The International Narcotics Control Board (INCB), the World Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNODC) call on governments to ensure that the procurement and supply of controlled medicines in countries meet the needs of patients, both those who have COVID-19 and those who require internationally controlled medicines for other medical conditions.
There is a need to ensure access to controlled medicines such as sedatives and analgesics for intubation protocols for the treatment of patients with COVID-19. Non-COVID patients continue to require controlled medicines for the management of pain and palliative care, surgical care and anaesthesia, mental health and neurological conditions, and for the treatment of drug use disorders.
It is important to remember the needs of existing patients who require controlled medicines for the management of these health conditions. These patients faced barriers to accessing controlled medicines before the COVID-19 pandemic. The COVID-19 pandemic has further resulted in interruptions of the medicines supply chain, and it is critical that access to essential health services and medications not be forgotten or de-prioritised during this pandemic.Need for equitable access
As the pandemic increasingly affects countries with under-resourced health infrastructure and services, it is an ethical imperative to ensure that all people in all countries of the world are able to access essential medicines. This includes those medicines that are under international control.
Governments should ensure that sufficient quantities of internationally controlled medicines, of assured quality, are available and affordable to people under medical care. Throughout the duration of the pandemic and beyond the acute phase of burden on the healthcare infrastructure, it is critical that governments work cooperatively to ensure that no country, no region, no district, no city and no patient is left behind. Competent national authorities, manufacturers, suppliers and distributors play a crucial role in ensuring that internationally controlled medicines urgently needed for medical treatment are available within and across national borders. The supply chain is the foundation of quality medical care because without the necessary supplies, including essential controlled medicines, patients will suffer.Solutions to address barriers
Governments are reminded that in acute emergencies, it is possible under the International Drug Control Conventions to utilize simplified control procedures for the export, transportation and supply of medicinal products containing controlled substances, especially in those cases where the competent authorities in the importing countries may not be operating at full capacity. Competent national authorities may permit the export of medicines containing narcotic drugs and/or psychotropic substances to affected areas even in the absence of the corresponding import authorizations and/or estimates. Urgent deliveries do not need to be included in the estimates of the receiving countries affected by emergencies. When possible, competent national authorities are also encouraged to issue electronic import and export authorizations through the INCB International Import and Export Authorization System (I2ES), PEN Online and share related contingency measures in the forum therein.
Countries should ease COVID-19 related transport restrictions for controlled medicines and consider local production solutions when feasible, to meet the COVID-19 driven demand spikes.
To assist countries as they work to find solutions to the lack of access and availability of controlled medicines, the three organizations suggest the following technical assistance and support documents:
The work of doctors, nurses, and health care professionals in general, who provide treatment and care to people including the most vulnerable, needs to be supported and safe and effective medicines should be available, accessible and affordable at all times for people who need them.
INCB, WHO and UNODC are committed to continue to work together to address this critical issue and will expand joint efforts to engage with other partners and increase advocacy and technical assistance to countries for improving access to controlled medicines during the COVID-19 pandemic and mitigate barriers to ensure that both patients affected by COVID-19 or by other non-COVID-related conditions requiring medicines under international control have access to these medicines when they need them.
As more women around the world are encouraged to choose to give birth in health facilities, it is essential that their right to a positive childbirth experience remains at the heart of the care they receive.
Optimal Intrapartum Care, a special supplement edited by staff at the WHO Department of Sexual and Reproductive Health and Research including HRP, presents some of the challenges emerging from the global shift towards facility-based childbirth over the last two decades.
Strategies to improve the quality of care every woman receives during childbirth are central to many of the solutions.Quality of care is fundamental to WHO approach to maternity care
Every pregnancy and birth is unique, meaning that the best intrapartum care for each woman and her baby is individualized as well as evidence-based.
This principle of person-centred care is reflected across all WHO guidance on maternal health and enshrined in the 2016 framework for improving quality of maternal and newborn care in health facilities.
The WHO 2018 recommendations on intrapartum care, 2016 recommendations on antenatal care and upcoming recommendations on postnatal care are each grounded in respectful, person-centered maternity care.
Respectful intrapartum care maintains women’s dignity, privacy and confidentiality, ensuring freedom from harm and mistreatment, and enabling informed choice during labour and childbirth. This WHO model of intrapartum care provides a basis for empowering all women to access and to demand the type of care that they want and need.Inequalities and challenges to quality of care for all
Many of the challenges highlighted in the special supplement are related to poor quality of care. These can significantly and negatively affect women’s clinical and psychological experience of childbirth.
‘Optimal intrapartum care in the twenty-first century,’ the first paper in the series, recalls evidence from a recent WHO-led study in four countries showing that more than one-third of women experienced mistreatment during childbirth in health facilities. This included physical and verbal abuse, stigma and discrimination, failure to meet professional standards of care, poor rapport between women and providers, and health system conditions and constraints.
Poor quality of care may be a significant barrier to uptake of facility-based birth services, in particular in low and middle-income countries. For example, experience of mistreatment and poor quality care is likely to influence women’s decisions about where to give birth in subsequent pregnancies.
Geography can also determine the quality of care available to a woman in childbirth: the partograph, an important tool for monitoring maternal and foetal wellbeing during labour, was found to be more frequently and appropriately used in urban facilities than in rural areas. Other interventions during labour and childbirth, including companion of choice or pain relief, are not always offered to women in low resource settings and access is highly inequitable.
Access to good quality medicines, including drugs for pain relief or for prevention of complication during childbirth, such as uterotonics and antibiotics, is another key global issue highlighted for improvement.Progress in maternal health is not fast enough
The number of women choosing to give birth in health facilities has increased in past decades, driven by urgent global efforts to reduce maternal deaths.
Progress has been made towards maternal and newborn targets set out in the 2030 Agenda for Sustainable Development – but it is slow, with vast inequalities worldwide.
“Abiding by the human rights principles of right for life, health, confidentiality, privacy, provision of information, agreeing with the woman’s informed choice will help to deliver personalised respectful care and that must be the norm in any birth care setting,” explained Sir Sabaratnam Arulkumaran, Past President FIGO, RCOG and the BMA.The WHO vision for maternal and newborn health globally
WHO, with Member States and international partners, is working towards a global vision where every pregnant woman and newborn receives quality care throughout pregnancy, childbirth and the postnatal period, under the umbrella of Universal Health Coverage.
“Increasing facility births has contributed to reducing maternal deaths, but this must not come at the price of overmedicalization of childbirth and poorer quality of care for women,” said Dr Mercedes Bonet, Medical Officer at WHO/HRP.
“Simply surviving pregnancy and childbirth can never be the marker of successful maternity care. Addressing inequalities and promoting respectful maternity care for all women is critical to improve health equity and quality.”
To make this a reality, evidence-based approaches to maternal health must be adapted for different settings.
The ongoing evolution and implementation of quality of care across the maternal health continuum is equally important. This means going beyond clinical requirements for a safe labour and childbirth to meet the needs of all women and their babies.
On 14 August Korean Ambassador, Ms Ji-ah Paik and WHO Director-General Dr Tedros Adhanom Ghebreyesus signed a new Memorandum of Understanding (MoU) with WHO in support of the Organization’s COVID-19 response efforts in the African region. The new MoU follows a recent call between Dr Tedros and Mr Moon Jae-in, President of the Republic of Korea, during which WHO Director-General expressed the need for additional support to scale up the COVID-19 response in the African region. The MoU sets out an in-kind contribution of US$ 6 million in polymerase chain reaction (PCR) tests / extraction kits to be delivered to 24 countries in Africa in the coming months. PCR has proven to be a critically important laboratory tool, providing results that are reliable and consistent.
“WHO is deeply grateful for this support, which is helping to increase the testing capacity in Africa,” said Dr Tedros. “This tremendous show of support is also strengthening the relationship between WHO and the Republic of Korea. The Republic of Korea is an important partner in global health.”
The support of the Republic of Korea follows the successful management of COVID-19 in the country and is now providing support to other countries. The Republic of Korea has a strong background in fighting infectious diseases, including the MERS CoV outbreak in 2015 and the recent outbreak of COVID-19. Leveraging this experience and demonstrating leadership, it has recently launched the Global Support Group for Infectious Disease Response (G4IDR) in Geneva.
Global health security and emergency response operations have long been a priority for the Republic of Korea. Dr JW Lee, WHO Director-General from 2003 to 2006, understood the critical need for international cooperation during public health emergencies, for trust, transparency and information sharing among all stakeholders in the global community. The first emergency operations centre, the Strategic Health Operations Centre (SHOC), was established thanks to the vision of Dr Lee. Today the SHOC is the hub of the Emergency Public Health Operations Centres Network, with more than 140 member institutions in over 80 countries around the world.
The Republic of Korea continues to demonstrate its commitment to global health, global health security and humanitarian response by supporting WHO emergency response programmes and funding mechanisms such as the Global Outbreak Alert and Response Network, the Emergency Medical Teams Initiative, the Contingency Fund for Emergencies, as well as their own innovative financing mechanism, the Global Disease Eradication Fund.
“I thank the Republic of Korea, for leading a comprehensive approach to COVID-19 response and control,” said Dr Tedros. “We are very grateful for this in-kind contribution to support COVID-19 response efforts in the African region, and we look forward to our continued partnership together towards achieving better health for all people, everywhere.”
As schools worldwide struggle with reopening, the latest data from the WHO/UNICEF Joint Monitoring Programme (JMP) reveal that 43 per cent of schools around the world lacked access to basic handwashing with soap and water in 2019 – a key condition for schools to be able to operate safely in the midst of the COVID-19 pandemic.
“Global school closures since the onset of the COVID-19 pandemic have presented an unprecedented challenge to children’s education and wellbeing,” said Henrietta Fore, UNICEF Executive Director. “We must prioritize children’s learning. This means making sure that schools are safe to reopen – including with access to hand hygiene, clean drinking water and safe sanitation.”
According to the report, around 818 million children lack basic handwashing facilities at their schools, which puts them at increased risk of COVID-19 and other transmittable diseases. More than one third of these children (295 million) are from sub-Saharan Africa. In the least developed countries, 7 out of 10 schools lack basic handwashing facilities and half of schools lack basic sanitation and water services.
The report stresses that governments seeking to control the spread of COVID-19 must balance the need for implementation of public health measures versus the associated social and economic impacts of lockdown measures. Evidence of the negative impacts of prolonged school closures on children’s safety, wellbeing and learning are well-documented, the report says.
“Access to water, sanitation and hygiene services is essential for effective infection prevention and control in all settings, including schools," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "It must be a major focus of government strategies for the safe reopening and operation of schools during the ongoing COVID-19 global pandemic.”
Other key findings from the report include:
The report identifies several resources necessary for COVID-19 prevention and control in schools, including 10 immediate actions and safety checklists. It builds on guidelines on the safe reopening of schools issued by UNESCO, UNICEF, WFP and the World Bank with practical advice for national and local authorities on how to prepare for safe school reopening and keep children safe when they return to school. The guidelines include several WASH-related protocols on hygiene measures, use of personal protective equipment, cleaning and disinfection, as well as providing access to clean water, handwashing stations with soap, and safe toilets.
UNICEF and WHO are committed to achieving equitable access to adequate WASH services worldwide. The agencies recently launched a joint initiative, Hand Hygiene for All, to support the most vulnerable communities with the means to protect their health and environment. It brings together international partners, national governments, public and private sectors, and civil society to ensure affordable products and services are available, especially in disadvantaged areas.
For further information, please contact:
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.
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.
About the Joint Monitoring Programme
The WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply, Sanitation and Hygiene is responsible for monitoring global progress towards the Sustainable Development Goal (SDG) targets and indicators relating drinking water, sanitation and hygiene (WASH). The JMP produces national, regional and global estimates of progress on WASH in households, schools and health care facilities.
My message to the young and the young at heart:
Today as we commemorate International Youth Day, we would like to recognize the role young people play towards shaping a better future in health and beyond. The theme this year ‘Youth engagement for Global Action’ puts the spotlight on how
the proactive engagement, resilience and creativity of young people at local, national, and global levels can drive progress, especially in times of crisis. This has been true especially for efforts to end tuberculosis(TB) - the world’s
top infectious killer.
There has been significant progress over the past year since WHO launched its global youth movement to end TB titled the 1+1 Initiative, followed by the adoption of the Youth Declaration to End TB at the first-ever Global Youth Townhall on Ending TB. The 1+1 Initiative has expanded to include thousands of youth across the world in countries like Bangladesh, Nepal, India, Indonesia, Philippines, Kenya and Viet Nam. The social media platforms set up as part of the 1+1 youth initiative and social media posts are followed by over 20 000 people, with the number growing each day. More than 100 different youth-led activities and events on ending TB have been conducted worldwide. This includes peer education training in schools and universities, sensitizing young people, encouraging them to become TB advocates, and supporting TB patients in the community with resources and advice.
One inspiring example of youth action to end TB is in Nepal. Young people in the country have established national and provincial youth networks to empower young people to end TB, through capacity building and by ensuring their participation in policy making and community level awareness building. Likewise, in March 2020, Viet Nam's National TB programme launched the National Youth Movement against TB which aims to reach 10 million young people, and educate all primary school students with knowledge and good practices on combating TB and lung diseases. We urgently need more such inspiring youth initiatives to end TB.
If you are a youth and looking for an opportunity to contribute to the fight against TB, we are just one message away. We are always happy to guide you, provide you with appropriate learning opportunities and a global platform to demonstrate your innovative ideas and creativity.
Please share your ideas, stories and experiences with us and the rest of world using the hashtags #EndTB and #Youth2EndTB or join our Facebook group Youth2EndTB.
Together we can End TB and make our world a better place.
Dr Tereza Kasaeva
Director, WHO Global TB Programme
Country examples: Youth action to End TB
National Youth Movement to End TB Launched officially in Vietnam
On March 20, 2020, on the occasion of World TB Day, Vietnam National Lung Hospital held a congress of the Youth Society against TB and lung diseases - Vietnam Lung Association. The congress elected 11 young people to represent the youth of the country in the Executive Committee of the Association for the term 2020–2022. This was the official commencement of Vietnam's youth movement against tuberculosis which is the adoption of the Global Youth Movement against TB at a national level. The event was virtually attended by the Director of WHO's Global TB Programme, Dr Tereza Kasaeva, who encouraged the youth gathered to instill new vitality in efforts to end TB.
The youth movement in Vietnam aims to reach 10 million young people and educate all primary school students with knowledge and good practices on combating TB and lung diseases.
Every day, young people are enriching institutions and processes at the local, national, and global levels.
This year, the theme of International Youth Day is "Youth Engagement for Global Action." It highlights the importance and value of young people’s contributions and draws lessons on how their representation and engagement in formal institutional politics can be significantly enhanced.
The theme of the day raises three questions:
Meaningful youth engagement, as defined by the 2018 Global Consensus Statement, is an inclusive, intentional, mutually-respectful partnership between young people and adults. Power is shared and respective contributions are valued.
Young people’s ideas, perspectives, skills, and strengths are integrated into the design and delivery of programs, strategies, policies, funding mechanisms - and organizations that affect their lives and their communities, countries, and world.What are the benefits and challenges of meaningful youth engagement?
Meaningful youth engagement ensures that young people are equal and valuable partners – not only beneficiaries – in efforts to improve their health and wellbeing. It increases the likelihood that policies and programmes will be acceptable, appropriate, and responsive to their needs and preferences.
Although global rhetoric increasingly acknowledges the value of meaningful youth engagement, it often remains more of an aspiration than a reality. There is still considerable resistance to giving young people a place at the table.
When young people are given opportunities to contribute, it is most often older, urban, educated, and well-connected young people that are selected. Their engagement is often tokenistic and their responsibilities small, for instance leading energizer activities at conferences, taking notes during meetings, or formatting references in reports. Additionally, young people’s contributions are rarely measured effectively to demonstrate their value, and their contributions are often not appropriately acknowledged, either with authorship or compensation.
This must not be the case. Meaningful youth engagement is central to the success of policies and programmes aimed at improving young people’s health and wellbeing, and can provide young people with opportunities to develop skillsets they will need as the next generation of leaders.How does the WHO strive to practice meaningful youth engagement in its work?
The WHO Department of Sexual and Reproductive Health and Research and the Human Reproduction Programme (HRP) strive to apply the principles of meaningful youth engagement, as defined in the Global Consensus Statement, particularly with work on adolescent sexual and reproductive health and rights (ASRHR).
For example, it put meaningful youth engagement into practice with the WHO and UNFPA-led supplement of the Journal of Adolescent Health. This supplement takes stock of progress made in ASRHR in the 25 years since the International Conference on Population and Development and sets out priorities for the future.
The process of developing the supplement was:
Transparent and informative. Seven young people from Botswana, Fiji, India, Lithuania, Mexico, Pakistan, and Turkey were identified using a structured selection process, in collaboration with the Partnership for Maternal, Newborn, and Child (PMNCH). Their selection was based on profiles with specific criteria, the same as for representatives from international organizations, governments, academia, civil society, and funding agencies.
Rights-based. The young people engaged actively and as equal partners with the other contributors throughout the process. They played a key role in ensuring that young people’s rights were front and center in the content of the supplement.
Voluntary and free from coercion. The young people were issued formal contracts, assuring co-authorship and compensation for their time and effort. These contracts were developed with and approved by the young people, themselves.
Safe. The contracts spelled out clear expectations regarding their roles and responsibilities, which were fully in line with their abilities. Additionally, throughout the process, they had a focal person they could turn to for support.
Respectful of young people’s views, backgrounds, and identities. The young people began by sharing their individual ideas and perspectives, and then worked collaboratively with each other and with the broader group of co-authors to pull together key themes and messages and develop the papers. Next, they worked with an artist to develop an illustrated video to bring the supplement to life, highlighting what they felt to be the most important messages of the supplement.
The International Federation of Medical Students Associations (IFMSA) and the International Youth Alliance for Family Planning (IYAFP), two of the organizations represented by the young people, are contributing to upcoming regional webinars to disseminate the supplement and draw out its particular relevance for each WHO region.
Member States have adopted the global strategy for TB research and innovation through an unprecedented written silence procedure of the 73rd session of the World Health Assembly (WHA) last week. The global strategy was developed to support efforts by governments and other partners to accelerate TB research and innovation, and to improve equitable access to the benefits of research in line with the commitments made in the WHO End TB Strategy, the Moscow Declaration to End TB and the political declaration of the United Nations high-level meeting on TB. The development of the strategy was requested by Member States during the 71st WHA with a view “to make further progress in enhancing cooperation and coordination in respect of tuberculosis research and development”.
Four major areas for action are highlighted in the strategy: creating an enabling environment for TB research and innovation; increasing financial investments in TB research and innovation; promoting and improving approaches to data sharing; and promoting equitable access to the benefits of research and innovation. In the spirit of fast-tracking efforts to end TB, a prerequisite for success is that all stakeholders make concerted efforts and collaborate. Hence, the strategy also makes the case for a unified and aligned response in which key national and international partners and affected communities support Member States by undertaking the investments and partnerships that are necessary for accelerating innovation. The primary audiences for the document are Member States, particularly ministries of health, science and technology, finance and education.
“Research and innovation are vital if we are to break the stronghold of TB - the world’s top infectious killer -that continues to claim millions of lives each year. This global strategy will guide Member States and other relevant stakeholders in translating political commitments on TB research and innovation into concrete action backed by investment, as an integral part of efforts to end TB” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme “We welcome this renewed commitment by Member States at a time where the COVID-19 pandemic has exposed many gaps in TB service provision that need to be addressed through innovation”.
Under the leadership of WHO, the strategy was developed during the past two years through a consultative process with Member States including managers of national tuberculosis programmes (NTPs) and other officials from within and beyond ministries of health such as ministries of science and technology; the WHO Strategic and Technical Advisory Group for Tuberculosis (STAG-TB); the WHO Global TB Research Task Force; representatives of civil society and affected communities; research funding institutions; and other stakeholders in TB research and innovation. The strategy has also benefited from an open web consultation, where extensive comments were received on a zero draft of the strategy.
The Assembly also passed a resolution requesting WHO to provide a report on the implementation of the strategy to WHA, biennially until 2030. The resolution also called for the support of the scientific community, international partners and other relevant stakeholders to undertake research and innovation aligned to the needs of the countries most affected by TB; to strengthen public-private partnerships; and to facilitate knowledge sharing. Furthermore, it requested WHO to provide technical and strategic assistance to Member States in the implementation of the strategy.
“This resolution reflects Member States’ recognition of research and innovation as a key priority for ending TB, and their commitment to take concerted action to address unmet needs. It will help pave the way for the successful implementation of the strategy,” said Dr Matteo Zignol, a.i. Unit Head, Prevention, Care and Innovations at WHO’s Global TB Programme.
The United Nations High-level Political Forum (HLPF), a mechanism that tracks and advances the implementation of the 2030 Agenda for Sustainable Development, was convened virtually due to the COVID-19 pandemic, on 7–16 July 2020, on the theme "Accelerated action and transformative pathways: realizing the decade of action and delivery for sustainable development ". Given the considerable impact of the pandemic on human health and the global economy, the Forum strongly focused on the potential impact of the pandemic on the implementation of the SDGs and the 2030 Agenda, and how the international community can respond and get back on track to achieving the sustainable development agenda.
WHO actively participated in the Forum, by contributing to the background materials and agenda for four of the six official thematic sessions (Advancing human well-being; Ending hunger and achieving food security for all; Protecting the planet and building resilience; Sharing economic benefits) as well as in the virtual special events, side events and the Voluntary National Reviews (VNRs). The 47 countries that presented VNRs, echoed the need to undertake substantial measures to contain the spread of COVID-19 and to ensure the proper functioning, preparedness and strengthening of health systems.
The eight WHO co-sponsored side events, focused on UHC and investing in health; tobacco control, COVID-19 and children; global strategy to leave no one behind during the COVID-19 pandemic; COVID-19 vaccines, Nutrition, as well as education in time of COVID-19, among others.
WHO’s main side event, co-hosted by Dr. Nata Menabde of the WHO office at the UN, focused on Investing in Health: the Key to Building Back Better from COVID-19 and Accelerating Progress for UHC and Sustainable Development, was organized in collaboration with the Group of Friends of UHC and Global Health and UHC2030. It addressed the extent to which COVID-19 has endangered global health and human security, threatening the progress made on the SDGs, as well as best practices and lessons learned to help accelerate response and recovery. Dr. Tedrosaddressed the meeting in a video message, urging leaders to fulfil the commitments made in the UHC Political Declaration to build back better, accelerate action to achieve the SDGs, and leave no one behind.
WHO was also represented by Mr. Stewart Simonson, Head of the WHO Office at the UN, at a side event on “Education and the Trying Times of COVID-19”, organized by theMission of the State of Qatar to the UN. He highlighted the vulnerability of children and young people due to the health and socioeconomic impacts resulting from the pandemic and stressed the need for national health system reform to be led by a strong multi-sectoral and whole-of-government approach.
The WHO VNR lab event cosponsored by the Financing for Sustainable Development Office of UNDESA and UHC2030, featuring Dr. Agnes Soucat, Director of Health Systems Governance and Financing at WHO, raised awareness of the health financing gaps as well as showcased solutions to financing health systems and build on lessons learned from COVID-19.
WHO also participated in thevirtualSDG Media Zone focusing on sustainability, solidarity and solutions, as the pillars for recovering back better. Dr Bruce Aylward, Epidemiologist and Senior Advisor to the WHO Director-General, highlighted the importance of vaccines in the global response efforts to COVID-19 and the crucial need for equitable access to them, once they become available.
Prior to officially concluding the Forum, the ECOSOC President, unveiled new UN stamps which pay tribute to frontline workers in the pandemic. Proceeds from an added surcharge will go directly to the COVID-19 Solidarity Response Fund to support the WHO and partners.
A plane carrying 20 tonnes of WHO health supplies has landed in Beirut, Lebanon, to support the treatment of patients injured by the massive blast that occurred in the city on 4 August. The supplies will cover 1000 trauma interventions and 1000 surgical interventions for people suffering from injuries and burns resulting from the blast.
The shipment was airlifted from WHO’s logistics hub in Dubai earlier this afternoon using a plane donated by the Government of the United Arab Emirates, a key WHO partner in health emergency response.
“Our hearts and prayers are with all those affected by this tragic event as we continue our mission to serve all people in Lebanon with life-saving and essential health care services. We are working closely with national health authorities, health partners and hospitals treating the wounded to identify additional needs and ensure immediate support,” said WHO Representative in Lebanon Dr Iman Shankiti.
As a result of the blast, 3 hospitals in Beirut are now non-functional and 2 hospitals are partially damaged, leaving a critical gap in hospital bed capacity. Injured patients are being transferred to hospitals across the country, as far as south Saida and north Tripoli, and many facilities are overwhelmed. WHO will distribute the supplies to priority hospitals across Lebanon receiving and treating injured patients.
This latest emergency comes in the context of recent civil unrest, a major economic crisis, COVID-19 outbreak and heavy refugee burden. The legendary resilience of the Lebanese people has rarely been so severely tested. Ensuring that there is continuity of the response to COVID-19 – including targeting the most vulnerable for assistance – is a priority for both the Ministry of Public Health and WHO.
“With the emergence of new challenges due to the latest devastating event, the United Nations in Lebanon and partners have been mobilized to provide immediate humanitarian assistance to the Lebanese people in support of the Government’s response to this tragedy. We are in this together, and we are committed to supporting Lebanon in this very difficult time,” said Dr Najat Rochdi, UN Resident Coordinator in Lebanon.
The Member States of the World Health Organization (WHO) have adopted a number of decisions to advance global public health that had been proposed to the 73rd World Health Assembly in May 2020, via a "Written Silence Procedure".
The proposals relate to: strengthening global immunization efforts; cervical cancer prevention and control; a global strategy for tuberculosis research and innovation; eye care - including preventing vision impairment and blindness; strengthening efforts on food safety, a global strategy and plan of action on public health, innovation and intellectual property; a decade of healthy ageing; and influenza preparedness.
Strengthening global immunization efforts to leave no one behind
The Immunization Agenda 2030 strategic proposal envisions a world where everyone, everywhere, at every age, fully benefits from vaccines to improve health and well-being. The key goal is to extend the benefits of vaccines to everyone, everywhere. The strategy is people-centric, led by countries, implemented through broad partnerships and driven by data. It systematically applies these 4 core principles across a set of key priorities, highlighting that immunization is an investment for the future, creating a healthier, safer and more prosperous world for all.
Vaccines are available to prevent more than 20 life-threatening diseases, helping people of all ages live longer, healthier lives. Immunization currently prevents well over 3 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles; yet far too many people around the world – including nearly 20 million infants each year – have insufficient access to vaccines.
Cervical cancer prevention and control
The WHO global strategy to accelerate the elimination of cervical cancer as a public health problem establishes goals and targets for 2020 to 2030. It focuses on 3 key pillars: prevention through HPV vaccination; screening and treatment of pre-cancerous lesions; and management of invasive cervical cancer, including access to palliative care. All pillars must be pursued collectively to reach elimination.
To eliminate cervical cancer, all countries must reach (and maintain) an incidence below 4 per 100 000 women-years. To get on the path to elimination, the strategy urges all countries to achieve the following targets by 2030: 90% of girls fully vaccinated (by 15 years of age); 70% coverage of screening with a high-performance test (once by the age of 35 and again by 45 years); and 90% of women who are identified with cervical disease receive treatment (90% of women with pre-cancer treated; 90% of women with invasive cancer managed). Achieving the 90-70-90 targets will yield impact on 2 fronts: we will see reductions in incidence and in mortality. By 2030, the median cervical cancer incidence rate would fall by 10%, setting the world on the path to avert 70 million cases in the century.
Cervical cancer currently kills more than 300 000 women each year. The fourth most common cancer among women globally, its burden is greatest in low- and middle-income countries, where access to public health services is limited.
Tuberculosis research and innovation
The global strategy for TB research and innovation was developed to support efforts by governments and other partners to accelerate progress and to improve equitable access to the benefits of research in line with the commitments made in the WHO End TB Strategy, the Moscow Declaration to End TB and the political declaration of the United Nations high-level meeting on TB.
It highlights 4 major areas for action are highlighted in the strategy: creating an enabling environment for TB research and innovation; increasing financial investments in TB research and innovation; promoting and improving approaches to data sharing; and promoting equitable access to the benefits of research and innovation. The strategy also makes the case for a unified and aligned response in which key partners and affected communities support Member States by undertaking the investments and partnerships that are necessary for accelerating innovation.
The resolution requests WHO to report biennially, until 2030, on the implementation of the strategy. The resolution calls for the support of the scientific community, international partners and other relevant stakeholders to undertake research and innovation aligned with the needs of the countries most affected by TB; to strengthen public-private partnerships; and to facilitate knowledge sharing. Furthermore, it calls on WHO to provide technical and strategic assistance to Member States in the implementation of the strategy.
Integrated people centred eye care
A new World Health Assembly resolution focuses on the need to integrate people-centred eye care services into health systems. The first ever WHO report on vision (published in 2019) predicts a substantial increase in the number of people with eye conditions and vision impairment in the coming years. The resolution highlights 4 key strategies for Member States to improve access to services and reduce inequities. The first is to better engage people and communities by raising awareness of the importance of early identification of eye conditions and simplifying access to care for underserved populations. The second is to strengthen eye care in primary health care so people can access services closer to their homes. The third is to improve coordination of eyecare services with other health services and with other sectors such as education and labour. The final recommendation is to integrate eye care into national health strategic plans and universal health coverage schemes. Member States recalled that preventing and addressing vision impairment not only improves quality of life for patients, it also enables them to remain economically productive.
Strengthening efforts on Food Safety
A new resolution urges Member States to apply a “One Health” approach that promotes the sustainability and availability of safe, sufficient and nutritious food for all populations. Recognizing food safety threats, including foodborne antimicrobial resistance and climate change, the resolution also calls upon Member States to invest in national food safety systems and innovations, and to share timely data and evidence on foodborne disease outbreaks and hazards to the International Network of Food Safety Authorities (INFOSAN).
The Secretariat is requested to update the Global strategy for food safety to address current and emerging challenges and incorporate new technologies and innovative strategies for strengthening food safety systems. It also calls on the WHO Director-General to strengthen the Organization’s leadership in the Codex Alimentarius Commission and INFOSAN, and produce updated foodborne disease estimates by 2025.
Around the world, an estimated 600 million - almost 1 in 10 people – fall ill after eating contaminated food each year, resulting in 420 000 deaths and the loss of 33 million healthy life years (DALYs). The burden of disease falls disproportionately on the most vulnerable, especially children and those living in developing countries.
Global strategy and plan of action on public health, innovation and intellectual property
The Global strategy and plan of action on public health, innovation and intellectual property urges Member States to reinforce implementation in line with the recommendations of an overall programme review panel. The decision also calls on Member States to further discuss, in informal consultations to be convened by the Director-General, the recommendations of the review panel on promoting and monitoring transparency of medicines prices and actions to prevent shortages. The decision emphasizes the necessity to allocate resources for WHO Secretariat implementation and further requests the Director-General to submit a report on progress made in implementing the decision to the Seventy-fourth World Health Assembly in 2021, through the Executive Board.
Decade of Healthy Ageing
Member States endorsed a proposal for a Decade of Healthy Ageing 2020–2030 and asked the Director-General to report back on progress on its implementation every 3 years during the Decade. The Health Assembly also asked the Director-General to transmit this decision to the Secretary-General of the United Nations for consideration of the proposal for the Decade by the United Nations General Assembly.
Populations around the world are ageing at a faster pace than in the past and this demographic transition will have an impact on almost all aspects of society. Already, there are more than 1 billion people aged 60 years or older, with most living in low- and middle-income countries. Many do not have access to even the basic resources necessary for a life of meaning and dignity. Many others confront multiple barriers that prevent their full participation in society.
The Decade of Healthy Ageing is an opportunity to bring together governments, civil society, international agencies, academia, the media, and the private sector for ten years of concerted, catalytic and collaborative action to improve the lives of older people, their families, and the communities in which they live.
Member States requested the Secretariat to continue its support for WHO’s Global Influenza Strategy 2019–2030. They also requested the promotion of synergies, where relevant and appropriate, with the International Health Regulations (2005), implementation of national plans for influenza preparedness and response, and immunization programmes. The Secretariat is requested to report back on progress through the Executive Board to the 75th World Health Assembly.
Date: 7 August 2020
Subject: Substandard/Falsified medical devices and personal protective equipment (PPE) used in the context of the COVID-19 pandemic
WHO-identifier: 2020/3, version 1
Type of action: Advice to users of medical devices and PPE used for prevention, treatment and care for COVID-19.
Attention: Users of medical devices and PPE, procurement entities and customs officials, national programme managers and their implementing partners, laboratories, ministry of health and national regulatory authorities for medical devices and PPE.
Purpose: To advise on actions to be taken to identify and prevent circulation of substandard/falsified medical devices and PPE for COVID-19.
Description of the problem:
WHO continues to be made aware of circulation of substandard/falsified medical devices and PPE for prevention of COVID-19 and in the treatment and case management of people with COVID-19.
WHO uses the following definitions:
Any adverse event or product problem for a medical device may reveal that a product is substandard or falsified.
Advice on action to be taken by buyers/donors of medical devices and PPE for COVID-19:
Advice on action to be taken by users of medical devices and PPE for COVID-19:
Adverse events may be:
Product problems may be:
Advice for action to be taken by national regulators of medical devices and PPE for COVID-19:
Note: For many jurisdictions, emergency use/approval mechanisms have been put in place for certain medical devices. These products should be the subject of increased monitoring by device users for adverse events and product problems.
Some PPE elements are classified as medical devices in some jurisdictions.
As a science-based institution, WHO is always striving to be at the forefront of scientific progress and its potential to improve health for all. A new WHO Science Council comprising international experts from a broad range of disciplines will support WHO in interpreting cutting-edge scientific and medical knowledge, as well as the latest advances in technology.
The Science Division’s Research for Health department will facilitate the Council’s work in advising on WHO’s top science, research, and innovation priorities, focusing on areas of greatest urgency and identifying the biggest gaps in evidence. The Council’s recommendations will be given to the Director-General as part of an expansion of the scope of the science underpinning WHO’s public health work.
New global health challenges are increasingly accompanied by rapid advances in science and technology, including solutions that arise in nonmedical fields and which employ innovative techniques. In accordance with WHO’s directing and coordinating role in health, the Organization is seeking advice from the Science Council on state-of-the-art evidence-based responses to health challenges.
The terms of reference for the Science Council, along with information on the call for nominations, are here.
The Emergency Committee on COVID-19, convened by the WHO Director-General under the International Health Regulations (2005) (IHR), held its fourth meeting on 31 July. In its statement following the meeting, published today, it expressed “appreciation for WHO and partners’ COVID-19 pandemic response efforts, and highlighted the anticipated lengthy duration of this COVID-19 pandemic, noting the importance of sustained community, national, regional, and global response efforts.”
After a full discussion and review of the evidence, the Committee unanimously agreed that the outbreak still constitutes a public health emergency of international concern (PHEIC) and offered this advice to Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
Dr Tedros accepted the advice of the Committee and confirmed that the outbreak of COVID-19 continues to constitute a PHEIC. The Director-General declared a PHEIC—WHO’s highest level of alarm under IHR—on 30 January at a time when there were fewer than 100 cases and no deaths outside China. He issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR.
“The pandemic is a once-in-a-century health crisis, the effects of which will be felt for decades to come," Dr Tedros told the Committee in his opening remarks on Friday. "Many countries that believed they were past the worst are now grappling with new outbreaks. Some that were less affected in the earliest weeks are now seeing escalating numbers of cases and deaths. And some that had large outbreaks have brought them under control."
The Committee made a range of recommendations to both WHO and State Parties. It advised WHO to continue to mobilize global and regional multilateral organizations and partners for COVID-19 preparedness and response, to support Member States in maintaining health services, while accelerating the research and eventual access to diagnostics, therapeutics, and vaccines.
It advised countries to support these research efforts, including through funding, and to join in efforts to allow equitable allocation of diagnostics, therapeutics and vaccines by engaging in the Access to COVID-19 Tools (ACT) Accelerator among other initiatives.
The committee also advised countries to strengthen public health surveillance for case identification and contact tracing, including in low-resource, vulnerable, or high-risk settings and to maintain essential health services with sufficient funding, supplies, and human resources.
Countries were advised to implement proportionate measures and advice on travel, based on risk assessments, and to review these measures regularly.
The Committee’s statement, with further details of the meeting and their recommendations, is available here
A list of the Committee members is available here
The Emergency Committee will be reconvened again within three months or earlier, at the discretion of the Director-General.
The fourth meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the coronavirus disease (COVID-19) took place on Friday, 31 July 2020 from 12:00 to 17:45 Geneva time (CEST).Proceedings of the meeting
Members and advisors of the Emergency Committee were convened by videoconference.
The Director-General welcomed the Committee, highlighted the advances in global understanding of the SARS-CoV-2 virus since the declaration of the public health emergency of international concern (PHEIC) on 30 January 2020, and outlined key areas where
further attention by the Emergency Committees is needed.
Representatives of the legal department and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities. The Ethics Officer from CRE provided the members and advisers with an overview of the
WHO Declaration of Interest process. The members and advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may
give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the committee. Each member who was present was surveyed and no conflicts
of interest were identified.
The Secretariat turned the meeting over to the Chair, Professor Didier Houssin. Professor Houssin also welcomed the Committee and reviewed the objectives and agenda of the meeting.
The WHO Regional Emergency Directors and the Executive Director of the WHO Health Emergencies Programme (WHE) provided regional and the global situation overview. WHO continues to assess the global risk level of COVID-19 to be very high. Dr David Heymann, chair of the WHE Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH), presented on national best practices and global COVID-19 experiences. Dr Johanna Jordaan presented an overview of the International Civil Aviation Organization (ICAO) Council Aviation Recovery Taskforce (CART)’s report and public health focused recommendations.
The Committee expressed appreciation for WHO and partners’ COVID-19 pandemic response efforts. The Committee noted progress made on the Temporary Recommendations issued on 1 May 2020 and examined additional areas that require further attention.
The Committee highlighted the anticipated lengthy duration of this COVID-19 pandemic, noting the importance of sustained community, national, regional, and global response efforts.
The Committee encouraged all individuals, in particular young people, and communities to continue to play an active role in preventing and controlling transmission of COVID-19. The Committee recognized that State Parties should enable and support communities and individuals and thus build trust in governments’ response measures.
After ensuing discussion, the Committee unanimously agreed that the pandemic still constitutes a public health emergency of international concern and offered advice to the Director-General.
The Director-General declared that the outbreak of COVID-19 continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR (2005).
The Emergency Committee will be reconvened within three months, at the discretion of the Director-General. The Director-General thanked the Committee for its work.