The COVID-19 pandemic is highlighting the need to urgently increase investment in services for mental health or risk a massive increase in mental health conditions in the coming months, according to a policy brief on COVID-19 and mental health issued by the United Nations today.
“The impact of the pandemic on people’s mental health is already extremely concerning,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Social isolation, fear of contagion, and loss of family members is compounded by the distress caused by loss of income and often employment.”
Depression and anxiety are increasing
Reports already indicate an increase in symptoms of depression and anxiety in a number of countries. A study in Ethiopia, in April 2020, reported a 3-fold increase in the prevalence of symptoms of depression compared to estimates from Ethiopia before the epidemic.
Specific population groups are at particular risk of COVID-related psychological distress. Frontline health-care workers, faced with heavy workloads, life-or-death decisions, and risk of infection, are particularly affected. During the pandemic, in China, health-care workers have reported high rates of depression (50%), anxiety (45%), and insomnia (34%) and in Canada, 47% of health-care workers have reported a need for psychological support.
Children and adolescents are also at risk. Parents in Italy and Spain have reported that their children have had difficulties concentrating, as well as irritability, restlessness and nervousness. Stay-at-home measures have come with a heightened risk of children witnessing or suffering violence and abuse. Children with disabilities, children in crowded settings and those who live and work on the streets are particularly vulnerable.
Other groups that are at particular risk are women, particularly those who are juggling home-schooling, working from home and household tasks, older persons and people with pre-existing mental health conditions. A study carried out with young people with a history of mental health needs living in the UK reports that 32% of them agreed that the pandemic had made their mental health much worse.
An increase in alcohol consumption is another area of concern for mental health experts. Statistics from Canada report that 20% of 15-49 year-olds have increased their alcohol consumption during the pandemic.
Mental health services interrupted
The increase in people in need of mental health or psychosocial support has been compounded by the interruption to physical and mental health services in many countries. In addition to the conversion of mental health facilities into care facilities for people with COVID-19, care systems have been affected by mental health staff being infected with the virus and the closing of face-to-face services. Community services, such as self-help groups for alcohol and drug dependence, have, in many countries, been unable to meet for several months.
“It is now crystal clear that mental health needs must be treated as a core element of our response to and recovery from the COVID-19 pandemic,” said Dr Tedros Adhanom Ghebreyesus. “This is a collective responsibility of governments and civil society, with the support of the whole United Nations System. A failure to take people’s emotional well-being seriously will lead to long-term social and economic costs to society.”
Finding ways to provide services
In concrete terms, it is critical that people living with mental health conditions have continued access to treatment. Changes in approaches to provision of mental health care and psychosocial support are showing signs of success in some countries. In Madrid, when more than 60% of mental health beds were converted to care for people with COVID-19, where possible, people with severe conditions were moved to private clinics to ensure continuity of care. Local policy-makers identified emergency psychiatry as an essential service to enable mental health-care workers to continue outpatient services over the phone. Home visits were organized for the most serious cases. Teams from Egypt, Kenya, Nepal, Malaysia and New Zealand, among others, have reported creating increased capacity of emergency telephone lines for mental health to reach people in need.
Support for community actions that strengthen social cohesion and reduce loneliness, particularly for the most vulnerable, such as older people, must continue. Such support is required from government, local authorities, the private sector and members of the general public, with initiatives such as provision of food parcels, regular phone check-ins with people living alone, and organization of online activities for intellective and cognitive stimulation.
An opportunity to build back better
The scaling-up and reorganization of mental health services that is now needed on a global scale is an opportunity to build a mental health system that is fit for the future,” said Dévora Kestel, Director of the Department of Mental Health and Substance Use at WHO. “This means developing and funding national plans that shift care away from institutions to community services, ensuring coverage for mental health conditions in health insurance packages and building the human resource capacity to deliver quality mental health and social care in the community.”
The effects of global warming are becoming evident even in Belgium. 2018 was exceptionally warm and dry and the summer of 2019 also broke many weather records, with temperatures above 40 degrees Celsius and an increasing shortage of precipitation. According to the KMI, 2020 will already belong to the list of years with the longest periods of drought, and we are only at the beginning of the growing season. Belgium falls into the category of countries with ‘high water scarcity’, which makes it one of the driest regions in Europe. These extreme conditions have ensured that the past few years have been recognized as an agricultural disaster, as a result of which agricultural subsidies were released as a financial safety net for the farmers who have seen their yield plummet due to the drought. These economic consequences, together with the growing demand for local, sustainable agricultural products, require adjustments. In addition to applying new techniques and better soil management, the necessary transition to climate-adapted agriculture calls for the cultivation of robust, more drought-resistant crops.
The maize varieties that will now be tested in the field have shown great promise in the greenhouse. The plants produce larger amounts of a growth-regulating protein. They grow better in normal conditions and give a noticeable yield increase in drought, at least in the greenhouse. With this field trial, the researchers want to investigate whether these positive effects are also preserved under normal cultivation conditions. The field trial is conducted in collaboration with ILVO, which has many years of experience with agricultural field research.
The maize in the three-year field trial that has now started is still based on 'classic' gene technology. The trial was authorized by the federal ministers for Health, Agriculture and the Environment, based on a favorable opinion from the Biosafety Advisory Council. In the meantime, the researchers are diligently looking for ways to obtain the required increased levels of the growth regulator through genome editing. Genome editing is a new breeding technique that allows us to edit genes in a highly targeted and much faster way than traditional breeding methods. This new breeding method is an important key in tackling agricultural problems that can be remedied by improving crops.
News Date: 14/05/2020
As of 12 May, 90 contacts are currently under surveillance, of which 41 are high-risk contacts who had direct contact with body fluids of the last confirmed case. All contacts have exited their high-risk period (seven to 13 days after last exposure). Contacts from the previous six cases reported in April have exited their follow-up period. Of the 41 high-risk contacts, 37 have been vaccinated. A total of 1486 people have been vaccinated in Beni and Karisimbi since 10 April 2020.
Global partners in the fight to end tuberculosis (TB) including the World Health Organization (WHO), UNICEF, UNITAID, US Agency for International Development (USAID), the Global Fund to Fight AIDS, Tuberculosis and Malaria, Stop TB Partnership, The Union, KNCV, European Respiratory Society and IAS, came together today to release a joint Call to Action to scale up access to TB preventive treatment. This follows the release of new WHO guidelines in March to help countries accelerate efforts to stop people with TB infection becoming sick with TB by giving them preventive treatment. A quarter of the world‘s population is estimated to have TB infection, and are at greater risk of developing TB disease, especially those with weakened immunity.
“This Call to Action comes at a vital time, as countries are putting in place measures to ensure continuity of prevention and care for those affected by TB and other diseases, in tandem with efforts to contain the COVID-19 pandemic,” said Dr Tereza Kasaeva, Director of the WHO Global TB Programme. “Ensuring access to TB preventive treatment will not only protect those infected from becoming ill with TB disease but also cut down on the risk of transmission in the community, saving lives. We need to unite forces to support countries in effectively rolling out TB preventive treatment”.
Although some progress has been made towards scaling up access to TB preventive treatment and reaching the targets set at the UN high-level meeting on TB in 2018, a massive acceleration of efforts is required. To date only a fraction of the UN high-level meeting target of reaching at least 30 million people with TB preventive treatment including 24 million contacts of people with active TB and 6 million people living with HIV has been reached, with countries putting less than 430 000 household contacts and 1.8 million people living with HIV on TB preventive treatment in 2018.
This call to action emphasizes that countries, partners, donors and communities should work together to overcome the main barriers standing in the way of global scale-up in TB preventive treatment by:
- ensuring that all TB programmes aiming to end or eliminate TB include TB preventive treatment as an integral part of a comprehensive strategy
- advocating strongly and communicating widely for TB preventive treatment scale-up
- strengthening contact investigation in the community and in households of people with active TB especially in the current context of the COVID-19 pandemic
- initiating contacts of all ages on TB preventive treatment after TB disease is ruled out
- expanding TB preventive treatment in HIV services and in facilities caring for other people eligible for it
- developing capacity to test for TB infection and to exclude TB disease
- providing better tolerated and shorter TB preventive treatment options on a large scale
- ensuring adherence and completion of the full course of TB preventive treatment
- collecting data on contact investigation, and the initiation and completion of TB preventive treatment to monitor programme performance
The Call is primarily addressed to programme managers and technical agencies helping them to revise their strategies and prepare funding proposals. This call stresses the specific need to strengthen contact investigation, a key activity that is underdeveloped in many countries and where a huge unmet need exists for TB preventive action. This does not diminish the importance of ensuring good coverage among people living with HIV and others who could benefit from TB preventive treatment.
Director, WHO Global TB Programme
WHO / Elena Longarini
Dear colleagues, partners and friends,
The current COVID-19 crisis has been a test for countries, health systems, key stakeholders, and those delivering health services at the front line. In the presence of new health threats like COVID-19, it has become even more critical to protect those most vulnerable and ensure continuity of care for those grappling with ongoing epidemics like tuberculosis (TB). This is a time for resilience, rapid learning and urgent action to save lives. At the forefront of these efforts are the health heroes: nurses, doctors and other health workers. Today on International Nurses Day I would like to salute their tireless dedication to alleviate suffering and save lives, at the risk of their own.
As we look forward to the easing of lockdown measures across many countries over this week and the coming weeks, we need to take the opportunity to build on lessons learned and put in place measures to mitigate future crises and disruption of health services for those in need.
Since January 2020, when Dr Tedros Adhanom Ghebreyesus, WHO Director-General declared the novel coronavirus outbreak (2019-nCoV) a Public Health Emergency of International Concern, the WHO Global TB Programme with Regional and Country Offices, in close collaboration with partners and civil society has been monitoring the impact of the COVID-19 pandemic and providing guidance and technical support to countries. We are also collating data and experiences of COVID-19 patients with concurrent or previous history of TB to document the natural history of disease and outcomes in these patients. Here are a few highlights:
- January onwards (still ongoing): Regular coordination with WHO Regional and Country Offices, partners and civil society to monitor impact of COVID-19 on TB services. Technical assistance, guidance and support is being provided to
countries on service delivery, infection control, and drug and diagnostics supply management.
- March: On 20 March, WHO issued an information note on considerations for TB services during the COVID-19 crisis. The note was developed with inputs from WHO regional and country offices, key partners and civil society including, USAID,
Stop TB Partnership, Global Fund and the WHO Civil Society Taskforce on TB. On 24 March, WHO organized an Online Talk Show on World TB Day, with a keynote speech delivered by Dr Tedros Adhanom Ghebreyesus, WHO Director-General. Dr Tedros highlighted
the importance to continue efforts to tackle longstanding health problems, including TB during global outbreaks such as COVID-19. He said, “COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems
can be. The world committed to end TB by 2030; improving prevention is key to making this happen. Millions of people need to be able to take TB preventive treatment to stop the onset of disease, avert suffering and save lives". Following the Talk
Show a joint virtual townhall was organized with Stop TB Partnership on TB and COVID.
- April: Scientific Brief on BCG vaccination and COVID-19 was released on 12 April. Two webinars were organized at the end of April jointly by WHO and the Stop TB Partnership on TB and COVID.
- May: WHO modelling and analysis on impact of COVID-19 on TB mortality was published on 4 May. Modelling is being used to inform planning and budgeting for TB prevention and care and to provide a basis for funding requirements. An analysis was also undertaken across 6 WHO Regions on the impact of COVID-19 on the implementation of National TB Programmes.
In parallel with these efforts to tackle TB and COVID-19, continue our core functions for the global TB response. This includes the development and roll out of new guidelines, in March we released new guidelines on TB preventive treatment. Countries continue to be supported to, build their capacity, implement new guidelines, ensure continuity of care and strengthen accountability. We are also working on the finalization of the Global TB Strategy for TB Research and Innovation and the UN Secretary General 2020 Progress Report on TB.
The coming months will be critical for all of us, especially for those affected by both TB and COVID-19. We need to focus on the following key actions:
- Ensure effective infection prevention and control measures, to protect the health and safety of health workers, staff, and patients. Personal protective equipment should be provided for all health staff involved in care delivery for
both TB and COVID-19.
- Stand against stigma and discrimination and promote the human rights of the most vulnerable. Stigma and fear around communicable diseases like TB and COVID-19 hamper the public health response. Governments, citizens, media and communities
have an important role to play in preventing and stopping stigma.
- Scale up simultaneous testing for TB and COVID-19, taking into consideration similarity of symptoms (cough, fever and difficulty breathing), and based on exposure or presence of risk factors. As countries prepare
to share existing molecular platforms for COVID-19 testing, it will be essential to maintain current molecular diagnostic services for TB patients.
- Promote access to people-centered prevention and care services. Home-based and community-based prevention and care should be strongly preferred over hospital treatment for TB patients (unless serious conditions require
hospitalization) to reduce opportunities for transmission. This includes WHO recommended, all-oral TB treatments for multidrug-resistant TB and extensively drug-resistant TB. Digital adherence technologies can help bridge the gap in communication.
TB preventive treatment should be ensured for household contacts, especially given increased risk of exposure.
- Build and strengthen community, youth and civil society engagement to close gaps in care. Community health workers, youth volunteers and civil society can be engaged in reaching those at risk or those affected by TB and/or COVID-19 with care. We need to harness the potential of these groups while ensuring effective infection control and protective measures for them. Please do read the touching story from China below about Xu Xinghua- a TB survivor who is now working as a volunteer and peer consultant for TB patients through an online peer-to-peer support group in China. With the outbreak of COVID-19 in the beginning of 2020, Xu has had to go beyond the line of duty to ensure that people with TB get uninterrupted treatment.
Dear colleagues, partners and friends; the COVID-19 pandemic has highlighted the need for more preparedness and solidarity to ensure access to health care in times of crisis. We must learn from this experience and emerge victorious. The commitments made, and targets set by Heads of State and other leaders to accelerate action to end TB must be kept even in crisis, backed by adequate investments. We need to do this to protect the lives of millions of people struggling with TB each day, and to sustain the gains we have made in the fight against TB.
The time is now for solidarity and action. Let us join forces and step up the fight to end TB and COVID-19 – only united will we succeed.
Dr Tereza Kasaeva
Global TB Programme
World Health Organization
The caretaker buddy: Peer-to-peer support for TB patients
Xu Xing-hua (Yunnan, China)
WHO / Xu Zixiang
Xu Xinghua is a volunteer and peer consultant for tuberculosis (TB) patients for 57 Zone, an online peer-to-peer support group in China. With the outbreak of COVID-19 in the beginning of 2020, Xu has had to go beyond the line of duty to ensure that people with TB get uninterrupted treatment.Read moreWHO Information Note and Q&A on TB and COVID-19
New WHO recommendations to prevent tuberculosis aim to save millions of lives
The WHO Global TB Programme, along with WHO regional and country offices, has developed an Information Note, in collaboration with stakeholders. This note is intended to assist national TB programmes and health personnel to urgently maintain continuity of essential services for people affected with TB during the COVID-19 pandemic, driven by innovative people-centred approaches, as well as maximizing joint support to tackle both diseases.Read the Information Note.
WHO Modelling analysis: Predicted impact of the COVID-19 pandemic on global deaths in 2020WHO has released results of modelling work undertaken on the predicted short-term impact of the COVID-19 pandemic on TB deaths in 2020. Results indicate that TB mortality will significantly increase in 2020 and will primarily affect the most vulnerable TB patients. If global TB case detection decreases by an average 25% over a period of 3 months (as compared to the level of detection before the pandemic), an additional 190 000 TB deaths are predicted (a 13% increase), bringing the total to 1.66 million TB deaths in 2020. This number is near the global level of TB mortality of the year 2015, a serious setback in the progress towards the targets of the UN High-Level Meeting on TB and WHO End TB Strategy.
Community-based health care, including outreach and campaigns,in the context of the COVID-19 pandemicCommunity-based health care is an essential part of primary care at all times; in the context of the COVID-19 pandemic, the distinct capacity of trusted community members for social engagement and delivering care where it is needed is ever more critical. This joint WHO, UNICEF and IFRC guidance addresses the role of community-based health care in the pandemic context. It includes practical recommendations for decision makers to help keep communities and health workers safe, to sustain essential services at the community level, and to ensure an effective response to COVID-19. Using this comprehensive and coordinated approach will help countries strengthen the resilience of community-based health services throughout the pandemic, into early recovery and beyond.
COVID-19 and National TB Programmes:
Summary of Findings across the Six WHO Regions
A preliminary analysis has revealed several challenges. These include a slow-down of routine and facility-based case finding and diagnosis across all WHO regions; human resources for TB increasingly engaged in COVID-19 response efforts; drop in TB
case notifications in several high burden countries; lack of real-time TB surveillance data that hampers countries’ ability to assess the situation in terms of decrease in case notifications and access; various levels of disruption in all
6 WHO regions concerning procurement and supply of medicines and diagnostics. Stock-out situations and stock shortages are noted in in several regions and a decline in routine, facility-based TB treatment services is observed in all regions. Countries
have been advised by WHO to shift to the provision of outpatient, community-based TB treatment and care services.
Joint WHO and Stop TB Partnership Webinars:
However, in parallel, positive steps have been taken by countries, with some implementing innovative, people-centered case finding strategies. Different approaches are being used in countries to dispense medications to patients at home, including through greater engagement of community and civil society actors in service delivery.
Coping with TB during the COVID-19 crisis
Access the webinar and presentations here.Scientific Brief:
Bacille Calmette-Guérin (BCG) vaccination and COVID-19
There is no evidence that the Bacille Calmette-Guérin vaccine (BCG) protects people against infection with COVID-19 virus. Two clinical trials addressing this question are underway, and WHO will evaluate the evidence when it is available. In the absence of evidence, WHO does not recommend BCG vaccination for the prevention of COVID-19. WHO continues to recommend neonatal BCG vaccination in countries or settings with a high incidence of tuberculosis.
Conflict and the COVID-19 pandemic present a significant threat to life in Libya. The health and safety of the country’s entire population are at risk.
Close to 400,000 Libyans have been displaced since the start of the conflict nine years ago – around half of them within the past year, since the attack on the capital, Tripoli, started.
Despite repeated calls for a humanitarian ceasefire, including by the United Nations Secretary-General, hostilities continue unabated, hindering access and the delivery of critical humanitarian supplies. Humanitarian workers face significant challenges every day to carry on with their mission. In March 2020, humanitarian partners reported a total of 851 access constraints on movement of humanitarian personnel and humanitarian items within and into Libya.
The situation for many migrants and refugees is especially alarming. Since the start of this year, more than 3,200 people have been intercepted at sea and returned to Libya. Many end up in one of the eleven official detention centers. Others are taken to facilities or unofficial detention centers to which the humanitarian community does not have access. The United Nations has repeatedly reiterated that Libya is not a safe port and that persons rescued at sea should not be returned to arbitrary detention.
Women and children continue to bear the brunt of the ongoing armed conflict in Libya: over the past year, the United Nations verified 113 cases of grave violations, including killing and maiming of children, attacks on schools, and health facilities. Hospitals and health facilities have been targeted by shelling, further disrupting Libya’s fragile health system. Since the beginning of the year, at least 15 attacks have damaged health facilities and ambulances and injured health care workers. These attacks are a blatant violation of international humanitarian law and even more egregious during the COVID-19 pandemic.
The onset of the coronavirus in Libya poses yet another strain on the already overstretched health system, and further threatens the most vulnerable people in the country. As of May 13, there were 64 confirmed cases of COVID-19, including three deaths, in different parts of the country. This shows that local/community transmission is taking place. The risk of further escalation of the outbreak is very high.
Food security, already a challenge, is being compromised by the spread of COVID-19 and its socioeconomic impact on Libyan families. Latest market assessments show that most cities are facing shortages of basic food items coupled with an increase in prices. Limited market availability of goods and higher prices are impacting plans, as are supply chain disruptions. Continued support to food security inside the country is essential so that this health crisis does not worsen by becoming a food crisis.
We urge all parties to the conflict to protect vital water supply facilities. We are acutely alarmed that water facilities have been deliberately targeted or indiscriminately attacked. This affects thousands of women and children and impedes efforts to implement basic virus prevention measures, such as hand-washing.
We support the Secretary-General’s call for a global ceasefire and a humanitarian pause to save lives and enable the Libyan authorities and their partners to devote their energies to stopping the spread of COVID-19. The international community must not turn a blind eye to the conflict in Libya and its catastrophic effect on civilians, including migrants and refugees, across the country.
Despite enormous challenges, the UN and our humanitarian partners have continued to reach the most vulnerable people in Libya. Funds are urgently required, including for vital enabling services such as the United Nations Humanitarian Air Service, if we are to continue meeting emergency needs. We look forward with anticipation to the pledged financial support to the Humanitarian Response Plan for Libya, as announced by the Government of National Accord. Donors have been supportive. We ask that they continue to show their generosity and stand by the people of Libya in their quest for peace and in this moment of great need.Signatories:
UN Under-Secretary-General for Humanitarian Affairs Mark Lowcock
UN High Commissioner for Refugees Filippo Grandi
Executive Director of UNICEF Henrietta Fore
Executive Director of UN Population Fund Dr. Natalia Kanem
Executive Director of the World Food Programme David Beasley
Director-General of World Health Organization Dr. Tedros Adhanom Ghebreyesus
Director General of International Organization for Migration António Vitorino
WHO announces the launch of the WHO Academy app designed to support health workers during COVID-19, and the WHO Info app designed to inform the general public.
Today, the WHO Academy, World Health Organization’s lifelong learning centre, launched a mobile app designed to enable health workers to expand their life-saving skills to battle the COVID-19 pandemic.
The app provides health workers with mobile access to a wealth of COVID-19 knowledge resources, developed by WHO, that include up-to-the-minute guidance, tools, training, and virtual workshops that will help them care for COVID-19 patients and protect themselves.
“With this new mobile app, the WHO is putting the power of learning and knowledge-sharing directly into the hands of health workers everywhere,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.
The app is built around the needs expressed by 20,000 global health workers in a WHO Academy survey conducted in March of 2020.
The survey found that two-thirds of respondents feel they need to be more prepared, particularly in infection prevention and control, case management, use of personal protective equipment and occupational safety, and risk communication and community engagement.
An overwhelming majority of respondents said virtual learning on demand would be helpful in preparing for COVID-19 challenges.
The establishment of the WHO Academy, based in Lyon, France, is planned for launch in May 2021. The state-of-the-art lifelong learning centre, will apply the latest technologies and adult learning science to meet the learning needs of millions of health workers, policy makers, and WHO staff around the world.
You can also learn more about the WHO Academy here: http://academy.who.int
The WHO Info app.
Also today, WHO will launch the WHO Info app which will give millions of people real-time mobile access to the latest news and developments. WHO has developed the app from the ground up with an intuitive user-interface and a clean, smart design. From the COVID-19 front, the WHO Info app will provide the latest WHO initiatives, partnerships, and to up-to-date information on the race to find medicines and vaccines for fighting the disease. The number of COVID-19 cases, organized by country, and by timelines, are continually updated in the app from the official WHO COVID-19 data streams.
All over the world, the COVID-19 pandemic is causing significant loss of life, disrupting livelihoods, and threatening the recent advances in health and progress towards global development goals highlighted in the 2020 World Health Statistics published by the World Health Organization (WHO) today.
“The good news is that people around the world are living longer and healthier lives. The bad news is the rate of progress is too slow to meet the Sustainable Development Goals and will be further thrown off track by COVID-19,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
“The pandemic highlights the urgent need for all countries to invest in strong health systems and primary health care, as the best defense against outbreaks like COVID-19, and against the many other health threats that people around the world face every day. Health systems and health security are two sides of the same coin.”
WHO’s World Health Statistics — an annual check-up on the world’s health — reports progress against a series of key health and health service indicators, revealing some important lessons in terms of progress made towards the Sustainable Development Goals and gaps to fill.
Life expectancy and healthy life expectancy have increased, but unequally.
The biggest gains were reported in low-income countries, which saw life expectancy rise 21% or 11 years between 2000 and 2016 (compared with an increase of 4% or 3 years in higher income countries).
One driver of progress in lower-income countries was improved access to services to prevent and treat HIV, malaria and tuberculosis, as well as a
number of neglected tropical diseases such as guinea worm. Another was better maternal and child healthcare, which led to a halving of child mortality between 2000 and 2018.
But in a number of areas, progress has been stalling. Immunization coverage has barely increased in recent years, and there are fears that malaria gains may be reversed. And there is an overall shortage of services within and outside the health system to prevent and treat noncommunicable diseases (NCDs) such as cancer, diabetes, heart and lung disease, and stroke. In 2016, 71 per cent of all deaths worldwide were attributable to NCDs, with the majority of the 15 million premature deaths (85%) occurring in low and middle-income countries.
This uneven progress broadly mirrors inequalities in access to quality health services. Only between one third and one half the world’s population was able to obtain essential health services in 2017. Service coverage in low- and middle-income countries remains well below coverage in wealthier ones; as do health workforce densities. In more than 40% of all countries, there are fewer than 10 medical doctors per 10 000 people. Over 55% of countries have fewer than 40 nursing and midwifery personnel per 10 000 people.
The inability to pay for healthcare is another major challenge for many. On current trends, WHO estimates that this year, 2020, approximately 1 billion people (almost 13 per cent of the global population) will be spending at least 10% of their household budgets on health care. The majority of these people live in lower middle-income countries.
“The COVID-19 pandemic highlights the need to protect people from health emergencies, as well as to promote universal health coverage and healthier populations to keep people from needing health services through multisecotral interventions like improving basic hygiene and sanitation,” said Dr Samira Asma, Assistant Director General at WHO.
In 2017, more than half (55%) of the global population was estimated to lack access to safely-managed sanitation services, and more than one quarter (29%) lacked safely-managed drinking water. In the same year, two in five households globally (40%) lacked basic handwashing facilities with soap and water in their home.
The World Health Statistics also highlight the need for stronger data and health information systems. Uneven capacities to collect and use accurate, timely, and comparable health statistics, undermining countries’ ability to understand population health trends, develop appropriate policies, allocate resources and prioritize interventions.
For almost a fifth of countries, over half of the key indicators have no recent primary or direct underlying data, another major challenge in enabling countries to prepare for, prevent and respond to health emergencies such as the ongoing COVID-19 pandemic. WHO is therefore supporting countries in strengthening surveillance and data and health information systems so they can measure their status and manage improvements.
“The message from this report is clear: as the world battles the most serious pandemic in 100 years, just a decade away from the SDG deadline, we must act together to strengthen primary health care and focus on the most vulnerable among us in order to eliminate the gross inequalities that dictate who lives a long, healthy life and who doesn’t,” added Asma. “We will only succeed in doing this by helping countries to improve their data and health information systems.”
Note for editors
The World Health Statistics have been compiled primarily from publications and databases produced and maintained by WHO or by United Nations (UN) groups of which WHO is a member, such as the UN Interagency Group for Child Mortality Estimation. In addition, some statistics have been derived from data produced and maintained by other international organizations, such as the UN Department of Economic and Social Affairs and its Population Division. The Global Health Observatory database contains additional details about the health-related SDG indicators, as well as interactive visualizations.
Despite the human suffering caused by COVID-19, this health emergency and our efforts to contain it are turning our attention to some of the more fundamental, systemic, causes of ill health related to the ways in which we organize our societies and interact with the environment.
As terrible and unwelcome as the current situation is, with so many people suffering and the world economy paralyzed, it is up to all of us to emerge stronger and more resilient than ever before.
That is why we would like to ask you to join us in collecting “clean, healthy memories" to build back better. Please share the experiences you are having during the coronavirus lockdown (good or bad) to inspire us in the green and healthy recovery we need.
Send us pictures of the blue skies, the clean waters, the vibrant nature blooming around you. Send us pictures of acts of kindness from neighbors and friends, of the ways in which you have found comfort and mental and physical well-being in these difficult times. Send us pictures of your city turned more people-friendly
This photo collection will become part of our Manifesto for a healthier and greener recovery to inspire us to imagine a "new normal" and call on global leaders to build the future we need.
You do not need to be a professional photographer or have a special camera, and anyone can participate, as long as you are the owner of the photos and give us permission to use and share them.
Please send us your picture/s at firstname.lastname@example.org, using the title "Healthy Memories" and including the sentence " I confirm I am the author of these pictures and I give permission to WHO to use and display these pictures".
Cities have provided more space for cyclists and pedestrians during lockdown, encouraging physical activity and reducing air pollution. (Credit: Jackman Chiu)
With lockdown measures in place in many parts of the world to limit the spread of COVID-19, many people are re-appreciating the need for green spaces and infrastructure for cycling and walking within their cities. (Credit: CC)
The United Nations Postal Administration (UNPA) in collaboration with WHO issue a stamp in the denomination of CHF 1,70, to commemorate the 40th anniversary of the eradication of smallpox. The stamp was unveiled virtually on 8 May by the WHO Director-General during a commemorative event in Geneva, signifies what national unity and global solidary can achieve.
Until it was wiped out, smallpox had plagued humanity for at least 3,000 years, killing 300 million people in the 20th century alone. The world got rid of smallpox thanks to an incredible demonstration of global solidarity, and because it had a safe and effective vaccine. Solidarity plus science equaled solution! The successful smallpox eradication programme yielded vital knowledge and tools for the field of disease surveillance, the benefits of vaccination and the importance of health promotion in fighting other diseases. It also laid the foundation for stronger national immunization programmes worldwide, underpinning the establishment of primary health care in many countries and creating momentum toward Universal Health Coverage.
Stewart Simonson, Assistant Director-General at the WHO Office at the UN, was the Assistant Secretary for Public Health Emergency Preparedness for the US Department of Health and Human Services during the post 9/11 era. At that time, he was heavily involved in the development of the second-generation smallpox vaccine, ACAM2000. He worked very closely on this project with the late D.A. Henderson, who led the WHO Smallpox Eradication Program. “Eradication of Smallpox is the greatest accomplishment of any UN agency, of any multilateral organization, ever. And it happened here. At WHO.” He pointed out that WHO’s role in smallpox eradication leaves two legacies; the eradication of the first, and only, infectious disease of humans; and the beginning of the Expanded Programme on Immunization, a child vaccination programme, under which 80% of the world’s children are vaccinated and protected from debilitating diseases”.
There are many lessons to learn from the eradication of smallpox that can help fight the COVID-19 pandemic today and prepare for future pandemics.