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The Africa Centres for Disease Control and Prevention (Africa CDC) and ECDC concluded a five-day Training of Trainers (ToT) workshop on simulation exercises aimed at public health emergency preparedness experts from member states of the Northern Africa Regional Coordination Centre (RCC).

ECDC has launched a revamped platform for its training courses and activities.

Africa CDC has completed the initial classroom phase of its intensive epidemiology training programme in Addis Ababa, Ethiopia, with significant support from ECDC.

Ahead of the 2024 UN Climate Change Conference in Baku (COP29), the World Health Organization (WHO) calls for an end to reliance on fossil fuels and advocates for people-centred adaptation and resilience.

Launching the COP29 special report on climate and health and a technical guidance on Healthy Nationally Determined Contributions, WHO urges world leaders at COP29 to abandon the siloed approach to addressing climate change and health. It stresses the importance of positioning health at the core of all climate negotiations, strategies, policies and action plans, to save lives and secure healthier futures for present and future generations. 

“The climate crisis is a health crisis, which makes prioritizing health and well-being in climate action not only a moral and legal imperative, but a strategic opportunity to unlock transformative health benefits for a more just and equitable future,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “COP29 is a crucial opportunity for global leaders to integrate health considerations into strategies for adapting to and mitigating climate change. WHO is supporting this work with practical guidelines and support for countries.”

Bold health argument for climate action

Developed by WHO in collaboration with over 100 organizations and 300 experts, the COP29 special report on climate change and health identifies critical policies across three integrated dimensions – people, place and planet. The report outlines key actions aiming to protect all people, particularly the estimated 3.6 billion people who live in areas which are most susceptible to climate change.

The report underlines the importance of the governance that integrates health in climate policy-making – and climate in health policy-making – being essential for progress. The report’s top recommendations include:

• make human health and well-being the top measure of climate success to catalyse progress and ensure people-centred adaptation and resilience;

• end fossil fuel subsidies and reliance by realigning economic and financial systems to protect both people's health and the environment, through investment in clean, sustainable alternatives that reduce pollution-related diseases and cut carbon emissions;

• mobilize financing for climate-health initiatives, particularly to strengthen responsive health systems and support the health workforce, creating resilient, climate-proof health systems to protect health and save lives;

• invest in proven solutions; just 5 interventions – from heat-health warning systems, to clean household energy, to efficient pricing of fossil fuels – would save almost 2 million lives a year, and bring US$ 4 in benefits for each dollar invested;

• build greater focus on the role of cities in health outcomes, through more sustainable urban design, clean energy, resilient housing, and improved sanitation; and

• increase protections for and restoration of nature and biodiversity, recognizing the synergistic health benefits of clean air, water and food security.

“Health is the lived experience of climate change,” said Dr Maria Neira, Director, Environment, Climate Change and Health, WHO. “By prioritizing health in every aspect of climate action, we can unlock significant benefits for public health, climate resilience, security, and economic stability. Health is the argument we need to catalyze urgent and large-scale action in this critical moment.”

Enhanced WHO action on health and climate

Climate NDCs or Nationally Determined Contributions are national plans and commitments made by countries under the Paris Agreement. While health is identified as a priority in 91% of the NDCs, few outline specific actions to leverage the health benefits of climate mitigation and adaptation or to protect health from climate-related risks.

To support countries to better integrate health into their climate policies, WHO has released today WHO quality criteria for integrating health into Nationally Determined Contributions: Healthy NDCs. The guidance outlines practical actions for ministries of health, ministries of environment, and other health-determining sectors (e.g. transport, energy, urban planning, water and sanitation) to incorporate health considerations within their adaptation and mitigation policies and actions.

This technical guidance serves as a concrete framework to implement the recommendations included in the WHO’s COP29 special report, addressing key areas such as leadership and enabling environment; national circumstances and policy priorities; mitigation; adaptation; loss and damage; finance; and implementation. Integrating health within climate plans will support:

• addressing health impacts: tackling the diverse health effects of climate change;
• strengthening health systems: enhancing climate resilience and decarbonization in health systems; and
• promoting co-benefits: focusing on key sectors that have a strong influence both on health and climate change mitigation and adaptation, such as transportation and energy.

In addition to its own initiatives, WHO convenes 90 countries and 75 partners through the Alliance for Transformative Action on Climate and Health (ATACH). This platform was established to advance the commitments made at COP26 for building climate-resilient and sustainable health systems. ATACH promotes the integration of climate change and health nexus into respective national, regional, and global plans using the collective power of WHO Member States and other stakeholders to drive this agenda forward with urgency and scale.

 Quotes of support

António Guterres, Secretary-General of the United Nations:

“The climate crisis is also a health crisis. Human health and planetary health are intertwined. Countries must take meaningful action to protect their people, boost resources, cut emissions, phase out fossil fuels, and make peace with nature. COP29 must drive progress towards those vital goals for the planet’s health and for people’s health.”

Dr Rajiv J. Shah, President of The Rockefeller Foundation:  

“The impact of climate change has to be measured in more than degrees: we have to account for lives saved, lost, and improved. The Rockefeller Foundation is working closely with the World Health Organization and many other partners to center health considerations in all climate action, including efforts to enable just energy transitions and to increase economic opportunities for people living in frontline communities.”

Dr Vanessa Kerry, WHO Director-General Special Envoy for Climate Change Health:

"This report exposes how the accelerating climate and health crisis impacts more than just our health – it undermines economies, deepens inequities, and fuels political instability. As leaders gather for COP29, we urge them to fast-track a just transition and increase funding for health systems and frontline health workers to protect the most vulnerable. Health must be central in climate discussions, metrics, and Nationally Determined Contributions. To safeguard people, economies, and global security, health must be at the heart of climate action. We can’t afford to wait."

Dr Alan Dangour, Director of Climate & Health at Wellcome: 

“In every single country, climate change is costing lives, causing pain and suffering. It is a common crisis that must unite us to act, and act quickly. At COP29, countries must grasp the opportunity to commit to ambitious cross-government climate actions that both protect the planet and improves health for all. By working together, we can still change our current course and save lives.” 

Dr Micaela Serafini, President, Médecins Sans Frontières (MSF), Switzerland:

“Today, we are in an unacceptable situation where the world’s most vulnerable people are paying the highest price for a problem they did not cause. Solutions to safeguard their health must be prioritized, with the well-being of people placed at the heart of climate action. Failing to do so will take a toll on the very vitals of humanity.”

Jagan Chapagain, Secretary General, The International Federation of Red Cross and Red Crescent Societies (IFRC):

“From the impacts of extreme heat to the spread of illnesses through floodwaters, from malnutrition as crops fail to mosquito-borne diseases where they haven’t been seen before, the climate crisis is the ultimate health crisis. This report is vital – highlighting how climate change makes us sick and what we need to do about it.”

More than 100 governments today made historic commitments to end childhood violence, including nine pledging to ban corporal punishment – an issue that affects 3 out of every 5 children regularly in their homes. These commitments were made at a landmark event in Bogotá, Colombia, where government delegations are set to agree on a new global declaration aimed at protecting children from all kinds of violence, exploitation and abuse.

Also at the event, which is hosted by the Governments of Colombia and Sweden together with the World Health Organization (WHO), UNICEF and the United Nations Special Representative of the Secretary-General on Violence against Children, several countries committed to improve services for childhood violence survivors or tackle bullying, while others said they would invest in critical parenting support – one of the most effective interventions for reducing violence risks in the home.

“Despite being highly preventable, violence remains a horrific day to day reality for millions of children around the world – leaving scars that span generations,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.  “Today countries made critical pledges that, once enacted, could finally turn the tide on childhood violence. From establishing lifechanging support for families to making schools safer places or tackling online abuse, these actions will be fundamental to protecting children from lasting harm and ill health.”

Over half of all children globally – some 1 billion – are estimated to suffer some form of violence, such as child maltreatment (including corporal punishment, the most prevalent form of childhood violence), bullying, physical or emotional abuse, as well as sexual violence.  Violence against children is often hidden, mostly occurs behind closed doors, and is vastly underreported. WHO estimates that fewer than half of affected children tell anyone they experienced violence and under 10% receive any help.

Such violence not only constitutes a grave violation of children’s rights but also increases the risk of immediate and long-term health issues. For some children, violence results in death or serious injury. Every 13 minutes, a child or adolescent dies as a result of homicide – equating to around 40 000 preventable deaths each year. For others, experiencing violence has devastating and life-long consequences. These include anxiety and depression, risky behaviours like unsafe sex, smoking and substance abuse, and reduced academic achievement.

Evidence shows that violence against children is preventable, with the health sector having a critical role to play. Proven solutions include parenting support to help caregivers avoid violent discipline and build positive relationships with their children; school-based interventions to strengthen life and social skills for children and adolescents, and prevent bullying; child-friendly social and health services for children that experience violence; laws that prohibit violence against children and reduce underlying risk factors such as access to alcohol and guns, and efforts to ensure safer internet use for children. Research has shown that when countries effectively implement such strategies, they can reduce violence against children by as much as 20-50%.

In line with the UN Convention on the Rights of the Child, the first global targets for ending violence against children were established in the United Nations’ Sustainable Development Goals. Progress in reducing overall prevalence of childhood violence has however been slow, despite gains in some individual countries. Around 9 in 10 children still live in countries where prevalent forms of childhood violence such as corporal punishment, or even sexual abuse and exploitation, are not yet prohibited by law.

Over 1000 people are attending this first-ever Ministerial Conference on Violence against Children, including high-level government delegations, children, young people, survivor and civil society allies.

Specific pledges at the event include among others, commitments to end physical punishment, to introduce new digital safety initiatives, increase the legally permitted age of marriage and to invest in parenting education and child protection. WHO provides significant support for efforts to end childhood violence, through technical guidance, guiding effective strategies for prevention and response, and conducting new research and data, including its global status reports. 

Key statistics

• Over half of all children aged 2-17 – more than 1 billion – experience some form of violence each year.
• Around 3 in 5 children are regularly punished by physical means in their homes.
• 1 in 5 girls and 1 in 7 boys experience sexual violence.
• Between 25% and 50% children are estimated to have experienced bullying.
• For adolescent males, violence – often involving firearms or other weapons - is now the leading cause of death. 
  

Notable pledges

• Eight countries pledged to pursue legislation against corporal punishment in all settings  – Burundi, Czechia, Gambia, Kyrgyzstan, Panama, Sri Lanka, Uganda and Tajikistan – and Nigeria in schools.
• Dozens of countries committed to invest in parenting support.
• The Government of the United Kingdom along with other partners committed to launch a Global Taskforce on ending violence in and through schools.
• Tanzania committed to introduce Child Protection Desks in all 25 000 schools.
• Spain committed to pursue a new digital law to promote digital safety.
• Solomon Islands pledged to raise the age of marriage from 15 to 18 – noting that early marriage is a significant risk factor for violence against adolescent girls.
• Many countries made commitments to strengthen national policies and/or develop specific plans to tackle violence against children.
  

All pledges

 

The second round of the polio vaccination campaign in the Gaza Strip was completed yesterday, with an overall 556 774 children under the age of 10 being vaccinated with a second dose of polio vaccine, and 448 425 children between 2- to 10-years-old receiving vitamin A, following the three phases conducted in the last weeks.

Administrative data confirm around 94% of the target population of 591 714 children under the age of 10 years received a second dose of nOPV2 across the Gaza Strip, which is a remarkable achievement given the extremely difficult circumstances the campaign was executed under. The campaign achieved 103% and 91% coverage in central and southern Gaza, respectively. However, in northern Gaza, where the campaign was compromised due to lack of access, approximately 88% coverage was achieved according to preliminary data. An estimated 7000-10 000 children in inaccessible areas like Jabalia, Beit Lahiya and Beit Hanoun remain unvaccinated and vulnerable to the poliovirus. This also increases the risk of further spread of poliovirus in the Gaza Strip and neighbouring countries.

The end of this second round concludes the polio vaccination campaign launched in September 2024. This round also took place in three phases across central, south and northern Gaza under area-specific humanitarian pauses. While the first two phases proceeded as planned, the third phase in northern Gaza had to be temporarily postponed on 23 October because of intense bombardments, mass displacements, lack of assured humanitarian pauses and access.

After careful assessment of the situation by the technical committee, comprising the Palestinian Ministry of Health, World Health Organization (WHO), United Nations Children’s Fund (UNICEF), and the United Nations Relief and Works Agency for Palestine Refugees (UNRWA), the campaign resumed on 2 November. However, the area under the assured humanitarian pauses comprising the campaign was substantially reduced, compared to the first round, as the access was limited to Gaza City. Due to hostilities, more than 150 000 people were forced to evacuate from North Gaza to Gaza City, which helped in accessing more children than anticipated.

Despite these challenges, and thanks to the tremendous dedication, engagement and courage of parents, children, communities and health workers, the phase in northern Gaza was completed.

At least two doses and a minimum of 90% vaccination coverage are needed in each community to stop circulation of the polio strain affecting Gaza. Efforts will now continue to boost immunity levels through routine immunization services offered at functional health facilities and to strengthen disease surveillance to rapidly detect any further poliovirus transmission (either in affected children or in environmental samples). The evolving epidemiology will determine if further outbreak response may be necessary.

To fully implement surveillance and routine immunization services, not just for polio but for all vaccine-preventable diseases, WHO and UNICEF continue to call for a ceasefire. Further, apart from the attack on the primary healthcare centre, the campaign underscores what can be achieved with humanitarian pauses. These actions must be systematically applied beyond the polio emergency response efforts to other health and humanitarian interventions to respond to dire needs.

 

Notes to editors:

The polio campaign, being conducted by the Palestinian Ministry of Health in collaboration with the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Relief and Works Agency for Palestinian Refugees (UNRWA), and other partners, was part of emergency efforts to stop a polio outbreak in Gaza, which was detected on 16 July 2024, and to prevent further spread of poliovirus.

Since July 2024, circulating variant poliovirus type 2 has been confirmed in Gaza in 11 environmental samples has been confirmed in Gaza in a 10-month-old paralysed child (in August 2024).

The Access and Allocation Mechanism (AAM) for mpox has allocated an initial 899 000 vaccine doses for 9 countries across the African region that are hit hard by the current mpox surge. In collaboration with affected countries and donors, this decision aims to ensure that the limited doses are used effectively and fairly, with the overall objective to control the outbreaks.

The AAM principals from the Africa Centres for Disease Control and Prevention (Africa CDC), the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance (Gavi), UNICEF, and the World Health Organization (WHO) approved the allocation, following the recommendations of an independent Technical Review Committee of the Continental Incident Management Support Team for mpox. The decision was informed by country readiness and epidemiological data.

The 9 countries are the Central African Republic, Cote d’Ivoire, the Democratic Republic of the Congo, Kenya, Liberia, Nigeria, Rwanda, South Africa and Uganda.  The largest number of doses – 85% of the allocation – will go to the Democratic Republic of the Congo as the most affected country, reporting four out of every five laboratory-confirmed cases in Africa this year.

These doses come from Canada, Gavi, the Vaccine Alliance, the European Union (Austria, Belgium, Croatia, Cyprus, France, Germany, Luxemburg, Malta, Netherlands, Poland, Portugal and Spain, as well as the European Union Health Emergency Response Authority), and the Unites States of America.

The outbreak of mpox, particularly the surge of the viral strain clade Ib, in the Democratic Republic of the Congo and neighbouring countries was declared a public health emergency of international concern by WHO and a public health emergency of continental security by Africa CDC in mid-August. This year, 19 countries in Africa have reported mpox, many of them newly affected by the viral disease. The epicentre of the outbreak remains the Democratic Republic of the Congo, with over 38 000 suspected cases and over 1000 deaths reported this year.

Vaccination is recommended as a part of a comprehensive mpox response strategy, focusing also on timely testing and diagnosis, effective clinical care, infection prevention, and the engagement of affected communities. Vaccines play an important role and are recommended to reduce transmission and help contain outbreaks.

In recent weeks, limited vaccination has begun in the Democratic Republic of the Congo and Rwanda. This allocation to the 9 countries marks a significant step towards a coordinated and targeted deployment of vaccines to stop the mpox outbreaks.

For most countries, the rollout of mpox vaccines will be a new undertaking. Implementing targeted vaccination requires additional resources. Partners of the mpox AAM, set up last month, are working to scale up the response. Further allocations of vaccines are expected before the end of the year.

 

Notes to editors

Key points of the vaccination approach under the global and continental strategic preparedness and response plans:

1. Vaccine availability: Over 5.85 million vaccine doses are expected to be available to the Mpox Vaccines AAM by the end of 2024, including the nearly 900 000 allocated doses. The supply includes contributions from multiple nations and organizations, including 1.85 million dose donations of MVA-BN from the European Union, United States, and Canada, 500 000 doses of MVA-BN from Gavi utilizing the First Response Fund, 500 000 doses procured through UNICEF, as well as a further 3 million doses of the LC16 vaccine from Japan.
   
   
2. Phased vaccination strategy:

• Phase 1: Stop outbreaks – Focused on interrupting transmission through targeted vaccination of people at highest risk of infection including contacts of confirmed cases, health-care workers, frontline responders, and key at-risk populations in areas with active human to human transmission.

• Phase 2: Expand protection – To protect more people at risk in affected communities, as additional doses of vaccine are available. It targets individuals at high risk of severe disease – based on local epidemiology – in affected areas, focusing on regions with the highest incidence of mpox. Special attention will be given to vulnerable populations, including those living with HIV, internally displaced persons, and refugees, due to their increased risk of severe outcomes.

• Phase 3: Protect for the future – Aimed at building population immunity to guard against future outbreaks as part of a longer-term mpox control programme.

The first phase targets the vaccination of approximately 1.4 million people at risk of infection by the end of 2024, with an initial 2.8 million doses of the MVA-BN vaccine to be allocated for this effort.


3. Maximizing the impact of vaccines through strategic vaccination is crucial: Implementing targeted vaccination approaches can reduce transmission by focusing on those at the highest risk of infection. This vaccination strategy prioritizes individuals at substantially higher risk of exposure, including close contacts – such as household members and sexual partners – of confirmed cases. A combination of prevention and control interventions are recommended to optimize the effectiveness of vaccination efforts.
   
   
4. Demand planning for Phase 2: Current demand forecasts for Phase 2 estimate the need to vaccinate at least an additional 10 million individuals to protect high-risk groups across Africa. The projection is based on current epidemiological data and emerging information on transmission patterns. These estimates will be updated as more data becomes available, and the outbreak trajectory evolves.
   
   
5. Regulatory and policy updates: The WHO Strategic Advisory Group of Experts (SAGE) recommends off-label use of vaccines for children and pregnant women in outbreak settings. Urgent action is required to expedite regulatory pathways for vaccine approval across affected countries, ensuring timely access for infants and children. Additionally, delivery support must be strengthened to address in-country vaccine delivery challenges and ensure efficient distribution.

 

A new World Health Organization (WHO) study published today in eBioMedicine names 17 pathogens that regularly cause diseases in communities as top priorities for new vaccine development. The WHO study is the first global effort to systematically prioritize endemic pathogens based on criteria that included regional disease burden, antimicrobial resistance risk and socioeconomic impact.

The study reconfirms longstanding priorities for vaccine research and development (R&D), including for HIV, malaria, and tuberculosis – three diseases that collectively take nearly 2.5 million lives each year.

The study also identifies pathogens such as Group A streptococcus and Klebsiella pneumoniae as top disease control priorities in all regions, highlighting the urgency to develop new vaccines for pathogens increasingly resistant to antimicrobials.

“Too often global decisions on new vaccines have been solely driven by return on investment, rather than by the number of lives that could be saved in the most vulnerable communities,” said Dr Kate O’Brien, Director of the Immunization, Vaccines and Biologicals Department at WHO. “This study uses broad regional expertise and data to assess vaccines that would not only significantly reduce diseases that greatly impact communities today but also reduce the medical costs that families and health systems face.”

WHO asked international and regional experts to identify factors that are most important to them when deciding which vaccines to introduce and use. The analysis of those preferences, combined with regional data for each pathogen, resulted in top 10 priority pathogens for each WHO region. The regional lists where then consolidated to form the global list, resulting in 17 priority endemic pathogens for which new vaccines need to be researched, developed and used.

This new WHO global priority list of endemic pathogens for vaccine R&D supports the Immunization Agenda 2030’s goal of ensuring that everyone, in all regions, can benefit from vaccines that protect them from serious diseases. The list provides an equitable and transparent evidence base to set regional and global agendas for new vaccine R&D and manufacturing, and is intended to give academics, funders, manufacturers and countries a clear direction for where vaccine R&D could have the most impact.

This global prioritization exercise for endemic pathogens, complements the WHO R&D blueprint for epidemics, which identified priority pathogens that could cause future epidemics or pandemics, such as COVID-19 or severe acute respiratory syndrome (SARS).

The findings of this new report on endemic pathogens are part of WHO’s work to identify and support the research priorities and needs of immunization programmes in low- and middle-income countries, to inform the global vaccine R&D agenda, and to strategically advance development and uptake of priority vaccines, particularly against pathogens that cause the largest public health burden and greatest socioeconomic impact. 

WHO Priority endemic pathogens list

Vaccines for these pathogens are at different stages of development.

Pathogens where vaccine research is needed

• Group A streptococcus
• Hepatitis C virus
• HIV-1
• Klebsiella pneumoniae

 Pathogens where vaccines need to be further developed

• Cytomegalovirus
• Influenza virus (broadly protective vaccine)
• Leishmania species
• Non-typhoidal Salmonella
• Norovirus
• Plasmodium falciparum (malaria)
• Shigella species
• Staphylococcus aureus

Pathogens where vaccines are approaching regulatory approval, policy recommendation or introduction

• Dengue virus
• Group B streptococcus
• Extra-intestinal pathogenic E. coli
• Mycobacterium tuberculosis
• Respiratory syncytial virus (RSV)

 We the leaders of 15 United Nations and humanitarian organizations urge, yet again, all parties fighting in Gaza to protect civilians, and call on the State of Israel to cease its assault on Gaza and on the humanitarians trying to help. 

The situation unfolding in North Gaza is apocalyptic. The area has been under siege for almost a month, denied basic aid and life-saving supplies while bombardment and other attacks continue. Just in the past few days, hundreds of Palestinians have been killed, most of them women and children, and thousands have once again been forcibly displaced. 

Hospitals have been almost entirely cut off from supplies and have come under attack, killing patients, destroying vital equipment, and disrupting life-saving services. Health workers and patients have been taken into custody. Fighting has also reportedly taken place inside hospitals. 

Dozens of schools serving as shelters have been bombed or forcibly evacuated. Tents sheltering displaced families have been shelled, and people have been burned alive. 

Rescue teams have been deliberately attacked and thwarted in their attempts to pull people buried under the rubble of their homes. 

The needs of women and girls are overwhelming and growing every day. We have lost contact with those we support and those who provide lifesaving essential services for sexual and reproductive health and gender-based violence. 

And we have received reports of civilians being targeted while trying to seek safety, and of men and boys being arrested and taken to unknown locations for detention. 

Livestock are also dying, crop lands have been destroyed, trees burned to the ground, and agrifood systems infrastructure has been decimated. 

The entire Palestinian population in North Gaza is at imminent risk of dying from disease, famine and violence. 

Humanitarian aid cannot keep up with the scale of the needs due to the access constraints. Basic, life-saving goods are not available. Humanitarians are not safe to do their work and are blocked by Israeli forces and by insecurity from reaching people in need. 

In a further blow to the humanitarian response, the polio vaccination campaign has been delayed due to the fighting, putting the lives of children in the region at risk. 

And this week, the Israeli Parliament adopted legislation that would ban UNRWA and revoke its privileges and immunities. If implemented, such measures would be a catastrophe for the humanitarian response in Gaza, diametrically opposed to the United Nations Charter, with potential dire impacts on the human rights of the millions of Palestinians depending on UNRWA’s assistance, and in violation of Israel’s obligations under international law. 

Let us be very clear: There is no alternative to UNRWA. 

The blatant disregard for basic humanity and for the laws of war must stop. 

International humanitarian law, including the rules of distinction, proportionality and precautions, must be respected. IHL obligations do not depend on reciprocity. No violation by one party ever releases the other from its legal obligations. 

Attacks against civilians and what remains of civilian infrastructure in Gaza must stop. 

Humanitarian relief must be facilitated, and we urge all parties to provide unimpeded access to affected people. Additionally, commercial goods must be allowed to enter Gaza. 

The wounded and sick must receive the care they need. Medical personnel and hospitals must be spared. Hospitals should not turn into battlegrounds. 

Unlawfully detained Palestinians must be released. 

Israel must comply with the provisional orders and determinations of the International Court of Justice. 

Hamas and other Palestinian armed groups must release the hostages immediately and unconditionally and must abide by international humanitarian law. 

Member States must use their leverage to ensure respect for international law. This includes withholding arms transfers where there is a clear risk that such arms will be used in violation of international law. 

The entire region is on the edge of a precipice. An immediate cessation of hostilities and a sustained, unconditional ceasefire are long overdue. 

Signatories: 

• Ms. Joyce Msuya, Acting Emergency Relief Coordinator and Under-Secretary-General for Humanitarian Affairs (OCHA) 
• Ms. Nimo Hassan, MBE, Chair, International Council of Voluntary Agencies (ICVA) 
• Mr. Jamie Munn, Executive Director, International Council of Voluntary Agencies (ICVA) 
• Ms. Amy E. Pope, Director General, International Organization for Migration (IOM) 
• Mr. Volker Türk, United Nations High Commissioner for Human Rights (OHCHR) 
• Ms. Abby Maxman, President and Chief Executive Officer, Oxfam 
  
• Ms. Paula Gaviria Betancur, United Nations Special Rapporteur on the Human Rights of Internally Displaced Persons (SR on HR of IDPs) 
• Mr. Achim Steiner, Administrator, United Nations Development Programme (UNDP) 
• Ms. Anacláudia Rossbach, Executive Director, United Nations Human Settlement Programme (UN-Habitat) 
• Mr. Filippo Grandi, United Nations High Commissioner for Refugees (UNHCR) 
• Dr. Natalia Kanem, Executive Director, United Nations Population Fund (UNFPA) 
• Ms. Catherine Russell, Executive Director, UN Children's Fund (UNICEF) 
• Ms. Sima Bahous, Under-Secretary-General and Executive Director, UN Women 
• Ms. Cindy McCain, Executive Director, World Food Programme (WFP) 
• Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization (WHO) 

 

The World Federation of United Nations Associations (WFUNA) and the World Health Organization concluded the first in-person Global Model WHO (GMWHO) today, marking a powerful gathering of over 350 youth delegates from 52 countries from all Regions.

The Quadripartite collaboration on One Health - comprising the Food and Agriculture Organization of the United Nations (FAO), the UN Environment Programme (UNEP), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH) - co-organized the G20 High-Level Meeting on One Health on 30 October 2024.

A third phase of the polio vaccination campaign is set to begin tomorrow in part of the northern Gaza Strip after being postponed from 23 October 2024 due to lack of access and assured, comprehensive humanitarian pauses, intense bombardment, and mass evacuation orders. These conditions made it impossible for families to safely bring their children for vaccination and to organize campaign activities.  

The humanitarian pause necessary to conduct the campaign has been assured; however, the area of the pause has been substantially reduced compared to the first round of vaccination in northern Gaza, conducted in September 2024. It is now limited to just Gaza City. Though in the past few weeks, at least 100 000 people have been forced to evacuate from North Gaza towards Gaza City for safety, around 15 000 children under ten years in towns in North Gaza like Jabalia, Beit Lahiya and Beit Hanoun still remain inaccessible and will be missed during the campaign, compromising its effectiveness. To interrupt poliovirus transmission, at least 90% of all children in every community and neighborhood must be vaccinated. This will be challenging to achieve given the situation. 

The final phase of the campaign had aimed to reach an estimated 119 000 children under ten years old in northern Gaza with a second dose of novel oral polio vaccine type 2 (nOPV2). However, achieving this target is now unlikely due to access constraints.  

Despite the lack of access to all eligible children in northern Gaza, the Polio Technical Committee for Gaza, including the Palestinian Ministry of Health, World Health Organization (WHO), United Nations Children’s Fund (UNICEF), United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and partners has taken the decision to resume the campaign. This aims to mitigate the risk of a long delay in reaching as many children as possible with polio vaccine and the opportunity to vaccinate those recently evacuated to Gaza City from other parts of North Gaza.   

 To overcome challenges posed by the volatile security situation and constant population movement, robust micro plans have been developed to ensure the campaign is responsive to the significant population shifts and displacement in the north, following the first round in September. The campaign will be delivered by 216 teams across 106 fixed sites, 22 of which have been added to ensure increased availability of vaccination in areas where recently displaced people are seeking refuge. Two hundred and nine social mobilizers will be deployed to engage communities and raise awareness around vaccination efforts. The time period for the humanitarian pause has been extended by two hours and is expected to run from 6am to 4pm daily. As in the first two phases, vitamin A will also be co-administered to children between two to ten years in the north to help boost overall immunity. 

The campaign in northern Gaza follows the successful implementation of the first two phases of the second round in central and southern Gaza, which reached 451 216 children – 96% of the target in these areas. A total of 364 306 children aged between 2 and 10 years have received vitamin A so far in this round.  

Despite the challenges, WHO and UNICEF urge for the humanitarian pauses to be respected to ensure the successful delivery of this second round of the polio vaccination campaign. This is crucial to help curb the spread of polio in Gaza and neighboring countries.

Ministers of Health expressed their support for WHO's Investment Round during a G20 meeting chaired by Brazil held today in Rio de Janeiro.

A comprehensive new report, “Refugee and migrant health system review: challenges and opportunities for long-term health system strengthening in Uganda”, officially launched on 15 October by Uganda’s Ministry of Health and the World Health Organization (WHO), emphasizes the urgent need to reinforce Uganda’s healthcare system to better support both refugee and migrant communities.

As part of ongoing efforts to enhance quality-assured testing options, the World Health Organization (WHO) has listed two additional mpox in vitro diagnostics under its Emergency Use Listing (EUL) procedure. WHO’s EUL is based on the review of quality, safety and performance data in compliance with international standards while addressing the specific needs of low- and middle-income countries (LMICs).

Polymerase Chain Reaction (PCR) testing, which detects viral DNA, is considered the gold standard for diagnosing mpox infection.

WHO listed the Xpert Mpox, a real-time PCR test manufactured by Cepheid under its EUL procedure, on 25 October. This test is designed for use on compatible GeneXpert systems. The Xpert Mpox test is easy to operate and delivers results in under 40 minutes. Once the cartridge is placed in the system, the process is fully automated, with real-time PCR detecting viral DNA of monkeypox virus clade II. The GeneXpert system is a near-point-of-care testing option, which can support decentralized testing.

Another PCR-based option, the cobas MPXV assay, developed by Roche Molecular Systems, Inc., was listed on 14 October 2024. It is intended for use on the cobas 6800/8800 Systems. This tool is a real-time PCR test capable of detecting both mpox clades and delivering results in under 2 hours. It can process multiple samples simultaneously and is suitable for clinical laboratories that handle large volumes of tests.

“Ensuring global access to mpox diagnostic tests that meet WHO standards for quality, safety and performance is essential for efficient and effective testing in settings affected by mpox outbreaks,” said Dr Rogerio Gaspar, WHO Director for Regulation and Prequalification. “Rapid access to those listed products is critical not only for prompt diagnosis and timely treatment but also for effectively containing the spread of the virus."

WHO previously listed Alinity m MPXV assay, manufactured by Abbott Molecular Inc. under EUL on 3 October. 

In 2024, 18 countries have reported over 40 000 suspected mpox cases with most remaining unconfirmed due to limited testing capacity, especially in LMICs. In the Democratic Republic of the Congo—the hardest-hit country—testing has significantly increased in 2024, following efforts to decentralize testing with support from WHO and partners. However, the proportion of tested cases remains low, accounting for 40-50% of the suspected cases.

WHO is working with manufacturers of the EUL-listed products and national regulatory authorities in affected countries to facilitate domestic registration or emergency listing. Fast-tracking approvals and applying reliance principles will enhance access to quality-assured mpox tests.

Overall, WHO has received over 60 expressions of interest for the EUL review of mpox diagnostic tests. Seven of these progressed to EUL applications, with 2 products currently under review and 2 more expected soon.

The status of active applications and listed mpox diagnostics under WHO EUL procedure can be seen on WHO webpages.

 

Editor’s note

After WHO Director-General Dr Tedros Adhanom Ghebreyesus declared mpox a public health emergency of international concern (PHEIC) on 14 August 2024, WHO called on mpox in vitro diagnostic manufacturers to submit expressions of interest for Emergency Use Listing on 28 August 2024.

WHO EUL is a risk-benefit assessment designed to meet urgent needs during public health emergencies based on limited available data, accelerating the availability of life-saving medical products such as vaccines, tests, and treatments. It assists decision-making for procurement by UN, partner agencies and Member States at international, regional and national levels. Under EUL, the manufacturers must commit to continue generating any missing information in order to fulfil prequalification requirements. Once this information is available, a prequalification application should be submitted to complete the full process for achieving a recommendation for international procurement in both emergency and non-emergency settings.

In October 2024, WHO and partners, in collaboration with Member States, activated the Global Health Emergency Corps (GHEC) for the first time to provide support to countries facing mpox outbreaks.

GHEC is a grouping of professionals with the objective of strengthening the response to health emergencies, and a collaboration platform for countries and health emergency networks. It supports countries on their health emergency workforce, the surge deployment of experts and the networking of technical leaders. GHEC was established by WHO in 2023 after the response to the COVID-19 pandemic revealed the need to streamline efforts of existing networks to ensure better-coordinated support to countries.

“WHO and partners are supporting the government of the Democratic Republic of the Congo and other countries to implement an integrated approach to case detection, contact tracing, targeted vaccination, clinical and home care, infection prevention and control, community engagement and mobilization, and specialized logistical support,” said Dr Mike Ryan, Executive Director of WHO’s Health Emergencies Programme. “The GHEC enhances the ability of the many effective responders at national and regional levels to collaborate and ensure the success on the ground in interrupting transmission and reducing suffering.”

The first activation of this new support mechanism follows the declaration of mpox as a public health emergency of international concern by WHO Director-General Dr Tedros Adhanom Ghebreyesus on 14 August 2024. Eighteen African countries have reported mpox cases this year, and the rapid spread of clade 1b mpox to at least two other regions has raised concerns about further spread.

In collaboration with the International Association of National Public Health Institutes, GHEC is assessing the emergency workforce capacities in 8 countries affected by the mpox outbreak, including the Democratic Republic of the Congo and Burundi, the two most affected countries. The assessment has so far identified 22 areas that need strengthening, including epidemiology and surveillance, laboratory capacities, infection prevention and control, risk communication and community engagement. In the Democratic Republic of the Congo, the Health Cluster partners have joined in strengthening the coordination set up by the Ministry of Health under the leadership of the public health emergency operations centre.

As of 17 October, WHO has managed the deployment of 56 experts to the affected countries. This includes WHO staff as well as experts mobilized through the Global Outbreak Alert and Response Network (GOARN) and the African Volunteers Health Corps (AVoHC-SURGE). The AVoHC-SURGE responders, coordinated by WHO’s Regional Office for Africa and the Africa Centres for Disease Control and Prevention, are a growing cohort of professionals with diverse skillsets that can be deployed in the region.

“By mobilizing trained professionals from within the continent, we ensure that responses are not only timely but also contextually relevant,” said Dr Abdou Salam Gueye, Regional Emergency Director for the WHO Regional Office for Africa. “The dedication and expertise of these responders are essential in saving lives and building resilient health systems capable of withstanding future threats.”

Additionally, GOARN is leading the efforts to map the support provided by partners on a bilateral basis to affected countries and the regional coordination structure. This includes the provision of experts, supplies, financial support, capacity strengthening and other activities. 

As part of the GHEC activation, on 22 October, technical leaders from affected countries and leaders from other countries, including those who have experienced previous mpox outbreaks, convened to discuss the most effective control measures, share best practices and coordinate their efforts to halt the outbreak.

 

Note to editors:

GHEC was established by WHO in 2023 in response to the gaps and challenges identified during the COVID-19 response. It supports countries experiencing public health emergencies through three key pillars:

• Emergency workforce assessment: GHEC conducts assessments of emergency workforce capacities in affected countries to identify gaps and challenges hindering an effective response.
• Rapid deployment of surge capacities: Countries can request support from various pools of experts with specific skill sets tailored to the identified needs. These experts can be rapidly deployed to affected countries to support the emergency response.
• Leadership network: Countries nominate representatives to connect with other leaders to share best practices and coordinate the response. Leaders include representatives from national public health agencies, national emergency operation centres or other disease experts.

The World Health Organization (WHO) today published a new report on tuberculosis revealing that approximately 8.2 million people were newly diagnosed with TB in 2023 – the highest number recorded since WHO began global TB monitoring in 1995. This represents a notable increase from 7.5 million reported in 2022, placing TB again as the leading infectious disease killer in 2023, surpassing COVID-19.

WHO’s Global Tuberculosis Report 2024 highlights mixed progress in the global fight against TB, with persistent challenges such as significant underfunding. While the number of TB-related deaths decreased from 1.32 million in 2022 to 1.25 million in 2023, the total number of people falling ill with TB rose slightly to an estimated 10.8 million in 2023.

With the disease disproportionately affecting people in 30 high-burden countries, India (26%), Indonesia (10%), China (6.8%), the Philippines (6.8%) and Pakistan (6.3%) together accounted for 56% of the global TB burden. According to the report, 55% of people who developed TB were men, 33% were women and 12% were children and young adolescents.

“The fact that TB still kills and sickens so many people is an outrage, when we have the tools to prevent it, detect it and treat it,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO urges all countries to make good on the concrete commitments they have made to expand the use of those tools, and to end TB.”

In 2023, the gap between the estimated number of new TB cases and those reported narrowed to about 2.7 million, down from COVID-19 pandemic levels of around 4 million in 2020 and 2021. This follows substantial national and global efforts to recover from COVID-related disruptions to TB services. The coverage of TB preventive treatment has been sustained for people living with HIV and continues to improve for household contacts of people diagnosed with TB.  

However, multidrug-resistant TB remains a public health crisis. Treatment success rates for multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) have now reached 68%. But, of the 400 000 people estimated to have developed MDR/RR-TB, only 44% were diagnosed and treated in 2023.

Funding gaps and challenges

Global funding for TB prevention and care decreased further in 2023 and remains far below target. Low- and middle-income countries (LMICs), which bear 98% of the TB burden, faced significant funding shortages. Only US$ 5.7 billion of the US$ 22 billion annual funding target was available in 2023, equivalent to only 26% of the global target.

The total amount of international donor funding in LMICs has remained at around US$ 1.1–1.2 billion per year for several years. The United States government remains the largest bilateral donor for TB. While the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) contribution to international funding of the TB response, especially in LMICs, is important, it remains insufficient to cover essential TB service needs. The report emphasizes that sustained financial investment is crucial for the success of TB prevention, diagnosis, and treatment efforts.

Globally, TB research remains severely underfunded with only one-fifth of the US$ 5 billion annual target reached in 2022. This impedes the development of new TB diagnostics, drugs, and vaccines. WHO continues leading efforts to advance the TB vaccine agenda, including with the support of the TB Vaccine Accelerator Council launched by the WHO Director-General.

Complex drivers of the epidemic

For the first time, the report provides estimates on the percentage of TB-affected households that face catastrophic costs (exceeding 20% of annual household income) to access TB diagnosis and treatment in all LMICs. These indicate that half of TB-affected households face such catastrophic costs.  

A significant number of new TB cases are driven by 5 major risk factors: undernutrition, HIV infection, alcohol use disorders, smoking (especially among men), and diabetes. Tackling these issues, along with critical determinants like poverty and GDP per capita, requires coordinated multisectoral action.

“We are confronted with a multitude of formidable challenges: funding shortfalls and catastrophic financial burden on those affected, climate change, conflict, migration and displacement, pandemics, and drug-resistant tuberculosis, a significant driver of antimicrobial resistance,” said Dr Tereza Kasaeva, Director of WHO’s Global Tuberculosis Programme. “It is imperative that we unite across all sectors and stakeholders, to confront these pressing issues and ramp up our efforts.”

Global milestones and targets for reducing the TB disease burden are off-track, and considerable progress is needed to reach other targets set for 2027 ahead of the second UN High-Level Meeting. WHO calls on governments, global partners, and donors to urgently translate the commitments made during the 2023 UN High-Level Meeting on TB into tangible actions. Increased funding for research, particularly for new TB vaccines, is essential to accelerate progress and achieve the global targets set for 2027.

Seasonal influenza and COVID-19 vaccination uptake for risk groups such as the elderly were sub-optimal in several EU/EEA Member States during the 2023-2024 season, according to two reports released today by the European Centre for Disease Prevention and Control (ECDC).

Meet Jonilda Sulo, a public health professional and MediPIET fellow with over 10 years of experience in infectious disease surveillance and digital health solutions. She holds a Masters in Public Health from the Medical University of Tirana and has dedicated her career to strengthening Albania's public health systems.

The European Centre for Disease Prevention and Control (ECDC) is aware of the recent confirmation of the first mpox clade Ib case in Germany and is monitoring the situation closely. The case was acquired abroad and detected on Friday, 20th October 2024.