How have country-based malaria experts adapted to the double challenge of malaria and COVID-19? What successes have they achieved, and where are the remaining gaps? In a virtual forum on 3 September, 10 Ministry of Health representatives shared their experiences and reflections; you can watch their presentations below.
On 4 September, participants heard from senior political and health leaders from 2 regions that are heavily impacted by malaria; you will find below the presentations of WHO’s Regional Director for Africa, India’s Health Secretary and the Ugandan Minister of Health. See, also, our photo story with images and quotes from global health leaders participating in the forum.
Ending Preventable Maternal Mortality (EPMM) is a global initiative with the ultimate goal of ending preventable maternal mortality to support achievement of Sustainable Development Goals (SDGs) targets to attain an average global maternal mortality ratio (MMR) of less than 70 per 100 000 live births by 2030.
By 2030, all countries should reduce their Maternal Mortality Ratio (MMR) by at least two thirds of their 2010 baseline level.
The supplementary national target is that no country should have an MMR greater than 140 per 100 000 live births by 2030.
Many countries have been successful at reducing MMR, but efforts are needed to accelerate progress to achieve SDG targets in all countries. Between 2000 and 2017, the average annual rate of reduction in global maternal mortality was 2.9%, which is far short of what is needed to achieve the global SDG targets.
The EPMM management team, chaired by WHO and UNFPA, is in the process of refining the EPMM initiative. In addition to mortality reduction targets, EPMM is establishing coverage targets and milestones to track progress for 2020 to 2025. As maternal and newborn health are inextricably linked, the coverage targets will be linked with the Every Newborn Action Plan (ENAP) targets as feasible, to provide countries with opportunities for accelerating implementation of integrated country level maternal and newborn health programmes.
The purpose of this open consultation is to solicit feedback from maternal and newborn stakeholders on the proposed EPMM coverage targets for 2020-2025. Each indicator will have a global target and a national target. Sub-national targets will be defined based on the national targets identified by this online consultation.
Please click here for participating to the survey (opened until September 30, 2020).
WHO and UNFPA (on behalf of the EPMM Management Team)
The World Health Organization convened its first Technical Advisory Group on Behavioural Insights and Sciences for Health.
“The COVID-19 pandemic has taught the world that public health agencies and experts need a better understanding of how people and societies behave and make decisions in relation to their health," said Dr Tedros Adhanom Ghebreyesus, Director-General
of WHO, to whom the Technical Advisory Group will report. "WHO wants to ensure that such understanding and evidence inform every policy, guideline and programme.”
Following a global call which attracted over 200 applications from 47 countries, some 21 advisers have been selected to represent a variety of countries and expertise in related disciplines, to design and implement policies and programmes –
not only in terms of COVID-19, but on public health in general.
Psychology, anthropology, health promotion, social and behavioural sciences, neurosciences, behavioural economics, social marketing, design thinking and epidemiology are some of the areas of expertise of the members that come from government agencies,
academia, international organizations and civil society – and are now to provide advice to WHO on a range of topics.
While behavioural and social sciences have for decades studied human behaviour, decision making and social and cultural drivers, past years have seen a growing integration into policies and programmes - ultimately translating into increased efficiency
and better health.
“Providing evidence-based advice is central to WHO's mission, but for that advice to produce results and save lives, we need to better understand the biases and triggers that affect whether or not people act on it,” Dr Tedros said.
The creation of the technical advisory group is part of a new behavioural insights and sciences initiative, expected to give a more prominent role and louder voice to disciplines that have social and behavioural sciences in common – in the context
of health. In addition to supporting the design of global policies, other outcomes of this sharpened focus are more defined methods, tools and mechanisms to support how WHO’s regional and country offices gather local and contextual evidence
for a better understanding of individual and community behaviour.
The establishment of the Advisory Group is in line with WHO’s 13th Global Programme of Work for the 2019-2023 period which aims at 1 billion more people benefitting from universal health coverage; 1 billion more people better protected from health emergencies; and 1 billion more people enjoying better health and well-being.
The image above captures the diversity of disciplines and areas of work that contributes to understanding human behaviour to improve health policies and programmes. The contributions were discussed by the members of the Technical Advisory Group during the introductory meeting on July 20, 2020. Click here to download image in full size
New research findings published today in the BMJ help to shed light on the risks of COVID-19 for pregnant women and their babies. The paper suggests that pregnant women seen at the hospital with suspected or confirmed COVID-19 are less likely to experience a fever or muscle pain, but if they develop severe disease they are more likely to need intensive care than non-pregnant women with COVID-19.
This is first paper of a ‘living systematic review’; ongoing, global, research which is collecting and synthesising data on the situation for pregnant women with COVID-19 in countries worldwide. It has been led by researchers at the University of Birmingham, UK, the World Health Organization, and the Special Programme HRP alongside other collaborators.Pre-existing medical conditions
Evidence currently suggests that people who are non-white, are older, who are overweight and/or have a pre-existing medical condition, are more vulnerable to severe disease due to COVID-19. According to the findings published today, pregnant women with COVID-19, who have pre-existing medical conditions, such as diabetes or chronic high blood pressure, or those who are older or overweight, are also more likely to suffer severe health complications due to COVID-19.Mercedes Bonet, an author of the study comments, “The evidence shows us that having pre-existing health conditions such as diabetes or high blood pressure, puts you at greater risk, whether or not you are pregnant.”
These findings underline the need for pregnant women and recently pregnant women to take all precautions to avoid COVID-19 disease, in particular if they have underlying conditions.Risks for newborn babies and women
The research findings show that pregnant or recently pregnant women with COVID-19 were more likely to give birth prematurely. The findings also show that 1 in 4 of all babies born to women with COVID-19, were admitted to a neonatal unit but data on causes of preterm births or indications for admission to neonatal units among these babies is lacking. Stillbirth and newborn death rates however were low.Implications for healthcare
It is important healthcare providers are aware that pregnant women with COVID-19 and their newborn babies may be more likely to need specialist care, and that women and their babies have access to this care. This is particularly true for pregnant women with COVID-19 alongside other co-morbidities.
In addition it is crucial to stress that whether or not a woman has COVID-19, her right to a positive pregnancy and childbirth experience must be ensured. Read more
It is also important to recognise the increased stress and anxiety caused by COVID-19 which may be particularly felt by pregnant women, recently-pregnant women, and their partners, children, and families; healthcare providers have a role in responding to pregnant women in an appropriate and compassionate way.
The World Health Organization (WHO) today published a first indicative survey on the impact of COVID-19 on health systems based on 105 countries’ reports. Data collected from five regions over the period from March to June 2020 illustrate that almost every country (90%) experienced disruption to its health services, with low- and middle-income countries reporting the greatest difficulties. Most countries reported that many routine and elective services have been suspended, while critical care - such as cancer screening and treatment and HIV therapy – has seen high-risk interruptions in low-income countries.
"The survey shines a light on the cracks in our health systems, but it also serves to inform new strategies to improve healthcare provision during the pandemic and beyond,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "COVID-19 should be a lesson to all countries that health is not an ‘either-or’ equation. We must better prepare for emergencies but also keep investing in health systems that fully respond to people’s needs throughout the life course."
Services hit across the board: Based on reports from key informants, countries on average experienced disruptions in 50% of a set of 25 tracer services. The most frequently disrupted areas reported included routine immunization – outreach services (70%) and facility-based services (61%), non-communicable diseases diagnosis and treatment (69%), family planning and contraception (68%), treatment for mental health disorders (61%), cancer diagnosis and treatment (55%).
Countries also reported disruptions in malaria diagnosis and treatment (46%), tuberculosis case detection and treatment (42%) and antiretroviral treatment (32%). While some areas of health care, such as dental care and rehabilitation, may have been deliberately suspended in line with government protocols, the disruption of many of the other services is expected to have harmful effects on population health in the short- medium- and long-term.
Potentially life-saving emergency services were disrupted in almost a quarter of responding countries. Disruptions to 24-hour emergency room services for example were affected in 22% of countries, urgent blood transfusions were disrupted in 23% of countries, emergency surgery was affected in 19% of the countries.
Disruption due to a mix of supply and demand side factors. 76% of countries reported reductions in outpatient care attendance due to lower demand and other factors such as lockdowns and financial difficulties. The most commonly reported factor on the supply side was cancellation of elective services (66%). Other factors reported by countries included staff redeployment to provide COVID-19 relief, unavailability of services due to closings, and interruptions in the supply of medical equipment and health products.
Adapting service delivery strategies. Many countries have started to implement some of the WHO recommended strategies to mitigate service disruptions, such as triaging to identify priorities, shifting to on-line patient consultations, changes to prescribing practices and supply chain and public health information strategies. However, only 14% of countries reported removal of user fees, which WHO recommends to offset potential financial difficulties for patients.
The pulse survey also provides an indication of countries’ experiences in adapting strategies to mitigate the impact on service provision. Despite the limitations of such a survey, it highlights the need to improve real-time monitoring of changes in service delivery and utilization as the outbreak is likely to wax and wane over the next months, and to adapt solutions accordingly.
To that end, WHO will continue to work with countries and to provide supportive tools to address the fallout from COVID-19. Given countries’ urgent demand for assistance during the pandemic response, WHO is developing the COVID19: Health Services Learning Hub, a web-based platform that will allow sharing of experiences and learning from innovative country practices that can inform the collective global response. WHO is also devising additional surveys at the sub-national level and in health facilities to gauge the longer-term impact of disruptions and help countries weigh the benefits and risks of pursuing different mitigation strategies.
Note to editors
The survey ‘Rapid assessment of continuity of essential health services during the COVID-19 pandemic’, was conducted in 159 countries (all WHO regions except the Americas). 105 responses were received (66% response rate) from senior ministry of health officials covering the period from March to June 2020. The purpose of the survey was to gain insights and perspectives on both the impact of the COVID-19 pandemic on up to 25 essential health services in countries and how countries are adapting strategies to maintain essential services.
While pulse surveys have some limitations, the strength of this effort is that it is comprehensive, looking at 25 core health services (as opposed to single topic surveys) and representing disruptions to these services in a comparable way across over 100 countries. It reveals that even robust health systems can be rapidly overwhelmed and compromised by a COVID-19 outbreak, reinforcing the need for sustained data collection and strategic adaptations to ensure maintenance of essential care provision.
Joint release by the World Health Organization, United for Global Mental Health and the World Federation for Mental Health
Mental health is one of the most neglected areas of public health. Close to 1 billion people are living with a mental disorder, 3 million people die every year from the harmful use of alcohol and one person dies every 40 seconds by suicide. And now, billions of people around the world have been affected by the COVID-19 pandemic, which is having a further impact on people’s mental health.
Yet, relatively few people around the world have access to quality mental health services. In low- and middle-income countries, more than 75% of people with mental, neurological and substance use disorders receive no treatment for their condition at all. Furthermore, stigma, discrimination, punitive legislation and human rights abuses are still widespread.
The limited access to quality, affordable mental health care in the world before the pandemic, and particularly in humanitarian emergencies and conflict settings, has been further diminished due to COVID-19 as the pandemic has disrupted health services around the world. Primary causes have been infection and the risk of infection in long-stay facilities such as care homes and psychiatric institutions; barriers to meeting people face-to-face; mental health staff being infected with the virus; and the closing of mental health facilities to convert them into care facilities for people with COVID-19.
Move for mental health: let’s invest
That’s why, for this year’s World Mental Health Day, WHO, together with partner organizations, United for Global Mental Health and the World Federation for Mental Health, is calling for a massive scale-up in investment in mental health. To encourage public action around the world, a World Mental Health Day campaign, Move for mental health: let’s invest will kick off in September.
“World Mental Health Day is an opportunity for the world to come together and begin redressing the historic neglect of mental health,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “We are already seeing the consequences of the COVID-19 pandemic on people’s mental well-being, and this is just the beginning. Unless we make serious commitments to scale up investment in mental health right now, the health, social and economic consequences will be far-reaching.”
During the past few months, the World Health Organization has issued, in collaboration with partners, guidance and advice on mental health for health workers and other frontline workers, managers of health facilities, and people of all ages whose lives have changed considerably as a result of the pandemic. With the disruption in health services, countries are finding innovative ways to provide mental health care, and initiatives to strengthen psychosocial support have sprung up. Yet, because of the scale of the problem, the vast majority of mental health needs remain unaddressed. The response is hampered by chronic under-investment in mental health promotion, prevention and care for many years before the pandemic.
Countries spend just 2% of their health budgets on mental health
Countries spend on average only 2% of their health budgets on mental health. Despite some increases in recent years, international development assistance for mental health has never exceeded 1% of all development assistance for health. This is despite the fact that for every US$ 1 invested in scaled-up treatment for common mental disorders such as depression and anxiety, there is a return of US$ 5 in improved health and productivity.
World Mental Health Day: an opportunity to commit
The World Mental Health Day campaign will offer opportunities, primarily online given the continuing pandemic, for all of us to do something life-affirming: as individuals, to take concrete actions in support of our own mental health, and to support friends and family who are struggling; as employers, to take steps towards putting in place employee wellness programmes; as governments, to commit to establishing or scaling-up mental health services; and as journalists, to explain what more can and must be done to make mental health care a reality for everyone.
“It is nearly 30 years since the first World Mental Health Day was launched by the World Federation for Mental Health,” said Dr Ingrid Daniels, President of the World Federation for Mental Health. “During that time, we have seen an increasing openness to talk about mental health in many countries of the world. But now we must turn words into actions. We need to see concerted efforts being made to build mental health systems that are appropriate and relevant for today’s – and tomorrow’s - world.
“With so many people lacking access to good quality, appropriate mental health services, investment is needed now more than ever,” said Elisha London, Founder and CEO of United for Global Mental Health. “Everyone, everywhere can participate in this year’s campaign. Whether you have struggled with your own mental health, know someone who has been affected, are a mental health expert, or if you simply believe that investing in mental health is the right thing to do, move for mental health, and help make mental health care and support accessible for everyone.”Key events
United for Global Mental Health: The 24-hour March for Mental Health
On 9 October, people from around the world will be encouraged to participate in a virtual march. A 24-hour livestream will feature people with lived experience, mental health leaders and influencers from the civil society groups already active in 19 countries through the Speak Your Mind campaign. In addition, global partner organizations that are leading and coordinating work on mental health are organizing hour-long sessions on specific themes, including mental health and young people, mental health and older people, and mental health and the LGBTQ+ community. Confirmed partners include Human Rights Watch and Alzheimer’s Disease International. The March will help increase awareness of mental health issues, break down stigma and bring about policy change. Members of the public will be urged to “add their voice” and join the March using online filters to be released in the lead-up to the event.
WHO: The Big Event for Mental Health
On World Mental Health Day, 10 October, the World Health Organization will, for the first time ever, host a global online advocacy Event on mental health. At this event - the Big Event for Mental Health - WHO will showcase the work that its staff are doing around the world to reduce mental illness and the harmful use of alcohol and drugs. World leaders and mental health experts will join the WHO Director-General to talk about their commitment to mental health and what more must be done. World-renowned musicians who have spoken out about the importance of mental health will talk about their motivation and perform. Sportsmen and women whose lives have been affected by mental ill health will share their experiences and how they have dealt with conditions such as depression and anxiety.
During the Event, a Special Prize for a mental health film, a newly-created category of WHO’s inaugural Health for All Film Festival, will be awarded.
World Federation for Mental Health: education and awareness raising
The Federation’s campaign kicks off on 1 September, with the Federation’s President launching the 2020 World Mental Health Day Campaign Educational Material “Mental Health for All: Greater Investment - Greater Access” under the Royal Patronage of HRH Princess Iman Afzan Al-Sultan Abdullah of Malaysia. This includes a Call to Action 2020 from Pamela Y. Collins and Deepa Rao, and will be followed by 45 days of awareness-raising activities led by the Federation’s youth section, including a global online discussion forum and art exhibition.
The World Health Organization
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 goals for 2019-2023 are to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and to provide a further billion people with better health and well-being.
United for Global Mental Health
United for Global Mental Health brings together the global mental health community with governments, funders and campaigners to help make sure everyone, everywhere has someone to turn to in support of their mental health. The not-for-profit organization was launched at the UN in September 2018.
Speak your Mind is a nationally driven and globally united campaign powered by United for Global Mental Health. It works in support of mental health for all. It brings together people with first-hand experience of mental health conditions, experts and civil society organizations to call on leaders to end the neglect of mental health by increasing investment, empowerment and education. The campaign involves campaigners from 19 countries: Argentina, Australia, Ghana, India, Indonesia, Kenya, Liberia, Nepal, New Zealand, Nigeria, Pakistan, Peru, Philippines, Sierra Leone, South Africa, Sri Lanka, Tonga, the United Kingdom and the United States of America.
The World Federation for Mental Health
The World Federation for Mental Health is an international membership organization founded in 1948 to advance, among all peoples and nations, the prevention of mental and emotional disorders, the proper treatment and care of those with such disorders, and the promotion of mental health. The Federation was the initiator of World Mental Health Day.
Today, as part of its commitment to strengthening health information systems and improving health, especially in the context of the COVID-19 pandemic, WHO announced a new approach to improving access to life-saving data: the SCORE for Health Data Technical Package. The COVID-19 pandemic has highlighted the urgent need for timely and reliable data to drive strategic health action. Too many countries still lack both the infrastructure to routinely gather health data and the analytical capacity to use these data for effective health actions and emergency response.
“Countries must be able to measure progress to make progress,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Particularly during COVID-19, reliable data is the best way to coordinate response efforts and improve health in all areas.”
Accurate health data are necessary to understand specific country needs in order to improve health and save lives. Data also helps direct scarce resources to where they are needed most.
The SCORE (Survey, Count, Optimize, Review, Enable) Technical Package aims to improve the availability of timely, reliable, validated, and comparable health data. For the first time in a single, harmonized package, it represents all the key elements for optimized health information system performance. Simply put, SCORE will help governments around the globe set benchmarks and improve standards in healthcare.
In response to the challenges of data availability highlighted in the WHO World Health Statistics 2020 report, SCORE includes more than 90 universally-accepted tools and standards for health information systems strengthening. “Using data to inform public health priorities and strategies has never been more important,” said Dr Kelly Henning, Director of Public Health Programs at Bloomberg Philanthropies. “The SCORE Technical Package provides country governments around the world with high-quality, essential technical guidance so that countries can strengthen their own data systems.” WHO is proud to partner with the Bloomberg Philanthropies Data for Health Initiative to deliver this timely resource to countries.
Below are some examples of how SCORE can improve individual lives and communities:
The package's initial release includes two documents:
“We must keep score to save lives. WHO is committed to working with countries and partners to rapidly scale up capacity for data collection and use in order to improve policy and performance,” added Dr Samira Asma, Assistant Director-General for Data, Analytics and Delivery for Impact at WHO. “We must act now to invest in statistical systems in countries, respond to this pandemic and meet the SDGs and the Triple Billion targets. Our window of opportunity is closing, and we cannot wait to address data gaps. Data use to address country needs has to be a priority today.”
Country-owned, disaggregated data will be essential for more resilient and sustainable health systems going forward. COVID-19 is both a wake-up call and a stark reminder of the challenges we still have to address. But it is also an opportunity to build back better through solidarity, information-sharing and collaboration.
SCORE is one example of how a collaborative approach can benefit countries by providing a common set of tools based on shared standards. This package is designed to be practical, actionable and flexible. We will only be successful in combatting COVID-19 if we work together.
Future components of the SCORE Technical Package are due to be released later this year, including the SCORE Assessment Instrument and global, regional and country status reports. Together, these will provide a complete package of information to plan and monitor progress against national and subnational priorities as well as global targets.-----
 Bloomberg Philanthropies Data for Health Initiative provided funding to support the SCORE for Health Data Technical Package
The World Health Organization (WHO) has launched target product profiles to drive the rapid development of novel tuberculosis (TB) preventive treatment today. The target product profiles characterise the most important product attributes to be considered for developing the best suited TB prevention treatments in future.
One quarter of the global population is estimated to be infected with TB and are at greater risk of developing TB disease, especially those with weakened immunity. Treatment of TB infection, also known as TB preventive treatment , aims to prevent the development of TB disease, and is one of the critical components of WHO’s End TB Strategy. At the United Nations High-level Meeting on TB in 2018, countries committed to provide TB preventive treatment to at least 30 million people by 2022.
“Existing options for TB preventive treatment still present a number of operational limitations that prevent wide-scale implementation” said Dr Tereza Kasaeva, Director, WHO Global TB Programme. “To successfully expand TB preventive treatment to the millions in need, we urgently require new drug regimens that are more effective, cheaper, shorter, easier to administer and better tolerated, than those currently available.”
The optimization of future TB preventive treatment regimens requires consideration of the efficacy and safety of the regimen components, their potential for drug-drug interactions, their propensity to generate drug resistance, and their use in specific patient populations - such as people living with HIV, pregnant women and children.
“The target product profiles identify the key product attributes to be considered for the development of best and most suitable TB prevention treatments” said Dr Christian Lienhardt, Director of Research at the Institute for Research on Sustainable Development (IRD), in Montpellier, France and who coordinated the compilation of the target product profiles. “This document should assist in aligning treatment developers’ performance and operational targets with programmatic needs at country level”.
The launch of the target product profiles was accompanied by a live Webinar 26 August from 15h00 to 17h00 CEST,during which they were presented to the audience, followed by a live Q&A. Speakers include Tereza Kasaeva, Director of WHO’s Global TB Programme, Saskia den Boon, Technical Officer at the WHO Global TB Programme, Christian Lienhardt from the Institute for Research on Sustainable Development (IRD) in Montpellier, France, Nim Arinaminpathy from Imperial College London, UK, Kevin Schwartzman from McGill University in Montreal, Canada and Alberto Matteelli from the University of Brescia, Italy.
Watch the Webinar:
172 economies are now engaged in discussions to potentially participate in COVAX, a global initiative aimed at working with vaccine manufacturers to provide countries worldwide equitable access to safe and effective vaccines, once they are licensed and approved. COVAX currently has the world’s largest and most diverse COVID-19 vaccine portfolio - including nine candidate vaccines, with a further nine under evaluation and conversations underway with other mayor producers.
COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, and the World Health Organization (WHO) – working in partnership with developed and developing country vaccine manufacturers. 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.
In order to be able to secure enough doses of vaccines to protect the most vulnerable populations, such as health workers and the elderly, the next step for the partnership is to confirm potential self-financing participants’ intent to participate by 31 August and to turn these into binding commitments to join the COVID-19 Vaccine Global Access Facility (COVAX Facility) by 18 September, with first upfront payments to follow thereafter, and no later than 9 October 2020.
“Equal access to a COVID-19 vaccine is the key to beating the virus and paving the way for recovery from the pandemic,” said Stefan Löfven, Prime Minister of Sweden. “This cannot be a race with a few winners, and the COVAX Facility is an important part of the solution – making sure all countries can benefit from access to the world’s largest portfolio of candidates and fair and equitable distribution of vaccine doses.”
The COVAX Facility is a Gavi-coordinated pooled procurement mechanism for new COVID-19 vaccines, through which COVAX will ensure fair and equitable access to vaccines for each participating economy, using an allocation framework currently being 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, allowing those vaccine manufacturers whose expertise is essential to large scale production of the new vaccines, to make early, at-risk investments in manufacturing capacity – providing participating countries and economies with the best chance at rapid access to doses of a successful COVID-19 vaccine.
The success of COVAX hinges not only on countries signing up to the COVAX Facility, but also filling key funding gaps for both COVAX R&D work and a mechanism to support participation of lower-income economies in the COVAX Facility.
“COVID-19 is an unprecedented global health challenge that can only be met with unprecedented cooperation between governments, researchers, manufacturers and multilateral partners,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “By pooling resources and acting in solidarity through the ACT Accelerator and the COVAX Facility, we can ensure that once a vaccine is available for COVID-19, it’s available equitably to all countries.”
CEPI is leading COVAX vaccine research and development work, which aims to develop three safe and effective vaccines which can be made available to countries participating in the COVAX Facility. Nine candidate vaccines are currently being supported by CEPI; seven of which are currently in clinical trials. Governments, vaccine manufacturers (in addition to their own R&D), organizations and individuals have committed US$ 1.4 billion towards vaccine R&D so far, but an additional US$1 billion is urgently needed to continue to move the portfolio forward.
A further nine candidates vaccines which complement the current CEPI portfolio are currently being evaluated for inclusion in COVAX. Furthermore, COVAX will consider procuring vaccines that complement the portfolio from any producer in the world; conversations are already underway with a number of additional manufacturers not receiving R&D support from CEPI to procure their vaccines if they are successful. Maximizing the portfolio of vaccines increases the probability of success as individual vaccines historically have a high failure rate.
“In the scramble for a vaccine, countries can act alone – creating a few winners, and many losers - or they can come together to participate in COVAX, an initiative which is built on enlightened self-interest but also equity, leaving no country behind,” said Richard Hatchett, CEO of CEPI. “Only by taking a global view can we protect those most at risk around the world from the terrible effects of this disease. COVAX can deliver the vaccines that could end the pandemic, but it needs countries to step forward both to join the COVAX Facility, and also to address the serious funding shortfalls, including for R&D. The decisions that are taken now about COVID-19 vaccines have the power to change our future. We must be courageous and ambitious in striving for a multilateral solution.”
A collaboration between Serum Institute of India (SII), Gavi and the Bill & Melinda Gates Foundation announced earlier this month will ensure up to 100 million doses of AstraZeneca or Novavax’s candidate vaccines, if successful, will be available to low- and middle-income economies through the COVAX Facility at just US$ 3 per dose. The arrangement also provides an option to secure additional doses if COVAX sees a need for it. Separate agreements between Gavi, CEPI and AstraZeneca, announced in June, guarantee a further 300 million doses of their candidate vaccine, if successful, for the COVAX Facility.
In addition, in June Gavi launched the COVAX Advance Market Commitment (AMC), a financing instrument aimed at supporting the participation of 92 lower and middle income economies in the COVAX Facility. The COVAX AMC has raised more than US$ 600 million against an initial target of securing US$ 2 billion seed funding from sovereign donors as well as philanthropy and the private sector, needed by the end of 2020. Funding the COVAX AMC will be critical to ensuring ability to pay is not a barrier to accessing COVID-19 vaccines, a situation which would leave the majority of the world unprotected, with the pandemic and its impact continuing unabated.
Eighty higher-income economies, which would finance the vaccines from their own public finance budgets, have so far submitted Expressions of Interest ahead of the deadline of 31 August for confirmation of intent to participate. They will partner with 92 low- and middle-income countries that will be supported by the AMC if it meets its funding targets. Together, this group of 172 countries represents more than 70% of the world’s population. Among the group are representatives from every continent and more than half of the world’s G20 economies.
“The momentum we are witnessing behind this unprecedented global effort means there could be light at the end of the tunnel: A vaccine is our best route to ending the acute phase of the pandemic and the COVAX effort is the best way to get there,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “For higher-income countries it represents a win-win: not only will you be guaranteed access to the world’s largest portfolio of vaccines, you will also be negotiating as part of a global consortium, bringing down prices and ensuring truly global access. Signing up to the COVAX Facility gives each country its best chance at protecting the most vulnerable members of their populations – which in turn gives the world its best chance at mitigating the toll this pandemic has taken on individuals, communities and the global economy. To make this end-to-end vision a reality, we need countries to make end-to-end commitments: funding R&D, signing up to the Facility, and supporting the COVAX AMC.”
The COVAX Facility is coordinated by Gavi, the Vaccine Alliance, and forms a key part of COVAX – the vaccines pillar of the ACT Accelerator, a ground-breaking global collaboration involving vaccine manufacturers to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. The overall aim of COVAX is to accelerate the development and manufacture of COVID-19 vaccines, and to guarantee fair and equitable access for every country in the world. It will achieve this by sharing the risks associated with vaccine development, and where necessary investing in manufacturing upfront so vaccines can be deployed at scale as soon as they are proven to be safe and effective, and pooling procurement and purchasing power to achieve sufficient volumes to end the acute phase of the pandemic by 2021.
The goal of COVAX is by the end of 2021 to deliver two billion doses of safe, effective vaccines that have passed regulatory approval and/or WHO prequalification. These vaccines will be offered equally to all participating countries, proportional to their populations, initially prioritising healthcare workers then expanding to cover vulnerable groups, such as the elderly and those with pre-existing conditions. Further doses will then be made available based on country need, vulnerability and COVID-19 threat. The COVAX Facility will also maintain a buffer of doses for emergency and humanitarian use, including dealing with severe outbreaks before they spiral out of control.
Notes to editors
The full list of CEPI-supported candidate vaccines is as follows:
The nine candidate vaccines that are currently being evaluated for inclusion in the COVAX Facility include two from China, two from the United States of America, one from Republic of Korea, one from the United Kingdom of Great Britain and Northern Ireland and one global, multi-manufacture partnership. Two of these are in Phase I trials, two are tech transfers and the remainder are at the discovery stage.
The 80 countries that have submitted expressions of interest to the Gavi-coordinated COVAX Facility include 43 that have agreed to be publicly named: Andorra, Argentina, Armenia, Botswana, Brazil, Canada, Chile, Colombia, Croatia, Czech Republic, Dominican Republic, Estonia, Finland, Greece, Iceland, Iraq, Ireland, Israel, Japan, Jordan, Kuwait, Lebanon, Luxembourg, Mauritius, Mexico, Monaco, Montenegro, New Zealand, North Macedonia, Norway, Palau, Portugal, Qatar, Republic of Korea, San Marino, Saudi Arabia, Seychelles, Singapore, South Africa, Switzerland, United Arab Emirates, United Kingdom of Great Britain and Northern Ireland and Venezuela.
In July the Gavi Board agreed on the 92 economies that will be supported the COVAX Advance Market Commitment (AMC). The full list is as follows:
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 760 million children – and prevented more than 13 million deaths, helping to halve child mortality in 73 developing 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 nine 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.
Today, the Africa Regional Certification Commission certified the WHO African Region as wild polio-free after four years without a case. With this historic milestone, five of the six WHO regions – representing over 90% of the world’s population – are now free of the wild poliovirus, moving the world closer to achieving global polio eradication.
Only two countries worldwide continue to see wild poliovirus transmission: Pakistan and Afghanistan.
The Global Polio Eradication Initiative (GPEI) congratulates the national governments of the 47 countries in the WHO African Region for today’s achievement.
“Ending wild polio virus in Africa is one of the greatest public health achievements of our time and provides powerful inspiration for all of us to finish the job of eradicating polio globally,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “I thank and congratulate the governments, health workers, community volunteers, traditional and religious leaders and parents across the region who have worked together to kick wild polio out of Africa.”
Strong leadership and innovation were instrumental in stopping the wild poliovirus in the region. Countries successfully coordinated their efforts to overcome major challenges to immunizing children, such as high levels of population movement, conflict and insecurity restricting access to health services, and the virus’s ability to spread quickly and travel across borders.
In addition, the continued generosity and shared commitment of donors – including governments, the private sector, multilateral institutions and philanthropic organizations – to achieving a polio-free world helped build the infrastructure that enabled the African region to reach more children than ever before with polio vaccines and defeat wild polio.
“During a challenging year for global health, the certification of the African region as wild poliovirus-free is a sign of hope and progress that shows what can be accomplished through collaboration and perseverance,” said Rotary International President Holger Knaack. “Since 1996, when Nelson Mandela joined with Rotary, the Global Polio Eradication Initiative, and governments of the African region we’ve achieved something remarkable. Today’s milestone tells us that polio eradication is possible, as long as the world remains committed to finishing the job. Let us work together to harness our collective energies to overcome the remaining challenges and fulfil our promise of a polio-free world.”
The resources and expertise used to eliminate wild polio have significantly contributed to Africa’s public health and outbreak response systems. The polio programme provides far-reaching health benefits to local communities, from supporting the African region’s response to COVID-19 to bolstering routine immunization against other vaccine-preventable diseases.
While this is a remarkable milestone, we must not become complacent. Continued commitment to strengthening immunization and health systems in the African region is essential to protect progress against wild polio and to tackle the spread of type 2 circulating vaccine-derived poliovirus (cVDPV2), which is present in 16 countries in the region. Pockets of low immunity mean such strains continue to pose a threat and the risk is magnified by interruptions in vaccination due to COVID-19, which have left communities more vulnerable to cVDPV2 outbreaks.
The GPEI calls on countries and donors to remain vigilant against all forms of polio. Until every strain is eradicated worldwide, the incredible progress made against polio globally will be at risk.
The WHO African Region’s success against wild polio has shown the world that progress against some of the biggest global health challenges is possible. The GPEI is grateful for every person, partner, donor and country who helped bring about this incredible achievement.
Note for editors:
The Global Polio Eradication Initiative is a public-private partnership led by national governments with six core partners – the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance.
For information and multimedia content on the WHO African Region’s efforts to eradicate wild polio, please visit africakicksoutwildpolio.com. For more information on the global effort to end polio, visit polioeradication.org.
The dedication, perseverance and self-sacrifice of these real-life heroes represent the best of humanity as they respond to the COVID-19 crisis and the massive increase in humanitarian needs it has triggered.
First responders are often people in need themselves — refugees, members of civil-society organizations and local health workers. They bring food, shelter, health care, protection and hope to others amid conflict, displacement, disaster and disease.
But humanitarian workers are being tested like never before, struggling with unprecedented movement restrictions and insufficient resources as needs are outpacing funds.
And all too often, they risk their own lives to save the lives of others.
In recent weeks alone, despicable attacks have killed aid workers in Niger and Cameroon, and since the onset of the pandemic, scores of health workers have come under attack across the world.
According to Humanitarian Outcomes’ Aid Worker Security Database, major attacks against humanitarians last year surpassed all previous years on record. A total of 483 relief workers were attacked, 125 killed, 234 wounded and 124 kidnapped in 277 separate incidents. This is an 18 per cent increase in the number of victims compared to 2018.
This is the eleventh World Humanitarian Day, designated by the UN General Assembly. It falls on the day of the attack on the UN compound in Baghdad on 19 August 2003, which claimed the lives of 22 people including the Secretary-General's Special Representative for Iraq, Sergio Vieira de Mello. Since then, nearly 5,000 humanitarians have been killed, wounded or abducted, and the 2010-2019 decade experienced a 117 per cent increase in attacks compared to 2000-2009.
A surge in attacks against health workers was recorded in 2019, including strikes against medics in Syria and shootings of Ebola workers in the Democratic Republic of the Congo (DRC).
Most of the attacks occurred in Syria, followed by South Sudan, DRC, Afghanistan and the Central African Republic. Mali and Yemen both saw a doubling of major attacks from the previous year. The UN condemns these attacks, and it calls for accountability for perpetrators and justice for survivors. Relief workers cannot be a target.
Mark Lowcock, the Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, said: “To humanitarian workers everywhere doing important, courageous work on the front lines we say Thank You. You are saving lives every day, and as new challenges and crises are piling on to existing ones, your perseverance is an inspiration. Your protection is also paramount to making sure we can deliver to people most in need. The best way to pay tribute to humanitarian workers is by funding their work and ensuring their safety.”
This year's World Humanitarian Day comes as the world fights the COVID-19 pandemic. To pay tribute to the efforts of humanitarians, OCHA and its partners present the personal stories of some of the #RealLifeHeroes who are stepping up to meet the challenges, particularly local humanitarian workers.
They include refugees who as health workers are playing essential roles in the pandemic response; Ebola health workers who are stepping in to fight COVID-19; and doctors and nurses who continue to provide critical health care to women and children.
Read their inspiring stories here: www.worldhumanitarianday.org
For media: Photos, videos, and social media assetsAbout World Humanitarian Day
In 2008, the United Nations General Assembly designated 19 August as World Humanitarian Day to raise awareness about humanitarian assistance worldwide and to pay tribute to the people who risk their lives to provide it. World Humanitarian Day was commemorated for the first time on 19 August 2009.