WHO today accepted the recommendation from the Solidarity Trial’s International Steering Committee to discontinue the trial’s hydroxychloroquine and lopinavir/ritonavir arms. The Solidarity Trial was established by WHO to find an effective COVID-19 treatment for hospitalized patients.
The International Steering Committee formulated the recommendation in light of the evidence for hydroxychloroquine vs standard-of-care and for lopinavir/ritonavir vs standard-of-care from the Solidarity trial interim results, and from a review of the evidence from all trials presented at the 1-2 July WHO Summit on COVID-19 research and innovation.
These interim trial results show that hydroxychloroquine and lopinavir/ritonavir produce little or no reduction in the mortality of hospitalized COVID-19 patients when compared to standard of care. Solidarity trial investigators will interrupt the trials with immediate effect.
For each of the drugs, the interim results do not provide solid evidence of increased mortality. There were, however, some associated safety signals in the clinical laboratory findings of the add-on Discovery trial, a participant in the Solidarity trial. These will also be reported in the peer-reviewed publication.
This decision applies only to the conduct of the Solidarity trial in hospitalized patients and does not affect the possible evaluation in other studies of hydroxychloroquine or lopinavir/ritonavir in non-hospitalized patients or as pre- or post-exposure prophylaxis for COVID-19. The interim Solidarity results are now being readied for peer-reviewed publication.
These countries should:
These countries should:
These countries should:
COVID-19 has changed our life: disinfectants, hand sanitizers, personal protective equipment (PPE) have become attributes of fighting against the virus transmission. Most of these products contain chemicals or are chemical in their nature. Their improper and unsafe use can lead to toxic effects in people that can be as dangerous as the virus itself.
Preliminary analysis of poisoning cases caused by non-intentional and intentional consumption of disinfectants and other relevant products, unsafe behaviours and actions, falsely considered preventive, confirm a need to pay more attention to precautionary measures to ensure their safe use. Environmental impacts of the increased use of disinfectants and other chemical products for COVID-19 require specific attention in a longer-term perspective.
These topics will be at a core of a webinar organized by the WHO European Centre for Environment and Health (ECEH), in cooperation with the WHO Headquarters on Tuesday, 7 July 2020 at 11:00 AM-12:30 PM CEST.
Invited speakers will share preliminary analysis of the situation on terms of chemical impact and COVID-19 and outline recommendations on how to ensure safety of chemical products applied to stop spreading of the virus.
The webinar is open and you are welcome to participate. Please, mark it in your calendar and do not hesitate to share within your professional networks.
Please right to [email protected] for more information on how to join.
An introductory meeting of WHO’s Strategic and Technical Advisory Group for Tuberculosis (STAG-TB) was held on 24-25 June 2020. STAG-TB, which is comprised of 15 eminent experts from ministries of health, national TB programmes, academic and research institutions, civil society organizations, and communities and patients affected by TB. The group is led by Dr Ariel Pablos-Méndez as Chair, and provides strategic advice to WHO's Director-General and the Global TB Programme on its TB response.
In his keynote address, WHO Director General Dr Tedros emphasized the important strategic role of STAG-TB in efforts to end TB especially in light of the current COVID-19 pandemic. He said, “Even at this difficult time, with COVID-19 threatening the world, WHO remains committed to meet the TB targets and driving high-level action and investment. Commitments must be kept to address all communicable disease threats, and reach the triple billion targets, despite the COVID-19 crisis. Doing so offers hope to end avoidable death and suffering for millions of people worldwide at risk from preventable and treatable diseases like TB.”
The meeting was opened by Dr Ren Minghui, WHO Assistant Director-General, Universal Health Coverage, Communicable and Noncommunicable Diseases Division. The first day focused on briefings from the WHO Global TB Programme secretariat on ongoing WHO efforts towards ending TB, preparations underway for the development of the 2020 progress report of the UN Secretary General on TB, and the impact of the COVID-19 pandemic on the TB response. The second day included a special session of STAG-TB members with WHO Director-General Dr Tedros Adhanom Ghebreyesus. Key partners – Stop TB Partnership, Global Fund and UNITAID also participated in this session.
Dr Ariel Pablos-Méndez, STAG-TB Chair highlighted the group’s commitment to guide WHO’s TB response. He emphasized, “We need to leverage existing synergies between TB and universal health coverage to save lives. This is especially critical in this time of crisis. STAG-TB is dedicated to providing strategic direction that will guide WHO in supporting countries to accelerate progress and investment to reach targets set by the UN High-level Meeting on TB.”
Dr Tereza Kasaeva, Director of WHO’s Global TB Programme appreciated the role of STAG-TB, she said, “The STAG-TB provides a critical contribution to WHO, and the world, in combatting TB. We look forward to receiving strategic advice from STAG-TB during this, and coming, years on how the world can meet commitments to end the TB epidemic especially in the face of new threats”.
The next meeting of the STAG-TB will be held in November 2020.
The Generation Equality Forum—a global gathering for gender equality, convened by UN Women and co-hosted by the governments of Mexico and France in partnership with civil society—today announced the leaders of the Generation Equality Action Coalitions, to achieve gender equality and all women’s and girls’ human rights. WHO, together with The United Nations Entity for Gender Equality and the Empowerment of Women (UN Women) have been invited to co-lead the Action Coalition focusing on ending gender-based violence.
The Action Coalitions will deliver concrete and transformative change for women and girls around the world in the coming five years. They will focus on six themes that are critical for achieving gender equality. In addition to the coalition on gender-based violence there are five other coalitions on economic justice and rights, bodily autonomy and sexual and reproductive health and rights, feminist action for climate justice, technology and innovation for gender equality, and feminist movements and leadership. Adolescent girls and young women will be at the heart of each Action Coalition’s work.
The 65 initial leaders of the Action Coalitions represent Member States, diverse feminist and women’s rights organizations, youth-led organizations, philanthropic entities, UN agencies and other international organizations ( full list here). The Action Coalitions’ leaders bring deep commitment to and experience in advancing gender equality and women’s human rights and reflect the different experiences and identities of women and girls from around the world.
Further appointments of the Action Coalitions’ leaders will be made in the next few months, including private sector companies and youth-led organizations, to ensure intersectional and intergenerational leadership.
The Action Coalitions’ leaders were selected by the Generation Equality Forum Core Group, which includes France, Mexico, Civil Society and UN Women. Five criteria were followed to select the leaders, including evidence of leaders’ commitment and past record of achievement in the respective Action Coalitions’ themes.
The Action Coalitions are one of the key outcomes of the Generation Equality Forum that will kick off in Mexico City, Mexico, and culminate in Paris, France, in the first half of 2021. The Generation Equality Forum, accelerated by the Action Coalitions, will mobilize urgent action to make irreversible progress towards gender equality and women’s and girls’ human rights globally.
This announcement comes as the world responds to the impacts of COVID-19, which is exacerbating gender and other inequalities and disproportionally affecting women and girls in all countries. In this context of the pandemic, the Generation Equality Forum and Action Coalitions are important and urgently needed to get through this pandemic, to recover faster, and build a more just, inclusive, and equitable future for everyone.Next steps
The Action Coalitions’ leaders will come together in the coming months to co-design concrete, game-changing Blueprints for action to be implemented over the next five years.
Beginning in September 2020, a set of virtual public conversations will mobilize and capture women’s and young people’s voices to inform the Action Coalitions.
The Action Coalition Blueprints will then be refined at the Generation Equality Forum in Mexico City, during the first part of 2021, and officially launched at the Generation Equality Forum in Paris, later in 2021.
The Action Coalitions aim to mobilize a broad support in addition to the leadership structure. A broad set of stakeholders will be involved in the design of the Action Coalitions during the next months and will be provided with opportunities to commit to transformative actions to advance gender equality and women’s rights.Violence against women is a major threat to global public health and human rights, cutting across boundaries of age, race, religion, ethnicity, disability, geography, culture and wealth. WHO is committed to working towards a world in which all women live their lives free of violence and discrimination. Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization
Today marks the end of the 10th outbreak of Ebola virus disease in the Democratic Republic of the Congo (DRC). This long, complex and difficult outbreak has been overcome due to the leadership and commitment of the Government of the DRC, supported by the World Health Organization (WHO), a multitude of partners, donors, and above all, the efforts of the communities affected by the virus.
WHO congratulates all those involved in the arduous and often dangerous work required to end the outbreak, but stresses the need for vigilance. Continuing to support survivors and maintaining strong surveillance and response systems in order to contain potential flare-ups is critical in the months to come.
"The outbreak took so much from all of us, especially from the people of DRC, but we came out of it with valuable lessons, and valuable tools. The world is now better-equipped to respond to Ebola. A vaccine has been licensed, and effective treatments identified,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.
“We should celebrate this moment, but we must resist complacency. Viruses do not take breaks. Ultimately, the best defence against any outbreak is investing in a stronger health system as the foundation for universal health coverage.”
The outbreak, declared in North Kivu on 1 August 2018, was the second largest in the world, and was particularly challenging as it took place an active conflict zone. There were 3470 cases, 2287 deaths and 1171 survivors.
Led by the DRC Government and the Ministry of Health and supported by WHO and partners, the more than 22-month-long response involved training thousands of health workers, registering 250 000 contacts, testing 220 000 samples, providing patients with equitable access to advanced therapeutics, vaccinating over 303 000 people with the highly effective rVSV-ZEBOV-GP vaccine, and offering care for all survivors after their recovery.
The response was bolstered by the engagement and leadership of the affected communities. Thanks to their efforts, this outbreak did not spread globally. More than 16 000 local frontline responders worked alongside the more than 1500 people deployed by WHO. Support from donors was essential, as was the work of UN partner agencies, national and international NGOs, research networks, and partners deployed through the Global Outbreak Alert and Response Network. Hard work to build up preparedness capacities in neighbouring countries also limited the risk of the outbreak expanding.
Work will continue to build on the gains made in this response to address other health challenges, including measles and COVID-19.
“During the almost two years we fought the Ebola virus, WHO and partners helped strengthen the capacity of local health authorities to manage outbreaks,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.
“The DRC is now better, smarter and faster at responding to Ebola and this is an enduring legacy which is supporting the response to COVID-19 and other outbreaks.”
As countries around the world face the COVID-19 pandemic, the DRC Ebola response provides valuable lessons. Many of the public health measures that have been successful in stopping Ebola are the same measures that are now essential for stopping COVID-19: finding, isolating, testing, and caring for every case and relentless contact tracing.
In DRC, community workers were provided with training and a smartphone data collection app that enabled them to track contacts and report in real time rather than fill in laborious paper reports. Even when violence locked down cities, the community workers, many of them local women, continued to track and trace contacts using the application, something that was crucial for ending this outbreak.
While this 10th outbreak in DRC has ended, the fight against Ebola continues. On 1 June 2020, seven cases of Ebola were reported in Mbandaka city and neighbouring Bikoro Health Zone in Equateur Province and an 11th outbreak was declared. WHO is supporting the government-led response with more than 50 staff already deployed and more than 5000 vaccinations already administered.
WHO salutes the thousands of heroic responders who fought one of the world’s most dangerous viruses in one of the world’s most unstable regions. Some health workers, including WHO experts, paid the ultimate price and sacrificed their lives to the Ebola response.
Note to Editors
WHO thanks the donors who provided funding to WHO for the Ebola response under the Strategic Response Plans:
African Development Bank, Bill & Melinda Gates Foundation, Canada, China, Denmark, ECHO, European Commission/DEVCO, Gavi, the Vaccine Alliance, Germany, Ireland, Italy, Luxembourg, Norway, Paul Allen Foundation, Republic of Korea, Sweden, Switzerland, Susan T Buffett Foundation, UK DFID, UN CERF, USAID/OFDA, US CDC, Wellcome Trust, World Bank, World Bank Pandemic Emergency Financing Facility.
Several donors also provided funding to the WHO Contingency Fund for Emergencies in recognition of the critical role the fund has played in responding to the Ebola outbreak.
The World Health Organization (WHO) is urging countries to expand access to rapid molecular tests for the detection of TB and drug-resistant TB in updated consolidated guidelines, released today. The guidelines are accompanied by an operational handbook to facilitate rapid implementation and roll out of rapid molecular tests by national TB programmes, ministries of health and technical partners.
“The use of rapid molecular assays as the initial test to diagnose TB is recommended instead of sputum smear microscopy as they have high diagnostic accuracy and will lead to major improvements in the early detection of TB and drug-resistant TB,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “We now need to urgently ensure universal access to these rapid molecular tests. This will impact positively on reducing transmission and enabling faster access to accurate life-saving treatment that will lead to better outcomes for those affected.”
The consolidated guidelines and the associated operational handbook recommend key updates of the approaches to diagnose TB including:
The Xpert MTB Rif assay has been used worldwide since 2010, while the Xpert Ultra assay and Truenat assay are new technologies.
The above updates were signaled in January 2020 through a Rapid Communication from WHO in advance of the publication of the updated guidelines. The purpose was to help national TB programmes and other stakeholders plan and prepare in advance for the rapid transition to new diagnostic tools at country level.
Globally, diagnosis of TB and drug-resistant TB remains a challenge with a third of people with TB and two-thirds of people with drug-resistant TB not being detected. Accelerated efforts to diagnose TB and drug-resistance are essential to end the global TB epidemic and achieve the targets of the political declaration of the UN high-level meeting, the WHO End TB Strategy, the UN Sustainable Development Goals, universal health coverage and the triple billion targets of WHO’s General Programme of Work.
Nucleic acid amplification tests (NAAT) are promising technologies for the rapid and accurate detection of TB and resistance to selected anti-TB agents. In December 2020, the World Health Organization (WHO) will convene a Guidelines Development Group (GDG) meeting to update its diagnostic guidelines on the use of NAATs to detect TB and resistance to selected anti-TB agents. Ahead of this meeting, WHO will commission reviews of relevant evidence on diagnostic accuracy for several NAAT assays.
The following NAAT assays or classes of NAAT assays will be discussed by the GDG:
Centralized assays that present end-to-end solutions for detection of TB and resistance to rifampicin and isoniazid (cDST: Index test 1);
Cartridge-based technology for isoniazid and second-line drug resistance detection (XDR cartridge: Index test 2);
Hybridization-based technology for pyrazinamide resistance detection (PZA LPA: Index test 3).
To enable this process, WHO is issuing a public call for data, appealing to industry, researchers, national TB programmes and other agencies to provide suitable evidence for the performance of these technologies. The obtained data will be essential to facilitate the process of WHO policy updates.
Please send relevant data by 1st August 2020, to [email protected]. For more information on the parameters of the datasets, variables, and the process see below:
Annex 1: Data requirements
Index test 1: Centralized assays that present end-to-end solutions for detection of TB and resistance to rifampicin and isoniazid (cDST platforms).
Desirable characteristics of the test: (a) Sample preparation workflow included; (b) Automated DNA extraction; (c) Automated PCR preparation; (d) Automated result interpretation; (c) Capacity per run: ≥24 tests; (d) Time from sample to full MDR-TB diagnosis: <12 hours; (e) Minimal desirable drug resistance detection: at least to INH and RIF.
Study type: Clinical evaluation studies to confirm diagnostic performance on clinical samples.
Study population: Random sample of unselected patients with signs and symptoms of TB, requiring evaluation for TB and/or resistance to isoniazid and rifampicin in sites of intended use.
Reference standard: At a minimum, result of a single sputum culture and phenotypic DST, wherever applicable (liquid or solid, with speciation) should be included for each result of Index test 1. The use of a genotypic sequencing results where available will have an added value to confirm the presence of mutations in addition to phenotypic DST results.
Index test 2: Cartridge-based technology for isoniazid and second-line drug resistance detection (XDR cartridge);
Desirable characteristics of the test: (a) Automated real-time PCR; (b) Automated result interpretation; (b) Capacity per run: ≥ 4 tests; (c) Time test results: <4 hours; (d) Minimal desirable drug resistance detection: at least to INH and FQ.
Study type: (a) Analytical validation studies measuring accuracy, precision, and reproducibility of the test in contrived specimens or panels, covering all key mutations to isoniazid and second-line drugs. (b) Clinical evaluation studies to confirm diagnostic performance on clinical samples.
Study population: Patients with detected TB, requiring evaluation for resistance to isoniazid and second-line anti-TB agents in sites of intended use.
Reference standard: At a minimum, result of a single sputum phenotypic DST (liquid or solid, with speciation) should be included for each result of Index test 2. The use of a genotypic sequencing results where available will have an added value to confirm the presence of mutations in addition to phenotypic DST results.
Index test 3: Hybridization-based technology for pyrazinamide resistance detection (PZA LPA).
Desirable characteristics of the test: (a) Automated or manual hybridization methodology; (b) Automated or manual result interpretation (c) Time from sample to test results: <24 hours; (d) Minimal desirable drug resistance detection: at least to PZA.
Study type: (a) Analytical validation studies measuring accuracy, precision, and reproducibility of the test in contrived specimens or panels, covering all key mutations to pyrazinamide; (b) Clinical evaluation studies to confirm diagnostic performance on clinical samples;
Study population: Patients with detected TB and resistance to rifampicin, requiring evaluation for resistance to pyrazinamide in sites of intended use;
Reference standard: At a minimum, result of a single sputum phenotypic DST (liquid or solid, with speciation) should be included for each result of Index test 3. The use of a genotypic sequencing results where available will have an added value to confirm the presence of mutations in addition to phenotypic DST results.
On June 25, WHO Director General Dr Tedros Adhanom Ghebreyesus and Dr Hand Kluge, Regional Director of WHO Europe, spoke at the European Parliament Committee for Environment, Public Health and Food Safety (ENVI) on the fight against COVID-19 and the global response and highlighted the leadership of the European Union during this unprecedented time.
“The EU is in a unique position to provide global leadership in defining the “new normal” as part of the global recovery”, Dr Tedros said.
He reminded parlamentarians, that “although the situation in Europe has improved, globally it is still getting worse” and he added that “In the first month of this outbreak, less than 10,000 cases were reported to WHO. In the last month, almost 4 million cases have been reported.”.
The pandemic is showing how essential it is for governments at all levels, including local governments, to strengthen their capacity for prevention, preparedness and response.
But plans for the post-COVID-19 recovery, and to reduce the risk of future epidemics, must go further upstream than early detection and control of disease outbreaks – “they must also lessen our impact on the environment, to reduce risk at the source”, Dr Tedros stressed.
In this regard, Dr Tedros welcomed the Team Europe approach and the European Union plans for a greener recovery, bringing nature back in our lives. He also praised the Global Coronavirus Response pledging campaign launched by the EU, which has so far raised €9.8 billion, and said more is needed.
Dr Kluge emphasized the complementarities and synergies between the European Programme of Work, entitled United Action for Better Health” entitled, in supporting WHO’s Thirteenth General Programme of Work (GPW13) and the EU4Health Programme of the European Commission.
Dr Kluge warned parliamentarians about a second wave in Europe and that countries should be prepared. In this regard, he announced that the WHO European Region has started an ACTION REVIEW, gathering lessons learned in order to develop policy options to help countries to prepare for the Autumn.
The Regional Director underlined that “health systems based on strong primary health care are the foundation for health security and universal health coverage” and that national routine immunization programmes needs to be maintained during the pandemic, he said.
Germany and France have reconfirmed their political, financial and technical support to WHO. His Excellency Olivier Véran, Minister for Solidarity and Health of the Republic of France, and His Excellency Jens Spahn Minister of Health of the Federal Republic of Germany, met with WHO Director General Dr Tedros Adhanom Ghebreyesus in Geneva on 25 June to discuss the status of the global COVID-19 pandemic and measures to help countries where it continues to spread.
“WHO is honoured to welcome you both here today,” said Dr Tedros during the press conference that followed the tripartite meeting, “we offer our sincere thanks for your expression of solidarity and support. We’re getting today all the support we need, political and financial. I would like to express my gratitude.”
Germany will lead the EU Presidency for the next six months. “Global health and managing the pandemic will be key themes,” said Minister Spahn. “This is why I came to discuss the Presidency plans and ways to support WHO during this critical time. Germany remains a strong supporter and a friend; this is why I am here today.” Germany will contribute an additional EUR 41.4 million to WHO‘s core work, and an additional EUR 200 million towards the implementation of the COVID-19 Strategic Preparedness and Response Plan. This follows Germany’s pledge in May of EUR 110 million to WHO in support of the Access to COVID-19 Tools (ACT) Accelerator, a Global Collaboration to Accelerate the Development, Production and Equitable Access to New COVID-19 diagnostics, therapeutics and vaccines.
“The world needs interconnected crisis management, we need a strong, efficient, transparent WHO, more than ever, that is able to lead and coordinate the response in a global crisis,” added Minister Spahn. “Germany will do its part to give WHO the political, financial and technical support that is needed.”
Minister Véran reaffirmed France’s confidence in the Organization as the leading global public health agency and its crucial role in the response to epidemic diseases and in this case the COVID-19 pandemic. “I am also here to announce increased support to the work WHO, firstly with contribution in the amount of EUR 90 million towards the establishment of the WHO Academy, a centre of excellence that brings together international cooperation in the area of training and innovation”. He also highlighted the importance of the Germany-France partnership – both Member States of WHO and of the European Union -- saying that international cooperation is needed today more than ever. On this occasion Minister Véran also confirmed President Macron’s commitment during the ACT Accelerator Marathon on 4 May to support WHO’s coordination role and to provide and additional contribution of EUR 50 million for 2020-2021.
Germany and France both have longstanding partnerships with WHO and are strong supporters of global public health. Chancellor Angela Merkel was the first world leader to invite WHO to the G20 in 2017 under Germany’s leadership, thus highlighting importance of health for all people all around the world. Germany was at the center of the development of the Global Action Plan for Healthy Lives and Well-Being for All, to drive progress towards the Sustainable Development Goals. Germany and WHO have engaged together on a multi-year Collaborative Programme providing decisive support in particular to implementation of Sustainable Development Goal 3 to ensure healthy lives and well-being for all people of all ages, health systems strengthening, health emergencies preparedness, anti-microbial resistance and access to medicine.
For more than 50 years, France has hosted the International Agency for Research on Cancer in Lyon. France has also hosted the WHO Lyon Office for Country readiness strengthening since 2001. More recently, France and WHO signed an agreement to establish the WHO Academy, also in Lyon, which will be a state-of-the-art training centre, bringing the latest lifelong learning innovations to the global health sector.
In addition to their political, financial and technical support, Germany and France have also donated masks, respirators and other medical supplies and equipment to vulnerable populations still suffering from the COVID-19 pandemic.
The 2020 “Triad Statement” was issued at the close of the 8th biennial meeting of the WHO, the International Confederation of Midwives, and the International Council of Nurses. In 2020 the Triad Meeting took place under the dual spotlight of the International Year of the Nurse and the Midwife and the COVID-19 pandemic. The resulting Triad Statement focuses on actions that participants in their respective roles agree to take to support WHO Member States in strengthening nursing and midwifery towards priority health targets, including responding to COVID-19 and achieving universal health coverage.
The 8th meeting of the Emergency Committee, convened by the WHO Director-General under the International Health Regulations (IHR) (2005) to review the Ebola virus disease (EVD) outbreak in the Ituri, North Kivu, and South Kivu provinces of the Democratic Republic of the Congo (DRC), took place on Friday, 26 June 2020, from 13:00 to 15:50 Geneva time (CEST). The Committee’s role is to give advice to the Director-General, who makes the final decision on the determination of a Public Health Emergency of International Concern (PHEIC) and issues Temporary Recommendations as appropriate.Proceedings of the meeting
Members and advisors of the Emergency Committee were convened by teleconference.
The Secretariat welcomed the Committee and thanked them for their support. The Director-General welcomed the Committee and expressed gratitude for all who have responded to this outbreak.
Representatives of WHO’s legal department and the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities. Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting.
The meeting was turned over to the Chair, Dr Preben Aavitsland. Dr Aavitsland also welcomed the Committee, outlined the objectives of the meeting, and introduced the presenters.
Presentations were made by a representative of the Ministry of Health of the DRC and the WHO Secretariat to update the Committee on the situation.
The DRC Ministry of Health provided an update of the epidemiological situation. As of 23 June 2020, a total of 3 470 EVD cases were reported from 29 health zones, including 3 317 confirmed and 153 probable cases, of which 2 287 cases died (CFR 66%). Since the last reported case on 27 April 2020, no new confirmed or probable cases of EVD have been reported. On 25 June 2020, the DRC Ministry of Health declared that human-to-human transmission of Ebola virus had ended in Ituri, North Kivu, and South Kivu provinces. The Ministry of Health of DRC notes that a separate EVD outbreak is occurring in the Equateur Province, not epidemiologically related to the outbreak in the Ituri, North Kivu, and South Kivu provinces.
The DRC Ministry of Health is implementing their national response plan to strengthen surveillance, laboratory diagnostic capacities, infection prevention and control (IPC), risk communication and community engagement (RCCE), the EVD survivor care programme, and provincial health departments’ operational capacities.
The WHO Secretariat presented the WHO risk assessment and context. Based on the evolution of the outbreak, current epidemiology, and response in Ituri, North Kivu, and South Kivu provinces, the overall national and regional risk levels remain moderate. The global risk level remains low.
WHO noted that regional preparedness capacities built for EVD response, such as coordination mechanisms; response plans; laboratory diagnostic capacity; rapid response teams; and community-based surveillance systems, are also being used to facilitate a robust COVID-19 response.
Remaining challenges include the need for continued human and financial resources to maintain prevention, preparedness, response and control activities, such as the EVD survivor care programme; the volatile security situation; the new EVD outbreak in Equateur Province; and the concurrent burden of COVID-19, cholera, and measles.
Although the outbreak in Ituri, North Kivu, and South Kivu provinces has been officially declared over, the detection of a new EVD outbreak in Equateur Province highlights the potential for re-introduction from animal reservoirs. The DRC and at-risk countries need to maintain vigilance to mitigate the risk of EVD re-emergence as well as to rapidly detect and respond to any new cluster.Context and Discussion
The Committee congratulated the Ministry of Health on the conclusion of the EVD outbreak in Ituri, North Kivu, and South Kivu provinces. The Committee conveyed their strong appreciation to the World Health Organization for their support in ending this challenging outbreak. The Committee also thanked the health workers, donors, and all partners who have supported the successful response and recognized the international collaboration and strong solidarity among DRC, neighbouring countries, WHO, and partners.
The Committee noted that the genetic sequencing has confirmed that the EVD outbreaks in the Ituri, North Kivu, and South Kivu provinces and the Equateur province are epidemiologically distinct events.
The Committee highlighted the importance of the 90-day national response plan which includes maintaining intensive surveillance, response capacity, and follow-up with EVD survivors. DRC and partners are engaging in all measures to reduce the potential for a resurgence in Ituri, North Kivu, and South Kivu provinces. The Committee noted the importance of the EVD survivor care programme and continued RCCE activities, which will continue to be conducted by locally trained staff in each province with support from national staff as needed.
The Committee expressed concern over the lack of prioritized resources to operationalize the 90-day national response plan and maintain long-term local capacity for prevention and response. Financial and human resources of DRC, WHO, and partners are challenged by the concurrent COVID-19, cholera, and measles outbreaks. The Committee encouraged DRC, WHO, and partners to harmonize EVD, cholera, measles, and COVID-19 prevention and control activities.Conclusions and Advice
The Committee agreed that the current situation in the Ituri, North Kivu, and South Kivu provinces no longer constitutes a public health emergency of international concern.
The Committee emphasized the importance of continued donors’ funding and human resources to operationalize the 90-day day national response plan.
The Committee provided the following advice to the Director-General for his issuance as revised Temporary Recommendations, in accordance with Article 15(1) of the IHR (2005) “…Temporary Recommendations may be modified or extended as appropriate, including after it has been determined that a public health emergency of international concern has ended, at which time other temporary recommendations may be issued as necessary for the purpose of preventing or promptly detecting its recurrence […] These Temporary Recommendations shall automatically expire three months after their issuance.”
The Committee provided the following advice to the Director-General for his issuance as revised Temporary Recommendations under the IHR (2005).For DRC:
Based on this advice, the report made by the affected State Party and the currently available information, the Director-General accepted the Committee’s assessment and on 26 June 2020 declared the end of the Public Health Emergency of International Concern (PHEIC) for this event.
The Director-General accepted the Committee’s advice and issued them as Temporary Recommendations under IHR (2005), effective 26 June 2020. The Director-General thanked the Committee Members and Advisors for their advice throughout the outbreak.
Today, the Access to COVID-19 Tools Accelerator (ACT-Accelerator) published its consolidated investment case, alongside the costed plans of the member organizations.
Launched at the end of April 2020, at an event co-hosted by the Director-General of the World Health Organization, the President of France, the President of the European Commission, and The Bill & Melinda Gates Foundation, the ACT-Accelerator brings together governments, health organizations, scientists, businesses, civil society, and philanthropists who have joined forces to speed up an end to the pandemic.
Since the ACT-Accelerator was launched, the partner organizations have moved fast to develop costed and implementable plans designed to contribute to the end of the pandemic through the accelerated development, equitable allocation, and scaled up delivery of new tools to reduce rapidly mortality and severe disease, protecting health systems and restoring full societal and economic activity globally in the near term, and facilitating high-level control of COVID-19 disease in the medium term.
The ACT-Accelerator’s investment case and the plans published by the organizations leading each of the ‘pillars’ show a path to the accelerated development, equitable allocation, and scaled up delivery of 500 million diagnostic tests to LMIC’s by mid-2021, 245 million courses of treatments to LMICs by mid-2021, and 2 billion vaccine doses, of which 50% will go to LMICs by the end of 2021.
To achieve this, the costed plans presented today call for US $31.3 billion in funding for diagnostics, therapeutics and vaccines, of which US$3.4 billion has so far been pledged. An additional US$27.9 billion is therefore needed, including US$13.7 billion to cover immediate needs (i.e. US$17.1 billion is immediately required, of which US$3.4 billion has been pledged).
The investment required is significant, but it pales in significance when compared to the cost of COVID-19: the total cost of the ACT-Accelerator's work is less than a tenth of what the IMF estimates the global economy is losing every month due to the pandemic. 468,000 thousand people have already lost their lives.
The tools developed will benefit the whole world; the ACT-Accelerator pillars will also buy and deliver tools to ensure that LMIC’s have access.
The ACT-Accelerator’s investment case is available here.ACT-Accelerator pillars
The ACT-Accelerator is led by the work of partner organizations collaborating under four pillars.
The diagnostics pillar is co-led by FIND and the Global Fund to Fight AIDS, Tuberculosis and Malaria, and aims to save 9 million lives and avoid 1.6 billion further infections through the power of equitable access to simple, accurate and affordable tests. With sufficient funding, it can bring to market 2–3 high-quality rapid tests, train 10,000 healthcare professionals across 50 countries, and establish testing for 500 million people in low- and middle-income countries. Its success will be determined by how quickly test, trace and isolate strategies can be put in place, to minimize disruption of health services and prepare countries for the effective roll-out of therapeutics and vaccines once available. The investment case is available here.
The therapeutics pillar is led by Unitaid and the Wellcome Trust (on behalf of the COVID-19 Therapeutics Accelerator) and seeks to accelerate the development and equitable delivery of treatments at all stages of disease, ensuring they are accessible to all, regardless of geography and level of economic resource. It targets development, manufacture, procurement and equitable distribution of 245 million courses of treatment for populations in Low and Middle Income Countries within 12 months. The investment case is available here.
The vaccine pillar, combines CEPI’s leadership in vaccine development and investment in manufacturing with GAVI’s track record in revolutionizing access and delivery, and WHO’s oversight of regulation, policy and allocation. Its role is to ensure that vaccines are developed as rapidly as possible, manufactured at the right volumes without compromising on safety and delivered to those that need them most. The current estimate to deliver 2 billion doses by the end of 2021, assuming a safe and effective vaccine is developed in the near future, is up to US$18.1 billion. In addition, 950 million doses will need to be procured by self-financing high-income countries and upper middle-income countries through the COVAX Facility. These numbers will become clearer once we get a better idea of, among other factors, the technology that the successful vaccine candidates will be based on and the number of doses required to protect people from COVID-19. The investment case is available here.
The health systems connector is the fourth pillar of the ACT-Accelerator and supports the other three by ensuring that health systems and local community networks can fully utilize these and other essential tools in their battle against COVID-19. This pillar is led by the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and supported by the WHO. It aims to build capacity – such as laboratory capacity, training for laboratory and health staff and management of protective equipment for health workers – needed to deploy the new tools effectively when they are ready. It also works on system innovations to complement the rollout of products, such as contact tracing, social distancing and isolation approaches as well as community engagement needed to sustain them. Global health security and the fight against COVID-19 depends on shoring up health systems around the world, now.
Since its launch, many governments and companies have signaled commitment to the ACT-Accelerator and made financial pledges. To date, contributing countries have committed a total US$3.4. The funding gap is US$ 27.9 billion.
On 27 June the Global Goal: Unite for Our Future, campaign, concert & summit will be calling on citizens to tackle global injustices by using our collective voice to drive change for everyone, everywhere. World leaders, corporations and philanthropists will announce new commitments to help develop equitable distribution of COVID-19 tests, treatments and vaccines, as well as rebuild communities devastated by the pandemic. Unite with Global Citizen, the European Commission, top artists and global leaders to end COVID-19, build equity for all and fight for the world we want. Link: https://www.globalcitizen.org/en/connect/globalgoalunite/
The Access to COVID-19 Tools ACT-Accelerator, is a new, groundbreaking global collaboration to accelerate the development, production, and equitable access to COVID-19 diagnostics, therapeutics, and vaccines. It was set up in response to a call from G20 leaders in March and launched by the WHO, EC, France and The Bill & Melinda Gates Foundation in April 2020.
The ACT-Accelerator is not a decision-making body or a new organization, but works to speed up collaborative efforts among existing organizations 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 by reducing COVID-19 mortality and severe disease through the accelerated development, equitable allocation, and scaled up delivery of vaccines, therapeutics and diagnostics, thereby protecting health systems and restoring societies and economies in the near term. It draws on the experience of leading global health organizations 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.
 An additional $1.7 billion has been pledged for health systems.
 The timeframe is 18 months for the vaccines pillar.
For more information please see ACT-Accelerator.
For media enquiries: [email protected]
Public Service Announcement reminds people about the importance of washing hands, physical distancing and showing kindness
The World Health Organization (WHO), Project Everyone and Tiger Aspect Productions have partnered to launch a Public Service Announcement (PSA) using global comedy cartoon star, Mr Bean.
With cases of COVID-19
continuing to rise globally, “Mr Bean’s Essential COVID-19 Checklist” is a reminder
to people about the importance of washing hands, physical distancing and
demonstrating kindness to their neighbours. The PSA features a cartoon sketch of
Mr Bean comically tackling a pesky roller blind to finally reveal a number of
essential tips to protect people against COVID-19.
Dr Tedros Adhanom Ghebreyesus,
Director-General of the World Health Organization, said: “COVID-19 affects
every walk of human life, and we need to use all tools and avenues at our
disposal to share life-saving information with all people around the world. I
am grateful for the support of the team behind Mr Bean for lending your voice
and talents to spread vital advice on physical distancing, hygiene and knowing
The PSA is voiced by Mr Bean
star, Rowan Atkinson, who created the Mr Bean character to be "a child in
a grown man's body" when he was at Oxford University along with filmmaker and
Sustainable Development Goal advocate Richard Curtis. Mr Bean, which was
originally broadcast in the 1990s before transforming into an animated series, has
since expanded on a global scale with 96 million Facebook followers globally and
major fanbases across India, Brazil and Indonesia. Mr Bean also celebrates his
30th anniversary in 2020.
was coordinated by Project Everyone, a not-for-profit agency devised by Richard
Curtis working to put the power of communications behind the UN’s Sustainable
Richard Curtis said: “We are delighted to work with the WHO on this Mr Bean sketch and to support health messaging around COVID-19. In 2015 193 world leaders committed to 17 Global Goals to end poverty, inequality and climate change by 2030. Good Health and Wellbeing is Goal 3 and central to achieving all of the Global Goals. It’s key that we work with creative partners - and that all sectors come together to continue to get messages out about how we can tackle COVID-19 and build back a better world where the Global Goals remain the guiding plan to be achieved by 2030. I’m not QUITE sure which sector Mr Bean belongs too - but we're delighted to have him on board.”
NOTES TO EDITORS
About the World Health Organization
The World Health Organization directs and coordinates international health within the United Nations system. Working with its 194 Member States, WHO’s mission is to promote health, keep the world safe and serve the vulnerable. For more information about WHO, visit www.who.int. Follow WHO on Twitter and FacebookAbout Project Everyone
Project Everyone was co-founded by writer, director, and SDG Advocate Richard Curtis, Kate Garvey and Gail Gallie with the ambition to help achieve the Global Goals through raising awareness, holding leaders accountable, and driving action. Find out more at www.project-everyone.org.About Tiger Aspect Productions
Tiger Aspect Productions, part of Endemol Shine Group, is internationally recognised as one of the UK’s most successful and prolific independent television producers. Producing high profile, multi genre content for both UK and international audiences, current productions include Peaky Blinders (BBC One), Good Karma Hospital (ITV 1), Jack Whitehall: Travels with My Father (Netflix), Mr Bean (CITV), Hitmen (Sky One), Man Like Mobeen (BBC Three), and many more.
Governments can help to save lives and improve every woman’s and adolescent girl’s experience of pregnancy by updating their national guidelines with the WHO recommendations on antenatal care. For WHO recommendations to be effective however, they must be adapted to local context and monitored in a consistent way.
That is why WHO has now released the Antenatal care recommendations adaptation toolkit, in collaboration with Ministries of Health, WHO Regional and Country offices, implementation experts and country stakeholders.
The toolkit sets out practical steps for governments wishing to introduce WHO recommendations at national and subnational level.
In addition, an antenatal care monitoring framework, has been developed to help countries and health facilities track their progress and impact.A standard process for adapting WHO guidance
The WHO antenatal care guidelines for a positive pregnancy experience include 23 recommendations which are context-specific: they need tailoring to local situations, for example, populations with different nutritional needs or rates of infections.
Currently there is no standardized method for implementing global recommendations at the national level.
The new antenatal care toolkit guides policy makers in how to interpret and apply context-specific recommendations; steps which can be time-consuming but which are essential for providing care to meet each person’s needs and preferences.
"Countries were not only asking for technical guidance on antenatal care, they also wanted an evidence-based approach on how to adapt that guidance for their own contexts,” explained Dr Nancy Kidula, a Medical Officer in the WHO Regional Office for Africa.Understanding local context to improve maternal health
The Ugandan Ministry of Health has successfully used the new toolkit as part of efforts to improve women’s experience of care during pregnancy.
Policy makers were able to take up the new recommendations while also addressing local practices which are not recommended, by following practical steps for community engagement, planning and analysis. They were also able to integrate antenatal care into the country’s wider maternal health framework, including TB screening and birth and emergency preparedness plans.
"This new toolkit has galvanized country teams, changing the way that they look at antenatal care coverage, quality and availability, continued Dr Kidula, who supported the toolkit development and its implementation in Uganda, as well as eSwatini, Namibia, Rwanda and Zambia.
“With the tools to analyse different levels of the health system, they have been able to see where there are not enough trained staff and essential supplies for the women seeking care. We are seeing a major difference in the antenatal care guideline of countries that have used the toolkit, and those that have not.”Monitoring delivery and impact of antenatal care
Monitoring is an important part of the improvement process for routine antenatal care, at both country and health facility level.
The new monitoring framework for the WHO antenatal care recommendations includes indicators on clinical care and strategies for improvement. Like the toolkit, the monitoring framework is meant for local adaptation, with global and context-specific indicators.
It also identifies gaps where new indicators are needed: in particular, the lack of indicators currently available to capture an individual’s experience of care.
This is crucial as experience of care is a core component of quality and respectful care, at the heart of the WHO recommendations on antenatal care for a positive pregnancy experience.Strategic support for countries to improve maternal health and beyond
The new antenatal care toolkit is part of a wider strategy to improve support for countries adapting and implementing WHO guidelines across the maternity care continuum.
“While the Ministry of Health has been proactively working towards strengthening the antenatal care in the country, there is need for aligning the package as per WHO recommendations,” explained Dr Ram Chahar, National Programme Officer (Maternal and Reproductive Health), WHO Country Office for India.
“The use of the antenatal care toolkit has simplified the process of adaptation and revision of the existing antenatal care package.”A similar approach could be useful across all areas of health
“When WHO guidelines are designed to be adapted for use in different contexts, they are more effective in addressing diverse health needs. As countries work to improve the health, well-being and rights of every individual, they need tools which can make WHO recommendations work, in turn, for them.” said Dr Ӧzge Tunçalp, a scientist at WHO/HRP.
These tools and and other antenatal care resources will be available on the WHO Antenatal Care Portal, launching in July.
Half of the world’s children, or approximately 1 billion children each year are affected by physical, sexual or psychological violence, suffering injuries, disabilities and death, because countries have failed to follow established strategies to protect them.
This is according to a new report published today by the World Health Organization (WHO), UNICEF, UNESCO, the Special Representative of the United Nations Secretary-General on Violence against Children and the End Violence Partnership.
“There is never any excuse for violence against children," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We have evidence-based tools to prevent it, which we urge all countries to implement. Protecting the health and well-being of children is central to protecting our collective health and well-being, now and for the future.”
The report – Global Status Report on Preventing Violence Against Children 2020 – is the first of its kind, charting progress in 155 countries against the “INSPIRE” framework, a set of seven strategies for preventing and responding to violence against children. The report signals a clear need in all countries to scale up efforts to implement them. While nearly all countries (88%) have key laws in place to protect children against violence, less than half of countries (47%) said these were being strongly enforced.
The report includes the first ever global homicide estimates specifically for children under 18 years of age – previous estimates were based on data that included 18 to 19-year olds. It finds that, in 2017, around 40,000 children were victims of homicide.
“Violence against children has always been pervasive, and now things could be getting much worse,” said UNICEF Executive Director Henrietta Fore. “Lockdowns, school closures and movement restrictions have left far too many children stuck with their abusers, without the safe space that school would normally offer. It is urgent to scale up efforts to protect children during these times and beyond, including by designating social service workers as essential and strengthening child helplines.”
Progress is generally uneven
Of the INSPIRE strategies, only access to schools through enrollment showed the most progress with 54% of countries reporting that a sufficient number of children in need were being reached in this way. Between 32% to 37% of countries considered that victims of violence could access support services, while 26% of countries provided programmes on parent and caregiver support; 21% of countries had programmes to change harmful norms; and 15% of countries had modifications to provide safe physical environments for children.
Although a majority of countries (83%) have national data on violence against children, only 21% used these to set baselines and national targets to prevent and respond to violence against children.
About 80% of countries have national plans of action and policies but only one-fifth have plans that are fully funded or have measurable targets. A lack of funding combined with inadequate professional capacity are likely contributing factors and a reason why implementation has been slow.
The COVID-19 response and its impact on children
“During the COVID-19 pandemic, and the related school closures, we have seen a rise in violence and hate online – and this includes bullying. Now, as schools begin to re-open, children are expressing their fears about going back to school,” said Audrey Azoulay, UNESCO Director-General. “It is our collective responsibility to ensure that schools are safe environments for all children. We need to think and act collectively to stop violence at school and in our societies at large.”
Stay-at-home measures including school closures have limited the usual sources of support for families and individuals such as friends, extended family or professionals. This further erodes victims’ ability to successfully cope with crises and the new routines of daily life. Spikes in calls to helplines for child abuse and intimate partner violence have been observed.
And while online communities have become central to maintain many children’s learning, support and play, an increase in harmful online behaviours including cyberbullying, risky online behavior and sexual exploitation have been identified.
“Whilst this report was being finalized, confinement measures and the disrupted provision of already limited child protection services exacerbated the vulnerability of children to various forms of violence,” said Najat Maalla M’jid, Special Representative of the United Nations Secretary-General on Violence against Children. “To respond to this crisis a unified, child rights and multisectoral framework for action for children is critical requiring a strong mobilization of governments, bilateral/multilateral donors, civil society, private sector and children, whose views must be heard and truly taken into account to ensure duly protection and the possibility for all to thrive and reach their full potential.”
Accelerating action to protect children
WHO and its partners will continue to work with countries to fully implement the INSPIRE strategies by enhancing coordination, developing and implementing national action plans, prioritizing data collection, and strengthening legislative frameworks. Global action is needed to ensure that the necessary financial and technical support is available to all countries. Monitoring and evaluation are crucial to determine the extent to which these prevention efforts are effectively delivered to all who need them.
“Ending violence against children is the right thing to do, a smart investment to make, and it’s possible. It is time to fully fund comprehensive national action plans that will keep children safe at home, at school, online and in their communities,” said Dr Howard Taylor, End Violence Partnership. “We can and must create a world where every child can thrive free from violence and become a new generation of adults to experience healthy and prosperous lives.”
The data for the report was compiled through a survey administered between 2018 and 2019 with responses from over 1000 decision-makers from 155 countries. The INSPIRE strategies launched in 2016 call for the implementation and enforcement of laws; changing norms and values to make violence unacceptable; creating safe physical environments for children; providing support to parent and caregivers; strengthening income and economic security and stability; improving response and support services for victims; and providing children with education and life skills.
To download the report (in English only) and executive summary (in English, French, Russian and Spanish), go to: https://who.canto.global/b/SSHOR and use password: 490759.
To watch the launch event taking place on Thursday, 18 June from 15:00 to 16:30 CEST, please register at https://bit.ly/2ApZXKa. After registering, you will receive a confirmation email with details on how to access the event. Interpretation will be provided in the 6 UN languages.
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 more information about WHO, visit www.who.int. Follow WHO on Twitter and Facebook.
UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across more than 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. Follow UNICEF on Twitter and Facebook.
The Special Representative of the United Nations Secretary-General on Violence against Children is a global independent advocate promoting the prevention and elimination of all forms of violence against children. The Special Representative acts as a bridge builder and a catalyst of actions in all regions, across sectors and settings where violence against children may occur. She mobilizes political support to generate renewed concern at the harmful effects of violence on children working with Governments, national institutions, civil society organizations and children promoting behavioral and social change to end violence against children by 2030. For more Information, visit: https://violenceagainstchildren.un.org/. Follow on Twitter Facebook and Instagram
The End Violence Partnership is a public-private partnership established by the UN Secretary-General in 2016. End Violence is made up of over 420 partners and act as a global platform for advocacy, evidence-based action and investments to end all forms of violence against children. The End Violence Partnership focus on three main areas: keeping children safe at home, online and in and through schools.
UNESCO is the United Nations Educational, Scientific and Cultural Organisation. It seeks to build peace through international co-operation in Education, the Sciences and Culture. UNESCO's programmes contribute to the Sustainable Development defined in Agenda 2030, adopted by the UN General Assembly in 2015.