This Medical Product Alert relates to a series of confirmed falsified antimalarials circulating in West and Central Africa. Medicines subject of this alert display a similar logo to the outdated
WHO Essential Drugs Programme logo.
Since 2013, different falsified medicines, all displaying the outdated WHO Essential Drugs Programme logo, have been reported to the WHO Global Surveillance and Monitoring System by various stakeholders. The continued and widespread availability of these falsified medicines highlights a strong need for additional vigilance. WHO previously published two alerts on this issue (No.132 in Oct 2014, and No.131 in March 2014)
This WHO medical product alert N°1/2020 refers to falsified Quinine Sulphate 300mg presented in six different combinations of batch numbers, expiry and manufacturing dates (see Table 1). The fraudulent use of the outdated WHO Essential Drugs Programme logo may create a false sense of product quality.
Table 1: List of identified falsified Quinine Sulphate 300mg, subject of WHO Alert N°1/2020
Recently received results of analysed samples show they do not contain any of the expected active ingredients.
Quinine sulphate is referenced on the WHO Model List of Essential Medicines, to manage and treat severe malaria. At this stage, no adverse reactions attributed to these falsified products have been reported to WHO.
All the above falsified products claim to be manufactured by REMEDICA LTD - Cyprus and to contain 300mg of quinine sulphate. Remedica Ltd has confirmed that:
These falsified medicines display the following common characteristics (please see photographs):
Product details, photographs and advice to the public are available on the following pages.Outdated WHO Essential Drugs Programme logo
Photographs of confirmed falsified Quinine Sulphate 300mg tablets subject of
1. Falsified Quinine Sulphate Tablets B.P 300mg identified in Chad (Batch 44680)
2. Falsified Quinine Sulphate Tablets B.P 300mg identified in Nigeria and Cameroon (Batch 44680)
WHO requests increased vigilance within the supply chains of countries likely to be affected by these falsified products. Increased vigilance should include hospitals, clinics, health centres, wholesalers, distributors, pharmacies and any other suppliers of medical products.
If you are in possession of the above products, please do not use. If you have used these falsified products, or if you suffer an adverse event having used these products, please seek immediate advice from a qualified healthcare professional, and ensure they report the incident to your local Ministry of Health/National Medicines Regulatory Authorities/National Pharmacovigilance Centre.
All medical products must be obtained from authentic and reliable sources. Their authenticity and condition should be carefully checked. Seek advice from a healthcare professional in case of doubt.
National health authorities are asked to immediately notify WHO if these falsified products are discovered in their country. If you have any information concerning the manufacture, distribution, or supply of these products, please contact [email protected] .WHO Global Surveillance and Monitoring System for Substandard and Falsified Medical Products
For further information, please visit our website: www.who.int/medicines/regulation/ssffc/en/
The protection of health workers is one of the priorities for the response to COVID19 outbreaks. Occupational health services in health care facilities have an important role for protecting health workers and ensuring the business continuity of health care services.
Non-healthcare workplaces, such as businesses and enterprises have also the responsibility to protect the health and safety of their workers and those affected by their operations.
Remarks by Dr Ibrahima Socé Fall, World Health Organization Assistant Director-General, Emergency Response
I hope that your busy week was interrupted, like mine, with a moment of joy on Tuesday.
That moment was the celebration of a woman being discharged from an Ebola treatment centre in Beni. Her name is Masika.
She was the last person in the Democratic Republic of the Congo confirmed to have Ebola.
Health workers and other responders sacrificed a lot to get to this point.
Since the outbreak was declared in August 2018 there have been 420 attacks on health facilities in DRC, resulting in 11 deaths and 86 injuries among health care workers and patients.
It’s been a huge amount of work. At the peak of the outbreak, more than 120 cases were being reported each week. 28 health zones were affected, with cases appearing 1200 kilometres apart. In response:
This work is continuing. The outbreak isn’t over. WHO recommends waiting two full incubation periods - that’s 42 days - after the last person tests negative a second time before declaring the end of the outbreak.
We must stay in active response mode to get us over that finish line.
We have to be prepared for other cases emerging. It’s is a very real risk.
Remember that during the Ebola outbreak in West Africa flare-ups of new cases occurred after the end of the outbreak.
There are four reasons why new cases may emerge during this 42-day period, or even after the end of the outbreak.
This is why it’s critical to maintain surveillance and rapid response capacities.
And that’s what we are doing. We’re still in full response mode.
In addition to the activities I already mentioned, I have to underline how critical it is to continue supporting the Survivor Programme, which provides follow-up care for almost all of the 1169 survivors in 26 health areas in North Kivu and Ituri. The programme also helps reduce the risks of re-introduction events.
We need to continue this work until the end of the outbreak, to keep the capacity in place to rapidly respond to flare-ups, to keep supporting survivors after the outbreak, and to transition the capacities built in this response toward building a stronger health system.
But to be very frank, right now the world risks dropping the baton at the finish line. WHO faces an immediate US $20 million funding gap. If no new resources are received, we will run out of money before the end of the outbreak.
We appreciate the generosity of donors who have supported the response since August 2018. Now we need to get over the finish line. WHO is calling on the international community to help us end this outbreak, and keep our promises to communities to build a stronger health system.
If we are forced to scale back operations because of a lack of funds, and then a new case emerges, we might not have the people and resources on the ground that we need to shut down transmission quickly. Just a single case could re-ignite the epidemic.
That would be a tragedy. An avoidable tragedy.
It is important that the global community doesn’t only focus efforts when there is an immediate threat, then walk away when the threat subsides.
The health system has to be strong to stop much more than Ebola. It has to stop malaria, measles, cholera, and now COVID-19.
There is a lot more work to do.
The 3rd Global Ministerial Conference on Road Safety convened 1700 delegates from around 140 countries, including more than 70 ministers and vice-ministers and heads of international agencies, civil society organizations, foundations and private companies. Hosted at the request of the UN General Assembly by the Government of Sweden in collaboration with WHO, the theme was “Achieving Global Goals 2030”, highlighting the connections between road safety and achievement of other Sustainable Development Goal targets.
Through its 6 high-level panels and 18 parallel sessions, the Ministerial Conference addressed a range of topics, from building effective leadership for road safety to promoting sustainable cities and communities, mitigating climate change through road safety, and ensuring the safety of pedestrians and cyclists. The gathering was instrumental in reviewing progress in the Decade of Action for Road Safety 2011-2020 and defining ways to accelerate action on proven strategies to save lives. Among many pre-events, the 2nd World Youth Assembly for Road Safety hosted by YOURS: Youth for Road Safety and co-hosted by WHO, brought 200 young leaders together proclaiming “Enough is enough!” and claiming their space at the decision-making table for sustainable mobility.
The Ministerial Conference culminated in the forward-looking “Stockholm Declaration”, which calls for a new global target to reduce road traffic deaths and injuries by 50% by 2030. In addition, it invites strengthened efforts on activities in all five pillars of the Global Plan for the Decade of Action: better road safety management; safer roads, vehicles and people; and enhanced post-crash care. It also calls for speeding up the shift to safe, affordable, accessible and sustainable modes of transport like walking, cycling and public transport. WHO is asked to continue to produce the series of global status reports, as a means of monitoring progress towards achievement of the 12 Global Road Safety Performance Targets.
Today, around 1.35 million people lose their lives on the world’s roads every year, and as many as 50 million are injured. More than one quarter of those killed and injured are pedestrians and cyclists. Road traffic injuries are now the leading cause of death for children and young adults aged 5-29 years. Given the enormous human suffering and major economic losses for families and societies, road traffic deaths remain an unacceptable price to pay for mobility.
WHO calls on industry and governments to increase manufacturing by 40 per cent to meet rising global demand
The World Health Organization has warned that severe and mounting disruption to the global supply of personal protective equipment (PPE) – caused by rising demand, panic buying, hoarding and misuse – is putting lives at risk from the new coronavirus and other infectious diseases.
Healthcare workers rely on personal protective equipment to protect themselves and their patients from being infected and infecting others.
But shortages are leaving doctors, nurses and other frontline workers dangerously ill-equipped to care for COVID-19 patients, due to limited access to supplies such as gloves, medical masks, respirators, goggles, face shields, gowns, and aprons.
“Without secure supply chains, the risk to healthcare workers around the world is real. Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding. We can’t stop COVID-19 without protecting health workers first,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.
Since the start of the COVID-19 outbreak, prices have surged. Surgical masks have seen a sixfold increase, N95 respirators have trebled and gowns have doubled.
Supplies can take months to deliver and market manipulation is widespread, with stocks frequently sold to the highest bidder.
WHO has so far shipped nearly half a million sets of personal protective equipment to 47 countries,* but supplies are rapidly depleting.
Based on WHO modelling, an estimated 89 million medical masks are required for the COVID-19 response each month. For examination gloves, that figure goes up to 76 million, while international demand for goggles stands at 1.6 million per month.
Recent WHO guidance calls for the rational and appropriate use of PPE in healthcare settings, and the effective management of supply chains.
WHO is working with governments, industry and the Pandemic Supply Chain Network to boost production and secure allocations for critically affected and at-risk countries.
To meet rising global demand, WHO estimates that industry must increase manufacturing by 40 per cent.
Governments should develop incentives for industry to ramp up production. This includes easing restrictions on the export and distribution of personal protective equipment and other medical supplies.
Every day, WHO is providing guidance, supporting secure supply chains, and delivering critical equipment to countries in need.
NOTE TO EDITORS
Since the start of the COVID-19 outbreak, countries that have received WHO PPE supplies include:
UN Humanitarian Chief Mark Lowcock today released US$15 million from the Central Emergency Response Fund (CERF) to help fund global efforts to contain the COVID-19 virus.
The announcement came as the World Health Organization (WHO) upgraded the global risk of the coronavirus outbreak to "very high" – its top level of risk assessment. The WHO has said there is still a chance of containing the virus if its chain of transmission is broken.
The sudden increases of cases in Italy, the Islamic Republic of Iran and the Republic of Korea are deeply concerning. There are now cases linked to Iran in Bahrain, Iraq, Kuwait and Oman, along with cases linked to Italy in Algeria, Austria, Croatia, Germany, Spain and Switzerland.
The UN funding has been released to the WHO and the United Nations Children’s Fund (UNICEF). It will fund essential activities including monitoring the spread of the virus, investigating cases, and the operation of national laboratories.
The WHO has called for US$675 million to fund the fight against coronavirus. There is a window of opportunity to contain the spread of the virus if countries take robust measures to detect cases early, isolate and care for patients, and trace contacts.
Emergency Relief Coordinator and Under-Secretary-General for Humanitarian Affairs, Mark Lowcock said: “We do not yet see evidence that the virus is spreading freely. As long as that’s the case, we still have a chance of containing it.
“But swift and robust action must be taken to detect cases early, isolate and care for patients, and trace contacts. We must act now to stop this virus from putting more lives at risk.
“This grant from the UN’s Emergency Fund will help countries with fragile health systems boost their detection and response operations. It has the potential to save the lives of millions of vulnerable people.”
This is a critical juncture in the outbreak. The focus is on containing COVID-19 by strengthening surveillance, conducting thorough outbreak investigations to identify contacts and applying appropriate measures to prevent further spread.
Tedros Adhanom Ghebreyesus, WHO Director-General, said: “The potential spread of the virus to countries with weaker health systems is one of our biggest concerns. These funds will help support these countries get ready for detecting and isolating cases, protecting their health workers, and treating patients with dignity and appropriate care. This will help us save lives and push back the virus”
UNICEF is leading on preventative actions in communities across the affected countries with risk communication, providing hygiene and medical kits to schools and health clinics and monitoring the impact of the outbreak to support continuity of care, education and social services.
“At this pivotal moment, every effort must be made to push back against the outbreak,” said UNICEF Executive Director Henrietta Fore. “These crucial funds will support our global efforts to bolster weaker health systems and inform children, pregnant women and families about how to protect themselves.”
Since it was launched in 2006, CERF has provided more than $6 billion to over 100 countries and helped hundreds of millions of people.
WHO is developing a guideline on parent training to prevent child maltreatment and promote the positive development of children aged 0-17 years. Part of the guideline development process involves constitution of a Guideline Development Group (GDG) which should represent a broad spectrum of perspectives, constituencies, and relevant expertise. The biographies of individuals proposed for membership of the GDG are provided below for public review and comment. Any comment or concern about the individuals listed should be sent to Dr Alexander Butchart ([email protected]).
The World Health Organization’s new action plan to speed up universal access to safe blood and blood products pulls together existing recommendations and recommends new improved ways of working. It’s the start of a four-year collaborative effort to improve blood transfusion and blood-based therapies in all countries.
Safe blood saves lives in all sorts of circumstances, not least in emergency and epidemic settings. Blood transfusion and blood products are critical for birth delivery for both the mother and baby; the survival and quality of life of patients suffering from life-threatening conditions such as haemophilia, thalassemia, immune deficiency and cancer; treating severe injuries and carrying out medical and surgical procedures.
But progress in blood safety and availability has been slow in many parts of the world, placing patients’ safety at risk and putting undue pressure on health workers. Progress is also mostly restricted to developed countries. Out of the approximate 118 million blood donations collected globally, 42% are collected in high-income countries, home to 16 % of the world’s population. And one out of four low-income countries do not test all donated blood, while 54% of countries do not have surveillance systems to securitise the supply chain from blood donor to patient.
Challenges include: slow implementation of national blood policies and weak blood regulatory systems; insufficient number of voluntary blood donors (who are considered the safest donors); poor quality management of screening tests, blood grouping and compatibility testing; inappropriate clinical use of blood; insufficient national funding for blood safety.
To address these, WHO has set out six key objectives for all countries and in particular those with weak blood systems:
The Organization looks forward to working with partners worldwide to implement the plan, improve blood supply particularly in the low and middle-income countries where this is so urgently needed, and save lives. The plan will run from 2020-2024.
As the current outbreak of the Coronavirus Disease (COVID-19) continues to develop, the World Health Organization (WHO) and the World Tourism Organization (UNWTO) are committed to working together in guiding the travel and tourism sectors’ response to COVID-19.
On 30 January 2020, the Director-General of the World Health Organization (WHO) declared the outbreak of COVID-19 to be a Public Health Emergency of International Concern and issued a set of Temporary Recommendations. WHO did not recommend any travel or trade restriction based on the current information available. WHO is working closely with global experts, governments and partners to rapidly expand scientific knowledge on this new virus, to track the spread and virulence of the virus, and to provide advice to countries and the global community on measures to protect health and prevent the spread of this outbreak.
Cooperation is key
The tourism sector is fully committed to putting people and their well-being first. International cooperation is vital for ensuring the sector can effectively contribute to the containment of COVID-19. UNWTO and WHO are working in close consultation and with other partners to assist States in ensuring that health measures be implemented in ways that minimize unnecessary interference with international traffic and trade.
Tourism’s response needs to be measured and consistent, proportionate to the public health threat and based on local risk assessment, involving every part of the tourism value chain – public bodies, private companies and tourists, in line with WHO’s overall guidance and recommendations.
UNWTO and WHO stand ready to work closely with all those communities and countries affected by the current health emergency, to build for a better and more resilient future. Travel restrictions going beyond these may cause unnecessary interference with international traffic, including negative repercussions on the tourism sector.
At this challenging time, UNWTO and WHO join the international community in standing in solidarity with affected countries.
Geneva: France’s Minister for Europe and Foreign Affairs, Mr Jean-Yves Le Drian, and Dr Tedros Adhanom Ghebreyesus, Director-General of WHO today met at the Permanent Mission of France to the United Nations in Geneva to discuss the WHO Academy, which will be the world’s largest and most innovative lifelong learning platform in global health.
The WHO Academy aims to reach millions of people worldwide, offering high-tech learning environments at a “hub” in Lyon with “spokes” in the six WHO regions. The Academy will provide learning opportunities for leaders, educators, researchers, health workers, WHO staff and the broader public, and will deliver high quality, multilingual learning, both online and in-person, alongside a cutting-edge simulation centre for health emergencies.
The discussion today follows a Declaration of Intent signed by Emmanuel Macron, President of the French Republic and Dr Tedros on 11 June 2019, and a pledge by France in the amount of US$ 100 million (€ 90 million) to WHO to support the creation of the WHO Academy, which will be established as an internal division within WHO.
“Technology and innovation in learning are creating exciting new opportunities to accelerate progress towards health for all in every country,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “The WHO Academy will support millions of learners to maximize health impacts with the best evidence, adult learning approaches and state-of-the-art technologies.”
By propelling and strengthening digital innovations and lifelong learning opportunities around the world, the WHO Academy will play an instrumental role towards achieving WHO’s triple billion goal by 2023 and the health Sustainable Development Goals: 1 billion more people will benefit from universal health coverage; 1 billion more will be better protected in health emergencies, and 1 billion more will enjoy improved health and wellbeing.
The funding from France represents a commitment to accelerate the development of the WHO Academy, and confirms the engagement of France -- a longstanding partner of WHO and a key actor in global health – and its strong support to the ambitions of 13th WHO General Programme of Work to ensure healthy lives and well-being for all ages.
In a new position paper, published in the Weekly Epidemiological Record today, WHO recommends vaccination against tick-borne encephalitis in people of all ages where the disease is highly endemic. Where the prevaccination incidence of the disease is moderate or low or is limited to particular geographical locations or certain outdoor activities, immunization should target individuals in the most severely affected groups. People travelling from non-endemic areas to endemic areas should be offered vaccination if their visits will include extensive outdoor activities.
Since the incidence of tick-borne encephalitis may vary considerably between and even within geographical regions, public immunization strategies should be based on risk assessments conducted at country, regional or district level, and should be appropriate to the local endemic situation.
Immunization offers the most effective protection against tick-borne encephalitis. Currently, there are four widely used vaccines of assured quality: FSME-Immun and Encepur, manufactured in Austria and Germany respectively, and TBE-Moscow and EnceVir, manufactured in the Russian Federation. The four vaccines are considered to be safe and efficacious.
Tick-borne encephalitis virus is an important cause of viral infections of the central nervous system in eastern, central and northern European countries, and in northern China, Mongolia, and the Russian Federation.
Approximately 10 000–12 000 clinical cases of tick-borne encephalitis are reported each year, but this figure is believed to be significantly lower than the actual total. Most infections with the virus result from tick bites acquired during outdoor activities in forested areas.