World Health Organization

In a global first, Uganda’s Ministry of Health, the World Health Organization (WHO) and other partners today launched a first ever vaccine trial for Ebola from the Sudan species of the virus, and at an unprecedented speed for a randomized vaccine trial in an emergency.

The principal investigators from Makerere University and the Uganda Virus Research Institute (UVRI), with support from WHO and other partners, have worked tirelessly to get the trial ready in 4 days since the outbreak was confirmed on 30 January. It is the first trial to assess the clinical efficacy of a vaccine against Ebola disease due to Sudan virus. The speed was achieved through advanced research preparedness, while ensuring full compliance with national and international regulatory and ethical requirements.

The candidate vaccine was donated by IAVI, with financial support from WHO, the Coalition for Epidemic Preparedness Innovations (CEPI), Canada’s International Development Research Centre (IDRC), and the European Commission's Health Emergency Preparedness and Response Authority (HERA) and support from the Africa Centres for Disease Control and Prevention (Africa CDC).

“This is a critical achievement towards better pandemic preparedness, and saving lives when outbreaks occur,” said Dr Tedros Adhanom Ghebreyesus, WHO’s Director-General.  “This is possible because of the dedication of Uganda’s health workers, the involvement of communities, the Ministry of Health of Uganda, Makerere University and UVRI, and research efforts led by WHO involving hundreds of scientists through our research and development Filoviruses network. We thank our partners for their dedication and cooperation, from IAVI for donating the vaccine, to CEPI, EU HERA and Canada’s IDRC for funding, and Africa CDC for further support. This massive achievement would simply not be possible without them.”

In 2022, during the previous outbreak of Ebola disease (also from the Sudan species of the virus) in Uganda, a randomized protocol for candidate vaccines was developed. Principal investigators were designated under the leadership of the Minister of Health, and teams were trained to allow such a trial to take place during an active outbreak.

The randomized vaccine trial to assess the recombinant vesicular stomatitis virus (rVSV) candidate vaccine was launched at a ceremony in Kampala today by the Minister of Health of Uganda. WHO is co-sponsoring the trial. WHO was represented by Dr Mike Ryan, Executive Director of WHO’s Health Emergencies Programme and Deputy Director-General, and the WHO representative to Uganda Dr Kasonde Mwinga, along with other colleagues.

Three vaccination rings were defined today. The first ring involves about 40 contacts and contacts of contacts of the first reported and confirmed case, a health worker who has died.

Although several promising candidate medical countermeasures are progressing through clinical development, as of now, there is no licensed vaccine available to effectively combat a potential future outbreak of Ebola disease from the Sudan species of the virus. Licensed vaccines exist only for the disease caused by Ebola virus, formerly known as Zaïre ebolavirus. Likewise for treatments, approved treatments are only available for Ebola virus.

The vaccine for the trial was recommended by the independent WHO candidate vaccine prioritization working group. If the candidate vaccine is effective, it can contribute to controlling this outbreak and generate data for vaccine licensure.

In 2022, the research teams were trained in good clinical practice (GCP) and standard operating procedures for such trials. They completed refresher training in recent days. WHO colleagues experienced in trials and in ring vaccination arrived in Uganda over the weekend to support the trial implementation and GCP compliance.

The vaccine doses were pre-positioned in the country. WHO worked with the principal investigators and national authorities and the vaccine developer to review cold chain documentation and ensure the doses were stored correctly over the previous years. As part of the signed agreement with the Ministry of Health, WHO has a signed agreement with IAVI for additional doses of the candidate vaccine to be made available shortly.

Notes to editors

The trial is a ring vaccination cluster randomized trial designed to assess the effect of one single, promptly given, dose of the candidate vaccine whose safety and immunogenicity have already been demonstrated in Phase 1, in protecting recent contacts and contacts of contacts of a newly confirmed case of Sudan virus disease (SVD).

Ring vaccination consists of the targeted vaccination of the recent contacts of an index case. It might protect the individual vaccinated or help create a small buffer zone of immunized people that could limit propagation of the infection.

The ring vaccination trial involves a population at increased risk of infection as they have recently been in contact with a case of SVD, so it may well provide useful information about the protection of such case-contacts quickly, within just a few months.

The same study design was used in the Ebola ça suffit trial in Guinea in 2015 by WHO and the Ministry of Health of Guinea to evaluate a now-licensed vaccine against a different species of ebolavirus.

WHO and partners have immediately boosted their support to the Ugandan government’s response to an outbreak of Sudan virus disease outbreak (SVD, part of the Ebola family), including by facilitating access to a candidate vaccine and candidate treatments. The first 2160 doses of the vaccine candidate and the treatments are already in Kampala, Uganda, as they were prepositioned as part of outbreak preparedness.  

The vaccine trial processes underway include orientation of the research teams on the trial procedures, and logistics arrangements. Research teams have been deployed to the field to work along with the surveillance teams as approvals are awaited.

The candidate vaccine and the candidate treatments (a monoclonal antibody and an antiviral) are being made available through clinical trial protocols, which will make it possible to further document their efficacy and safety.

As of 30 January, there was one confirmed case and 45 contacts who are being followed up.  

Uganda has experienced five previous SVD outbreaks. The last one was declared in September 2022 and ended in January 2023, with 164 cases and 77 deaths. During that outbreak, a WHO committee of external experts evaluated candidate vaccines and provided recommendations on their suitability for evaluation in Uganda, as part of a clinical trial against the SVD virus.

WHO is working with the Ministry of Health of Uganda and its designated Ugandan Principal Investigators and their teams from Makerere University Lung Institute and the Ugandan Virus Research Institute, as well as worldwide filovirus and trial experts and regulators, to initiate the trials.

The trials were designed via a global collaborative effort coordinated by WHO, that included developers, academic institutions, regulatory authorities, other experts and researchers from Uganda and other countries at risk of filoviruses outbreaks.

The aim of the vaccine trial is to evaluate a potentially efficacious candidate vaccine, and if efficacious, to possibly contribute to ending the ongoing outbreak and protect populations at risk in the future. Those eligible to join the trial are those at highest risk of SVD, i.e. close contacts of a person who has been confirmed to have had SVD or who has died from the disease. The study sites will therefore be the locations where contacts of the case or cases reside. Study teams will be mobile and able to rapidly move to these areas to do their work using the ring vaccination approach.

WHO is working with the Ministry of Health and with Makerere University Lung Institute and the Ugandan Virus Research Institute, who will lead the trials’ implementation.

The development of the protocols and research priorities has been done via the MARVAC Consortium and the Collaborative Open Research Consortium (CORC) for the Filoviridae Family, and numerous developers facilitated the availability of the candidate vaccine and treatments: IAVI provided their candidate Sudan vaccine, Gilead provided remdesivir, an antiviral.

Among those supporting the trials’ implementation are the Coalition for Epidemic Preparedness Innovations (CEPI), the Africa Centres for Disease Control and Prevention, Canada’s International Development Research Centre, the European Commission's Health Emergency Preparedness and Response Authority (HERA) and WHO. This rapid action is the result of tireless efforts to build international cooperation on research, innovation and evaluation and deployment of countermeasures in the face of dangerous pathogens.

While outbreaks of SVD are controllable without vaccines, control can be achieved more quickly using safe and effective vaccines. In the meantime, a comprehensive outbreak response is underway in Uganda to rapidly halt transmission, identify contacts and carry out epidemiological investigations, while enhancing community awareness.

WHO has allocated US$ 1 million from its Contingency Fund for Emergencies to help accelerate outbreak control efforts.

Sudan virus disease is a severe, often fatal illness affecting humans and other primates that is due to Orthoebolavirus sudanense (Sudan virus), a viral species belonging to the same genus of the virus causing Ebola virus disease.  Case fatality rates of Sudan virus disease have varied from 41% to 100% in past outbreaks. There are no approved treatments or vaccines for Sudan virus, but early initiation of supportive treatment has been shown to significantly reduce deaths from Sudan virus disease.

 

 

The World Health Organization (WHO) congratulates Niger for having met the criteria for onchocerciasis elimination, making it the fifth country globally and the first country in Africa to be acknowledged by WHO for interrupting transmission of the parasite Onchocerca volvulus.

The World Health Organization (WHO) congratulates Guinea for eliminating the gambiense form of human African trypanosomiasis as a public health problem.

The World Health Organization (WHO) expresses deep concern about the implications of the immediate funding pause for HIV programmes in low- and middle-income countries. These programmes provide access to life-saving HIV therapy to more than 30 million people worldwide. Globally, 39.9 million people were living with HIV at the end of 2023.

A funding halt for HIV programmes can put people living with HIV at immediate increased risk of illness and death and undermine efforts to prevent transmission in communities and countries. Such measures, if prolonged, could lead to rises in new infections and deaths, reversing decades of progress and potentially taking the world back to the 1980s and 1990s when millions died of HIV every year globally, including many in the United States of America.

For the global community, this could result in significant setbacks to progress in partnerships and investments in scientific advances that have been the cornerstone of good public health programming, including innovative diagnostics, affordable medicines, and community delivery models of HIV care.

We call on the United States Government to enable additional exemptions to ensure the delivery of lifesaving HIV treatment and care.

PEPFAR’s legacy and current risks

The United States President's Emergency Plan for AIDS Relief (PEPFAR) has been a flagship initiative of the global HIV response since its establishment over 20 years ago. The current funding pause for PEPFAR will have a direct impact on millions of lives that depend on the predictable supply of safe and effective antiretroviral treatment.

PEPFAR works in over 50 countries around the world. Over the past two decades, PEPFAR funding has saved more than 26 million lives. Currently, PEPFAR is providing HIV treatment for more than 20 million people living with HIV globally, including 566 000 children under 15 years of age.

Over the past year, PEPFAR and partners, including WHO, have been working on sustainability plans with countries for greater country ownership and reduced donor support up to and beyond 2030. A sudden and prolonged stop to programmes does not allow for a managed transition and puts the lives of millions at risk.

WHO is committed to support PEPFAR and other partners, as well as national governments, in managing change processes effectively to minimize the impact on people living with HIV.

Following a nearly century-long effort, Georgia has been certified malaria-free by the World Health Organization (WHO). With today’s announcement, Georgia joins the ranks of 45 countries and 1 territory that have achieved this milestone.

“Today we congratulate the people of Georgia for their decades of targeted and sustained actions to eliminate malaria, one of the world’s leading killers,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Georgia’s commitment and success gives us hope that a malaria-free world is possible.”

“This is a huge milestone worth marking; with Georgia’s achievement, the WHO European Region is another step closer to initiate certification as the first malaria-free region in the world,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “This doesn’t happen in a vacuum, this was made possible thanks to sustained investment, dedication of the health workforce and targeted efforts in prevention, early detection and effective treatment of all malaria cases.”

Certification of malaria elimination is granted by WHO when a country has proven, beyond reasonable doubt, that the chain of indigenous transmission has been interrupted nationwide for at least the previous three consecutive years.

The Minister of Health, Mikheil Sarjveladze, noted that certifying Georgia as malaria-free is a recognition of the sustainability of its healthcare system, “this success means that Georgia can address important health challenges."

A longstanding challenge

Malaria has plagued Georgia since ancient times. Before the introduction of systematic control efforts in the early 1900s, at least 3 malaria parasite species—P. falciparum, P. malariae and P. vivax—were endemic in the country. In the 1920s, an estimated 30% of the population suffered from malaria caused by the P. vivax malaria species.

By 1940, large-scale mosquito control programmes had helped reduce malaria cases significantly through improved access to diagnostic and treatment facilities. A few years later, however, World War II caused a surge again due to population movement and the strain on health facilities. 

In the post-war period, Georgia launched an intensive programme aimed at eliminating malaria, using newer medicines, insecticide spraying and robust entomological surveillance. The campaign successfully interrupted the transmission of P. falciparum by 1953, P. malariae by 1960 and P. vivax by 1970. 

Georgia remained malaria-free for 25 years, but by 2002, malaria had reemerged in the country with 474 cases reported.

Renewed commitments to stop the disease

In 2005, together with 9 other countries in the WHO European Region, Georgia signed the Tashkent Declaration, reaffirming its pledge to eliminate malaria. The intensified interventions that followed significantly reduced malaria incidence in Georgia, with the last indigenous case recorded in 2009. By 2015, all 53 countries of the WHO European Region, including Georgia, reported zero indigenous cases of malaria.

To prevent further re-establishment of malaria transmission in the region, the original signatories of the Tashkent Declaration issued the Ashgabat Statement in 2017 committing to take all efforts to remain malaria-free. Türkiye is the only country in the WHO European Region remaining to be certified.

In 2024, during the Georgia’s malaria-free certification process, members of the Technical Advisory Group on Malaria Elimination and Certification, an independent WHO advisory body, noted that Georgia has a well-functioning and adequately resourced health system, strong public-private cooperation, and political commitment to maintaining a malaria-free status.

 Note to the editor

WHO malaria-free certification

The final decision on awarding a malaria-free certification is made by the WHO Director-General, based on a recommendation by the Technical Advisory Group on Malaria Elimination and Certification and validation from the Malaria Policy Advisory Group. For more on WHO’s malaria-free certification process, visit this link.

 

The World Health Organization regrets the announcement that the United States of America intends to withdraw from the organization.

The World Health Organization (WHO) welcomes the Gaza ceasefire, hostage and prisoner release deal, which brings hope for millions of people whose lives have been ravaged by the conflict.   

The health challenges ahead are immense. The entire population of Gaza has faced multiple displacements. More than 46 600 people have been killed and over 110 000 have been injured. The real figures are likely much higher. Only half of Gaza’s 36 hospitals remain partially operational, nearly all hospitals are damaged or partly destroyed, and just 38% of primary health care centres are functional. An estimated 25% of those injured – around 30 000 people – face life-changing injuries and will need ongoing rehabilitation. Specialized health care is largely unavailable, medical evacuations abroad are extremely slow. Transmission of infectious diseases has massively increased, malnutrition is rising, and the risk of famine persists. The breakdown of public order, exacerbated by armed gangs, raises further concerns.  

Addressing the massive needs and restoring the health system will be an extremely complex and challenging task, given the scale of destruction, operational complexity and constraints involved. Billions in investment are needed to support recovery of the health system, which will require the unwavering commitment of donors and the international community.  

WHO is ready to scale up the response together with UN health partners including UNFPA, UNICEF, UNRWA and 67 Health Cluster partners. However, it is critical that the security obstacles hindering operations are removed. WHO will need conditions on the ground that allow systematic access to the population across Gaza, enabling the influx of aid via all possible borders and routes, and lifting restrictions on the entry of essential items. Also essential are active protection of civilians and health-care workers, expediting medical evacuations through all possible routes for over 12 000 patients (and their companions) who urgently require specialized care, strengthening and speeding up the referral system to East Jerusalem and the West Bank, and addressing road repairs, rubble removal, and the remediation of unexploded ordnances. 

WHO and partners will need a massive scale-up of funding to meet immediate health needs, and to begin to restore the heath system, including the workforce, supply chain and infrastructure.

WHO and partners will implement a 60-day plan to support the urgent restoration and expansion of the health system. Focus will be on key priority response areas, including trauma and emergency care, comprehensive primary health care, child health, noncommunicable diseases (NCDs), sexual and reproductive health and rights (SRHR), rehabilitation, mental health and psychosocial support (MHPSS).  

Given the immense needs, WHO is scaling up operations and mobilizing critical supplies and resources for delivery into Gaza. A priority will be the assessment and rehabilitation of partially damaged health facilities in high-need areas. Work is ongoing to urgently increase bed capacity across selected hospitals in northern and southern Gaza, together with the expansion of operational capacities, supporting the hiring and redistribution of national health workers, and increasing deployment of international health workers to fill gaps. Plans are underway to integrate prefabricated clinics and hospitals with existing health facilities to enhance service delivery in underserved and newly accessible areas.   

Efforts also are underway to strengthen referral processes for critical care within Gaza and facilitate cross-border medical evacuations. Given the high level of malnutrition and disease outbreaks, WHO is working with partners to expand infant and young child feeding programmes, enhance immunization efforts and reinforce disease surveillance systems for timely prevention, reporting, and outbreak management. 

WHO calls on all parties to uphold their commitment to fully implement the ceasefire agreement and to continue working towards a political solution to address the protracted crisis in the occupied Palestinian territory, which is essential for lasting peace.