves tubes) and genetic engineering of mosquitoes.

Researchers are prioritizing the development of non-ACT treatments in the field of antimalarial medicines due to the emergence and spread of partial artemisinin resistance. The development of next-generation medicines, such as "triple ACTs," which use a combination of artemisinin and two partner drugs, is underway to reduce the risk of drug resistance.

 

Notes to the editor:

For more information on the WHO World Malaria Day campaign, visit:  https://www.who.int/campaigns/world-malaria-day/2023

 

‘The Big Catch-up’ is an extended effort to lift vaccination levels among children to at least pre-pandemic levels and endeavours to exceed those. It also aims to ensure stronger primary health care services for essential immunization in the future.

At the start of European Immunization Week, the ECDC report “Poliomyelitis situation update” reveals that between 2012 and 2021, approximately 2.4 million children in the EU/EEA may have not received three doses of polio-containing vaccines on time. Additionally, the newly published ECDC “Measles Annual Epidemiological Report 2022” highlights the risks when having pockets of an under-vaccinated population or groups not immunised at all.

Governments this week examined in detail more than a third of over 300 proposed amendments to the WHO International Health Regulations 2005 (IHR).

European Immunization Week (EIW) is marked across Europe every year in the final week of April, to raise awareness of the importance of immunisation for the general health and well-being of the European and wider population.

Over 200 international participants working with the mRNA Technology Transfer Programme met in Cape Town this week for their first face-to-face meeting.

The repository allows for tracking health inequalities across population groups and over time, by breaking down data according to group characteristics, ranging from education level to ethnicity.

The World Health Organization (WHO) has appointed five new senior figures to its headquarters leadership team in Geneva.

The new appointments follow the reappointment of Dr Tedros Adhanom Ghebreyesus to his second five-year term as Director-General. The overall leadership team has been consolidated to align with the Organization’s priorities for the next five years and will work closely with the Director-General to drive forward these priorities and WHO’s ambitious transformation agenda.

To accelerate progress on implementation of WHO’s 13th General Programme of Work (GPW13), and achievement of its “triple billion” targets and the health-related Sustainable Development Goals, WHO’s work for the coming five years is focused on five priorities: making a paradigm shift towards promoting health and preventing disease by addressing its root causes; radically reorienting health systems towards primary health care; strengthening the systems for health emergency preparedness and response; harnessing the power of science, innovation, data and  technologies to advance health; and strengthening WHO as the leading authority on global health and to achieve impact in countries. 

The headquarters leadership team, comprising equal numbers of women and men, will work jointly with WHO regional and country offices.  

New members of the headquarters leadership team:

• Dr Jeremy Farrar will become WHO’s Chief Scientist as of 8 May 2023. The appointment of Dr Farrar was previously announced in December 2022. In this role Dr Farrar will oversee the Science Division, bringing together the best experts and networks in science and innovation from around the world to guide, develop and deliver high quality health policies and services to the people who need them most. Prior to joining WHO Dr Farrar was Director of the Wellcome Trust. Before joining Wellcome in 2013 Dr Farrar spent 17 years as Director of the Clinical Research Unit at the Hospital for Tropical Diseases in Viet Nam where his research interests were in global health with a focus on emerging infectious diseases. Dr Farrar is a clinician researcher with a medical degree and a PhD.

• Dr Ailan Li will become Assistant Director-General for Universal Health Coverage, Healthier Populations as of 8 May 2023. In this role Dr Li will oversee the Organization’s efforts to promote better health and well-being through interventions relating to the environmental, social, and economic determinants of health, including climate change, tobacco control, chemical safety, road safety, food systems and nutrition, physical activity, air pollution and radiation, through a One Health approach. Dr Li has been serving as the WHO Representative to the Kingdom of Cambodia since 15 July 2019. Prior to this role, Dr Li served as Regional Emergency Director for the WHO Health Emergencies Programme in the WHO Regional Office for the Western Pacific. Dr Li holds a medical degree and degree in health social sciences.

• Dr Yukiko Nakatani will become Assistant Director-General for Access to Medicines and Health Products as of 2 May 2023. In this role Dr Nakatani will oversee the development and implementation of WHO’s norms and policies to ensure equitable access to quality medicines, vaccines and diagnostics for all populations everywhere, including for preventing and responding to epidemics. Dr Nakatani has been serving as the Director of the Cancer and Disease Control Division of the Japanese Ministry of Health, Labour and Welfare. Dr Nakatani holds a medical degree and a PhD in public health.

• Dr Razia Pendse will become the Chef de Cabinet as of 4 May 2023. In this role Dr Pendse will head the Director-General’s Office, helping to drive the Organization’s priorities and initiatives, and will ensure alignment within the WHO leadership team and across the three levels of WHO. Dr Pendse has been serving as the Director of Healthier Populations and Noncommunicable Diseases in the WHO Regional Office for South-East Asia and was previously the WHO Representative to Sri Lanka. Dr Pendse holds a medical degree and master's degree in public health.

• Dr Jérôme Salomon will become Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases as of 17 April 2023. In this role Dr Salomon will oversee a broad portfolio of technical programmes covering HIV, viral hepatitis, sexually-transmitted infections, tuberculosis, malaria, neglected tropical diseases, mental health, substance use disorders, and noncommunicable diseases such as cardiovascular disease, diabetes, chronic respiratory diseases and cancer. Dr Salomon has been serving as the Director-General for Health at the Ministry of Health and Prevention of France. He was a Member of the WHO Executive Board prior to his appointment and has extensive experience in health systems management, communicable diseases and international public health. Dr Salomon holds a medical degree, a master’s degree in public health and a PhD in epidemiology.

The portfolios of existing members of the headquarters leadership team:

• Dr Samira Asma will continue as the Assistant Director-General for Data, Analytics and Delivery for Impact. Dr Asma oversees a portfolio which ensures that health data are reliable and accessible, and are used to improve health outcomes worldwide, including tracking and accelerating progress towards the triple billion targets and the health-related Sustainable Development Goals. Prior to joining WHO in 2018, Dr Asma held leadership positions at the U.S. Centers for Disease Control and Prevention (CDC) for over two decades. She holds a doctorate degree in dental surgery and a master's degree in public health.

• Dr Bruce Aylward has been appointed Assistant Director-General of the Universal Health Coverage, Life Course Division as of 4 May 2023. Dr Aylward has been leading WHO’s Transformation Agenda and the Organization’s work on the multi-agency Access to COVID-19 Tools Accelerator (ACT-A) Hub. In his new role, Dr Aylward will drive the Organization’s agenda to transform primary health care as central to universal health coverage, as well as overseeing WHO’s work on health systems, immunization and reproductive, maternal and child health. Dr Aylward holds a medical degree and a master’s degree in public health.

• Dr Hanan Balkhy will continue as Assistant Director-General for Antimicrobial Resistance. Dr Balkhy provides technical and political leadership to curb the health and economic burdens of drug resistance, including through multi-sectoral collaboration with the Food and Agriculture Organization, the World Organization for Animal Health, and the United Nations Environment Programme. Prior to joining WHO, Dr Balkhy was Executive Director for Infection Prevention and Control at Saudi Arabia’s Ministry of National Guard. Dr Balkhy holds a medical degree with specialization in paediatric infectious diseases.

• Dr Catharina Boehme will become Assistant Director-General, External Relations and Governance as of 4 May 2023. In this role Dr Boehme will lead WHO’s strategic engagement in the areas of governance, resource mobilization and partner relations. Her portfolio will include critical Member States processes, such as their negotiation of a pandemic accord, the reform of WHO’s governance and the implementation of recommendations on sustainable financing. Dr Boehme has been serving as the Director-General’s Chef de Cabinet during which time she drove the leadership’s strategic vision, ensuring alignment across the Organization and with Member States and partners. She joined WHO in 2021, having been the Chief Executive Officer of FIND, the international alliance for diagnostics. Dr Boehme holds a medical degree and diplomas in public health and management.

• Dr Chikwe Ihekweazu will continue as Assistant Director-General for the Division of Health Emergency Intelligence and Surveillance Systems in the Emergencies Programme. As part of his portfolio, Dr Ihekweazu leads the WHO Hub for Pandemic and Epidemic Intelligence, bringing together partners to address future pandemic and epidemic risks with better access to data, analytical capacities, and tools for decision-making. Prior to joining WHO, Dr Ihekweazu was the first Director General of the Nigeria Centre for Disease Control (NCDC), from 2016 to 2021. Dr Ihekweazu holds a medical degree, with specialization as an infectious disease epidemiologist, and a master’s degree in public health.

• Dr Michael Ryan will continue as Executive Director of WHO’s Health Emergencies Programme. Dr Ryan has been managing health emergencies in WHO for the past 25 years and most recently led WHO’s emergency response to the COVID-19 pandemic. He leads WHO’s response to disease outbreaks, humanitarian crises and other public health emergencies. Dr Ryan is a founding member of the Global Outbreak Alert and Response Network (GOARN), which has aided the response to hundreds of disease outbreaks around the world.  Dr Ryan holds a degree in medicine and a master’s degree in public health.

• Mr Raul Thomas will continue as Assistant Director-General for Business Operations. Mr Thomas has overall responsibility for WHO’s business functions, including budget, finance, human resources, administration, audit, risk management, accountability and compliance, and general management. He is responsible for implementing many of the initiatives under the Organization’s transformation agenda and creating a respectful, inclusive workplace. During his 20 years of employment with WHO, Mr Thomas has served in the regions of Africa, the Americas, the Eastern Mediterranean and the Western Pacific, as well as with the International Agency for Research on Cancer (IARC). Mr Thomas holds a master’s degree in organizational management and a bachelor’s degree in business administration.

 

The purpose of the meeting was two-fold: to review the evidence on the performance of updated COVID-19 vaccines that incorporate descendent lineages of Omicron as a booster dose; and to establish timelines for COVID-19 vaccine composition recommendations in 2023.

The report Public health considerations for mpox in EU/EEA countries, released today by the European Centre for Disease Prevention and Control (ECDC), sets out a number of considerations for public health authorities in areas such as vaccination, surveillance, testing, contact tracing and risk communication.

The second “Surveillance of antimicrobial resistance in Europe” report, published jointly by the European Centre for Disease Prevention and Control (ECDC) and WHO/Europe on 14 April 2023, shows high percentages of resistance to last-line antibiotics, such as carbapenems, in several countries of the WHO European Region. The report features data from 2021.

We talked to Dr Flavia Riccardo after ECDC’s three-day workshop on how to strengthen preparedness and response to West Nile Virus (WNV) infections.

Countries of the World Health Organization have mapped out how negotiations on a global accord on pandemic prevention, preparedness and response will move forward with a view to presenting a draft accord for approval by the World Health Assembly in May 2024.

Ending Thursday, discussions on the draft pandemic accord took place during the fifth meeting of the Intergovernmental Negotiating Body (INB), which includes WHO’s 194 countries.

Ms Precious Matsoso, Co-Chair of the INB Bureau, from South Africa, said: “Countries from all parts of the world were able to discuss their ideas, concerns and suggestions in a forum for all countries to hear and consider.”

Countries agreed to keep a window open for additional written proposals until 22 April and that those proposals will be compiled with all others made over recent weeks into a package that will be made available to all drafting group participants.

The INB Bureau will then provide, by 22 May, in addition to this package, for consideration of the Drafting Group, a Bureau’s Text, including options where feasible, based on all submissions received and included in the compilation document.

The Drafting Group of the INB will then meet in June to continue negotiations.

INB Bureau Co-Chair, Mr Roland Driece of the Netherlands, said: “The world realises that what we want and need to achieve is an accord that will help us not to repeat the mistakes of the COVID-19 pandemic response. There are many proposals and constructive suggestions on the table for how to do this.”

According to the process agreed by governments at a special session of the World Health Assembly in late 2021, negotiations on the draft pandemic accord will aim to produce a final draft for consideration by the 77th World Health Assembly in May 2024.

In parallel with the pandemic accord negotiations,  governments are also discussing more than 300 amendments to the International Health Regulations (2005) (IHR) in an effort to strengthen those regulations and make the world safer from communicable diseases while ensuring greater equity in the global response to public health emergencies.

Governments have been working to ensure consistency and alignment across the INB and IHR processes. The proposed IHR amendments will also be presented to the World Health Assembly in 2024, and would together, with a future pandemic accord, provide a comprehensive, complementary, and synergistic set of global health agreements.

Nearly 800 film makers from 106 countries have submitted short films for the 4th edition of the WHO Health for All Film Festival, on themes ranging from the trauma of war to living with COVID-19. Some 90 films have been chosen for the shortlist, for review by a jury of international artists and development leaders, before the announcement of the winners in June 2023.

“The Health for All Film Festival gathers powerful stories on many health issues from all over the world, bringing emotion and a human face to WHO’s scientific work,” says WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “Film has great potential to raise awareness of lesser-known health issues and improve understanding of people’s experiences with health – these are important ways to advance towards Health for All.”

The following distinguished professionals, artists and activists, joined by WHO senior experts, comprise this year’s festival jury: Sharon Stone (actor from the USA); Alfonso Herrera (actor from Mexico); Ricky Kej (musician from India); Melissa Fleming (United Nations Under-Secretary-General for Global Communications); Dr Tlaleng Mofokeng (United Nations Special Rapporteur on the Right to Health from South Africa); Sherrie Silver (dance choreographer from Rwanda), Sophia Kianni (Iranian-American climate activist ); and Adelle Onyango (media personality and podcaster from Kenya).

The 90 shortlisted films are available on WHO’s YouTube channel in six playlists, one for each of the competition categories: Universal health coverage, Health emergencies, Better health and well-being, Climate change and health, Sexual and reproductive health and rights and Very short films.

A wide range of topics are covered by this year’s selection: trauma of war; diseases, including COVID-19, HIV/AIDS, mental health issues; disability; as well as environmental and social factors of health, including gender-based violence. The public is encouraged to view and comment on their favourite shortlisted films and champion them on social media using the hashtag #Film4Health.

In the coming weeks, jurors will review the shortlisted films and recommend winners to the WHO Director-General, who will make the final decision. Three “GRAND PRIX” and four special prizes will be announced in June at the online Awards Ceremony followed by a series of discussions with winners and jurors.

Since the festival launched in 2020, almost 4300 films have been submitted by patients, health workers, activists, students and professional film makers.

For more details on the official selection, the jury composition and further information, please visit https://www.who.int/film-festival

 

 

This report provides an overview of the total number of cases of mpox (monkeypox) reported to ECDC and the WHO Regional Office for Europe through IHR/EWRS mechanisms .

To decrease the impact of COVID-19, and related hospitalisations and mortality, countries should plan for a continued roll-out of COVID vaccines in 2023.

The annual European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE) is taking place in Barcelona and online from 22-24 November 2023.

ECDC has published the latest long-term surveillance framework that identifies concrete objectives, actions, targets and milestones to be achieved in surveillance of infectious diseases in the EU/EEA by 2027.