Statement on the seventh meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic
The seventh meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the coronavirus disease (COVID-19) took place on Thursday, 15 April 2021 from 12:00 to 16:30 Geneva time (CEST).
Members and Advisors of the Emergency Committee were convened by videoconference.
The Director-General welcomed the Committee, expressed concern over the continued rise in cases and deaths, and the need to scale up the global vaccination efforts. He thanked the committee for their continued support and advice.
Representatives of the Office of Legal Counsel (LEG) and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities. The Ethics Officer from CRE provided the Members and Advisers with an overview of the WHO Declaration of Interest process. The Members and Advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the Committee. Each member who was present was surveyed and no conflicts of interest were identified. Two members of the Committee and one advisor who were members of the joint international team participating in the WHO-convened Global Study of Origins of SARS-CoV-2 agreed not to contribute to potential recommendations made by the Committee regarding the investigations concerning the origin and emergence of the virus.
The Secretariat turned the meeting over to the Chair, Professor Didier Houssin. Professor Houssin also expressed concern over the current trends with the COVID-19 pandemic and reviewed the objectives and agenda of the meeting.
The Secretariat presented on the following topics and responded to questions from the Committee.
- Progress made on WHO’s implementation of the 15 January 2021 advice to the Secretariat;
- Recent global and regional epidemiological trends, the tracking, monitoring and assessment process for SARS-CoV-2 variants, updates on the mission to understand SARS-CoV-2 origins, and the actions that WHO is taking to ensure a coordinated response to the COVID-19 pandemic;
- Global COVID-19 vaccine rollout and equity, the impact of vaccines on asymptotic infection and transmission, and vaccine performance against variants of concern (VOC);
- WHO’s assessment of the impact of SARS-CoV-2 variants of concern on public health interventions; and
- An overview of WHO actions related to health measures in relation to international traffic.
The Committee thanked the Secretariat for the quality of the presentations made and unanimously agreed that the COVID-19 pandemic still constitutes an extraordinary event that continues to adversely affect the health of populations around the world, pose a risk of international spread and interference with international traffic, and to require a coordinated international response. As such, the Committee concurred that the COVID-19 pandemic remains a public health emergency of international concern (PHEIC) and offered advice to the Director-General.
The Committee noted that many of the past recommendations remain relevant to current global response efforts. The Committee requests that the IHR Secretariat review past advice and temporary recommendations and bring to the committee a proposal for the process of new issuance, termination, or modification of advice and temporary recommendations in a consistent manner.
The Committee recognized WHO’s and States Parties’ progress in implementing the previous advice and Temporary Recommendations from the 6th meeting of the Emergency Committee. The Committee congratulated the mission team and the report from the WHO-convened Global Study of Origins of SARS-CoV-2 and encouraged implementation of the recommendations published in the Mission report. The Committee remains concerned that the world will not exit the pandemic unless, and until, all countries have access to appropriate supplies of diagnostics, treatments and vaccines, irrespective of their ability to pay and the capacity and financial resources to rapidly and effectively vaccinate their populations. Inequities within and among all countries is slowing the return to normal social and economic life. The Committee provided the following advice to the Director-General accordingly.
The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General. The Director-General thanked the Committee for its work.
- Promote global solidarity and equitable vaccine access by encouraging States Parties and manufacturers to support the COVAX Facility, including by sharing vaccine doses, and to conduct technology transfer for local production of COVID-19 vaccines and ancillary supplies, including in low- and middle-income countries with scalable capacities.
- Accelerate evaluation of COVID-19 vaccine candidates, encourage regulatory agencies to use reliance mechanisms, and support States Parties in strengthening their regulatory agencies to facilitate supply of vaccines with assured quality, efficacy, and safety.
- Mobilize technical assistance and financial support to States Parties with insufficient capacity and financial resources for vaccine introduction and roll out.
- Encourage States Parties to prioritize vaccination of high-risk groups as identified in the Strategic Advisory Group of Experts in Immunization (SAGE) roadmap.
- Continue to closely monitor potential vaccine safety signals globally, disseminate timely reports on adverse events following immunization (AEFI), and provide regular SAGE interim recommendations to inform timely national decision-making on the use of COVID-19 vaccines.
- Continuously collect and share best practices and lessons learned from COVID-19 vaccination, to guide national, regional, and global decision-making.
- Strengthen WHO and support strengthening of States Parties’ capacities to prevent, detect and respond to the growing threat of substandard and falsified vaccines.
- Encourage all countries and support low- and middle-income countries to conduct research in line with WHO guidance and best practices. Research topics include COVID-19 vaccine efficacy and effectiveness with regards to infection, transmission, and disease including due to VOC, duration of protection against disease and asymptomatic infection, long-term protection after using different vaccination intervals, protection after one/two/booster dose schedules, and protection following mixed vaccine product schedules.
- Accelerate research to establish correlates of protection from COVID-19 vaccines against infection and disease, including for VOC, thereby facilitating implementation of vaccines and policy development on the use of vaccines. SARS-CoV-2 Variants
- Support States Parties to strengthen their epidemiological and virologic surveillance as part of a comprehensive strategy to control COVID-19.
- Provide clear guidance to States Parties for sequencing to monitor virus evolution and encourage broader geographic representative of genetic testing, rapid sharing of sequences, and meta-data with WHO and publicly available platforms. This will strengthen SARS-CoV-2 evolution monitoring, increase global understanding of variants, and inform decision-making for public health and social measures, diagnostics, therapeutics and vaccines.
- Strengthen the WHO SARS-CoV-2 risk monitoring and assessment framework for variants by accelerating collaboration, harmonizing research to answer critical unknowns about mutations and VOC, and prioritizing issues most relevant for vaccine development, regulatory authorization, and policy formulation, through relevant networks and expert groups such as WHO SARS-CoV-2 Virus Evolution Working Group, WHO Research and Development Blueprint for Epidemics.
- Work with States Parties to conduct in-depth analyses into the factors contributing to the current surge of cases and deaths, including the potential role of SARS-CoV-2 variants.
Health Measures in Relation to International Traffic
- Update the WHO December 2020 risk-based guidance for reducing SARS-CoV-2 transmission related to international travel (by air, land, and sea) based on current science and best practices that include clear recommendations for testing approaches and traveler quarantine duration, as appropriate. Incorporate an ethical framework into the updated guidance to guide national decision making. The guidance should take into consideration COVID-19 vaccination roll out, immunity conferred by past infection, risk settings, movements of migrants, temporary workers, and purpose of travel (non-essential versus essential).
- Continue to coordinate with relevant stakeholders in the fields of international travel and transport, including ICAO, UNWTO, and IATA, for the regular review, updating, and dissemination of evidence-based guidance on travel-related risk reduction measures.
- Continue to update the WHO interim position on the considerations regarding requirements of proof of vaccination and to produce interim guidance and tools related to standardization of paper and digital documentation of COVID-19 travel-related risk reduction measures (vaccination status, SARS-COV-2 testing and COVID-19 recovery status) in the context of international travel.
- Continue to work with States Parties and partners to enable essential travel and repatriation and to facilitate the movement of goods to prevent delays in access to aid and essential supplies.
- Continue to encourage vaccination of seafarers and air crews in line with the Joint statement on prioritization of COVID-19 vaccination for seafarers and aircrew.
- Proceed with rapid implementation of the recommendations in the WHO-convened Global Study of Origins of SARS-CoV-2 report as part of the phase two studies.
- Encourage research into the genetic evolution of the SARS-CoV-2 virus.
- Promote One Health approaches to better understand and reduce the risk of spill-over of emerging infections from animal to human populations and from humans to animals, including from domestic animals.
- Work with partners to develop and disseminate joint risk-based guidance for regulation of wet markets and farms to reduce transmission of novel pathogens from humans to animals and vice-versa.
Risk Communications, Community Engagement, and Risk Management
- Provide communications materials and guidance to explain to communities the continued need for a sustained pandemic response; document and provide messaging to respond to pandemic fatigue.
- Provide the public with communication materials that outline the relative benefits and risks of vaccinations and therapeutics, explain the need for the continuation of public health and social measures, and dispel misinformation.
- Assist States Parties in providing their populations with credible and current information to guide national decision-making by analyzing the latest scientific evidence, sharing evidence-based good practices and experiences, and providing tools and strategies for engaging and understanding community concerns.
- Contribute to global solidarity efforts to increase equitable access to COVID-19 vaccines and ancillary supplies by supporting the COVAX Facility and engaging in technology transfer, where feasible.
- Reduce national and global inequities by ensuring vulnerable populations’ access to COVID-19 vaccines and by prioritizing vaccination of high-risk groups in line with the SAGE Roadmap. In light of currently limited global supply, prioritized vaccination can ensure vaccine supply is available for all countries.
- Enhance capacity for COVID-19 vaccination by using the guidance, tools, and trainings for national/subnational focal points and health workers available in the COVID-19 vaccine introduction toolkit.
- Incorporate, as necessary and appropriate, the private sector into the COVID-19 vaccine planning and introduction to supplement existing service provision and vaccination capacity.
- Share with WHO data and key insights on COVID-19 vaccine uptake and acceptance, wherever possible, and provide the public with credible information on vaccine safety and the benefits of vaccination to address concerns.
- Strengthen national vaccine pharmacovigilance systems to identify, report, and respond to vaccine safety signals. SARS-CoV-2 Variants
- Strengthen epidemiological and virologic surveillance as part of a comprehensive strategy to control COVID-19 and leverage existing systems such as the Global Influenza Surveillance and Response System (GISRS) and relevant networks for systematic sharing of data and specimens.
- Share sequences and meta-data with WHO and publicly available platforms to strengthen SARS-CoV-2 evolution monitoring, increase global understanding of variants, and inform decision-making for public health and social measures, diagnostics, therapeutics and vaccines.
- Virus sharing, including sharing of VOC, should be undertaken to facilitate evaluation of vaccines against VOC using internationally standardized assays.
Health measures in relation to international traffic
- Do not require proof of vaccination as a condition of entry, given the limited (although growing) evidence about the performance of vaccines in reducing transmission and the persistent inequity in the global vaccine distribution. States Parties are strongly encouraged to acknowledge the potential for requirements of proof of vaccination to deepen inequities and promote differential freedom of movement.
- Prioritize vaccination for seafarers and air crews in line with the Joint statement on prioritization of COVID-19 vaccination for seafarers and aircrew. Special attention should be paid to seafarers who are stranded at sea and who are stopped from crossing international borders for crew change due to travel restrictions, including requirements for proof of COVID-19 vaccination, to ensure that their human rights are respected.
- Implement coordinated, time-limited, risk-based, and evidence-based approaches for health measures in relation to international traffic in line with WHO guidance and IHR provisions. If States Parties implement quarantine measures for international travelers on arrival at their destination, these measures should be based on risk assessments and consider local circumstances.
- Reduce the financial burden on international travelers for the measures applied to them for the protection of public health (e.g. testing, isolation/quarantine, and vaccination), in accordance with Article 40 of the IHR.
- Share information with WHO on the effects of health measures in minimizing transmission of SARS-CoV-2 during international travel to inform WHO’s development of evidence-based guidance.
- Strengthen regulation of wet markets and discourage the sale or import of wild animals that pose a high risk of transmission of novel pathogens from animals to humans or vice versa.
- Conduct risk-based monitoring of animal populations to reduce disease transmission from animals to humans. Monitoring efforts should prioritize potential high-risk animal populations that may become reservoirs or lead to emergence of novel viruses or variants.
Origins of SARS-CoV-2
- Support global research efforts to better understand critical unknowns about SARS-CoV-2 including the origin of the virus as well as specific mutations, variants, and genetic factors associated with severe disease.Risk Communications, Community Engagement and Risk Management
Communicate about COVID-19 vaccinations clearly and consistently, including on the benefit-risk of vaccination and on potential AEFI. It should be clearly communicated that no vaccination is 100% effective and that risk of disease, especially severe disease, is significantly reduced but not eliminated. Consequently, public health and social measures are still critically needed to prevent infections and control transmission of SARS-CoV-2 while vaccination supplies increase and coverage grows. Materials should be provided in an easily understandable format and local languages.
Engage and enable communities, the media, and civil society stakeholders in response efforts to reduce pandemic fatigue and enhance vaccine acceptance.
Establish mechanisms to prepare and support health workers and public health authorities as the pandemic is likely to continue for many additional months.
In addition, the following previous recommendations are extended as advised by the Committee.Extension and Updates of Previous Advice to the WHO Secretariat:
Essential Health Services and Strengthening Health Systems: Work with partners to support States Parties in strengthening their essential health services, with a particular focus on mental health, public health prevention and control systems, and other societal impacts, as well as preparing for and responding to concurrent outbreaks, such as seasonal influenza. Special attention should continue to be provided to vulnerable settings.
Provide strategic insight on how States Parties can strengthen and sustain their public health infrastructure, capacities, and functions developed for COVID-19 response to support strengthened health systems, emergency preparedness, and universal health coverage in the long-term.Extension and Updates of Previous Temporary Recommendations to States Parties:
Essential Health Services and Strengthening Health Services: Maintain essential health services with sufficient funding, supplies, and human resources; strengthen health systems to cope with mental health impacts of the pandemic, concurrent disease outbreaks, and other emergencies.
Continue to strengthen public health infrastructure, system capacities, and functions for COVID-19 response, build health systems that can meet health security demands, and to enhance universal health coverage.
Greta Thunberg, climate and environment activist, joins World Health Organization’s call for vaccine equity
The Greta Thunberg Foundation to donate 100 000 Euros to support vaccine equity
Ms Thunberg urges countries and manufacturers to boost and share COVID-19 vaccine supplies so everyone everywhere can be vaccinated
Greta Thunberg, the climate and environment activist, will donate 100,000 Euros (US$ 120 000) via her foundation, to the WHO Foundation, in support of COVAX to purchase COVID-19 vaccines, as part of the global effort to ensure equitable access of vaccines to the most at-risk in all countries, including health workers, older people and those with underlying conditions.
The donation has been made possible thanks to awards that the Greta Thunberg Foundation has received for her advocacy in support of action on climate change.
Ms Thunberg, who today will join the World Health Organization’s COVID-19 press conference (details below) said: “The international community must do more to address the tragedy that is vaccine inequity. We have the means at our disposal to correct the great imbalance that exists around the world today in the fight against COVID-19. Just as with the climate crisis, we must help those who are the most vulnerable first. That is why I am supporting WHO, Gavi and all involved in the COVAX initiative, which I believe offers the best path forward to ensure true vaccine equity and a way out of the pandemic.”
On average, 1 in 4 people in high-income countries have received a coronavirus vaccine, compared with just 1 in more than 500 in low-income countries.
WHO Director-General Dr Tedros Adhanom Ghebreyesus thanked Greta Thunberg for her advocacy in support of vaccine equity and the example she has set, through the Greta Thunberg Foundation, for making this life-saving donation to COVAX.
“Greta Thunberg has inspired millions of people worldwide to take action to address the climate crisis, and her strong support of vaccine equity to fight the COVID-19 pandemic yet again demonstrates her commitment to making our world a healthier, safer and fairer place for all people,” said Dr Tedros. “I urge the global community to follow Greta’s example and do what they can, in support of COVAX, to protect the world’s most vulnerable people from this pandemic.”
Anil Soni, chief executive officer of the WHO Foundation, applauded the donation by the Greta Thunberg Foundation as an important signal to policymakers that there is widespread support from young people around the world for a global response to this global challenge.
“Greta’s gift shows how we, as a global community, must come together to ensure that everyone, everywhere has access to COVID-19 vaccines. Each of us can do our part,” said Mr Soni. “The WHO Foundation is committed to working hand in hand with all those who share this vision.”
The WHO Foundation is mobilizing resources to support COVAX, in part through a new fundraising campaign being launched at the end of April.
Greta Thunberg will join the WHO COVID-19 press conference later today, Monday 19 April, at 5pm Central European Summer Time. She will be joined by WHO Director-General, Dr Tedros, and youth activists from the Global Youth Mobilization initiative.
Journalists can follow the press conference on WHO’s social media channels or connect using the following details:
- By Zoom: https://who-e.zoom.us/j/97576439142 Password: VPCyouth21
- By phone: Webinar ID 975 7643 9142; Numeric passcode for phone: 4662611775; International numbers https://who-e.zoom.us/u/aczVepLgsX
About Greta Thunberg:
Greta Thunberg (born 2003) is a climate and environmental activist from Sweden. In 2018, she started a global school strike movement to protest against governments’ inaction on the climate crisis. Since then, millions of young people have demonstrated on the streets and online, asking world leaders to listen to the science and take action to protect our future.
The Greta Thunberg Foundation was founded in 2019 and supports projects and groups working towards a just and sustainable world by donating award and royalty funds linked to Greta Thunberg’s activism.
About the WHO Foundation:
The WHO Foundation is an independent grant-making foundation, based in Geneva, that sets out to protect the health and well-being of everyone in every part of the world, working alongside the World Health Organization and the global health community. It aims to support donors, scientists, experts, implementing partners, and advocates around the world in rapidly finding new and better solutions to the most pressing global health challenges of today and tomorrow.
The Foundation targets evidence-based initiatives that support WHO in delivering Sustainable Development Goal (SDG) 3 (To ensure healthy lives and promote well-being for all). It is focused on reducing health risks, averting pandemics, better managing diseases, and creating stronger health systems. It tackles these areas by building awareness and supporting its partners, including WHO, so that every life is invested in and the world is ready for any health emergency that may arise.
WHO Foundation. Together we have so much to achieve
More information: www.who.foundation
The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable.
WHO-backed global youth mobilization funds young people's ideas to combat impact of COVID-19 pandemic
- Initiative led by the world’s six largest youth organizations and supported by the World Health Organization and United Nations Foundation will fund the work of young people in communities impacted by the global COVID-19 pandemic
- Impact of the global pandemic on young people to be addressed at Global Youth Summit
- Young people will decide where the money goes and how it is spent
- Global Youth Mobilization backed by UNICEF, USAID, UNFPA, European Commission, Salesforce, FIFA and Heads of State and Governments from around the world
From today, young people around the world will be able to apply for funding to support innovative Local Solutions to address the impact of the COVID-19 pandemic, as part of a new initiative called the Global Youth Mobilization. Dr Tedros Adhanom Ghebreyesus, WHO Director-General, climate change activist Greta Thunberg and youth representatives from the Global Youth Mobilization will launch the call for applications at a press conference on Monday 19 April 2021 at 1700 CEST.
Led by the Big 6 Youth Organizations and backed by the WHO and United Nations Foundation, the Global Youth Mobilization is an initiative of young people and voluntary organizations taking action to improve their lives now and in a post-COVID-19 world.
Hundreds of millions of young people have had to put their lives on hold because of the COVID-19 pandemic. 90 per cent of young people have reported increased mental anxiety during the pandemic; more than one billion students in almost every country have been impacted by school closures; 80 per cent of young women are worried about their future; and one in six young people worldwide have lost their jobs during the pandemic.
The Global Youth Mobilization Local Solutions funding will by-pass traditional funding and support streams to invest in young people and community grassroots organizations anywhere in the world. A world first at this scale and level of ambition, young people and community organizations are able to apply for funding via one centralised platform, available in multiple languages. These local solutions will be judged and decided on by young people, for young people.
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said: “WHO is committed to ensuring the voices, energy and solutions offered by youth are at the centre of the world’s recovery from COVID-19. Our collaboration with the Big 6 and the United Nations Foundation will fuel wide-ranging actions led by young people to address the challenges their own communities face, and will also provide global platforms for their wisdom and ideas to be heard and acted on.”
From education disruption and job losses, to a decline in mental health and rising gender-based violence, the Global Youth Mobilization will support young people to overcome the challenges created by the COVID-19 pandemic. An initial $2 million of funding will be available in four tiers, from $500 through to $5,000 and an ‘accelerator’ program will scale and replicate the most promising solutions, with further funding lined up over the coming months.
A Global Youth Summit, to be held virtually on 23- 25 April, marks the starting point for young people to get involved in the mobilization. Over the three days, thousands of young people, leaders, policy makers and changemakers will come together in one space to discuss the issues facing young people across the world.
The mobilization is being supported by Governments, UN agencies and Royal Families including, the Queen of Malaysia, the President of Kenya, President of Ghana, the Vice President of Nigeria, the Government of Fiji, the Prime Minister of Belgium, the Government of Singapore as well as the European Commission, USAID, UNICEF and UN Population Fund. More details, and further Government support, will be announced at the Global Youth Summit.
The Global Youth Mobilization and its supporters are calling on governments, businesses, and policy makers to back the initiative and commit to prioritising young people in their policies and investing in their futures.
Funded by the COVID-19 Solidarity Response Fund, other supporting global partners include high-profile brands and advocates, including: Salesforce, FIFA, the Special Olympics, UNHCR, Cambridge International, Peace First, Generation Unlimited and Influential.
Dr Tedros will open the Global Youth Summit alongside Youth Representatives of the Global Youth Mobilization Board. It will feature youth activists from hundreds of countries, three plenary sessions with high-profile speakers, and over 60 interactive breakout sessions involving a range of partners. The Summit will be available to anyone, via broadcast and in five core languages: English, French, Spanish, Arabic and Russian.
Daisy Moran, Youth Board Representative, Global Youth Mobilization Board, said: “This is a pivotal moment for our generation. The Global Youth Mobilization provides an opportunity for young people to take an active role in the immediate and long-term recovery from the impact of COVID-19. Our experiences, creativity and passions will inform policies and decisions affecting all our lives and I urge people to apply for the funding available. Together, as campaigners, members of youth focused organisations, global health actors, and volunteers from around the world, we are calling for action now.”
For more information, please visit: www.globalyouthmobilization.org
 All sources are included in this paper: Young People Championing Post-Pandemic Futures: Policy Recommendations from the Big 6 Youth Organizations
NOTES TO EDITORS
The WHO press conference will take place at 1700 CEST on Monday 19 April.
You can join the press conference by:
Webinar ID: 975 7643 9142
Numeric passcode for phone: 4662611775
International numbers available: https://who-e.zoom.us/u/aczVepLgsX
For media inquiries and interview requests, please contact:
- WHO Media team - email@example.com
- Global Youth Mobilization - GYMGD@mhpc.com
- United Nations Foundation - firstname.lastname@example.org
About the Global Youth Mobilization
The Global Youth Mobilization is led by the Big 6 Youth Organizations, an alliance of leading international youth-serving organizations:
World Organization of the Scout Movement (WOSM), Young Men’s Christian Association (YMCA), World Young Women’s Christian Association (YWCA), World Association of Girl Guides and Girl Scouts (WAGGGS), The International Federation of Red Cross and Red Crescent Societies (IFRC) and a leading programme for youth development, The Duke of Edinburgh’s International Award (The Award).
Together, the Big 6 actively involve and engage more than 250 million young people, contributing to the empowerment of more than one billion young people during the last century.
The Global Youth Mobilization is led by a diverse Board made up of youth representatives drawn from across the Big 6, alongside CEOs of the Big 6 and representatives from the World Health Organization and United Nations Foundation.
Media interview opportunities
The following are available for interview from the 19 April through to the Global Youth Summit from 23 – 25 April.
Global Youth Mobilization Board members
- Daisy Moran, Global Youth Mobilization Youth Board member
Daisy is a youth activist based in Illinois, USA. An active member of the YMCA movement, she is currently Director of Youth Achievement & Community Engagement at Two Rivers YMCA. You can read her full biography here.
- Tharindra Arumapperuma, Global Youth Mobilization Youth Board member
Tharindra is a youth activist based in Sri Lanka. An emerging leader for The Duke of Edinburgh’s International Award since 2017. She has achieved all three levels of the Award Programme and volunteers as a trainer for the Award in Sri Lanka and globally. You can read her full biography here.
- Ahmad Alhendawi, Chair of the Global Youth Mobilization Board
Ahmad Alhendawi is the 10th Secretary General of the World Organization of the Scout Movement (WOSM), becoming the youngest to helm one of the world’s leading educational youth movements. Prior to his appointment in WOSM, Mr. Alhendawi served as the first-ever United Nations Secretary General’s Envoy on Youth and the youngest senior official in the history of the UN. You can read his full biography here.
Elahi is an IFRC volunteer who has been supporting communities across Bangladesh throughout the pandemic. Initially in hospitals in the immediate response to the crisis and since supporting young people with online skills development. Read about Elahi here.
- Estrella Gutierrez – 24, Mexico - World Association of Girl Guides and Girl Scouts
Estrella is a Girl Guide from Mexico who worked a student doctor volunteer throughout the pandemic. Read her incredible story here.
- Gregory Kipchirchir - 22, Kenya – The Duke of Edinburgh’s International Award
Stories from the pandemic
Gregory is a Gold Award participant who during the pandemic become heavily involved in farming and local community tree planting projects as a way to support those around him. Read his story here
Global Advisory Committee on Vaccine Safety (GACVS) review of latest evidence of rare adverse blood coagulation events with AstraZeneca COVID-19 Vaccine (Vaxzevria and Covishield)
A very rare new type of adverse event called Thrombosis with Thrombocytopenia Syndrome (TTS), involving unusual and severe blood clotting events associated with low platelet counts, has been reported after vaccination with COVID-19 Vaccines Vaxzevria and Covishield. A specific case definition for TTS is being developed by the Brighton Collaboration1. This will assist in identifying and evaluating reported TTS events and aid in supporting causality assessments.
The biological mechanism for this syndrome of TTS is still being investigated. At this stage, a ‘platform specific’ mechanism related to the adenovirus-vectored vaccines is not certain but cannot be excluded. Ongoing review of TTS cases and related research should include all vaccines using adenoviral vector platforms. The GACVS noted that an investigation has been initiated into the occurrence of TTS following the Johnson & Johnson vaccine administered in the United States. The TTS syndrome has not been linked to mRNA-based vaccines (such as Comirnaty or the Moderna mRNA-1273 vaccine).
Based on latest available data, the risk of TTS with Vaxzevria and Covishield vaccines appears to be very low. Data from the UK suggest the risk is approximately four cases per million adults (1 case per 250 000) who receive the vaccine, while the rate is estimated to be approximately 1 per 100 000 in the European Union (EU). Countries assessing the risk of TTS following COVID-19 vaccination should perform a benefit-risk analysis that takes into account local epidemiology (including incidence and mortality from COVID-19 disease), age groups targeted for vaccination and the availability of alternative vaccines.
Work is ongoing to understand risk factors for TTS. Some investigators have looked into rates of TTS by age2. GACVS supports further research to understand age-related risk because while available data suggest an increased risk in younger adults, this requires further analysis. On the issue of sex-related risk, although more cases have been reported in females, it is important to underscore that more women have been vaccinated and that some TTS cases have also been reported in men. Therefore, further analysis is required to determine any sex-related risk. GACVS recommends further epidemiological, clinical and mechanistic studies to fully understand TTS.
Thrombosis in specific sites (such as the brain and abdomen) appears to be a key feature of TTS. Clinicians should be alert to any new, severe, persistent headache or other significant symptoms, such as severe abdominal pain and shortness of breath, with an onset between 4 to 20 days after adenovirus vectored COVID-19 vaccination.
At a minimum, countries should encourage clinicians to measure platelet levels and conduct appropriate radiological imaging studies as part of the investigation of thrombosis. Clinicians should also be aware that although heparin is used to treat blood clots in general, administration of heparin in TTS may be dangerous, and alternative treatments such as immunoglobulins and non-heparin anticoagulants should be considered.
There may be a geographic variation in the risk of these rare adverse events. It is therefore important to evaluate potential cases of TTS in all countries. Countries are encouraged to review, report and investigate all cases of TTS following COVID-19 vaccinations. Countries should assess cases according to the presence of thrombosis with thrombocytopenia and the time to onset following vaccination, using the Brighton Case Definition of TTS.
Whilst we have some information on Comirnaty, Moderna (mRNA-1273), Vaxzevria and Covishield vaccines, there is limited post-market surveillance data on other COVID-19 vaccines and from low- and middle-income countries. GACVS highly recommends that all countries conduct safety surveillance on all COVID-19 vaccines and provide data to their local authorities and to the WHO global database of individual case safety reports. This is urgently needed to support evidence-based recommendations on these life-saving vaccines.
Open, transparent, and evidence-based communication about the potential benefits and risks to recipients and the community is essential to maintain trust. WHO is carefully monitoring the rollout of all COVID-19 vaccines and will continue to work closely with countries to manage potential risks, and to use science and data to drive response and recommendations.
The World Health Organization (WHO) is convening a Guideline Development Group (GDG) to advise on updates needed to its recommendations on the treatment of drug susceptible tuberculosis (TB).
Drug susceptible TB affects approximately 7 million people annually. It is currently treated with four first line TB medicines for a period of six months. Approximately 85% of patients who take the six-month regimen will have a successful treatment outcome. Ensuring access to effective treatment is a key component of the End TB Strategy, which includes a priority indicator that 90% or more of patients should have a successful treatment outcome.
Despite its effectiveness, the current treatment regimen of six months remains too long for many patients. In recent years, research efforts have been directed towards finding safe and effective shorter regimens. New evidence from a randomized controlled trial on a 4-month treatment regimen containing a fluoroquinolone and high dose rifapentine has recently become available to WHO. This will be the evidence that will be reviewed and considered by the GDG.
WHO last updated its guidance on the treatment of drug susceptible TB in 2017. At this time WHO issued a recommendation against the use of shorter fluoroquinolone containing regimens as the evidence did not support that these regimens were more effective than the six-month regimen. However, it is now time to review the evidence on shorter regimens again, to provide users worldwide with the most up to date evidence-informed guidance on how to treat drug susceptible TB.
The GDG meeting will be held online in late April 2021, in accordance with WHO requirements for the development of evidence-informed policy guidance. The updated recommendations will be released in 2021, as part of the treatment module of the WHO consolidated guidelines on tuberculosis. More details of the process, inclusive of brief biographies of the experts invited to serve in the current GDG, are available here.
The World Health Organization’s new Global Diabetes Compact aims to bring a much-needed boost to efforts to prevent diabetes and bring treatment to all who need it ̶ 100 years after the discovery of insulin.
The Compact is being launched today at the Global Diabetes Summit, which is co-hosted by WHO and the Government of Canada, with the support of the University of Toronto. During the event, the President of Kenya will join the Prime Ministers of Fiji, Norway and Singapore; the WHO Global Ambassador for Noncommunicable Diseases and Injuries, Michael R. Bloomberg; and ministers of health from a number of countries as well as diabetes experts and people living with diabetes, to highlight the ways in which they will support this new collaborative effort. Other UN agencies, civil society partners and representatives of the private sector will also attend.The risk of early death from diabetes is increasing
“The need to take urgent action on diabetes is clearer than ever,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “The number of people with diabetes has quadrupled in the last 40 years. It is the only major noncommunicable disease for which the risk of dying early is going up, rather than down. And a high proportion of people who are severely ill in hospital with COVID-19 have diabetes. The Global Diabetes Compact will help to catalyze political commitment for action to increase the accessibility and affordability of life-saving medicines for diabetes and also for its prevention and diagnosis.”
“Canada has a proud history of diabetes research and innovation. From the discovery of insulin in 1921 to one hundred years later, we continue working to support people living with diabetes,” said the Honourable Patty Hajdu, Minister of Health, Canada. “But we cannot take on diabetes alone. We must each share knowledge and foster international collaboration to help people with diabetes live longer, healthier lives — in Canada and around the world.”Urgent action needed on increasing access to affordable insulin
One of the most urgent areas of work is to increase access to diabetes diagnostic tools and medicines, particularly insulin, in low- and middle-income countries.
The introduction of a pilot programme for WHO prequalification of insulin in 2019 has been an important step. Currently the insulin market is dominated by three companies. Prequalification of insulin produced by more manufacturers could help increase the availability of quality-assured insulin to countries that are currently not meeting demand. In addition, discussions are already underway with manufacturers of insulin and other diabetes medicines and diagnostic tools about avenues that could help meet demand at prices that countries can afford.
Insulin is not the only scarce commodity: many people struggle to obtain and afford blood glucose metres and test strips as well.
In addition, about half of all adults with type 2 diabetes remain undiagnosed and 50% of people with type 2 diabetes don’t get the insulin they need, placing them at avoidable risk of debilitating and irreversible complications such as early death, limb amputations and sight loss.
Innovation will be one of the core components of the Compact, with a focus on developing and evaluating low-cost technologies and digital solutions for diabetes care.Global targets to be agreed on
The Compact will also focus on catalyzing progress by setting global coverage targets for diabetes care. A “global price tag” will quantify the costs and benefits of meeting these new targets. The Compact will also advocate for fulfilling the commitment made by governments to include diabetes prevention and treatment into primary health care and as part of universal health coverage packages.
“A key aim of the Global Diabetes Compact is to unite key stakeholders from the public and private sectors, and, critically, people who live with diabetes, around a common agenda, to generate new momentum and co-create solutions,” said Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO. “The “all hands on deck” approach to the COVID-19 response is showing us what can be achieved when different sectors work together to find solutions to an urgent public health problem.”
People watching the Summit will hear from people living with diabetes from India, Lebanon, Singapore, the United Republic of Tanzania, the USA and Zimbabwe about the challenges they face in managing their diabetes and how these could be overcome. Part of the Summit has been co-designed with people who live with diabetes and will give them a global platform to explain what they are expecting from the Compact and how they would like to be involved in its further development and implementation.
“It is time to create momentum not just for living with diabetes, but thriving with it,” said Dr Apoorva Gomber, a diabetes advocate living with type 1 diabetes who is taking part in the Summit. “We must grab the opportunity of the Compact with both hands and use it to ensure that we can look back in a few years’ time and say that, finally, our countries are equipped to help people with diabetes live healthy and productive lives.”Note for journalists:
The Global Diabetes Summit has three segments:
- a first segment primarily for governments, donors, non-state actors and people living with diabetes;
- a second segment on operationalizing meaningful engagement of people living with diabetes; and
- a third segment for people living with diabetes entitled ‘100 Years of Insulin ̶ Celebrating Its Impact on Our Lives’ organized by the University of Toronto
Join the WHO Director-General and world leaders for the launch of the Global Diabetes Compact, a collective effort to prevent diabetes and bring the right care to all who need it.
Moderated by awarding-winning journalist Femi Oke
11:00-13:00 - New York, 17:00-19:00 - Geneva, 20.30-22.30 - New DelhiSegment 2
Organized in collaboration with a consultative group of people living with diabetes, this segment will discuss how people with lived experience of diabetes will meaningfully engage in all phases of the Global Diabetes Compact.
13:00-15:00 - New York, 19:00-21:00 - Geneva time, 22:30-00:30 - New Delhi
Join us for both segments at www.youtube.com/whoSegment 3
100 Years of Insulin ̶ Celebrating Its Impact on Our Lives
This segment, organized by the University of Toronto, will focus on the latest approaches to using insulin, the experiences of people living with diabetes, and how research on insulin is changing.
Starting at 16:30 Toronto time, 22:30 Geneva time