A second WHO-led joint UN mission, working in collaboration with the Palestine Red Crescent Society, earlier today evacuated 31 babies from Al-Shifa Hospital in northern Gaza, to a hospital in southern Gaza. The severely ill babies were transported in 6 ambulances supplied and staffed by the Palestine Red Crescent. Other mission members included UN Mine Action, UNICEF and UNRWA. The mission was once again assessed as high-risk, due to the active combat taking place in close proximity to the hospital.
These premature and low birthweight babies had earlier been moved from the neonatal unit in Al-Shifa to a safer area in the hospital, due to lack of electricity to run their life support, and security risks in the hospital. Yesterday and last night, two babies died before the evacuation could take place. (Note, there were 33 babies under care yesterday, according to a Ministry of Health update.)
The babies were successfully transported to the neonatal intensive care unit at Al-Helal Al-Emarati Maternity Hospital in southern Gaza, where they are being assessed and stabilized. Doctors there say all the babies are fighting serious infections due to lack of medical supplies and impossibility to continue infection control measures in Al-Shifa Hospital. Eleven are in critical condition.
Sadly, none of the infants were accompanied by family members, as the Ministry of Health has only limited information, and is not currently able to find close family members. Six health workers and 10 of their family members, who had been sheltering at the hospital, were also evacuated.
The evacuation, which was requested by health workers and patients during the joint mission yesterday, became necessary as Al-Shifa Hospital is no longer able to function due to a lack of clean water, fuel, medical supplies, food, other essential items and the intense hostilities. WHO remains deeply concerned about the safety and health needs of patients and health workers who remain at Al-Shifa Hospital, and in the few partially functional hospitals in the north that face imminent closure.
Al-Shifa Hospital, previously the largest and most advanced referral hospital in Gaza, together with other hospitals, must be fully restored to provide urgently needed health services in Gaza.
Today’s mission was led by senior WHO staff, including a medical specialist and a doctor, and representatives from UNICEF, UNMAS and UNRWA as noted above. It included medical staff from the Palestine Red Crescent Society, along with their ambulances. WHO is grateful for their partnership, and the support of the rest of the UN, working together as One UN.
The complex and high-risk operation, occurring in an active conflict zone, follows an assessment mission yesterday, 18 November, which included public health experts, logistics specialists, and security staff from OCHA, UNDSS, UNMAS/UNOPS, UNRWA and WHO. Today’s mission was deconflicted with the Israel Defense Forces and with the defacto authorities.
There remain over 250 patients and 20 health workers at Al-Shifa, who all request immediate evacuation. Planning is ongoing to evacuate the remaining patients, their families and the health-care workers. Given the complex security and logistics constraints, these evacuations will take several days to complete. Priority will be given to the 22 dialysis patients and 50 patients with spinal injuries. WHO reaffirms its respect for the dedication, professionalism, humanity and courage of the health staff who have continued to care for their patients under unimaginably difficult conditions.
WHO reiterates its plea for collective efforts to bring an end to the hostilities and humanitarian catastrophe in Gaza. We call for an immediate ceasefire, the sustained flow of humanitarian assistance at scale, unhindered humanitarian access to all of those in need, the unconditional release of all hostages—many of whom have serious medical needs—and the cessation of attacks on health care and other vital infrastructure.
Earlier today, a joint UN humanitarian assessment team led by WHO accessed Al-Shifa Hospital in northern Gaza to assess the situation on the ground, conduct a rapid situational analysis, assess medical priorities and establish logistics options for further missions. The team included public health experts, logistics officers and security staff from OCHA, UNDSS, UNMAS/UNOPS, UNRWA and WHO.
The mission was deconflicted with the Israel Defense Forces (IDF) to ensure safe passage along the agreed route. However, this was a high-risk operation in an active conflict zone, with heavy fighting ongoing in close proximity to the hospital.
Earlier in the day, the IDF had issued evacuation orders to the remaining 2500 internally displaced people who had been seeking refuge on the hospital grounds. They, along with a number of mobile patients and hospital staff, had already vacated the facility by the time of the team's arrival.
Due to time limits associated with the security situation, the team was able to spend only one hour inside the hospital, which they described as a “death zone,” and the situation as “desperate.” Signs of shelling and gunfire were evident. The team saw a mass grave at the entrance of the hospital and was told more than 80 people were buried there.
Lack of clean water, fuel, medicines, food and other essential aid over the last 6 weeks have caused Al-Shifa Hospital – once the largest, most advanced and best equipped referral hospital in Gaza – to essentially stop functioning as a medical facility. The team observed that due to the security situation, it has been impossible for the staff to carry out effective waste management in the hospital. Corridors and the hospital grounds were filled with medical and solid waste, increasing the risk of infection. Patients and health staff with whom they spoke were terrified for their safety and health, and pleaded for evacuation. Al-Shifa Hospital can no longer admit patients, with the injured and sick now being directed to the seriously overwhelmed and barely functioning Indonesian Hospital.
There are 25 health workers and 291 patients remaining in Al-Shifa, with several patient deaths having occurred over the previous 2 to 3 days due to the shutting down of medical services. Patients include 32 babies in extremely critical condition, 2 people in intensive care without ventilation, and 22 dialysis patients whose access to life-saving treatment has been severely compromised. The vast majority of patients are victims of war trauma, including many with complex fractures and amputations, head injuries, burns, chest and abdominal trauma, and 29 patients with serious spinal injuries who are unable to move without medical assistance. Many trauma patients have severely infected wounds due to lack of infection control measures in the hospital and unavailability of antibiotics.
Given the current state of the hospital, which is no longer operational or admitting new patients, the team was requested to evacuate health workers and patients to other facilities. WHO and partners are urgently developing plans for the immediate evacuation of the remaining patients, staff and their families. Over the next 24–72 hours, pending guarantees of safe passage by parties to the conflict, additional missions are being arranged to urgently transport patients from Al-Shifa to Nasser Medical Complex and European Gaza Hospital in the south of Gaza. However, these hospitals are already working beyond capacity, and new referrals from Al-Shifa Hospital will further strain overburdened health staff and resources.
WHO is deeply concerned about the safety and health needs of patients, health workers and internally displaced people sheltering at the few remaining partially functional hospitals in the north, which are facing the risk of closure due to a lack of fuel, water, medical supplies and food, and the intense hostilities. Immediate efforts must be made to restore the functionality of Al-Shifa and all other hospitals to provide urgently needed health services in Gaza.
WHO reiterates its plea for collective efforts to bring an end to the hostilities and humanitarian catastrophe in Gaza. We call for an immediate ceasefire, the sustained flow of humanitarian assistance at scale, unhindered humanitarian access to all of those in need, the unconditional release of all hostages, and the cessation of attacks on health care and other vital infrastructure. The extreme suffering of the people of Gaza demands that we respond immediately and concretely with humanity and compassion.
World leaders, cervical cancer survivors, advocates, partners, and civil society are coming together today to mark the third Cervical Cancer Elimination Day of Action. The Initiative, which marked the first time Member States adopted a resolution to eliminate a noncommunicable disease, has continued to gain momentum, and this year's commemoration promises to be a beacon of hope, progress, and renewed commitment from nations around the world.
“In the last three years, we have witnessed significant progress, but women in poorer countries and poor and marginalized women in richer countries still suffer disproportionately from cervical cancer,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “With enhanced strategies to increase access to vaccination, screening and treatment, strong political and financial commitment from countries, and increased support from partners, we can realize our vision for eliminating cervical cancer.”
Governments and communities are leading the way by declaring commitment and developing strategies to eliminate cervical cancer and countries around the world are rallying behind WHO’s call to action on 17 November.
- Australia is on target to be among the first countries in the world to eliminate cervical cancer, which the country anticipates to achieve in the next 10 years.
- In Benin, the First Lady, Her Excellency, Claudine Talon will host an HPV screening campaign.
- The Democratic Republic of the Congo will join the day of action for the first time with a march across Kinshasa calling for cervical cancer elimination, organized by the Ministry of Health and women’s associations.
- In Norway, researchers have recently reported finding no cases of cervical cancer caused by the human papillomavirus (HPV) in 25-year-olds, the first cohort of women who were offered the vaccine as children through the national vaccination programme.
- Indonesia announced this week a declaration committing to reach the 90-70-90 targets for cervical cancer elimination through the national cervical cancer elimination plan (2023 to 2030).
- Japan is lighting up the country in teal to mark the day, and honour two years of the re-introduction of the HPV vaccine in the country.
- In Singapore, the Alliance for Active Action Against HPV (A4HPV) will host a spin cycling event to help raise awareness.
- In the United Kingdom, England’s National Health Service (NHS) pledged this week to eliminate cervical cancer by 2040.
Strong progress on HPV vaccination
Since the launch of the Global strategy to accelerate the elimination of cervical cancer as a public health problem three years ago, a further 30 countries, including countries with large populations and cervical cancer burden such as Bangladesh, Indonesia and Nigeria, introduced the HPV vaccine. As of today, 140 countries have introduced HPV vaccine into national immunization programmes.
The global HPV vaccination coverage of girls that received at least one dose of HPV vaccine has increased to 21% in 2022 – exceeding the pre-pandemic levels for the first time. If this rate of progress is maintained the world would be on track to meet the 2030 target to make HPV vaccines available to all girls everywhere.
WHO, in collaboration with GAVI and other partners, has initiated systematic efforts to catch-up vaccinations for girls who missed HPV vaccination as a result of pandemic disruptions and to revitalize HPV vaccination programmes towards reaching the 90% coverage target.
In Nigeria, for example, HPV vaccine was introduced into the routine immunization programme with a single-dose schedule in October 2023. The country aims to vaccinate 7.7 million girls – the largest number in a single round of HPV vaccination in the region.
Weak progress on screening and treatment
Countries have invested to improve access to screening all over the world. This year, together with Unitaid and its implementing partners, Ministries of Health in 14 low- and middle-income countries reached a milestone of screening over a million women.
In most countries, those diagnosed with cervical cancer still need better access to surgery, radiotherapy, chemotherapy and palliative care. Still, only 65% of countries include cervical cancer screening services and 69% include radiotherapy for treatment of cervical cancer in the health benefit packages as part of universal health coverage schemes.
However, pioneering country experiences showcase progress that is being made on the ground:
- El Salvador released new screening targets to achieve 70% coverage by 2030 and to provide access to treatment for 90% of women with cervical disease. The Ministry of Health now offers services in all 75 screening facilities throughout the country. The country also made progress on the treatment of precancerous lesions; and
- Bhutan, which was among the Member States that raised this agenda to the WHO Executive Board in 2019, continues to make remarkable strides in cervical cancer prevention and treatment. The country recently reported that it has screened 90.8% of eligible women for cervical pre-cancer and cancer through its health flagship project, of these, 92% of women with cervical pre-cancer were treated and all women with invasive cancer were managed.
To enhance screening quality, reduce costs and broaden access to health-care services, WHO now endorses HPV testing as the preferred method for cervical cancer screening. This includes support for self-sampling, which makes screening even more convenient. In addition, WHO prequalified a fourth HPV test in June 2023, providing an additional option for countries seeking to implement advanced screening methods to identify patients requiring treatment more effectively.
Notes for editors:
To eliminate cervical cancer, all countries must reach and maintain an incidence rate of below 4 per 100 000 women. Achieving that goal rests on three key pillars and their corresponding targets. The three key pillars are:
- 90% of girls fully vaccinated with the HPV vaccine by the age of 15;
- 70% of women screened using a high performance test by the age of 35, and again by the age of 45;
- 90% of women with pre-cancer treated and 90% of women with invasive cancer managed.
Each country should meet the 90–70–90 targets by 2030 to get on the path to eliminate cervical cancer within the next century.
Global measles threat continues to grow as another year passes with millions of children unvaccinated
Mr Ingo Behnel, Ambassador Dr Katharina Stasch, Dr Gesa Miehe-Nordmeyer and Dr Catharina Boehme. ©WHO/Lindsay Mackenzie
In a meeting on 3 November, Germany reaffirmed its support for WHO as the Organization takes on wide-ranging global health challenges and advocated prompt action to establish a pandemic accord – an international agreement that would pave the way for better collaboration on emergencies, science and research.
A German delegation that included Dr Katharina Stasch, UN Ambassador in Geneva; Ingo Behnel, Director-General of European and International Policy Issues at the German Ministry of Health; and Dr Gesa Miehe-Nordmeyer, Director General of the German Chancellery’s Department for Social, Health, Labor Market, Environment and Social Policy, met with WHO representatives including Assistant Director-General Dr Catharina Boehme, Emergencies Programme Executive Director Dr Michael Ryan and Chief Scientist Dr Jeremy Farrar.
During the meeting Germany also reaffirmed its support for flexible, sustainable funding to carry out WHO’s 14th General Programme of Work for 2025-28 (GPW14) towards vital objectives such as withstanding pandemics, responding to health emergencies, and confronting the threats to health posed by climate change and drug-resistant infections.
“Germany is very supportive of WHO, and also supportive of the pandemic agreement,” Dr Miehe-Nordmeyer said, adding that Member States have a clear window of opportunity to establish the pandemic agreement in time for the World Health Assembly next May.
Dr Ryan praised Germany for having been a “huge supporter of global health security over many years,” cited the country’s voluntary contributions to WHO’s Contingency Fund for Emergencies, its support during the COVID-19 pandemic for technology, science, innovation and operations, and for its hosting of the World Health Summit, a leading strategic forum for global health advocacy.
Germany is the largest donor to the WHO Contingency Fund for Emergencies (CFE), which enables WHO to respond without delay to health emergencies worldwide.
Dr Ryan called the Germany-supported WHO Hub for Pandemic and Epidemic Intelligence in Berlin “a physical manifestation of Germany’s commitment” to global health security. The Hub was launched in 2021 to provide the world with better data and analytics to detect and respond to health emergencies.
At the meeting Germany and WHO signed funding agreements to support emergency responses in Libya (€1 million) and Yemen (€3 million).
An afternoon session with WHO Chief Scientist Jeremy Farrar touched on embedding science and research action across the Organization, helping countries develop ecosystems for health research and science, and supporting the international community with a digitalization agenda.
Dr Farrar also discussed WHO’s aim to add WHO collaborating centres, particularly in the Global South, and branch out into new research areas. WHO has 847 collaborating centers in more than 80 countries.
“We’d like to see collaborating centres on digital, on A.I., on trust, or on horizon scanning for the future of science,” Dr Farrar said. “We would like to work more closely with the collaborating centres and for them to see themselves very much as a part of WHO,” Dr Farrar said.