Substantial investment needed to avert mental health crisis

4 months 1 week ago

The COVID-19 pandemic is highlighting the need to urgently increase investment in services for mental health or risk a massive increase in mental health conditions in the coming months, according to a policy brief on COVID-19 and mental health issued by the United Nations today. 

“The impact of the pandemic on people’s mental health is already extremely concerning,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Social isolation, fear of contagion, and loss of family members is compounded by the distress caused by loss of income and often employment.”

Depression and anxiety are increasing

Reports already indicate an increase in symptoms of depression and anxiety in a number of countries. A study in Ethiopia, in April 2020, reported a 3-fold increase in the prevalence of symptoms of depression compared to estimates from Ethiopia before the epidemic. 

Specific population groups are at particular risk of COVID-related psychological distress. Frontline health-care workers, faced with heavy workloads, life-or-death decisions, and risk of infection, are particularly affected. During the pandemic, in China, health-care workers have reported high rates of depression (50%), anxiety (45%), and insomnia (34%) and in Canada, 47% of health-care workers have reported a need for psychological support. 

Children and adolescents are also at risk. Parents in Italy and Spain have reported that their children have had difficulties concentrating, as well as irritability, restlessness and nervousness. Stay-at-home measures have come with a heightened risk of children witnessing or suffering violence and abuse. Children with disabilities, children in crowded settings and those who live and work on the streets are particularly vulnerable. 

Other groups that are at particular risk are women, particularly those who are juggling home-schooling, working from home and household tasks, older persons and people with pre-existing mental health conditions. A study carried out with young people with a history of mental health needs living in the UK reports that 32% of them agreed that the pandemic had made their mental health much worse.

An increase in alcohol consumption is another area of concern for mental health experts. Statistics from Canada report that 20% of 15-49 year-olds have increased their alcohol consumption during the pandemic.

Mental health services interrupted

The increase in people in need of mental health or psychosocial support has been compounded by the interruption to physical and mental health services in many countries. In addition to the conversion of mental health facilities into care facilities for people with COVID-19, care systems have been affected by mental health staff being infected with the virus and the closing of face-to-face services. Community services, such as self-help groups for alcohol and drug dependence, have, in many countries, been unable to meet for several months. 

“It is now crystal clear that mental health needs must be treated as a core element of our response to and recovery from the COVID-19 pandemic,” said Dr Tedros Adhanom Ghebreyesus. “This is a collective responsibility of governments and civil society, with the support of the whole United Nations System. A failure to take people’s emotional well-being seriously will lead to long-term social and economic costs to society.”

Finding ways to provide services

In concrete terms, it is critical that people living with mental health conditions have continued access to treatment. Changes in approaches to provision of mental health care and  psychosocial support are showing signs of success in some countries. In Madrid, when more than 60% of mental health beds were converted to care for people with COVID-19, where possible, people with severe conditions were moved to private clinics to ensure continuity of care. Local policy-makers identified emergency psychiatry as an essential service to enable mental health-care workers to continue outpatient services over the phone. Home visits were organized for the most serious cases. Teams from Egypt, Kenya, Nepal, Malaysia and New Zealand, among others, have reported creating increased capacity of emergency telephone lines for mental health to reach people in need. 

Support for community actions that strengthen social cohesion and reduce loneliness, particularly for the most vulnerable, such as older people, must continue. Such support is required from government, local authorities, the private sector and members of the general public, with initiatives such as provision of food parcels, regular phone check-ins with people living alone, and organization of online activities for intellectual and cognitive stimulation. 

An opportunity to build back better

The scaling-up and reorganization of mental health services that is now needed on a global scale is an opportunity to build a mental health system that is fit for the future,” said Dévora Kestel, Director of the Department of Mental Health and Substance Use at WHO. “This means developing and funding national plans that shift care away from institutions to community services, ensuring coverage for mental health conditions in health insurance packages and building the human resource capacity to deliver quality mental health and social care in the community.” 

 

Global partners issue Call to Action to overcome barriers to scale up TB preventive treatment

4 months 1 week ago

Global partners in the fight to end tuberculosis (TB) including the World Health Organization (WHO), UNICEF, UNITAID, US Agency for International Development (USAID), the Global Fund to Fight AIDS, Tuberculosis and Malaria, Stop TB Partnership, The Union, KNCV, European Respiratory Society and IAS, came together today to release a joint Call to Action to scale up access to TB preventive treatment. This follows the release of new WHO guidelines in March to help countries accelerate efforts to stop people with TB infection becoming sick with TB by giving them preventive treatment. A quarter of the world‘s population is estimated to have TB infection, and are at greater risk of developing TB disease, especially those with weakened immunity.

“This Call to Action comes at a vital time, as countries are putting in place measures to ensure continuity of prevention and care for those affected by TB and other diseases, in tandem with efforts to contain the COVID-19 pandemic,” said Dr Tereza Kasaeva, Director of the WHO Global TB Programme. “Ensuring access to TB preventive treatment will not only protect those infected from becoming ill with TB disease but also cut down on the risk of transmission in the community, saving lives. We need to unite forces to support countries in effectively rolling out TB preventive treatment”.

Although some progress has been made towards scaling up access to TB preventive treatment and reaching the targets set at the UN high-level meeting on TB in 2018, a massive acceleration of efforts is required. To date only a fraction of the UN high-level meeting target of reaching at least 30 million people with TB preventive treatment including 24 million contacts of people with active TB and 6 million people living with HIV has been reached, with countries putting less than 430 000 household contacts and 1.8 million people living with HIV on TB preventive treatment in 2018.

This call to action emphasizes that countries, partners, donors and communities should work together to overcome the main barriers standing in the way of global scale-up in TB preventive treatment by:

  • ensuring that all TB programmes aiming to end or eliminate TB include TB preventive treatment as an integral part of a comprehensive strategy
  • advocating strongly and communicating widely for TB preventive treatment scale-up
  • strengthening contact investigation in the community and in households of people with active TB especially in the current context of the COVID-19 pandemic
  • initiating contacts of all ages on TB preventive treatment after TB disease is ruled out
  • expanding TB preventive treatment in HIV services and in facilities caring for other people eligible for it
  • developing capacity to test for TB infection and to exclude TB disease
  • providing better tolerated and shorter TB preventive treatment options on a large scale
  • ensuring adherence and completion of the full course of TB preventive treatment
  • collecting data on contact investigation, and the initiation and completion of TB preventive treatment to monitor programme performance
The current COVID-19 crisis will further impact efforts to scale up TB prevention and care worldwide, including the roll-out of TB preventive treatment. Nonetheless, TB programmes should continue to scale up TB services and seek synergies when measures to combat COVID-19 are implemented. People who are confined at home due to COVID-19 may be more exposed to TB in their household, making it more important for contact investigation to target both conditions and to expand massively the coverage of TB preventive treatment among contacts.

The Call is primarily addressed to programme managers and technical agencies helping them to revise their strategies and prepare funding proposals. This call stresses the specific need to strengthen contact investigation, a key activity that is underdeveloped in many countries and where a huge unmet need exists for TB preventive action. This does not diminish the importance of ensuring good coverage among people living with HIV and others who could benefit from TB preventive treatment. 

 

Joining forces to end TB and COVID-19

4 months 1 week ago
Message from Dr Tereza Kasaeva,
Director, WHO Global TB ProgrammeHeader

WHO / Elena Longarini

Dear colleagues, partners and friends,

The current COVID-19 crisis has been a test for countries, health systems, key stakeholders, and those delivering health services at the front line. In the presence of new health threats like COVID-19, it has become even more critical to protect those most vulnerable and ensure continuity of care for those grappling with ongoing epidemics like tuberculosis (TB). This is a time for resilience, rapid learning and urgent action to save lives. At the forefront of these efforts are the health heroes: nurses, doctors and other health workers. Today on International Nurses Day I would like to salute their tireless dedication to alleviate suffering and save lives, at the risk of their own.

As we look forward to the easing of lockdown measures across many countries over this week and the coming weeks, we need to take the opportunity to build on lessons learned and put in place measures to mitigate future crises and disruption of health services for those in need.

Since January 2020, when Dr Tedros Adhanom Ghebreyesus, WHO Director-General declared the novel coronavirus outbreak (2019-nCoV) a Public Health Emergency of International Concern, the WHO Global TB Programme with Regional and Country Offices, in close collaboration with partners and civil society has been monitoring the impact of the COVID-19 pandemic and providing guidance and technical support to countries. We are also collating data and experiences of COVID-19 patients with concurrent or previous history of TB to document the natural history of disease and outcomes in these patients. Here are a few highlights:

  • January onwards (still ongoing): Regular coordination with WHO Regional and Country Offices, partners and civil society to monitor impact of COVID-19 on TB services. Technical assistance, guidance and support is being provided to countries on service delivery, infection control, and drug and diagnostics supply management.

  • March: On 20 March, WHO issued an information note on considerations for TB services during the COVID-19 crisis. The note was developed with inputs from WHO regional and country offices, key partners and civil society including, USAID, Stop TB Partnership, Global Fund and the WHO Civil Society Taskforce on TB. On 24 March, WHO organized an Online Talk Show on World TB Day, with a keynote speech delivered by Dr Tedros Adhanom Ghebreyesus, WHO Director-General. Dr Tedros highlighted the importance to continue efforts to tackle longstanding health problems, including TB during global outbreaks such as COVID-19. He said, “COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be. The world committed to end TB by 2030; improving prevention is key to making this happen. Millions of people need to be able to take TB preventive treatment to stop the onset of disease, avert suffering and save lives". Following the Talk Show a joint virtual townhall was organized with Stop TB Partnership on TB and COVID.

  • April: Scientific Brief on BCG vaccination and COVID-19 was released on 12 April. Two webinars were organized at the end of April jointly by WHO and the Stop TB Partnership on TB and COVID.

  • May: WHO modelling and analysis on impact of COVID-19 on TB mortality was published on 4 May. Modelling is being used to inform planning and budgeting for TB prevention and care and to provide a basis for funding requirements. An analysis was also undertaken across 6 WHO Regions on the impact of COVID-19 on the implementation of National TB Programmes.

In parallel with these efforts to tackle TB and COVID-19, continue our core functions for the global TB response. This includes the development and roll out of new guidelines, in March we released new guidelines on TB preventive treatment. Countries continue to be supported to, build their capacity, implement new guidelines, ensure continuity of care and strengthen accountability. We are also working on the finalization of the Global TB Strategy for TB Research and Innovation and the UN Secretary General 2020 Progress Report on TB.

The coming months will be critical for all of us, especially for those affected by both TB and COVID-19. We need to focus on the following key actions:

  • Ensure effective infection prevention and control measures, to protect the health and safety of health workers, staff, and patients. Personal protective equipment should be provided for all health staff involved in care delivery for both TB and COVID-19.

  • Stand against stigma and discrimination and promote the human rights of the most vulnerable. Stigma and fear around communicable diseases like TB and COVID-19 hamper the public health response. Governments, citizens, media and communities have an important role to play in preventing and stopping stigma.

  • Scale up simultaneous testing for TB and COVID-19, taking into consideration similarity of symptoms (cough, fever and difficulty breathing), and based on exposure or presence of risk factors. As countries prepare to share existing molecular platforms for COVID-19 testing, it will be essential to maintain current molecular diagnostic services for TB patients.

  • Promote access to people-centered prevention and care services. Home-based and community-based prevention and care should be strongly preferred over hospital treatment for TB patients (unless serious conditions require hospitalization) to reduce opportunities for transmission. This includes WHO recommended, all-oral TB treatments for multidrug-resistant TB and extensively drug-resistant TB. Digital adherence technologies can help bridge the gap in communication. TB preventive treatment should be ensured for household contacts, especially given increased risk of exposure.

  • Build and strengthen community, youth and civil society engagement to close gaps in care. Community health workers, youth volunteers and civil society can be engaged in reaching those at risk or those affected by TB and/or COVID-19 with care. We need to harness the potential of these groups while ensuring effective infection control and protective measures for them. Please do read the touching story from China below about Xu Xinghua- a TB survivor who is now working as a volunteer and peer consultant for TB patients through an online peer-to-peer support group in China. With the outbreak of COVID-19 in the beginning of 2020, Xu has had to go beyond the line of duty to ensure that people with TB get uninterrupted treatment.

Dear colleagues, partners and friends; the COVID-19 pandemic has highlighted the need for more preparedness and solidarity to ensure access to health care in times of crisis. We must learn from this experience and emerge victorious. The commitments made, and targets set by Heads of State and other leaders to accelerate action to end TB must be kept even in crisis, backed by adequate investments. We need to do this to protect the lives of millions of people struggling with TB each day, and to sustain the gains we have made in the fight against TB.

The time is now for solidarity and action. Let us join forces and step up the fight to end TB and COVID-19 – only united will we succeed.

Dr Tereza Kasaeva
Director
Global TB Programme
World Health Organization

#ThanksHealthHeroes
The caretaker buddy: Peer-to-peer support for TB patients
Xu Xing-hua (Yunnan, China)

Xu patiently showing the TB patient the right way of putting on the mask and sharing related knowledge on the disease prevention and control.

WHO / Xu Zixiang

Xu Xinghua is a volunteer and peer consultant for tuberculosis (TB) patients for 57 Zone, an online peer-to-peer support group in China. With the outbreak of COVID-19 in the beginning of 2020, Xu has had to go beyond the line of duty to ensure that people with TB get uninterrupted treatment.

Read moreWHO Information Note and Q&A on TB and COVID-19

New WHO recommendations to prevent tuberculosis aim to save millions of lives

The WHO Global TB Programme, along with WHO regional and country offices, has developed an Information Note, in collaboration with stakeholders. This note is intended to assist national TB programmes and health personnel to urgently maintain continuity of essential services for people affected with TB during the COVID-19 pandemic, driven by innovative people-centred approaches, as well as maximizing joint support to tackle both diseases.

Read the Information Note.

 

Access the new Q&A on TB & COVID-19

 

WHO Modelling analysis: Predicted impact of the COVID-19 pandemic on global deaths in 2020Graphic showing predicted excess in TB deaths in 2020 in relation to the duration and extent of a temporary average reduction in TB case detectionWHO has released results of modelling work undertaken on the predicted short-term impact of the COVID-19 pandemic on TB deaths in 2020. Results indicate that TB mortality will significantly increase in 2020 and will primarily affect the most vulnerable TB patients. If global TB case detection decreases by an average 25% over a period of 3 months (as compared to the level of detection before the pandemic), an additional 190 000 TB deaths are predicted (a 13% increase), bringing the total to 1.66 million TB deaths in 2020. This number is near the global level of TB mortality of the year 2015, a serious setback in the progress towards the targets of the UN High-Level Meeting on TB and WHO End TB Strategy. 

Read the analysis


Community-based health care, including outreach and campaigns,in the context of the COVID-19 pandemicCommunity-based health care is an essential part of primary care at all times; in the context of the COVID-19 pandemic, the distinct capacity of trusted community members for social engagement and delivering care where it is needed is ever more critical. This joint WHO, UNICEF and IFRC guidance addresses the role of community-based health care in the pandemic context. It includes practical recommendations for decision makers to help keep communities and health workers safe, to sustain essential services at the community level, and to ensure an effective response to COVID-19. Using this comprehensive and coordinated approach will help countries strengthen the resilience of community-based health services throughout the pandemic, into early recovery and beyond.
Read more  


COVID-19 and National TB Programmes:
Summary of Findings across the Six WHO RegionsInfographic

 

A preliminary analysis has revealed several challenges. These include a slow-down of routine and facility-based case finding and diagnosis across all WHO regions; human resources for TB increasingly engaged in COVID-19 response efforts; drop in TB case notifications in several high burden countries; lack of real-time TB surveillance data that hampers countries’ ability to assess the situation in terms of decrease in case notifications and access; various levels of disruption in all 6 WHO regions concerning procurement and supply of medicines and diagnostics. Stock-out situations and stock shortages are noted in in several regions and a decline in routine, facility-based TB treatment services is observed in all regions. Countries have been advised by WHO to shift to the provision of outpatient, community-based TB treatment and care services.


However, in parallel, positive steps have been taken by countries, with some implementing innovative, people-centered case finding strategies.  Different approaches are being used in countries to dispense medications to patients at home, including through greater engagement of community and civil society actors in service delivery.

Joint WHO and Stop TB Partnership Webinars:
Coping with TB during the COVID-19 crisisScreenshots of the webinar

Access the webinar and presentations here.

Scientific Brief: 
Bacille Calmette-Guérin (BCG) vaccination and COVID-19

 

There is no evidence that the Bacille Calmette-Guérin vaccine (BCG) protects people against infection with COVID-19 virus. Two clinical trials addressing this question are underway, and WHO will evaluate the evidence when it is available. In the absence of evidence, WHO does not recommend BCG vaccination for the prevention of COVID-19. WHO continues to recommend neonatal BCG vaccination in countries or settings with a high incidence of tuberculosis.

 

Read more

WHO statement: Tobacco use and COVID-19

4 months 1 week ago

Tobacco kills more than 8 million people globally every year. More than 7 million of these deaths are from direct tobacco use and around 1.2 million are due to non-smokers being exposed to second-hand smoke.

Tobacco smoking is a known risk factor for many respiratory infections and increases the severity of respiratory diseases. A review of studies by public health experts convened by WHO on 29 April 2020 found that smokers are more likely to develop severe disease with COVID-19, compared to non-smokers.

COVID-19 is an infectious disease that primarily attacks the lungs. Smoking impairs lung function making it harder for the body to fight off coronaviruses and other diseases. Tobacco is also a major risk factor for noncommunicable diseases like cardiovascular disease, cancer, respiratory disease and diabetes which put people with these conditions at higher risk for developing severe illness when affected by COVID-19. Available research suggests that smokers are at higher risk of developing severe disease and death.

WHO is constantly evaluating new research, including research that examines the link between tobacco use, nicotine use, and COVID-19. WHO urges researchers, scientists and the media to be cautious about amplifying unproven claims that tobacco or nicotine could reduce the risk of COVID-19.  There is currently insufficient information to confirm any link between tobacco or nicotine in the prevention or treatment of COVID-19.

Nicotine replacement therapies, such as gum and patches are designed to help smokers quit tobacco. WHO recommends that smokers take immediate steps to quit by using proven methods such as toll-free quit lines, mobile text-messaging programmes, and nicotine replacement therapies. 

Within 20 minutes of quitting, elevated heart rate and blood pressure drop. After 12 hours, the carbon monoxide level in the bloodstream drops to normal. Within 2-12 weeks, circulation improves and lung function increases. After 1-9 months, coughing and shortness of breath decrease.

WHO stresses the importance of ethically approved, high-quality, systematic research that will contribute to advancing individual and public health, emphasizing that promotion of unproven interventions could have a negative effect on health.

Launch of the WHO Academy and the WHO Info mobile applications

4 months 1 week ago

WHO announces the launch of the WHO Academy app designed to support health workers during COVID-19, and the WHO Info app designed to inform the general public.

Today, the WHO Academy, World Health Organization’s lifelong learning centre, launched a mobile app designed to enable health workers to expand their life-saving skills to battle the COVID-19 pandemic.

The app provides health workers with mobile access to a wealth of COVID-19 knowledge resources, developed by WHO, that include up-to-the-minute guidance, tools, training, and virtual workshops that will help them care for COVID-19 patients and protect themselves.

“With this new mobile app, the WHO is putting the power of learning and knowledge-sharing directly into the hands of health workers everywhere,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. 

The app is built around the needs expressed by 20,000 global health workers in a WHO Academy survey conducted in March of 2020.

The survey found that two-thirds of respondents feel they need to be more prepared, particularly in infection prevention and control, case management, use of personal protective equipment and occupational safety, and risk communication and community engagement.

An overwhelming majority of respondents said virtual learning on demand would be helpful in preparing for COVID-19 challenges.

The establishment of the WHO Academy, based in Lyon, France, is planned for launch in May 2021. The state-of-the-art lifelong learning centre, will apply the latest technologies and adult learning science to meet the learning needs of millions of health workers, policy makers, and WHO staff around the world.

The application is available for free download from both the Apple App Store and Google Play Store in Arabic Chinese, English, French, Russian and Spanish.

You can also learn more about the WHO Academy here: http://academy.who.int

The WHO Info app.

Also today, WHO will launch the WHO Info app which will give millions of people real-time mobile access to the latest news and developments. WHO has developed the app from the ground up with an intuitive user-interface and a clean, smart design. From the COVID-19 front, the WHO Info app will provide the latest WHO initiatives, partnerships, and to up-to-date information on the race to find medicines and vaccines for fighting the disease. The number of COVID-19 cases, organized by country, and by timelines, are continually updated in the app from the official WHO COVID-19 data streams.

The WHO Info app is available for free download from both the Apple App Store and Google Play Store

The cost of inaction: COVID-19-related service disruptions could cause hundreds of thousands of extra deaths from HIV

4 months 1 week ago

A modelling group convened by the World Health Organization and UNAIDS has estimated that if efforts are not made to mitigate and overcome interruptions in health services and supplies during the COVID-19 pandemic, a six-month disruption of antiretroviral therapy could lead to more than 500 000 extra deaths from AIDS-related illnesses, including from tuberculosis, in sub-Saharan Africa in 2020–2021. In 2018, an estimated 470 000 people died of AIDS-related deaths in the region.

There are many different reasons that could cause services to be interrupted—this modelling exercise makes it clear that communities and partners need to take action now as the impact of a six-month disruption of antiretroviral therapy could effectively set the clock on AIDS-related deaths back to 2008, when more than 950 000 AIDS-related deaths were observed in the region. And people would continue to die from the disruption in large numbers for at least another five years, with an annual average excess in deaths of 40% over the next half a decade. In addition, HIV service disruptions could also have some impact on HIV incidence in the next year.

“The terrible prospect of half a million more people in Africa dying of AIDS-related illnesses is like stepping back into history,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization.

“We must read this as a wake-up call to countries to identify ways to sustain all vital health services. For HIV, some countries are already taking important steps, for example ensuring that people can collect bulk packs of treatment, and other essential commodities, including self-testing kits, from drop-off points, which relieves pressure on health services and the health workforce. We must also ensure that global supplies of tests and treatments continue to flow to the countries that need them,” added Dr Tedros.

In sub-Saharan Africa, an estimated 25.7 million people were living with HIV and 16.4 million (64%) were taking antiretroviral therapy in 2018. Those people now risk having their treatment interrupted because HIV services are closed or are unable to supply antiretroviral therapy because of disruptions to the supply chain or because services simply become overwhelmed due to competing needs to support the COVID-19 response.

“The COVID-19 pandemic must not be an excuse to divert investment from HIV,” said Winnie Byanyima, Executive Director of UNAIDS. “There is a risk that the hard-earned gains of the AIDS response will be sacrificed to the fight against COVID-19, but the right to health means that no one disease should be fought at the expense of the other.”

When treatment is adhered to, a person’s HIV viral load drops to an undetectable level, keeping that person healthy and preventing onward transmission of the virus. When a person is unable to take antiretroviral therapy regularly, the viral load increases, impacting the person’s health, which can ultimately lead to death. Even relatively short-term interruptions to treatment can have a significant negative impact on a person’s health and potential to transmit HIV.

This research brought together five teams of modellers using different mathematical models to analyse the effects of various possible disruptions to HIV testing, prevention and treatment services caused by COVID-19.

Each model looked at the potential impact of treatment disruptions of three months or six months on AIDS mortality and HIV incidence in sub-Saharan Africa. In the six-month disruption scenario, estimates of excess AIDS-related deaths in one year ranged from 471 000 to 673 000, making it inevitable that the world will miss the global 2020 target of fewer than 500 000 AIDS-related deaths worldwide.

Shorter disruptions of three months would see a reduced but still significant impact on HIV deaths. More sporadic interruptions of antiretroviral therapy supply would lead to sporadic adherence to treatment, leading to the spread of HIV drug resistance, with long-term consequences for future treatment success in the region.

Disrupted services could also reverse gains made in preventing mother-to-child transmission of HIV. Since 2010, new HIV infections among children in sub-Saharan Africa have declined by 43%, from 250 000 in 2010 to 140 000 in 2018, owing to the high coverage of HIV services for mothers and their children in the region. Curtailment of these services by COVID-19 for six months could see new child HIV infections rise drastically, by as much as 37% in Mozambique, 78% in Malawi, 78% in Zimbabwe and 104% in Uganda.

Other significant effects of the COVID-19 pandemic on the AIDS response in sub-Saharan Africa that could lead to additional mortality include reduced quality clinical care owing to health facilities becoming overstretched and a suspension of viral load testing, reduced adherence counselling and drug regimen switches. Each model also considered the extent to which a disruption to prevention services, including suspension of voluntary medical male circumcision, interruption of condom availability and suspension of HIV testing, would impact HIV incidence in the region.

The research highlights the need for urgent efforts to ensure the continuity of HIV prevention and treatment services in order to avert excess HIV-related deaths and to prevent increases in HIV incidence during the COVID-19 pandemic. It will be important for countries to prioritize shoring up supply chains and ensuring that people already on treatment are able to stay on treatment, including by adopting or reinforcing policies such as multimonth dispensing of antiretroviral therapy in order to reduce requirements to access health-care facilities for routine maintenance, reducing the burden on overwhelmed health-care systems.

“Every death is a tragedy,” added Ms Byanyima. “We cannot sit by and allow hundreds of thousands of people, many of them young, to die needless deaths. I urge governments to ensure that every man, women and child living with HIV gets regular supplies of antiretroviral therapy—something that’s literally a life-saver.”

 

Sources:

Jewell B, Mudimu E, Stover J, et al for the HIV Modelling consortium, Potential effects of disruption to HIV programmes in sub-Saharan Africa caused by COVID-19: results from multiple models. Pre-print, https://doi.org/10.6084/m9.figshare.12279914.v1, https://doi.org/10.6084/m9.figshare.12279932.v1.

 

Alexandra B. Hogan, Britta Jewell, Ellie Sherrard-Smith et al. The potential impact of the COVID-19 epidemic on HIV, TB and malaria in low- and middle-income countries. Imperial College London (01-05-2020). doi: https://doi.org/10.25561/78670.

 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

 

WHO

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.

 

Clean Memories & Photo Collection for a Green and Healthy Recovery

4 months 1 week ago

Despite the human suffering caused by COVID-19, this health emergency and our efforts to contain it are turning our attention to some of the more fundamental, systemic, causes of ill health related to the ways in which we organize our societies and interact with the environment.

As terrible and unwelcome as the current situation is, with so many people suffering and the world economy paralyzed, it is up to all of us to emerge stronger and more resilient than ever before.

That is why we would like to ask you to join us in collecting “clean, healthy memories" to build back better. Please share the experiences you are having during the coronavirus lockdown (good or bad) to inspire us in the green and healthy recovery we need.

Send us pictures of the blue skies, the clean waters, the vibrant nature blooming around you. Send us pictures of acts of kindness from neighbors and friends, of the ways in which you have found comfort and mental and physical well-being in these difficult times. Send us pictures of your city turned more people-friendly

This photo collection will become part of our Manifesto for a healthier and greener recovery to inspire us to imagine a "new normal" and call on global leaders to build the future we need.

You do not need to be a professional photographer or have a special camera, and anyone can participate, as long as you are the owner of the photos and give us permission to use and share them.

 

Please send us your picture/s at [email protected], using the title "Healthy Memories" and including the sentence " I confirm I am the author of these pictures and I give permission to WHO to use and display these pictures". 

Biking to work

Cities have provided more space for cyclists and pedestrians during lockdown, encouraging physical activity and reducing air pollution. (Credit: Jackman Chiu)

 

Cycling

With lockdown measures in place in many parts of the world to limit the spread of COVID-19, many people are re-appreciating the need for green spaces and infrastructure for cycling and walking within their cities. (Credit: CC)

 

UN issues a stamp to commemorate the 40th anniversary of the eradication of smallpox

4 months 1 week ago

The United Nations Postal Administration (UNPA) in collaboration with WHO issue a stamp in the denomination of CHF 1,70, to commemorate the 40th anniversary of the eradication of smallpox. The stamp was unveiled virtually on 8 May by the WHO Director-General during a commemorative event  in Geneva, signifies what national unity and global solidary can achieve.

Until it was wiped out, smallpox had plagued humanity for at least 3,000 years, killing 300 million people in the 20th century alone. The world got rid of smallpox thanks to an incredible demonstration of global solidarity, and because it had a safe and effective vaccine. Solidarity plus science equaled solution! The successful smallpox eradication programme yielded vital knowledge and tools for the field of disease surveillance, the benefits of vaccination and the importance of health promotion in fighting other diseases. It also laid the foundation for stronger national immunization programmes worldwide, underpinning the establishment of primary health care in many countries and creating momentum toward Universal Health Coverage.

Stewart Simonson, Assistant Director-General at the WHO Office at the UN, was the Assistant Secretary for Public Health Emergency Preparedness for the US Department of Health and Human Services during the post 9/11 era.  At that time, he was heavily involved in the development of the second-generation smallpox vaccine, ACAM2000.   He worked very closely on this project with the late D.A. Henderson, who led the WHO Smallpox Eradication Program.  “Eradication of Smallpox is the greatest accomplishment of any UN agency, of any multilateral organization, ever. And it happened here. At WHO.” He pointed out that WHO’s role in smallpox eradication leaves two legacies;  the eradication of the first, and only, infectious disease of humans;  and the beginning of the Expanded Programme on Immunization, a child vaccination programme, under which 80% of the world’s children are vaccinated and protected from debilitating diseases”.

There are many lessons to learn from the eradication of smallpox that can help fight the COVID-19 pandemic today and prepare for future pandemics.

ECOSOC Informal Briefing on 'Joining Forces: Effective Policy Solutions for Covid-19 Response'

4 months 1 week ago
    Dr T

WHO Director-General, Dr Tedros, joined senior UN officials, virtually, to brief UN Member States on the COVID-19 response. He highlighted the current dimensions of the outbreak, WHO’s response efforts and the urgent need for global solidarity to beat the virus and to ensure equitable access to vaccines, when they become available.

 

 

Happy international Nurses Day

4 months 1 week ago
On the occasion of the International Day of the Nurse and the 200th anniversary of the birth of Florence Nightingale, the World Health Organization (WHO) joins hundreds of partners worldwide to highlight the importance of nurses in the healthcare continuum and thank nurses for what they do. The theme for this year is” Nursing the World to Health”.

WHO Statement on false allegations in Der Spiegel

4 months 1 week ago

Der Spiegel reports of a 21 January, 2020, telephone conversation between WHO Director-General Dr Tedros Adhanom Ghebreyesus and President Xi Jingping of China are unfounded and untrue.

Dr Tedros and President Xi did not speak on 21 January and they have never spoken by telephone.

Such inaccurate reports distract and detract from WHO’s and the world’s efforts to end the COVID-19 pandemic.

To note: China confirmed human-to-human transmission of the novel coronavirus on 20 January.

 

Noncommunicable diseases, mental health and COVID-19

4 months 2 weeks ago

People with NCDs such as cardiovascular disease (e.g. hypertension, heart disease and stroke), chronic respiratory disease, diabetes and cancer, appear to be more vulnerable to becoming severely ill with the COVID-19. 

Smokers are likely to be more vulnerable to COVID-19. Smokers may also already have lung disease or reduced lung capacity which would greatly increase risk of serious illness.

A healthy lifestyle will make all bodily functions work better, including immunity. Eating healthy diets, keeping physically active, quitting smoking, limiting or avoiding alcohol intake, and getting enough sleep are key components of a healthy lifestyle.

Fear, worry, and stress are normal responses to perceived or real threats, and at times when we are faced with uncertainty or the unknown. It is normal and understandable that people are experiencing stress in the context of the COVID-19 pandemic.

During the pandemic, people with NCDs and mental health conditions may experience difficulties in accessing the health care, including life-saving treatment.

For more information see WHO Information note on COVID-19 and NCDs.

What the Task Force is doing during COVID-19Harnessing the collective energies of the UN and multilateral system

The Task Force comes together once a week to allow its members to prioritize action to support Member States respond to NCDs and the challenges of mental health during the COVID-19 pandemic. 

A summary of activities being undertaken by Task Force members is available here.

Relevant information on COVID-19 and NCDs from across WHO is available here.

In addition, the Task Force Secretariat represents members of the Task Force on each of the 8 workstreams of the WHO COVID-19/NCDs Working Group in order to maximize synergies between WHO and the wider UN system. 

Multi-partner trust fund to catalyze country action for NCD and mental health

To respond to ECOSOC and World Health Assembly resolutions and the recommendation of the WHO Independent High-level Commission on NCDs, WHO is establishing a multi-partner trust fund. The Fund will support governments to better coordinate and integrate NCDs and mental health responses into their health and development strategies, to develop and implement optimized fiscal, legislative and regulatory policies, and to ensure access to life saving healthcare for NCDs and mental health conditions. In the first instance, the Trust Fund will support countries respond to NCDs as part of their COVID-19 response and recovery.

The Steering Group will be chaired by the WHO Deputy Director General, with membership across Task Force members and development partners. The Secretariat of the Task Force will serve as the Secretariat of the Trust Fund. The Multi-Partner Trust Fund Office will be the management agent.

Joint programme and theme groups

The Task Force’s joint programmes and thematic working groups (TWG) are ensuring that their work is providing relevant, timely and effective support to Member States during COVID-19. Every effort is being made to maintain current work through remote working.

NCD2030: NCD and mental health investment cases continue to be undertaken remotely. Where possible, the impact of the COVID-19 pandemic will be reflected in the investment cases.

SAFER: The joint programme is compiling a repository of peer reviewed articles around the impact of the COVID-19 pandemic on alcohol consumption.

Tobacco control: The workstream ‘Tobacco prevention among youth’ recognizes children and adolescent increased risk of second-hand smoke during the lockdown and is developing advocacy material around smoke free homes.

Nutrition: Members of the TWG are compiling a list of UN resources highlighting the linkages between COVID-19 and nutrition and developing relevant advocacy material on maintaining a healthy diet during the COVID-19 pandemic.

Mental Health: The TWG is conducting a survey to map agencies’ activities around mental health and COVID-19, in order to streamline information sharing and dissemination.

NCDs and the environment: The main focus of the TWG is around the impact of the COVID-19 pandemic on air pollution, waste management (especially hospital waste), and climate change.

Selected products from Task Force members

UNICEF, WHO and IFRC have issued the following guidance, Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic. The guidance included and overview and specific considerations for mental health and NCDs.

 

Medical Product Alert N°5/2020

4 months 2 weeks ago
Falsified and contaminated Defibrotide identified in WHO regions of Western Pacific, Europe and Eastern Mediterranean

This alert relates to falsified DEFIBROTIDE 200MG VIALS OF 2.5ML (80MG/ML) CONCENTRATE FOR SOLUTION FOR INFUSION identified in Australia, Latvia and Saudi Arabia. This product is sold under the brand name Defitelio.

On 13 March 2020, the WHO Global Surveillance and Monitoring System on Substandard and Falsified (SF) Medical Products was informed that falsified DEFIBROTIDE 200MG vials were identified at patient level in Australia, displaying batch number 0286 (see Table 1 below for full details).

Following enquiries with stakeholders, on 8 April 2020, WHO was informed that falsified DEFIBROTIDE 200MG vials had also been supplied to Saudi Arabia, displaying batch number 0286 and 0126 (see Table 1 below for full details).

Following enquiries with stakeholders, on 9 April 2020, WHO was informed that falsified DEFIBROTIDE 200MG vials, displaying batch number 0126, had also been identified in Australia and Latvia.

DEFIBROTIDE is used to treat hepatic veno-occlusive disease, in which the blood vessels in the liver become damaged and obstructed by blood clots. This can be caused by treatments prior to a stem cell transplantation.

Laboratory analyses, conducted by national medicines regulatory authorities and the manufacturer of the genuine product, established that these falsified products do not contain any of the expected active ingredient. The solution in the vials is also contaminated with mould (Cladosporium sp. and Aspergillus niger).

Information available to WHO indicates that both batches of falsified DEFIBROTIDE 200MG vials were present within the regulated supply chain in Latvia as early as January 2020 and were also handled by medicine wholesalers in the United Kingdom in February 2020. It is important to note that widespread vigilance is required from all countries, regardless of where the product was originally identified.

Table 1: falsified defibrotide subject of WHO Alert n°5/2020, identified in Australia, Latvia and Saudi Arabia

The two products listed in Table 1 are confirmed falsified, on the basis that there is deliberate misrepresentation of their identity, composition and source.

The genuine manufacturer of Defibrotide, GENTIUM S.R.L has also confirmed to WHO that:

  • They did not manufacture the above products.
  • Authentic DEFIBROTIDE 200MG VIALS with batch number 0286 were supplied to Argentina, Hong Kong, Malaysia, Singapore and Turkey.
  • Authentic DEFIBROTIDE 200MG VIALS with batch number 0126 were supplied to Australia, Jordan, Kuwait, Lebanon, New Zealand, Qatar, Singapore, Turkey and the United Arab Emirates. 

    For guidance and photographs, please refer to page 2 of this Alert n°5/2020.

Photos of Falsified DEFIBROTIDE Batch number: 0286, with expiry date: 09/2021

         
Sample from Latvia       Sample from Latvia

Photos of Falsified DEFIBROTIDE Batch number: 0126, with expiry date: 08/2021

           
Sample from Australia       Sample from Australia

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 them. If you have used these falsified products, or if you suffer an adverse reaction/event having used these products, you are advised to seek immediate medical advice from a qualified healthcare professional, and to report the incident to the National Regulatory Authorities/National Pharmacovigilance Centre.

All medical products must be obtained from licensed, authorized and reliable sources. Their authenticity and condition should be carefully checked. Seek advice from a healthcare professional in case of doubt.

National regulatory/health authorities are advised to immediately notify WHO if these falsified products are identified in their country(ies). 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: https://www.who.int/medicines/regulation/ssffc/en/ 

Billions worldwide living with herpes

4 months 2 weeks ago

About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show, highlighting the need to improve awareness and scale up services to prevent and treat herpes.

About 13% of the world’s population aged 15 to 49 years were living with herpes simplex virus type 2 (HSV-2) infection in 2016, the latest year for which data is available.  HSV-2 is almost exclusively sexually transmitted, causing genital herpes. Infection can lead to recurring, often painful, genital sores in up to a third of people infected.

Herpes simplex virus type 1 (HSV-1) is mainly transmitted by oral to oral contact to cause oral herpes infection – sometimes leading to painful sores in or around the mouth (“cold sores”). However, HSV-1 can also be transmitted to the genital area through oral sex, causing genital herpes.

Around 67% of the world’s population aged 0 to 49 had HSV-1 infection in 2016 – an estimated 3.7 billion people. Most of these infections were oral; however, between 122 million to 192 million people were estimated to have genital HSV-1 infection.

Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health” says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at the World Health Organization (WHO). 

Herpes and HIV

People with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. Thus, HSV-2 likely plays a substantial role in the spread of HIV globally. Women are more susceptible to both HSV-2 and HIV. Women living in the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection.

No cure: vaccine needed

There is no cure for herpes. Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

Better awareness, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines.  

“A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

Authored by staff at the University of Bristol, the WHO, and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization, this new study estimates the global infection prevalence and incidence of HSV-1 and HSV-2 in 2016. 

Compendium of research projects at the interface of tuberculosis and COVID-19

4 months 2 weeks ago

As the world comes together to tackle the COVID-19 pandemic, it is important to ensure that tuberculosis (TB) prevention and care approaches are adapting appropriately to ensure continuous and safe delivery of high-quality TB services. Considering the overlaps in TB and COVID-19 in disease presentation and transmission, the pandemic presents many questions for the TB field that may require learning through research and innovation. 

To better understand challenges and opportunities in this space, the World Health Organization Global TB Programme is collating information on ongoing research at the interface of TB and COVID-19 (i.e. research which would improve TB prevention and care approaches in the context of the COVID-19 pandemic). We are developing a living compendium (listing), which will be updated periodically to make ongoing research projects and publications visible on its website. With your consent we would like to include any study you have in this compendium.

To fulfill these objectives, we need the cooperation of organizations and individuals engaged in TB/COVID-19 research to complete this  one page template before 20 May 2020. We encourage you to please share this in your network, so we can reach all stakeholders widely.

We thank you in advance for your cooperation, and please do not hesitate to contact us if you have any questions.

WHO and European Investment Bank strengthen efforts to combat COVID-19 and build resilient health systems to face future pandemics

4 months 2 weeks ago
  • WHO and the European Investment Bank enhance cooperation to support countries in addressing the health impact of COVID-19
  • The first phase will address urgent needs and strengthen primary health care in ten African countries
  • Enhanced WHO-EIB partnership will scale up financing to assure the chain of essential supplies, including personal protective equipment, diagnostics and clinical management
  • New initiative will accelerate investment in health preparedness and primary health care with a focus on health work force, infrastructure, and water, sanitation and hygiene
  • The initiative involves measures to address the growing threat of antimicrobial resistance

The World Health Organization and the European Investment Bank will boost cooperation to strengthen public health, supply of essential equipment, training and hygiene investment in countries most vulnerable to the COVID-19 pandemic.

The new partnership between the United Nations health agency and the world’s largest international public bank, announced at WHO headquarters in Geneva earlier today, will help increase resilience to reduce the health and social impact of future health emergencies. 

"Combining the public health experience of the World Health Organization and the financial expertise of the European Investment Bank will contribute to a more effective response to COVID-19 and other pressing health challenges," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. 

"WHO looks forward to strengthening cooperation with the EIB to improve access to essential supplies including medical equipment and training, and deliver better water, sanitation and hygiene where most needed. New initiatives to improve primary health care in Africa and support the EU Malaria Fund hint at the potential impact of our new partnership,” Dr Tedros concluded.

“The world is facing unprecedented health, social and economic shocks from COVID-19. The European Investment Bank is pleased to join forces with the World Health Organization as a key part of Team Europe’s efforts to address the global impact of the COVID-19 pandemic. The EU Bank’s new partnership with the WHO will help communities most at risk by scaling up local medical and public health efforts and better protect people around the world from future pandemics. This new cooperation will enable us to combat malaria, address anti-microbial resistance and enhance public health in Africa more effectively,” said Werner Hoyer, President of the European Investment Bank.

Improving local public health efforts to tackle coronavirus

The WHO and the EIB will increase cooperation to help governments in low- and middle-income countries to finance and secure access to essential medical supplies and protective equipment through central procurement.

Building resilient health systems in vulnerable countries across Africa

The WHO and the EIB will reinforce cooperation to support immediate COVID-19 needs and jointly develop targeted financing to enhance health investment and build resilient health systems and primary health care to address public health emergencies as well as accelerate progress towards Universal Health Coverage.

The partnership will benefit from the EIB’s planned 1.4 billion EUR response to address the health, social and economic impact of COVID-19 in Africa.

This will address immediate needs in the health sector and provide both technical assistance and support for medium-term investment in specialist health infrastructure.

The collaboration envisages rapid identification and fast-track approval of financing for health care, medical equipment and supplies. 

The first phase of the collaboration will see public health investment in ten African countries. 

Long-term collaboration to overcome market failures in global health

The agreement signed today establishes a close collaboration to overcome market failure and stimulate investments in global health, accelerating progress towards Universal Health Coverage. Increased cooperation between the WHO and the EIB will strengthen the resilience of national public health systems and enhance preparedness of vulnerable countries against future pandemics, thanks to investments in primary care infrastructure, health workers and improved water, sanitation and hygiene. 

Future cooperation will strengthen the EIB’s 5.2 billion EUR global response to COVID-19 outside the European Union.

Scaling up investment to tackle antimicrobial resistance

The two organisations will also cooperate in an initiative to address investment barriers hindering development of new antimicrobial treatment and related diagnostics. Antimicrobial resistance is amongst the most significant global health threats.

The WHO and the EIB are working on a new financing initiative to support development of novel antimicrobials and address the estimated 1 billion EUR needed to provide medium-term solutions to antimicrobial resistance. Other crucial partners have been invited to join this discussion. 

Improving the effectiveness of malaria treatment

Under the new agreement the EIB and WHO will support development of the EU Malaria Fund, a new 250 million EUR public-private initiative intended to address market failures holding back more effective malaria treatment. 

Strengthening EIB support for healthcare, life science and COVID-19 investment

In recent years the European Investment Bank has provided more than 2 billion EUR annually for health care and life science investment.

In the context of the COVID-19 pandemic, the EIB is currently assessing over 20 projects in the field of vaccine development, diagnostic and treatment, leading to potential investments in the 700 million EUR range. The EIB will also take part in the EU’s rolling pledging effort for the coronavirus global response that is taking place on May 4th.

Background information

The European Investment Bank (EIB) is the long-term lending institution of the European Union owned by its Member States. It makes long-term finance available for sound investment in order to contribute towards EU policy goals.

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube

WHO’s information site on the COVID-19 pandemic

Statement on the third meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of coronavirus disease (COVID-19)

4 months 3 weeks ago

The third meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the coronavirus disease (COVID-19), took place on Thursday, 30 April 2020, from 12:00 to 17:45 Geneva time (CEST).

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference. Membership of the Emergency Committee was expanded to reflect the nature of the pandemic and the need to include additional areas of expertise.

The Director-General welcomed the Committee, thanked them for their commitment to enhancing global public health, and provided an overview of the major achievements in the COVID-19 response since the last Emergency Committee meeting on 30 January 2020. 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. Only those committee members and advisers who were not considered to have any perceived or direct conflict of interest participated in the meeting.

The Secretariat turned the meeting over to the Chair, Professor Houssin. He 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. After ensuing discussion, the Committee unanimously agreed that the outbreak still constitutes a public health emergency of international concern (PHEIC) 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. 

The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General. The Director-General thanked the Committee for its work.

Advice to WHO Coordination, planning, and monitoring
  • Continue to lead and coordinate the global response to the COVID-19 pandemic in collaboration with countries, the United Nations (UN), and other partners.
  • Work with fragile states and vulnerable countries that require additional technical, logistical and commodity support.
  • Establish mechanisms to compile lessons learned from country and partner experiences and WHO missions and share the best practices and updated recommendations.
  • Provide further guidance to countries about adjusting public health measures, taking into account the different epidemiological situations of the pandemic.
  • Promote the inclusion of all interested countries, including low- and middle-income countries from all regions, in the Solidarity clinical trials for therapeutics and vaccines.
  • Continue efforts with partners to obtain equitable access to personal protective equipment, diagnostics, and biomedical equipment essential to the pandemic COVID-19 response.
  • Continue to coordinate global expert networks in epidemiology, laboratory, vaccines, clinical care, infection prevention and control, social sciences, and operational research; modelling; and other technical support.
One Health
  • Work with the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO), and countries to identify the zoonotic source of the virus and the route of introduction to the human population, including the possible role of intermediate hosts. This should be accomplished through efforts such as scientific and collaborative field missions, which will enable targeted interventions and a research agenda to reduce the risk of similar events.
  • Work closely with OIE and FAO to provide guidance on how to prevent            SARS-CoV-2 infections in animals and humans and prevent the establishment of new zoonotic reservoirs.
  • Work with partner organizations and countries to strengthen the global food supply chain, protect food workers, properly manage food markets, and mitigate possible disruptions to the food supply.
Essential Health Services
  • Support countries to assess and manage the unintended consequences of public health measures implemented to control the COVID-19 pandemic, including gender-based violence and child neglect.
  • Support countries to monitor their ability to provide and strengthen essential health services throughout a likely extended COVID-19 response. This should include, but is not limited to, essential prevention for communicable diseases, particularly vaccination; services related to reproductive health, including care during pregnancy and childbirth; care of vulnerable populations, such as young infants and older adults; provision of medications and supplies for the ongoing management of chronic diseases, including mental health conditions; continuity of critical inpatient therapies; management of emergency health conditions and common acute presentations that require time-sensitive intervention; and auxiliary services, such as basic diagnostic imaging, laboratory services, and blood bank services. 
  • Support countries to address shortages of essential medicines and health products, personal protective equipment, and other medical supplies and to establish sustainable risk management practices to prevent future shortages.
Risk communication and community engagement
  • Continue risk communications and community engagement activities through the WHO Information Network for Epidemics (EPI-WIN) and other platforms to counter rumours and misinformation.
  • Continue to regularly communicate clear messages, guidance, and advice about the evolution of the COVID-19 pandemic, how to reduce transmission, and save lives.
  • Work with partners and countries to articulate potential long-term consequences of COVID-19 pandemic, emphasizing the need for strengthened cross-sectoral preparedness, transparency and global coordination.
Surveillance
  • Clarify the testing strategy, support countries to increase testing capacity, and aim to provide equitable access to diagnostic tests and supplies in light of market failures and global shortages.
  • Continue to provide guidance on monitoring disease trends using Severe Acute Respiratory Infections (SARI) and Influenza Like Illness (ILI) surveillance systems in anticipation of the co-circulation of influenza viruses.
  • Develop qualitative and quantitative indicators that countries can use to assess and monitor SARS-CoV-2 transmission at all levels of public health response.
  • Continue to support countries and partners by providing technical and operational guidance, training platforms, and tools such as Go.Data,to enhance case identification and contact tracing capacity, strengthen the public health workforce, and engage communities for contact tracing.
  • Provide clear qualitative and quantitative indicators to monitor SARS-CoV-2 transmission to inform the adjustment of public health and social measures.
Travel and Trade
  • Continue working with countries and partners to enable essential travel needed for pandemic response, humanitarian relief, repatriation, and cargo operations.
  • Develop strategic guidance with partners for the gradual return to normal operations of passenger travel in a coordinated manner that provides appropriate protection when physical distancing is not feasible.
  • Update recommendations on appropriate travel measures and analyze their effects on international transmission of COVID-19, with consideration of the balance between benefits and unintended consequences, including entry and exit screening, education of travelers on responsible travel behaviour, case finding, contact tracing, isolation, and quarantine, by incorporating evidence on the potential role of pre-symptomatic and asymptomatic transmission.
To all States Parties Coordination and Collaboration
  • Support WHO leadership and continue to collaborate with WHO at all levels of the organization and with other countries to enable effective global COVID-19 pandemic preparedness and response.
  • Participate in global solidarity efforts to enable access to essential supplies for all.
  • Document and share lessons learned from efforts to control the pandemic, including the timing, pace, and sequencing of the application and lifting of public health measures.
Preparedness
  • Strengthen preparedness for health emergencies, and build resilient health systems, incorporating lessons learned during different stages of the pandemic, and sharing experiences with other countries. 
Surveillance
  • Work with WHO and multisectoral partners to interrupt transmission by maintaining robust surveillance systems; enhancing capacities for case detection, testing, isolation of cases, contact tracing, quarantine of contacts, and rapid response; strengthening the public health workforce; and actively engaging communities for contact tracing, with a particular focus on high risk areas.
  • In settings where testing a large proportion of suspected cases is not possible, monitor overall trends; undertake early detection through laboratory confirmation of a limited number of cases with a focus on health workers; and rapidly implement public health measures.
  • Share with WHO all data necessary to conduct global risk assessments through data platforms, such as the Global Influenza Surveillance and Response System and the IHR mechanism. These data should include SARI and ILI where available.
  • Use the WHO qualitative and quantitative indicators to assess and monitor SARS-CoV-2 transmission at all levels of public health response.
Additional Health Measures
  • Avoid restrictions on international transport of food, medical and other essential supplies and permit the safe movement of essential personnel required for an effective pandemic response.
  • Implement appropriate travel measures with consideration of their public health benefits, including entry and exit screening, education of travelers on responsible travel behaviour, case finding, contact tracing, isolation, and quarantine, by incorporating evidence on the potential role of pre-symptomatic and asymptomatic transmission.
  • Implement and monitor case finding and contact tracing of travellers, using digital tools where appropriate.
  • Continue to review travel and trade measures based on regular risk assessments, transmission patterns at origin and destination, cost-benefit analysis, evolution of the pandemic, and new knowledge of COVID-19.
  • Engage in global efforts to respond to the challenges of COVID-19 in managing maritime vessels.
  • Do not implement trade restrictions beyond those considered to be of public health importance in accordance with relevant international agreements.
  • Continue to provide appropriate public health rationale to WHO for additional health measures in accordance with IHR.
Health Workers
  • Prioritize the protection of the health workforce through access to training and provision of personal protective equipment, infection prevention and control measures, improved working conditions, application of WHO recommended testing strategies, and prevention of stigma and attacks on health workers.
Food Security
  • Work with WHO and partners to strengthen the global food supply chain, protect food workers, properly manage food markets, and mitigate possible disruptions to the food supply, especially for vulnerable populations.
One Health
  • Promote sound practices to manage risks of trade of live animals in food markets and regulate trade of exotic wildlife.
Risk Communications and Community Engagement
  • Continue to engage communities to address rumours and misinformation and keep the public informed, with a focus on vulnerable populations.
Research and development
  • Address research gaps such as: routes of transmission, including the role of asymptomatic and pre-symptomatic infection droplet, contact, fomite and aerosol transmission; and viral shedding; and animal source and intermediate hosts, in collaboration with partners.
  • Continue to support and conduct COVID-19 research, in line with the WHO Research and Development Blueprint, and the road map for COVID-19 vaccines, diagnostics, and therapeutics.
  • Continue sharing full genome sequences to increase global understanding of virus evolution and phylogenetics and their application to public health practices.
Essential Health Services
  • Maintain essential health services throughout a likely extended COVID-19 response. This should include essential prevention for communicable diseases, particularly vaccination; services related to reproductive health, including care during pregnancy and childbirth; care of vulnerable populations, such as young infants and older adults; provision of medications and supplies for the ongoing management of chronic diseases, including mental health conditions; continuity of critical inpatient therapies; management of emergency health conditions and common acute presentations that require time-sensitive intervention; and auxiliary services, such as basic diagnostic imaging, laboratory services, and blood bank services. 
  • Continue to track and document the impact of COVID-19 on essential health services.

Massive proportion of world’s population are living with herpes infection

4 months 3 weeks ago
Virus causing genital herpes may put millions of people at greater risk of infection with HIV

About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show.

Authored by staff at the University of Bristol, World Health Organization (WHO), and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization, the new study estimates the global infection prevalence and incidence of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 2016. 

“Herpes infection affects millions of people across the globe and can have far-reaching health effects. We need more investment and commitment to develop better treatment and prevention tools for this infection.” says Dr Sami Gottlieb, Medical Officer at WHO and an author of the study.

Prevalence and incidence

An estimated 491.5 million people were living with HSV-2 infection in 2016, equivalent to 13.2% of the world’s population aged 15 to 49 years. HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital herpes).

An estimated 3.7 billion people had HSV-1 infection during the same year – around 66.6% of the world’s population aged 0 to 49. HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes). However, HSV-1 can also be transmitted to the genital area through oral-genital contact – during oral sex – to cause genital herpes. Most HSV-1 infections were oral; however, between 122 million to 192 million people were estimated to have genital HSV-1 infection, depending on the assumptions used in the estimation model.

Because herpes is a lifelong infection, estimated prevalence increased with age; HSV-2 prevalence was also higher among women and in the WHO African Region.

Health and social impacts

Most people living with herpes, caused by either HSV-1 or 2, are unaware they have the infection.

When symptoms do occur however, oral herpes infection can lead to painful sores around the mouth (“cold sores”). Genital herpes infection can cause recurring, often painful, genital sores, often referred to as genital ulcer disease. 

WHO and partners published a study in March 2020 estimating that around 5% of the world’s population (187 million people) suffered from at least one episode of herpes-related genital ulcer disease in 2016 (1). Most of these episodes were due to HSV-2, which can recur frequently over many years.

Recurrent symptoms of genital herpes can lead to stigma and psychological distress, and can have an important impact on quality of life and sexual relationships. However, in time, most people with herpes adjust to living with the infection.

“Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health” says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at WHO. 

Herpes and HIV

A strong association exists between HSV-2 infection and HIV infection. In 2019, WHO commissioned a modeling study to estimate how much HSV-2 infection might contribute to HIV incidence. The study estimated that almost 30% of new sexually acquired HIV infections in 2016 worldwide were likely attributable to HSV-2 infection (2). 

Evidence shows that people with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. HSV-2 leads to inflammation and small breaks in the genital and anal skin that can make it easier for HIV to cause infection. In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others.

Women have higher biologic susceptibility to both HSV-2 and HIV. Women living in the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection, with negative implications for their health and well-being. 

For people living with HIV (or who are living with other conditions that compromise their immune systems) as well as HSV-2, the symptoms of herpes can be more severe and more frequent. 

Neonatal herpes

Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. This is a rare condition, occurring in an estimated 10 out of every 100,000 births globally, but can lead to lasting neurologic disability or death. The risk for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants.

No cure – better treatment and prevention needed

There is no cure for herpes. At present, antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. 

In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of HSV infections. Such research includes the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.

“A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

Related publications

WHO guidelines for the treatment of Genital Herpes Simplex Virus

WHO preferred product characteristics for herpes simplex virus vaccines

 

----------------------

(1) Looker KJ, Johnston C, Welton NJ, et al. The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study. BMJ Glob Health. 2020;5(3):e001875. doi: 10.1136/bmjgh-2019- 001875.

(2) Looker KJ, Welton NJ, Sabin KM, et al.Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence: a population attributable fraction analysis using published epidemiological data. Lancet Infect Dis.2020;20(2):240-249. doi: 10.1016/S1473-3099(19)30470-0.

Corporate news releases, statements, and notes for media issued by the World Health Organization.