- COVAX announced the signing of an advance purchase agreement for up to 40 million doses of the Pfizer-BioNTech vaccine; rollout to commence with successful execution of supply agreements.
- Additionally, COVAX announced that, pending WHO emergency use listings, nearly 150 million doses of the AstraZeneca/Oxford candidate are anticipated to be available in Q1 2021, via existing agreements with the Serum Institute of India (SII) and AstraZeneca.
- COVAX is therefore on track to deliver at least 2 billion doses by the end of the year, including at least 1.3 billion doses to 92 lower income economies in the Gavi COVAX AMC.
- Click here for the latest COVAX supply forecast
Geneva/Oslo 22 January 2021 – COVAX, the global initiative to ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income level, today announced the signing of an advance purchase agreement with Pfizer for up to 40 million doses of the Pfizer-BioNTech vaccine candidate, which has already received WHO emergency use listing. Rollout will commence with the successful negotiation and execution of supply agreements.
In further support of its mission to expedite early availability of vaccines to lower-income countries and help bring a rapid end to the acute stage of the COVID-19 pandemic, COVAX also confirmed today that it will exercise an option – via an existing agreement with Serum Institute of India (SII) – to receive its first 100 million doses of the AstraZeneca/Oxford University-developed vaccine manufactured by SII.
Of these first 100 million doses, the majority are earmarked for delivery in the first quarter of the year, pending WHO Emergency Use Listing. The WHO review process, which is currently underway, follows approval for restricted use in emergency situations by the Drugs Controller General of India earlier this month, and is a critical aspect of ensuring that any vaccine procured through COVAX is fully quality assured for international use. According to the latest WHO update, a decision on this vaccine candidate is anticipated by the middle of February.
COVAX also anticipates that, via an existing agreement with AstraZeneca, at least 50 million further doses of the AstraZeneca/Oxford vaccine will be available for delivery to COVAX participants in Q1 2021, pending emergency use listing by WHO of the COVAX-specific manufacturing network for these doses. A decision on this candidate is also anticipated by WHO in February.
“Today marks another milestone for COVAX: pending regulatory approval for the AstraZeneca/Oxford candidate and pending the successful conclusion of the supply agreement for the Pfizer-BioNTech vaccine, we anticipate being able to begin deliveries of life-saving COVID-19 vaccines by the end of February. This is not just significant for COVAX, it is a major step forward for equitable access to vaccines, and an essential part of the global effort to beat this pandemic. We will only be safe anywhere if we are safe everywhere,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, which leads COVAX procurement and delivery.
Preparations, led by WHO, UNICEF and Gavi, are already well under way for COVAX to deliver vaccines to economies eligible for support via the COVAX AMC, with Gavi making US$ 150 million available from its core funding as initial, catalytic support for preparedness and delivery.
“The urgent and equitable rollout of vaccines is not just a moral imperative, it’s also a health security, strategic and economic imperative,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “This agreement with Pfizer will help to enable COVAX to save lives, stabilize health systems and drive the global economic recovery.”
Building on the work of the past months supporting country readiness efforts, a “Country Readiness Portal” will be launched by WHO this month, which will allow AMC participants to submit final national deployment and vaccination plans (NDVPs). This is a vital step before allocations can be made, to ensure that delivered doses are able to be effectively deployed and to identify where, if necessary, further support is needed.
“These purchase agreements open the door for these lifesaving vaccines to become available to people in the most vulnerable countries,” said UNICEF Executive Director Henrietta Fore. “But at the same time we are securing vaccines we must also ensure that countries are ready to receive them, deploy them, and build trust in them.”
The COVAX Facility intends to provide all 190 participating economies with an indicative allocation of doses by the end of this month. This indicative allocation will provide interim guidance to participants – offering a minimum planning scenario
to enable preparations for the final allocation of the number of doses each participant will receive in the first rounds of vaccine distribution.
COVAX now has agreements in place to access just over two billion doses of several promising vaccine candidates. Negotiations continue for further doses to be secured through existing R&D agreements by COVAX co-lead the Coalition for Epidemic Preparedness Innovations (CEPI), through evaluations of new products with promising results and through contributions from donors.
Based on this, COVAX anticipates being able to provide participating economies doses of safe and effective vaccines – enough to protect health care and other frontline workers as well as some high-risk individuals – beginning in Q1 2021. The aim is to protect at least 20% of each participating population by the end of the year – unless a participant has requested a lower percentage of doses. At least 1.3 billion of these doses will be made available to the 92 economies eligible for the Gavi COVAX AMC by the end of 2021.
To meet its goal of securing two billion safe and effective vaccines in 2021, COVAX has built a diverse portfolio of vaccine candidates which mitigates the risk of a product failing development, production or regulatory processes, and ensures availability of products suitable for various contexts and settings. This work will continue at pace to enable further supply of vaccines suitable for use across a wide range of populations and settings in 2021 and beyond.
“The progress in vaccine development so far has been extraordinary, and it is clear that we are now assembling the tools we need to bring the acute phase of the pandemic to an end. But we cannot afford to slow our efforts given the speed with which this pandemic continues to wreak havoc,” said Dr Richard Hatchett, CEO of CEPI. “The emergence of new variants of COVID-19 puts into sharp focus the need for us to be one step ahead of the virus by continuing to invest in vaccine R&D - specifically for next-generation vaccine candidates and to be ready for strain changes in existing vaccines - to ensure we have the tools to meet the needs of all populations in all countries for the long term.”
Notes to editors
COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, is co-led by CEPI, Gavi and WHO – working in partnership with developed and developing country vaccine manufacturers, UNICEF, the World Bank, and others. It is the only global initiative that is working with governments and manufacturers to ensure COVID-19 vaccines are available worldwide to both higher-income and lower-income countries.
CEPI is leading on the COVAX vaccine research and development portfolio, investing in R&D across a variety of promising candidates, with the goal to support development of three safe and effective vaccines which can be made available to countries participating in the COVAX Facility. As part of this work, CEPI has secured first right of refusal to potentially over one billion doses for the COVAX Facility to a number of candidates, and made strategic investments in vaccine manufacturing, which includes reserving capacity to manufacture doses of COVAX vaccines at a network of facilities, and securing glass vials to hold 2 billion doses of vaccine. CEPI is also investing in the ‘next generation’ of vaccine candidates, which will give the world additional options to control COVID-19 in the future.
Gavi is leading on procurement and delivery for COVAX, coordinating the design and implementation of the COVAX Facility and the COVAX AMC and working with Alliance partners UNICEF and WHO, along with governments, on country readiness and delivery. The COVAX Facility is the global pooled procurement mechanism for COVID-19 vaccines through which COVAX will ensure fair and equitable access to vaccines for all 190 participating economies, using an allocation framework formulated by WHO. The COVAX Facility will do this by pooling buying power from participating economies and providing volume guarantees across a range of promising vaccine candidates. The Gavi COVAX AMC is the financing mechanism that will support the participation of 92 low- and middle-income countries in the Facility, enabling access to donor-funded doses of safe and effective vaccines. UNICEF and the Pan-American Health Organisation (PAHO) will be acting as procurement coordinators for the COVAX Facility, helping deliver vaccines to all participants.
WHO has multiple roles within the COVAX: among other things it supports countries as they prepare to receive and administer vaccines and does so in partnership with UNICEF. It provides normative guidance on vaccine policy, regulation, safety, R&D, allocation, and country readiness and delivery. Its Strategic Advisory Group of Experts (SAGE) on Immunization develops evidence-based immunization policy recommendations. Its Emergency Use Listing (EUL)/prequalification programmes ensure harmonized review and authorization across member states. It provides global coordination and member state support on vaccine safety monitoring. It developed the target product profiles for COVID-19 vaccines and provides R&D technical coordination. Along with COVAX partners, it is developing a no-fault compensation scheme for indemnification and liability issues. COVAX is part of the Act accelerator which WHO launched with partners in 2020.
About Gavi, the Vaccine Alliance
Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate half the world’s children against some of the world’s deadliest diseases. Since its inception in 2000, Gavi has helped to immunise a whole generation – over 822 million children – and prevented more than 14 million deaths, helping to halve child mortality in 73 lower-income countries. Gavi also plays a key role in improving global health security by supporting health systems as well as funding global stockpiles for Ebola, cholera, meningitis and yellow fever vaccines. After two decades of progress, Gavi is now focused on protecting the next generation and reaching the unvaccinated children still being left behind, employing innovative finance and the latest technology – from drones to biometrics – to save millions more lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency. Learn more at www.gavi.org and connect with us on Facebook and Twitter.
The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. View the full list of donor governments and other leading organizations that fund Gavi’s work here.
CEPI is an innovative partnership between public, private, philanthropic, and civil organisations, launched at Davos in 2017, to develop vaccines to stop future epidemics. CEPI has moved with great urgency and in coordination with WHO in response to the emergence of COVID-19. CEPI has initiated 11 partnerships to develop vaccines against the novel coronavirus. The programmes are leveraging rapid response platforms already supported by CEPI as well as new partnerships.
Before the emergence of COVID-19, CEPI’s priority diseases included Ebola virus, Lassa virus, Middle East Respiratory Syndrome coronavirus, Nipah virus, Rift Valley Fever and Chikungunya virus. CEPI also invested in platform technologies that can be used for rapid vaccine and immunoprophylactic development against unknown pathogens (Disease X).
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. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube
The Access to COVID-19 Tools ACT-Accelerator, is a new, ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. It was set up in response to a call from G20 leaders in March and launched by the WHO, European Commission, France and The Bill & Melinda Gates Foundation in April 2020.
The ACT-Accelerator is not a decision-making body or a new organisation, but works to speed up collaborative efforts among existing organisations to end the pandemic. It is a framework for collaboration that has been designed to bring key players around the table with the goal of ending the pandemic as quickly as possible through the accelerated development, equitable allocation, and scaled up delivery of tests, treatments and vaccines, thereby protecting health systems and restoring societies and economies in the near term. It draws on the experience of leading global health organisations which are tackling the world’s toughest health challenges, and who, by working together, are able to unlock new and more ambitious results against COVID-19. Its members share a commitment to ensure all people have access to all the tools needed to defeat COVID-19 and to work with unprecedented levels of partnership to achieve it.
The ACT-Accelerator has four areas of work: diagnostics, therapeutics, vaccines and the health system connector. Cross-cutting all of these is the workstream on Access & Allocation.
GACVS COVID-19 Vaccine Safety subcommittee meeting to review reports of deaths of very frail elderly individuals vaccinated with Pfizer BioNTech COVID-19 vaccine, BNT162b2
The GACVS COVID-19 Vaccine Safety subcommittee met virtually on Tuesday, 19 January 2021, to review available information and data on deaths reported in frail, elderly individuals who had received the Pfizer BioNTech COVID-19 mRNA vaccine, BNT162b2 (hereafter, BNT162b2). Experts invited from the European Medicines Agency (EMA) and the Uppsala Monitoring Center (UMC) provided an overview of deaths reported in Europe and in the WHO global database (VigiBase) following vaccination with BNT162b2.
Based on a careful scientific review of the information made available, the subcommittee came to the following conclusions:
The current reports do not suggest any unexpected or untoward increase in fatalities in frail, elderly individuals or any unusual characteristics of adverse events following administration of BNT162b2. Reports are in line with the expected, all-cause mortality rates and causes of death in the sub-population of frail, elderly individuals, and the available information does not confirm a contributory role for the vaccine in the reported fatal events. In view of this, the committee considers that the benefit-risk balance of BNT162b2 remains favourable in the elderly, and does not suggest any revision, at present, to the recommendations around the safety of this vaccine.
Countries should continue to monitor the safety of vaccines, and promote routine after-care following immunization, consistent with good immunization practices for any vaccine. The committee recommends that data on suspected adverse events should be collected and reviewed continuously - nationally, regionally, and globally - as the COVID-19 vaccines are rolled out, world-wide.
The GACVS subcommittee will continue to monitor the safety data from these vaccines and update any advice as necessary.
 The WHO COVID-19 vaccine safety surveillance manual provides guidance to countries on the safety monitoring and adverse events data sharing for the new COVID-19 vaccines, and can be accessed here.
Product type: All in vitro diagnostic medical devices (IVDs) for detection of SARS-CoV-2
Date: 18 January 2021
WHO-identifier: 2021/01, version 1
Target audience: Laboratory professionals and users of IVDs.
Purpose of this notice: To request that IVD users monitor mutations of SARS-CoV-2 and their impact on diagnosis.
Description of the problem:
Following the detection of SARS-CoV-2 variants containing mutations, including SARS-CoV-2 VOC 202012/01, and SARS-CoV-2 501Y.V2, WHO reminds users of IVDs to monitor detection rates for SARS-CoV-2 at their site.
IVD users should routinely review test results to detect unexpected increases or decreases in test results, including positivity rate, target detection rate, invalid or unreturnable result rate, etc. These variations may be early indicators of impact on the safety, quality or performance of the IVD products. Certain mutations may increase the risk of delayed diagnosis (due to inconclusive or invalid results), and misdiagnosis.
Manufacturers of IVDs listed by WHO (through Emergency Use Listing) must proactively scan literature and other sources for any documented mutations that might impact the safety, quality or performance of their product. This should be incorporated as part of their post-market surveillance plan and will be supplemented by feedback reported by IVD users in the form of unexpected results, as well as other product problems and adverse events. All gathered information must be reviewed in a timely fashion, using risk management principles to determine any necessary actions.
Advice on action to be taken by IVD users:
IVD users should notify the IVD manufacturer in the following circumstances:
Increased discrepancies in cycle threshold (Ct) values between different gene targets.
Failure to detect specific gene targets, including those containing gene sequences that coincide with documented mutations.
Misdiagnosis (for example, false negative).
See WHO website for reporting form for IVD users to give feedback to manufacturers
Contact person for further information:
Anita SANDS, Regulation and Prequalification, World Health Organization,
Guidance for post-market surveillance and market surveillance of medical devices, including in vitro diagnostics. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
Statement to the 148th Executive Board by the Chair of the Review Committee on the Functioning of the International Health Regulations (2005) during the COVID-19 Response
Honorable Chair, Excellencies, Director-General, Ladies and Gentlemen
Thank you once again for the opportunity to provide you with an update on the work of the Review Committee on the Functioning of the International Health Regulations (2005) during COVID-19.
As you know, this Committee was convened by the Director-General on 8 September 2020, in line with World Health Assembly Resolution WHA73.1. The Committee is composed of experts with a wide range of expertise and with adequate gender and geographical representation. I have the honour to be the Chair of this Committee and am ably supported by our Vice-Chair, Professor Lucille Blumberg of South Africa and our Rapporteur, Professor Preben Aavitsland, from Norway.
Our mandate is to review the functioning of the International Health Regulations (2005) during the COVID-19 response and the status of implementation of the relevant recommendations of previous IHR Review Committees and to make technical recommendations to the Director-General, including any potential amendments.
We convened for 16 closed meetings so far, and we continue to work through three sub-groups: preparedness, alert, and response. I take this opportunity to reiterate my thanks to our three subgroup leads. We also convened 5 open meetings, when we provided updates on our work and listened to the submissions and questions raised by Member States, international agencies and non-governmental organizations in official relation to WHO. These open meetings continue to be attended by numerous designated representatives.
I reported on our progress to the 73rd World Health Assembly on 9 November 2020. And I continue to interact regularly with the Co-Chairs of the Independent Panel for Pandemic Preparedness and Response and the Chair of the Independent Oversight Advisory Committee.
Let me now turn to the substance of our work. I invite you to read our Interim Progress Report, document EB148/19. It details our preliminary findings as of December 2020, which were reached following numerous interviews, discussions and the review of a wealth of documentation.
Let me point out the most important ones:
- Member States and experts overwhelmingly support the IHR as a cornerstone of international public health and health security law, but several areas need improving if we are to be better prepared for the next pandemic. While we have not finalized our article-by-article assessment, there is a growing belief in the Committee that most of the necessary improvements can be achieved through more effective implementation of the existing provisions of the IHR, and do not require at this point changes to the design of the IHR.
- National IHR Focal Points need to be further empowered, including where necessary through national legislation. National Focal Points play a critical role in the timely sharing of information, but their limited authority and status often lead to delays in notification. The Committee noted that effective IHR implementation requires many functions that are not within the narrow mandate of the national IHR focal points, such as multisectoral coordination for preparedness and response and collaborative risk assessment. The absence of a dedicated national entity with sufficient authority and a clear mandate to take ownership and leadership is considered a significant limitation to effective implementation of the IHR at national and subnational levels. At country level, national IHR focal points need to be integrated in the national emergency plan as well as the national health committee or similar body.
- The possible need for an intermediate level of alert before a Public Health Emergency of International Concern (PHEIC) is declared, is also under consideration. The previous review committee on the Ebola response recommended such an intermediate level, but this recommendation was not taken up. The 5th open meeting of the Committee on 12 January 2021 discussed issues surrounding the possible introduction of a grading system. The different views expressed by Member States and the advantages and potential disadvantages of a new system will be further studied by the Committee. It is clear, that global preparedness, alert and response actions need to start much earlier and more decisively than they did during COVID-19. But it is far from certain, that introducing an intermediate level of alert would result in such earlier action. The Committee is considering how regular global and regional risk assessments can be used better to drive earlier and more targeted response measures at all levels. The aim, the Committee feels, should be to react early and strongly enough so as to prevent the need to declare a PHEIC.
- Compliance with IHR provisions remains a challenge in several areas, from setting up core capacities to implementing travel measures during health emergencies. The Committee is mindful of the lack of teeth in the IHR. We are therefore looking at new ways to monitoring and evaluating adherence to the IHR – both in preparedness and response – and to strengthen existing tools without overburdening countries. Considering a peer-review mechanism similar to the Universal Periodic Review used by the Human Rights Council, may be useful in improving preparedness and response. For example, the Universal Periodic Review has been shown to foster intersectoral coordination and whole-of-government approaches, to encourage good practices, and to link implementation of its recommendations with other government agendas – all of which are vital to strengthening IHR implementation. It is in this context that the Director-General has proposed the Universal Health and Preparedness Review initiative which is currently being pilot tested.
- Last but far from least, political support and resources for IHR implementation remain insufficient and irregular at all levels. In this context, the Committee is awaiting further detailed information on the funding mechanisms for IHR implementation.
I would like to clearly state my conviction that we need more meaningful cooperation during and in-between health emergencies; more transparency, more regular detailed exchange of real-time data and experiences at all levels, more reliability of interaction, and greater speed in sharing data and samples. Fortunately, digital technology supporting such developments is increasingly becoming available, from data mining to find disease outbreaks early, to next generation sequencing to follow a pathogen around the globe, to virtual conferencing that makes human interaction easier.
To come to the conclusion, the deadline for our final report is the 74th World Health Assembly in May 2021. However, as we all know, the COVID-19 pandemic will be far from over in 4 months’ time, and therefore our findings and recommendations will not necessarily be complete. Further deliberations may be needed later.
Let me reiterate what I said in November 2020 on the occasion of the 73rd Health Assembly: The IHR are your instrument, our instrument, of international public health law. Making them work requires giving WHO the tools and the resources it needs to better prepare and protect humanity against public health risks, through an effective, coordinated, multisectoral and evidence-based public health response.
Thank you again for the opportunity to speak to you today and let me also thank the Director-General for the excellent support provided by the WHO Secretariat to this Review Committee.
More than 2,800 scientists from 130 countries gathered on Friday (January 15) in a virtual forum hosted by the World Health Organization (WHO) to identify knowledge gaps and set research priorities for vaccines against SARS-CoV-2, the virus that causes COVID-19.
They discussed the safety and efficacy of existing vaccines and new candidates, ways to optimize limited supply, and the need for additional safety studies.
“The development and approval of several safe and effective vaccines less than a year after this virus was isolated and sequenced is an astounding scientific accomplishment,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in his opening remarks. “The approval of the first few vaccines does not mean the job is done. Far from it. More vaccines are in the pipeline, which must be evaluated to ensure we have enough doses to vaccinate everyone.”
More than 30 million vaccine doses have already been administered in 47 mostly high-income countries. But the global vaccine rollout has exposed glaring inequalities in access to this life-saving tool.
“The spirit of collaboration has to prevail in these challenging times as we seek to understand this virus,” said Dr John Nkengasong, Director of the Africa Centres for Disease Control and Prevention. “We have to be mindful of the inequalities and we must deliberately promote investment in regional capacities to level the playing field and have meaningful collaboration to begin to address some of the challenges.”
Experts agreed the need for critical research on administering vaccines in different target populations, as well as on vaccination delivery strategies and schedules. This includes trials, modelling and observational studies, all of which would help to inform policy.
They discussed the impact of emerging SARS-CoV-2 variants on the efficacy of vaccines, the impact of vaccines on transmission of infection, and the need to develop the next generation of vaccine platforms.
“The world needs multiple vaccines that work in different populations in order to meet global demand and end the COVID-19 outbreak. Ideally, those will be single-dose vaccines that do not require cold chain, could be delivered without a needle and syringe and are amenable to large-scale manufacture,” said Professor Mike Levine, Director of the Center for Vaccine Development at the University of Maryland.
The meeting concluded with agreement to establish a WHO-hosted platform for global sharing and coordination of emerging vaccine research information on efficacy and safety. The forum would enable scientists to share and discuss unpublished and published data and research protocols to further our collective understanding of SARS-CoV-2 vaccines.
“The WHO will regularly convene experts from around the world, promote collaborative research, provide standard protocols and develop a platform for sharing the latest knowledge in the field,” said Dr Soumya Swaminathan, WHO Chief Scientist.
Statement on the sixth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic
The sixth 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, 14 January 2021 from 12:15 to 16:45 Geneva time (CEST).
Proceedings of the meeting
Members and Advisors of the Emergency Committee were convened by videoconference.
The Director-General welcomed the Committee, expressed the need for global solidarity in addressing the challenges posed by the pandemic, and emphasized the need for protection of the most vulnerable. He thanked the Committee for their continued support and advice.
Representatives of the legal department 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.
The Secretariat turned the meeting over to the Chair, Professor Didier Houssin. Professor Houssin also welcomed the Committee and reviewed the objectives and agenda of the meeting.
The WHO Director of the Health Emergency Information and Risk Assessment Department provided an overview of the evolution of the pandemic and the progress made on the implementation of the 30 October 2020 Temporary Recommendations. WHO continues to monitor the global risk level of the COVID-19 pandemic. WHO assessed the global risk level as very high due, in part, to recent reports of new SARS-CoV-2 variants.
A representative of the United Kingdom of Great Britain and Northern Ireland presented on the new SARS-CoV-2 variant which is causing increased transmission but not severity of COVID-19. A representative of Denmark presented on the SARS-CoV-2 mink variants and their response which has resulted in these variants no longer circulating in human populations. The WHO Technical Lead for COVID-19 Response and an Emergency Committee Member from South Africa provided an overview of the variant detected by South Africa. The WHO Technical Lead then shared a global overview of SARS-CoV-2 mutations and variants as well as plans to develop and implement standard nomenclature for variants that does not reference a geographical location.
The WHO Director of the Immunization, Vaccines and Biologicals Department presented the current status of the COVID-19 vaccine landscape and introduction. The Chair of the Strategic Advisory Group of Experts on Immunization (SAGE) noted available guidance including WHO SAGE Roadmap for Prioritizing Uses of COVID-19 Vaccines in the Context of Limited Supply and the Interim Recommendations for Use of the Pfizer-BioNTech COVID-19 Vaccine (BNT162b2) under Emergency Use Listing. The Director of Air Transport Bureau of the International Civil Aviation Organization (ICAO) shared their COVID-19 activities related to testing and vaccination, including the Manual on Testing and Cross Border Risk Management Measures (Doc 10152) which provides countries with risk management strategies for international travel. The WHO Unit Head of the IHR Secretariat provided an overview of the legal provisions as well as the scientific, ethical and technological considerations for vaccination certificates related to international travel.
The Committee recognized the challenges posed by some manufacturers’ delayed submission of vaccine data to WHO. These data delays impact WHO’s ability to provide emergency use listing which ultimately affect equitable vaccine access. The Committee strongly encourages manufacturers to provide data to WHO as rapidly as possible.
The Committee unanimously agreed that the COVID-19 pandemic still constitutes an extraordinary event, a public health risk to other States through international spread, and continues 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 recognized WHO’s and States Parties’ progress in implementing the previous Temporary Recommendations from the 5th meeting of the Emergency Committee. The Committee noted that these recommendations remain relevant and had acquired additional urgency given the evolution of the pandemic and the continued need for a coordinated global response. The Committee advised on extending the previous Temporary Recommendations and provided additional advice to the Director-General.
The Director-General determined that the COVID-19 pandemic continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR.
The Emergency Committee will be reconvened within three months, at the discretion of the Director-General. The Director-General thanked the Committee for its work.
Advice to the WHO Secretariat
- Continue to work with partners to develop standardized definitions and nomenclature of SARS-CoV-2 virus variants, based on their genetic sequence, that avoids stigmatization and is geographically and politically neutral. Provide clear information to State Parties on what constitutes a variant of concern.
- Continue to increase worldwide capacities for SARS-CoV-2 molecular testing and genetic sequencing, in line with WHO guidance, and encourage rapid sharing of sequences and meta-data to strengthen monitoring of virus evolution and to increase global understanding of variants and their effects on vaccine, therapeutics and diagnostic efficacy.
- Strengthen the SARS-CoV-2 risk monitoring framework for variants by accelerating collaboration and harmonizing research to answer critical unknowns about specific mutations and variants, through relevant networks and expert groups such as WHO SARS-CoV-2 Virus Evolution Working Group and the WHO R&D Blueprint for Epidemics.
- Accelerate research on critical unknowns about COVID-19 vaccination efficacy on transmission, duration of protection against severe disease and asymptomatic infection, duration of immunity (following infection or vaccination), long-term protection after using different vaccination intervals, protection after a single dose, and vaccination regimes, in line with the SAGE and the Research and Development Blueprint recommendations.
- Promote global solidarity and equitable vaccine access by encouraging States Parties and manufacturers to donate resources and provide support to the COVAX Facility.
- Promote technology transfer to low- and middle- income countries with the potential capacity to accelerate global production of COVID-19 vaccines.
- Support State Parties, including fragile states, in preparing for COVID-19 vaccine introduction by developing a national deployment and vaccination plan, in line with WHO guidance, that addresses barriers to COVID-19 vaccine readiness. Such planning should include prioritization of populations, regulatory authorization, supply and logistics preparation, indemnification and liability, health workforce planning, and access for humanitarian and vulnerable population.
Health Measures in Relation to International Traffic
- Lead development of risk-based international standards and guidance for reducing SARS-CoV-2 transmission related to international travel (by air, land, and sea) based on current science and good practices that include clear recommendations for testing approaches and quarantine duration as appropriate. The guidance should additionally include advice on adapting those measure to specific risk settings, including movements of migrants, temporary workers, travellers and conveyance operators.
- Rapidly develop and disseminate the WHO policy position on the legal, ethical, scientific, and technological considerations related to requirements for proof of COVID-19 vaccination for international travelers, in accordance with relevant IHR provisions.
- Coordinate with relevant stakeholders the development of standards for digital documentation of COVID-19 travel-related risk reduction measures ,that can be implemented on interoperable digital platforms. This should include vaccination status in preparation for widespread vaccine access.
- Encourage States Parties to implement coordinated, time-limited, risk-based, and evidence-based approaches for health measures in relation to international travel.
Evidence-Based Response Strategies
- Continue to rapidly provide and regularly update evidence-based advice; guidance; tools; and resources, including regular dissemination of resources to combat misinformation for COVID-19, to enhance evidence-based COVID-19 preparedness and response strategies and implementation of such strategies.
- Continue to actively support countries to further strengthen their SARS-CoV-2 surveillance systems, including strategic use of genetic sequencing, by leveraging existing systems such as the Global Influenza Surveillance and Response System (GISRS) and relevant networks for systematic sharing of data and specimens.
Strengthening Health Systems
- Provide strategic insight on how State Parties can sustain the public health infrastructure, capacities, and functions developed for COVID-19 response to support strengthened health systems and universal health coverage in the long-term.
Additional Temporary Recommendations to State Parties
- Increase molecular testing and genetic sequencing and share sequences and meta-data with WHO and through publicly accessible databases to enhance global understanding of the virus evolution and inform response efforts.
- Support coordinated global research efforts to better understand critical unknowns about SARS-CoV-2 specific mutations and variants.
- Engage in technology transfer to accelerate global production and deployment of COVID-19 vaccines and ancillary supplies.
- Prepare for COVID-19 vaccine introduction and post-introduction evaluation using the guidance, tools, and trainings for national/subnational focal points and health workers developed by the Access to COVID-19 Tools (ACT) Accelerator’s Country Readiness and Delivery workstream.
- Incorporate, as necessary and appropriate, the private sector into the COVID-19 vaccine planning and introduction to supplement existing service provision and vaccination capacity.
- Encourage and facilitate vaccine acceptance and uptake by providing credible information on vaccine safety and the benefits of vaccination to address concerns.
Health Measures in Relation to International Traffic
- At the present time, do not introduce requirements of proof of vaccination or immunity for international travel as a condition of entry as there are still critical unknowns regarding the efficacy of vaccination in reducing transmission and limited availability of vaccines. Proof of vaccination should not exempt international travellers from complying with other travel risk reduction measures.
- 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. Careful consideration should be given to when and if travel bans should or should not be used as tools to reduce spread. Such decisions should be based on the best available evidence.
- 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.
Evidence-Based Response Strategies
Refine evidence-based strategies according to WHO guidance to control the spread of SARS-CoV-2 using appropriate public health and social measures, including strategies that address pandemic fatigue.
Increase investment in surveillance and sequencing capacities to detect and report early emergence of variants and assess abrupt changes in transmission or disease severity to increase understanding of the evolution of the pandemic.
Utilize the WHO SARS-CoV-2 global laboratory network, leverage GISRS and other laboratory networks for timely reporting and sharing of samples; support other State Parties, where needed, in timely sequencing of SARS-CoV-2 virus specimens.
Strengthening Health Systems
Continue to strengthen public health infrastructure, system capacities, and functions for COVID-19 response and to enhance universal health coverage.
The COVID-19 pandemic continues to constitute a Public Health Emergency of International Concern (PHEIC), according to the WHO Emergency Committee (EC) on COVID-19.
The EC met virtually yesterday (14 January) at the request of WHO Director-General Dr Tedros Adhanom Ghebreyesus to review the emerging variants of SARS-CoV-2, the virus that causes COVID-19, and to consider the potential use of vaccination and testing certificates for international travel.
On variants, the EC called for a global expansion of genomic sequencing and sharing of data, along with greater scientific collaboration to address critical unknowns.
The committee urged WHO to develop a standardized system for naming new variants that avoids geographical markers, an area WHO has already begun work on.
On vaccines, the committee underlined the need for equitable access through the COVAX Facility as well as technology transfer to increase global production capacities.
The committee strongly encouraged vaccine manufacturers to rapidly provide safety and efficacy data to WHO for emergency use listing. The lack of such data is a barrier to ensuring the timely and equitable supply of vaccines at the global level.
Given that the impact of vaccines in reducing transmission is yet unknown, and the current availability of vaccines is too limited, the committee recommended that countries do not require proof of vaccination from incoming travellers.
The committee advised countries to implement coordinated, evidence-based measures for safe travel and to share with WHO experiences and best practices learned.
This was the sixth meeting of the Emergency Committee on COVID-19. Since the declaration of a PHEIC on 30 January 2020, the Director-General has been reconvening the committee at three-month intervals to review progress.The full statement of the Committee can be accessed here.
At the 73rd Session of the World Health Assembly, Member States overwhelmingly endorsed a resolution calling for urgent action on meningitis prevention and control through the implementation of a bold, comprehensive global roadmap to defeat meningitis by 2030. Developed under WHO leadership, through extensive and broad consultation, this global roadmap paves the way for the implementation of multidisciplinary, integrated interventions to achieve:
- long-term integrated meningitis prevention and control for an accelerated and durable reduction in cases and deaths;
- shifting from epidemic preparedness and response to prevention and elimination of epidemics;
- recognition of long-term sequelae from meningitis and concerted action to reduce disability and provide support to people affected and their families.
Despite successful efforts to control meningitis in several regions of the world, meningitis continues to be a major global public health issue causing up to 5 million cases each year, including epidemics of new strains that spread between countries and across the world. The meningitis belt in Africa is the most vulnerable to recurrent outbreaks, but meningitis kills people of all ages in all countries. The burden of bacterial meningitis is particularly high, causing 300,000 deaths annually and leaving one in five of those affected with devastating long-term health consequences.
The Defeating Meningitis Roadmap addresses all types of meningitis, regardless of the cause, but particularly targets the main causes of acute bacterial meningitis (meningococcus, pneumococcus, Haemophilus influenzae, and group B streptococcus). Many of these cases and deaths are vaccine-preventable but efforts to get the vaccine to all those who need it have lagged behind other vaccine-preventable diseases. The roadmap will provide the framework to step up these prevention efforts.
Solidly grounded in Universal Health Coverage, it will be a powerful lever to drive progress towards stronger immunization programmes and Primary Health Care, and improved control of infectious diseases, global health security and access to disability support.At a time of worldwide recognition of the widespread socio-economic impact and devastating effects on the welfare and well-being of populations caused by epidemics, this global roadmap comes at a critical time, helping to save lives and reduce suffering in all regions of the world.
On 7 December 2020 high level representatives from the French government and WHO gathered virtually for their annual strategic dialogue to take stock of collaboration during the year 2020 and to discuss key joint priorities for collaboration for 2021. The objective of the meeting was to agree on specific ways to enhance cooperation and a road map around key areas: the WHO Academy, health emergencies preparedness and response, including COVID-19 response, investing in resilient health systems in particular through primary health care and multilateralism in health with a strengthened WHO as the leader in global health.
“Today France and WHO are joining forces on top health priorities that deepens even more their already existing partnership,” said Ms Jane Ellison, WHO Executive Director for External Relations and Governance. “We are honoured to count France among our top contributors and strong supporters in all circumstances.”
The meeting had a strong focus on the next steps for the WHO Academy, a WHO Director-General’s special priority initiative, supported by France. The world’s largest and most innovative lifelong learning platform in global health will offer high-tech learning environments at a “hub” in Lyon. The WHO Academy, which aims to reach 10 million learners around the world by 2023, will be a game-changer for lifelong learning in health and will help reach WHO’s “triple billion” goal.
Other health topics such as the role of the International Health Regulations (IHR), the future of the WHO Lyon Office, the Access to COVID-19 Tools (ACT) Accelerator’s progress- a global collaboration initiated by WHO, France and other partners, and primary health care-centred universal health coverage were discussed.
This meeting was also an opportunity for France to stress the importance of reinforced multilateralism and its support for the essential role WHO plays in providing a coordinated response to global health challenges.
The annual strategic dialogue comes at a time when France has reaffirmed its strong commitment and leadership in global health with three key announcements this year: 1) the launch of the ACT-Accelerator initiative by President Emmanuel Macron, WHO and partners to support the development and equitable access to COVID-19 tests, treatments and vaccines 2) an additional contribution of 50 million euros to steer the ACT-Accelerator initiative through WHO to intensify the global response to the COVID-19 pandemic for 2020-2021 3) the launch of a High level Council of experts moving forward with the One Health approach to strengthen prevention and preparedness for emerging zoonotic diseases.
Read more about France’s strategic support to WHO
Global scientists are intensifying research into COVID-19, as the World Health Organization (WHO) moves to expand its scientific collaboration and monitoring of emerging variants of SARS-CoV-2, the virus that causes COVID-19.
A day-long virtual meeting of scientists from around the globe, convened by WHO, brought together more than 1 750 experts from 124 countries to discuss critical knowledge gaps and research priorities for emerging variants of the virus.
Welcoming them, Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said: “Science and research have played a vital role in responding to the pandemic since day one and will continue to be the heartbeat of everything WHO does.”
The consultation was structured around six thematic areas covering epidemiology and mathematical modelling, evolutionary biology, animal models, assays and diagnostics, clinical management and therapeutics and vaccines.
Scientists noted the importance of research to detect and understand early on the potential impact of emerging variants on diagnostics, treatments and vaccines.
There was a consensus on the importance of integrating the new SARS-CoV-2 variants research into the global research and innovation agenda while enhancing coordination across disciplines.
“Our collective goal is to get ahead of the game and have a global mechanism to quickly identify and study variants of concern and understand their implications for disease control efforts,” said Dr Ana Maria Henao Restrepo, Head of WHO’s R&D Blueprint.
It is normal for viruses to mutate, but the more the SARS-CoV-2 virus spreads, the more opportunities it has to change. High levels of transmission mean that we should expect more variants to emerge.
Of the significant variants reported so far, some are associated with increases in transmissibility but not disease severity. Research is ongoing to address whether the changes impact public health tools and measures.
Genomic sequencing has been critical in identifying and responding to new variants.
“So far an astounding 350 000 sequences have been publicly shared, but most come from just a handful of countries. Improving the geographic coverage of sequencing is critical for the world to have eyes and ears on changes to the virus,” said Dr Maria Van Kerkhove, WHO Technical Lead on COVID-19.
Increasing sequencing capacity across the world is a priority research area for WHO.
Better surveillance and laboratory capacity to monitor strains of concern needs to be accompanied by prompt sharing of virus and serum samples via globally agreed mechanisms so that critical research can be promptly initiated each time.
Scientists highlighted the importance of national data platforms to document critical clinical, epidemiological and virus data that facilitates the detection and assessment of new SARS-CoV-2 variants.
Early childhood development in conflict-affected countries is key to life-long health, wellbeing and prosperity, says WHO and partners
The early years in a child’s life are critical in building a foundation for optimal development through a stable and nurturing environment. However, for infants and young children living in humanitarian settings, risks such as forced displacement, migration, malnutrition, limited access to health services and insecurity threaten their chances to survive and thrive.
In 2018, more than 29 million children were born into conflict-affected areas, and an estimated 43% of children under-5 years in low- and middle-income countries—inclusive of humanitarian contexts—are currently at risk of not reaching their developmental potential. As the number of crisis-affected people continues to rise, so the proportion of future generations who experience severe distress will also increase.
Today, WHO, UNICEF, the Partnership for Maternal, Newborn & Child Health, International Rescue Committee and ECDAN launched a new thematic brief, Nurturing care for children living in humanitarian settings, highlighting actions countries must take to strengthen nurturing care and minimize the impact that emergencies have on the lives of young children and their families.
“Every moment, whether you are feeding children or reading them stories is an opportunity to ensure they are healthy, receive nutritious food, are safe and learning about themselves, others and their world,” says Bernadette Daelmans, WHO unit head for child health and development. “We must ensure young children and caregivers receive the early interventions they need to thrive, even in humanitarian settings.”
Nurturing care comprises of five interrelated and indivisible components for optimal early childhood development: good health, adequate nutrition, safety and security, responsive caregiving and opportunities for early learning.
- All infants and children receive responsive care during the first 3 years of life; and parents and other caregivers are supported to provide responsive care.
- All infants and children have early learning activities with their parents and other caregivers during the first 3 years of life; and parents and other caregivers are supported to engage in early learning with their infants and children.
- Support for responsive care and early learning should be included as part of interventions for optimal nutrition of infants and young children.
- Psychosocial interventions to support maternal mental health should be integrated into early childhood health and development services.
While these recommendations are for all settings, interventions implemented in emergencies may be adjusted based on the length and type of humanitarian, security or displacement factors at play in a given context. The brief calls on stakeholders across sectors to raise awareness about nurturing care and work together to craft early childhood development policies, plans, services and tools before, during and after a crisis.
The new brief is part of an advocacy series which seeks to apply a nurturing care lens when addressing specific issues affecting children’s development. Situated in the Nurturing Care Framework Advocacy toolkit, these resources serve to demonstrate what is already happening and what can be improved at multiple levels to ensure families receive the support they need, and children receive nurturing care.
The four leading international health and humanitarian organizations announced today the establishment of a global Ebola vaccine stockpile to ensure outbreak response.
The effort to establish the stockpile was led by the International Coordinating Group (ICG) on Vaccine Provision, which includes the World Health Organization (WHO), UNICEF, the International Federation of Red Cross and Red Crescent Societies (IFRC), and Médecins Sans Frontières (MSF), with financial support from Gavi, the Vaccine Alliance. The stockpile will allow countries, with the support of humanitarian organizations, to contain future Ebola epidemics by ensuring timely access to vaccines for populations at risk during outbreaks.
The injectable single-dose Ebola vaccine (rVSV∆G-ZEBOV-GP, live) is manufactured by Merck, Sharp & Dohme (MSD) Corp. and developed with financial support from the from the government of the United States of America (USA). The European Medicines Agency licensed the Ebola vaccine in November 2019, and the vaccine is now prequalified by WHO, and licensed by the US Food and Drug Administration as well as in eight African countries.
Before achieving licensure, the vaccine was administered to more than 350,000 people in Guinea and in the 2018-2020 Ebola outbreaks in the Democratic Republic of the Congo under a protocol for “compassionate use”.
The vaccine, which is recommended by the Strategic Advisory Group of Experts (SAGE) on Immunization for use in Ebola outbreaks as part of a broader set of Ebola outbreak response tools, protects against the Zaire ebolavirus species which is most commonly known to cause outbreaks.
“The COVID-19 pandemic is reminding us of the incredible power of vaccines to save lives from deadly viruses,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Ebola vaccines have made one of the most feared diseases on earth preventable. This new stockpile is an excellent example of solidarity, science and cooperation between international organizations and the private sector to save lives.”
UNICEF manages the stockpile on behalf of the ICG which, as with stockpiles of cholera, meningitis and yellow fever vaccines, will be the decision-making body for its allocation and release.
The stockpile is stored in Switzerland and ready to be shipped to countries for emergency response. The decision to allocate the vaccine will be made within 48 hours of receiving a request from a country; vaccines will be made available together with ultra-cold chain packaging by the manufacturer for shipment to countries within 48 hours of the decision. The targeted overall delivery time from the stockpile to countries is seven days.
“We are proud to be part of this unprecedented effort to help bring potential Ebola outbreaks quickly under control,” said Henrietta Fore, UNICEF Executive Director. “We know that when it comes to disease outbreaks, preparedness is key. This Ebola vaccine stockpile is a remarkable achievement - one that will allow us to deliver vaccines to those who need them the most as quickly as possible.”
As Ebola outbreaks are relatively rare and unpredictable, there is no natural market for the vaccine. Vaccines are only secured through the establishment of the stockpile and are available in limited quantities. The Ebola vaccine is reserved for outbreak response to protect people at the highest risk of contracting Ebola – including healthcare and frontline workers.
“This is an important milestone. Over the past decade alone we have seen Ebola devastate communities in West and Central Africa, always hitting the poorest and most vulnerable the hardest,” said IFRC Secretary General, Jagan Chapagain. “Through each outbreak, our volunteers have risked their lives to save lives. With this stockpile, it is my hope that the impact of this terrible disease will be dramatically reduced.”
“The creation of an Ebola vaccine stockpile under the ICG is a positive step”, said Dr Natalie Roberts, Programme Manager, MSF Foundation. “Vaccination is one of the most effective measures to respond to outbreaks of vaccine preventable diseases, and Ebola is no exception. An Ebola vaccine stockpile can increase transparency in the management of existing global stocks and the timely deployment of the vaccine where it’s most needed, something MSF has called for during recent outbreaks in the Democratic Republic of Congo.”
An initial 6890 doses are now available for outbreak response with further quantities to be delivered into the stockpile this month and throughout 2021 and beyond. Depending on the rate of vaccine deployment, it could take 2 to 3 years to reach the SAGE-recommended level of 500,000 doses for the emergency stockpile of Ebola vaccines. WHO, UNICEF, Gavi and vaccine manufacturers are continuously assessing options to increase vaccine supply should global demand increase.
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The ICG was established in 1997, following major outbreaks of meningitis in Africa, as a mechanism to manage and coordinate the provision of emergency vaccine supplies and antibiotics to countries during major outbreaks. The ICG works to improve cooperation and coordination of epidemic preparedness and response.
UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children, visit www.unicef.org. For more information about COVID-19, visit www.unicef.org/coronavirus. Find out more about UNICEF’s work on the COVID-19 vaccines here, or about UNICEF’s work on immunization here. Follow UNICEF on Twitter and Facebook.
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 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing.
For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube, Twitch
WHO issues its first emergency use validation for a COVID-19 vaccine and emphasizes need for equitable global access
Since the global youth movement, 1+1 youth Initiative was launched on World TB Day 2019, followed by the adoption of the Youth Declaration to End TB at the first-ever Global Youth Townhall on ending TB, there has been significant progress over the past year. The 1+1 Initiative has expanded to include thousands of youth across the world in countries like Bangladesh, Nepal, India, Indonesia, Philippines, and Vietnam.
The social media platforms set up as part of the 1+1 youth initiative are joined and followed by more than 15000 young people including WHO End TB forum.
Similarly, Global TB Programme has established #Youth2EndTB Global Youth Network where more than 1800 youths from 95+ countries have already joined. Besides, in order to recognise the youth efforts and encourage youth engagement on ending TB, youth story series was conducted.
Moreover, 50 and more different youth-led activities and virtual events on ending TB have been conducted worldwide. This includes sensitizing young people, peer education trainings in schools and universities,and encouraging them to become TB advocates, and supporting TB patients in the community with resources, advice, and encouragement. In addition, we are enthusiastic about cross country youth dialogue series that have been started where youths from different countries can participate and learn from each other.
For instance, one of the inspiring examples is that of Nepal, young people in this country have established national and provincial youth networks to help young people, through capacity building and in ensuring their participation in policy making and community level awareness building programmes.
Likewise, in March 2020, Vietnam National Tuberculosis program launched National Youth Movement against TB which aims on reaching 10 million young people as well as educating all primary school students with TB knowledge and good practices on combating TB and lung diseases.
Another exciting example is from Indonesia. Their national youth movement against TB has been conducting Art exhibitions as well as creating TB awareness through social media campaign.
Furthermore, WHO Global TB Program is currently developing training manual targeting End TB youth leaders, young survivors, and young health professionals. It will be available at End TB channel of Open WHO platform after completing it's six regional youth consultations.