The World Health Organization (WHO) and the Wikimedia Foundation, the nonprofit that administers Wikipedia, announced today a collaboration to expand the public’s access to the latest and most reliable information about COVID-19.
The collaboration will make trusted, public health information available under the Creative Commons Attribution-ShareAlike license at a time when countries face continuing resurgences of COVID-19 and social stability increasingly depends on the public’s shared understanding of the facts.
Through the collaboration, people everywhere will be able to access and share WHO infographics, videos, and other public health assets on Wikimedia Commons, a digital library of free images and other multimedia.
With these new freely-licensed resources, Wikipedia’s more than 250,000 volunteer editors can also build on and expand the site’s COVID-19 coverage, which currently offers more than 5,200 coronavirus-related articles in 175 languages. This WHO content will also be translated across national and regional languages through Wikipedia’s vast network of global volunteers.
“Equitable access to trusted health information is critical to keeping people safe and informed during the COVID-19 pandemic," said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. "Our new collaboration with the Wikimedia Foundation will increase access to reliable health information from WHO across multiple countries, languages, and devices."
Since the beginning of the pandemic, WHO has taken steps to prevent an “infodemic”— defined by the organization as “an overabundance of information and the rapid spread of misleading or fabricated news, images, and videos.”
Wikipedia editors have similarly been on the frontlines of preventing the spread of misinformation surrounding the coronavirus, ensuring information about the pandemic is based on reliable sources and updated regularly on Wikipedia.
By making verified information about the pandemic available to more people on one of the world’s most-visited knowledge resources, the organizations aim to help curb this infodemic and ensure everyone can access critical public health information.
“Access to information is essential to healthy communities and should be treated as such,” said Katherine Maher, CEO at the Wikimedia Foundation. “This becomes even more clear in times of global health crises when information can have life-changing consequences. All institutions, from governments to international health agencies, scientific bodies to Wikipedia, must do our part to ensure everyone has equitable and trusted access to knowledge about public health, regardless of where you live or the language you speak.”
WHO has served as the leading international health agency spearheading the global response to the coronavirus outbreak. Since the beginning, WHO has worked to rapidly establish international coordination, scale up country readiness and response, and accelerate research and innovation. Today, as information on the transmission and epidemiology of the virus evolves, WHO continues to provide essential guidance and public health recommendations to governments, communities and individuals everywhere.
At the same time, Wikipedia volunteer editors, many of whom are from the medical community, have been creating, updating, and translating Wikipedia articles with information from reliable sources about the pandemic. As one of the top ten sites in the world, studies have shown that Wikipedia is one of the most frequently viewed sources for health information.
At the moment, readers can access WHO’s mythbusting series of infographics on Wikimedia Commons. The infographics, which focus on addressing common misconceptions about COVID-19, are also available for Wikipedia editors to incorporate into Wikipedia articles.
In the coming months, the Wikimedia Foundation and WHO will continue uploading resources to Wikimedia Commons and collaborating with Wikipedia volunteer editors to better understand gaps in information needs on Wikipedia articles related to COVID-19 and how WHO resources can help fill these gaps.
Additionally, under the Creative Commons Attribution-ShareAlike license, other organizations, individuals, and websites can more easily share these materials on their own platforms without having to address stricter copyright restrictions.
About the World Health Organization
The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 149 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, and Twitch.
About the Wikimedia Foundation
The Wikimedia Foundation is the nonprofit organization that operates Wikipedia and the other Wikimedia free knowledge projects. Our vision is a world in which every single human can freely share in the sum of all knowledge. We believe that everyone has the potential to contribute something to our shared knowledge, and that everyone should be able to access that knowledge freely. We host Wikipedia and the Wikimedia projects, build software experiences for reading, contributing, and sharing Wikimedia content, support the volunteer communities and partners who make Wikimedia possible, and advocate for policies that enable Wikimedia and free knowledge to thrive. The Wikimedia Foundation is a United States 501(c)(3) tax-exempt organization with offices in San Francisco, California, USA.
The World Health Organization’s (WHO) Global TB Programme welcomes the results from a landmark study on the treatment of drug-susceptible TB presented at the 51st virtual Union World Conference on Lung Health. The study, named Study 31/A5349, was led by the U.S. Centers for Disease Control and Prevention’s (CDC) Tuberculosis Trials Consortium (TBTC) in collaboration with the AIDS Clinical Trials Group (ACTG) and funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
Study 31/A5349 is a phase 3, open-label randomized controlled clinical trial that examined the efficacy and safety of two four-month treatment regimens with high-dose rifapentine with or without moxifloxacin for the treatment of drug susceptible pulmonary TB, compared to the currently recommended six-month regimen composed of rifampicin, isoniazid, pyrazinamide and ethambutol (2RHZE/4RH). Thirteen countries contributed data to the study, from 34 clinical sites. Approximately 2 500 people aged 12 years and older participated in the study, including 214 people living with HIV infection.
One of the key findings from the study was that the four-month regimen which included a combination of high-dose rifapentine, isoniazid, pyrazinamide and moxifloxacin, was shown to be non-inferior in terms of efficacy to the currently recommended six-month regimen composed of rifampicin, isoniazid, ethambutol and pyrazinamide. In addition, this four-month regimen was safe and well-tolerated by patients.
New, shorter and effective treatment regimens for both drug-susceptible and drug-resistant TB are urgently needed to treat all patients with TB and achieve the WHO’s End TB Strategy targets. Therefore, the findings from this study have the potential to complement current options for the treatment of drug-susceptible TB with a new effective and safe 4-month regimen.
Robust and representative scientific data constitute the premise for WHO public health policy recommendations, which are developed using a rigorous, systematic and evidence-based approach. WHO regularly reviews the findings from key studies on TB treatment in order to offer patients the most effective and safe treatment regimens. The results from Study 31/A5349 mark an important step forward in this process and once the final data become available, WHO intends to initiate a policy development process to refine its current policy recommendations on the treatment of drug-susceptible TB.
The twenty-sixth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened and opened by the WHO Deputy Director-General on 14 October 2020 with committee members attending via video conference, supported by the WHO Secretariat. Dr Zsuzsana Jakab in opening remarks on behalf of Dr Tedros congratulated all those involved in eliminating wild polioviruses from the WHO African Region despite some very challenging obstacles. The COVID-19 pandemic and the ongoing spread of cVDPV2 were both growing major challenges, which would require strenuous efforts to overcome in order to restart progress toward global polio eradication.
The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV). The following IHR States Parties provided an update at the video conference or in writing on the current situation in their respective countries: Afghanistan, Chad, Egypt, Guinea, Pakistan, Somalia, South Sudan, Sudan and Yemen.
The higher incidence of global WPV1 cases seen during 2020 continues, with 121 cases reported between 1 January – 5 October 2020 compared to 85 for the same period in 2019, a 42% increase. Last year there were 176 WPV1 cases, the highest number reported since the PHEIC was declared in 2014, when there were 359 cases in nine countries. The lowest number of WPV1 cases was reported in 2017, when only 22 cases were found. No wild polio cases have been detected outside of Pakistan and Afghanistan since the last cases in Nigeria in 2016 four years ago. The number of positive environmental samples has increased 70% to 375 compared to 221 for the same time last year. Since the last meeting, exportation of WPV1 from Pakistan to Afghanistan has been documented.
The Committee noted that based on results from sequencing of WPV1 since the last committee meeting in June, there were further instances of international spread of viruses from Pakistan to Afghanistan. The ongoing frequency of WPV1 international spread between the two countries and the increased vulnerability in other countries where routine immunization and polio prevention activities have both been adversely affected by the COVID-19 pandemic are two major factors that suggest the risk of international spread may be at the highest level since 2014. While border closures and lockdowns may mitigate the risk in the short term while in force, this would be outweighed in the longer term by falling population immunity through disruption of vaccination and the resumption of normal population movements.
On the other hand the certification of the WHO African Region as wild polio free in August 2020 indicated a lessening of the global risk from this previous source.
Vaccine derived poliovirus (VDPV)
The committee was very concerned that the international spread of cVDPV2 continues, causing new outbreaks in Guinea, South Sudan and Sudan, the latter two due to importation of a cVDPV2 lineage that emerged in Chad in 2019. The same virus has also been detected in sewage in Cairo, Egypt but with no evidence of local circulation. The number of cases in 2020 is 409 as at 5 October 2020, already exceeding the 378 cases reported for the whole of 2019. As in all other years after 2016 when OPV2 was withdrawn, the number of cVDPV2 cases has been greater than the number of WPV1 cases in 2020. However, the number of sub-types / lineages detected so far in 2020 is 27, compared to 42 for the whole of 2019, and the number of newly emerged viruses is only seven so far this year, compared to 38 during 2019.
Cross border spread of cVDPV2 is now occurring regularly. Based on analysis by the US CDC of isolates, in the three months from April to June 2020, there has been evidence of exportation of cVDPV2 from:
· Pakistan to Afghanistan
· Côte d’Ivoire to Mali
· Guinea to Mali
· Côte d’Ivoire to Ghana, and Ghana to Côte d’Ivoire
· CAR to Cameroon
· Chad to Sudan and South Sudan
· Ghana to Burkina Faso
The committee heard that nearly all countries (90%) have experienced disruption to health services especially in low and middle income countries, according to a survey of 105 countries conducted March – June 2020. Routine immunization particularly outreach services was the area most frequently reported as disrupted.
The committee was very concerned that most of the current outbreak countries have had to delay immunization responses in recent months, meaning that transmission is likely continuing unchecked. Furthermore, there appear to be significant falls in surveillance indicators in many of the outbreak countries, such as drops in AFP reporting rates, and lesser drops in environmental sampling. Vaccine management and supply has been significantly impacted. More than 60 campaigns in 28 countries have been postponed since late February and early March. Vaccine supplies have been disrupted in many ways, with some quantities already in-country at risk of exceeding their expiry data and therefore unusable. Some suppliers are reaching storage capacity and may well be forced to stop production.
Although the resumption of Supplementary Immunization Activities (SIAs) is now occurring, the waves of the pandemic are expected to fluctuate considerably from country to country and across the WHO Regions, so the program will need to adjust according to the COVID-19 situation for the foreseeable future.
Although in general surveillance processes are continuing, there are clear signs of a significant drop in AFP case reporting, including in endemic countries, some outbreak countries and some other non-infected high risk countries.
The committee noted that GPEI modeling indicated there is a risk of an exponential rise in the number of cVDPV2 infected districts in the African Region, leading to a 200% increase if response SIAs had not resumed. In addition to the risk of WPV1 geographical spread and intensification, cVDPV2 cases could rise exponentially in Pakistan and Afghanistan potentially reaching more the 3,500 cases without a resumption of immunization response. Consequently, both Pakistan and Afghanistan are now implementing large scale mOPV2 campaigns and will continue with tOPV/mOPV2 until controlled. While there has been rapid spread, particularly in Afghanistan, expected exponential rise has been curtailed by the resumption of campaigns in July.
The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months. The Committee recognizes the concerns regarding the lengthy duration of the polio PHEIC, but concludes that the current situation is extraordinary, with clear ongoing and increasing risk of international spread and ongoing need for coordinated international response. The Committee considered the following factors in reaching this conclusion:
Rising risk of WPV1 international spread:
Based on the following factors, the risk of international spread of WPV1 appears to be currently very high:
· increasing transmission in Pakistan and Afghanistan as evidenced by higher case numbers and positive environmental samples;
· greater geographical spread within the endemic countries, particularly Afghanistan;
· the ongoing inaccessibility in many provinces of Afghanistan, leading increasingly to highly susceptible populations which are and will continue to drive higher transmission;
· the drop in population immunity consequent on the pause in polio vaccination necessitated by the COVID-19 pandemic, leading to greater susceptibility to poliovirus importation and outbreaks in high risk countries;
· the complicated context of WPV eradication activities in Afghanistan and Pakistan created by the need to simultaneously respond to cVDPV2 and COVID-19;
· the difficulties in supplying vaccines due to the pandemic (as is being seen in Yemen, for example);
· the possible expiring of vaccines in country and stockpiles caused by delays in polio vaccination activities;
· the results of modelling done by GPEI on the potential consequences for WPV1 of the pause on eradication activities.
Rising risk of cVDPV international spread:
The international spread of cVDPV2 is now established, with three newly infected countries being reported since June 2020. While experience demonstrates the effectiveness of Sabin OPV2 in controlling outbreaks, and changes in the strategy and standard operating procedures for responding to cVDPV2 appear to be succeeding in reducing the risk of new emergences in outbreak zones and neighbouring areas, overall the problem continues to grow, affecting more countries and paralyzing more children.
● COVID-19: This unprecedented pandemic is likely to continue to substantially negatively impact the polio eradication program and outbreak control efforts. The need to take extra precautions to prevent COVID-19 transmission will probably have an impact on vaccination coverage, and also hamper polio surveillance activities leading to increased risk of missed transmission.
● Falling PV2 immunity: Global population mucosal immunity to type 2 polioviruses (PV2) continues to fall, as the cohort of children born after OPV2 withdrawal grows, exacerbated by poor coverage with IPV particularly in some of the cVDPV infected countries.
● Weak routine immunization: Many countries have weak immunization systems that can be further impacted by various humanitarian emergencies including COVID19, and the number of countries in which immunization systems have been weakened or disrupted by conflict and complex emergencies poses a growing risk, leaving populations in these fragile states vulnerable to outbreaks of polio.
● Lack of access: Inaccessibility continues to be a major risk, particularly in several countries currently infected with WPV or cVDPV, i.e. Afghanistan, Nigeria, Niger, Somalia and Myanmar, which all have sizable populations that have been unreached with polio vaccine for prolonged periods.
● Population movement: While border closures may have mitigated the short term risk, conversely the risk once borders begin to be re-opened is likely to be higher.
● The results of cVDPV2 modelling, done by GPEI in June 2020 which had indicated that there was a risk of an exponential rise in the number of cVDPV2 infected districts in the African Region and in Pakistan and Afghanistan.
● New cVDPV1 outbreak: The new outbreak of cVDPV1 in Yemen in an area of conflict is a further example of the risks anywhere that conflict can contribute to lower immunization rates and therefore new emergences of other cVDPV.
The Committee provided the Director-General with the following advice aimed at reducing the risk of international spread of WPV1 and cVDPVs, based on the risk stratification as follows:
● States infected with WPV1, cVDPV1 or cVDPV3, with potential risk of international spread.
● States infected with cVDPV2, with potential risk of international spread.
● States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV.
Criteria to assess States as no longer infected by WPV1 or cVDPV:
● Poliovirus Case: 12 months after the onset date of the most recent case PLUS one month to account for case detection, investigation, laboratory testing and reporting period OR when all reported AFP cases with onset within 12 months of last case have been tested for polio and excluded for WPV1 or cVDPV, and environmental or other samples collected within 12 months of the last case have also tested negative, whichever is the longer.
● Environmental or other isolation of WPV1 or cVDPV (no poliovirus case): 12 months after collection of the most recent positive environmental or other sample (such as from a healthy child) PLUS one month to account for the laboratory testing and reporting period
● These criteria may be varied for the endemic countries, where more rigorous assessment is needed in reference to surveillance gaps.
Once a country meets these criteria as no longer infected, the country will be considered vulnerable for a further 12 months. After this period, the country will no longer be subject to Temporary Recommendations, unless the Committee has concerns based on the final report.
States infected with WPV1, cVDPV1 or cVDPV3 with potential risk of international spread
Afghanistan (most recent detection 7 Sep 2020)
Pakistan (most recent detection 16 Sep 2020)
Malaysia (most recent detection 13 March 2020)
Philippines (most recent detection 28 November 2019)
Yemen (most recent detection 5 June 2020)
These countries should:
● Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency and implement all required measures to support polio eradication; where such declaration has already been made, this emergency status should be maintained as long as the response is required.
● Ensure that all residents and longterm visitors (i.e. > four weeks) of all ages, receive a dose of bivalent oral poliovirus vaccine (bOPV) or inactivated poliovirus vaccine (IPV) between four weeks and 12 months prior to international travel.
● Ensure that those undertaking urgent travel (i.e. within four weeks), who have not received a dose of bOPV or IPV in the previous four weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travelers.
● Ensure that such travelers are provided with an International Certificate of Vaccination or Prophylaxis in the form specified in Annex 6 of the IHR to record their polio vaccination and serve as proof of vaccination.
● Restrict at the point of departure the international travel of any resident lacking documentation of appropriate polio vaccination. These recommendations apply to international travelers from all points of departure, irrespective of the means of conveyance (e.g. road, air, sea).
● Further intensify crossborder efforts by significantly improving coordination at the national, regional and local levels to substantially increase vaccination coverage of travelers crossing the border and of high risk crossborder populations. Improved coordination of crossborder efforts should include closer supervision and monitoring of the quality of vaccination at border transit points, as well as tracking of the proportion of travelers that are identified as unvaccinated after they have crossed the border.
● Further intensify efforts to increase routine immunization coverage, including sharing coverage data, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication.
● Maintain these measures until the following criteria have been met: (i) at least six months have passed without new infections and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until the state meets the above assessment criteria for being no longer infected.
● Provide to the Director-General a regular report on the implementation of the Temporary Recommendations on international travel.
States infected with cVDPV2s, with potential or demonstrated risk of international spread
Afghanistan (most recent detection 5 September 2020)
Angola (most recent detection 9 February 2020)
Benin (most recent detection 12 June 2020)
Burkina Faso (most recent detection 11 June 2020)
Cameroon (most recent detection 1 September 2020)
CAR (most recent detection 28 July 2020)
Chad (most recent detection 22 August 2020)
Cote d’Ivoire (most recent detection 20 June 2020)
DR Congo (most recent detection 4 August 2020)
Ethiopia (most recent detection 13 June 2020)
Ghana (most recent detection 16 June 2020)
Guinea (most recent detection 21 July 2020)
Malaysia (most recent detection 13 March 2020)
Mali (most recent detection 23 June 2020)
Niger (most recent detection 25 August 2020)
Nigeria (most recent detection 18 June 2020)
Pakistan (most recent detection 24 September 2020)
Philippines (most recent detection 16 January 2020)
Somalia (most recent detection 29 August 2020)
South Sudan (most recent detection 8 July 2020)
Sudan (most recent detection 18 August 2020)
Togo (most recent detection 3 May 2020)
Zambia (most recent detection 25 November 2019)
These countries should:
● Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency and implement all required measures to support polio eradication; where such declaration has already been made, this emergency status should be maintained.
● Noting the existence of a separate mechanism for responding to type 2 poliovirus infections, consider requesting vaccines from the global mOPV2 stockpile based on the recommendations of the Advisory Group on mOPV2.
● Encourage residents and longterm visitors to receive a dose of IPV four weeks to 12 months prior to international travel; those undertaking urgent travel (i.e. within four weeks) should be encouraged to receive a dose at least by the time of departure.
● Ensure that travelers who receive such vaccination have access to an appropriate document to record their polio vaccination status.
● Intensify regional cooperation and crossborder coordination to enhance surveillance for prompt detection of poliovirus, and vaccinate refugees, travelers and crossborder populations, according to the advice of the Advisory Group.
● Further intensify efforts to increase routine immunization coverage, including sharing coverage data, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication.
● Maintain these measures until the following criteria have been met: (i) at least six months have passed without the detection of circulation of VDPV2 in the country from any source, and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until the state meets the criteria of a ‘state no longer infected’.
● At the end of 12 months without evidence of transmission, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.
States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV
Mozambique (most recent cVDPV2 detection 17 December 2018)
PNG (most recent cVDPV1 detection 6 November 2018)
Indonesia (most recent cVDPV1 detection 13 February 2019)
Myanmar (most recent cVDPV1detection 9 August 2019)
China (most recentcVDPV2 detection 18 August 2019)
These countries should:
● Urgently strengthen routine immunization to boost population immunity.
● Enhance surveillance quality, including considering introducing supplementary methods such as environmental surveillance, to reduce the risk of undetected WPV1 and cVDPV transmission, particularly among high risk mobile and vulnerable populations.
● Intensify efforts to ensure vaccination of mobile and crossborder populations, Internally Displaced Persons, refugees and other vulnerable groups.
● Enhance regional cooperation and cross border coordination to ensure prompt detection of WPV1 and cVDPV, and vaccination of high risk population groups.
● Maintain these measures with documentation of full application of high quality surveillance and vaccination activities.
● At the end of 12 months without evidence of reintroduction of WPV1 or new emergence and circulation of cVDPV, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.
The committee noted with concern the drop in the number of SIAs due to the problems caused by COVID-19, including preventive SIAs in high risk countries that are done to maintain population immunity in places where routine immunization is weak or disrupted. This indicates a very dangerous situation could arise: not only is there increasing WPV1 in the two potential source countries, but the susceptibility in potential outbreak prone countries could significantly and relatively rapidly increase. Furthermore, importations leading to outbreaks may be detected late due to the pandemic’s effect on surveillance. The committee urges all at-risk countries to pay careful attention to managing these risks, ensuring population immunity for polio is maintained throughout the course of the pandemic whether through SIAs or improvements to routine immunization, and attention is also given to enhancement of surveillance, especially environmental surveillance where it remains limited in some high risk areas.
The committee also noted the risk of vaccine hesitancy could be exacerbated during the pandemic, so that adverse events during the development or future deployment of any COVID-19 vaccine could compound the existing issues around polio vaccines, particularly but not only in Pakistan. Conversely, vaccine issues arising out of novel OPV2 or trivalent OPV2 use could adversely affect any future COVID-19 vaccine deployment. The committee urged countries with particular problems around vaccine hesitancy to make preparations now to avert situations of greater vaccine refusals through education campaigns, activities to counter misinformation and rumors and wherever possible provide incentives to target populations such as multi-antigen campaigns and offering other health and wellbeing services (vitamins, anti-worming medication, soap etc).
The committee commended Egypt for its thorough investigation of the finding in Cairo of the VDPV2 poliovirus genetically closely linked to that which is circulating in Sudan and noted there was no evidence that it was circulating in Egypt. However, given recent experience in other countries where such findings often heralded the beginning of an outbreak, the committee requests Egyptian health authorities to continue to monitor the situation carefully and provide a detailed update to the committee at its next meeting. The committee urged any country that detects importation of a VDPV2 known to be circulating in another country prepare for a rapid response should local circulation be identified.
The committee was also very concerned about the polio program funding gap which is developing in 2021 and beyond and urged countries and donors to maintain funding of polio eradication activities, as the potential for reversal of progress appears high, with many years of work undone easily and swiftly if WPV1 spreads outside the endemic countries. The committee was saddened to learn of several deaths of polio workers due to COVID-19, which serves as a reminder that both the polio PHEIC and the COVID-19 PHEIC are at dangerous crossroads and need equal attention. The Committee recommends that in countries with strong polio programs to intensify efforts to link polio eradication and COVID-19 activities including surveillance to provide greater mutual benefits to both initiatives.
The phased replacement during 2021 of Sabin OPV2 with novel OPV2 is expected to substantially reduce the source of cVDPV2 emergence, transmission and subsequent risk of international spread. Full licensure and pre-qualification of nOPV2 is not expected before 2022; therefore all countries at risk of cVDPV2 outbreak should consider preparing for nOPV2 use under Emergency Use Listing procedure.
Based on the current situation regarding WPV1 and cVDPV, and the reports provided by affected countries, the Director-General accepted the Committee’s assessment and on 19 October 2020 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV. The Director-General endorsed the Committee’s recommendations for countries meeting the definition for ‘States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread’, ‘States infected with cVDPV2 with potential risk for international spread’ and for ‘States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV’ and extended the Temporary Recommendations under the IHR to reduce the risk of the international spread of poliovirus, effective 19 October 2020.
The new version of the World Health Organization (WHO) 2020 Global TB Report app is now available for your smartphone and tablet. The game-changing app brings to the users’ fingertips the latest TB statistics and trends, country and region comparisons and quick search for indicators.
The app is now updated with latest data from the WHO 2020 Global Tuberculosis Report.
In addition to allowing users to explore and interact with data from 215 countries and areas, this update includes new features, such as:
· the ability to create your own groups of countries for which the app will automatically calculate values for key indicators;
· an expanded ‘favourites’ functionality where you can make specific countries, regions, personalized groups, as well as profile comparisons easily available;
· the app is now available in English, French and Russian – switch between languages at any time.
Other languages and more features will be available in future updates of the app.The app is available for free download on the Apple App stores and Google Play. It works both online and offline.
*The data in the app are from WHO’s Global TB Report, which provides a comprehensive and up-to-date assessment of the TB epidemic, and progress in the response at global, regional and country levels. TB remains one of the top 10 causes of death worldwide and is the world’s top infectious killer.
In recognition of World Sight Day 2020, the UN Friends of Vision, the Permanent Missions of Antigua and Barbuda, Bangladesh and Ireland to the United Nations, organized a high-Level event entitled ‘2020 and Beyond: Accelerating Vision for Everyone’. The event was aimed at bringing awareness and global attention to blindness and vision impairment, as well as discussion with Member States the way forward towards a UN General Assembly resolution on Vision Care and a preview of the forthcoming report of The Lancet Global Health Commission on Global Eye Health.
WHO ADG Stewart Simonson gave key remarks, presenting WHO’s work on the issue and emphasizing the importance of multi-sectoral approach to scale up integrated people-centred eye care for all. He expressed appreciation of the Member States’ support in implementing the recommendations included in the WHO World Report on Vision fortified by the recent adoption of the WHA resolution 73.4 - ‘Integrated people-cantered eye care, including preventable vision impairment and blindness’. Dr. Alarcos Cieza: Unit Head, Sensory Functions, Disability and Rehabilitation in WHO, also participated in the technical panel discussion and provided further details on the WHO Report as well as its work on prevention of blindness and promoting eye care. Participants voiced their concerns of disrupted services for eye care, particularly in the context of the COVID-19 pandemic, and stressed the need to strengthen health systems so that eye care becomes an integral part of health care service delivery to ensure all people obtain the eye care services they need without hindrance or financial hardship.
The World Health Organization invites independent film-makers, production companies, NGOs, communities, students, and film schools from around the world to submit their original short films to the 2nd Health for All Film Festival.
Launched in 2020, the festival aims to recruit a new generation of film and video innovators to champion global health issues.
The inaugural Health for All Film Festival in 2019/2020 accepted 1,300 short film submissions from more than 110 countries.
“Telling stories is as old as human civilization. It helps us understand our problems and heal ourselves. WHO is proud to announce the second Health for All Film Festival, to cultivate visual storytelling about public health,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We look forward to receiving creative entries inspired by WHO’s mission to promote health, keep the world safe, and serve the vulnerable.”
The competition categories this year will align with WHO’s global goals for public health.
For each of these three grand prix categories, judges will accept short documentaries or fiction films (3 to 8 minutes in length), short videos for social media or animation films (1 to 5 minutes in length).
Three other prizes will be awarded for a student-produced film, a health educational film aimed at youth, and a short video designed exclusively for social media platforms.
Submissions are open from 24 October 2020 to 30 January 2021.
After the close of submissions, critically-acclaimed artists from the film and music industries will review the shortlisted films with WHO experts and recommend winners to WHO’s Director-General, who will make the final decision. The jury composition
will be announced in by January 2021.
A special edition cover of Sister Sledge’s timeless hit We Are Family will be released in a new and inspiring call for global solidarity to respond to the COVID-19 pandemic and to generate proceeds to address the most pressing global health challenges of our time. The initiative is being launched by The World We Want, the global social impact enterprise, and Kim Sledge, part of the legendary multi-Gold and Platinum recording music group, in benefit of the WHO Foundation, and supported by the World Health Organization (WHO).
This new initiative, being launched ahead of United Nations Day on 24 October, will also be accompanied by a unique video and social media campaign, and sound a bold and hopeful call for solidarity, unity, and collaboration to promote and protect the health and wellbeing for every person on the planet.
The inspiration to release a special edition of the classic track came in March 2020 as communities around the world were left reeling from the impact of COVID-19.
Kim Sledge said: “From the doctors and nurses on the front lines, to the paramedics and police, from the midwives and scientists to the carers for the vulnerable, the We Are Family initiative will salute each and every one with a feeling of unity, strength and solidarity in response to the unprecedented challenges the world faces as a result of the coronavirus outbreak.”
“There are many people who motivated me to embark on this new initiative in support of making We Are Family come to life, and who are very dedicated to finding ways to conquer this crisis. They include my close family friend Lou Weisbach, my Mercy Seat Ministry brothers and sisters, and all of the global health workers, scientists, the essential labourers, care givers and emergency personnel around the world who have been working day and night during the pandemic in support of others,” added Kim, a vocalist, philanthropist, novelist, songwriter, producer and Minister.
Using music’s universal power in bringing the world together, the #WeAreFamily campaign is focused on raising awareness on, and much needed resources for, addressing global public health needs, from emergency preparedness, outbreak response, and stronger health systems to promoting mental health and preventing non-communicable diseases.
Natasha Mudhar, founder of The World We Want and the driving force behind the #WeAreFamily campaign, said: “We Are Family is one of the most instantly recognizable anthems in the world. The song carries such an inspiring message of unity and solidarity. We are certain that the We Are Family song and video initiative is being launched at the right time. It is a rallying cry for togetherness, for the strength of our global family. We are all together during these times.”Special edition version song to support health efforts
The special edition of the classic We Are Family song will be released online for download on 9 November 2020 in conjunction with the opening of the World Health Assembly, at which Kim Sledge is also scheduled to perform the song alongside choral singers from New York to Tonga. A portion of the song’s proceeds will be donated to the WHO Foundation to support the delivery of life-saving health services.
Dr Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization, said: “We Are Family is more than a song. It is a call to action for collaboration and kindness, and a reminder of the strength of family and the importance of coming together to help others in times of need.”
Dr Tedros added: “Now more than ever, communities and individuals all over the world need to heed this message and come together, as a global family, to support each other through this COVID-19 challenge, and to remember that our health and wellbeing is our most precious gift. I am grateful to Kim Sledge and the World We Want for sharing this masterpiece and message of hope with us all. It is only through national unity and global solidarity that we will overcome COVID-19 and ensure people all over the world attain the highest level of health and well-being."
In support of the song’s release, a call is being launched today (19 October) for people worldwide to submit videos of themselves singing We Are Family for inclusion in a unique and inspiring compilation video for release on 7 December 2020. This video will honour the incredible work of the frontline workforces risking their lives around to save ours, and all those around the world who have been affected by the pandemic.
To submit sing-along videos to the Special Edition Cover Version of the We Are Family song, the key steps are:
For further information, please contact The World We Want: [email protected]
The World Health Organization has appointed two distinguished leaders to co-chair an Independent Commission on sexual abuse and exploitation during the response to the tenth Ebola Virus Disease epidemic in the provinces of North Kivu and Ituri, the Democratic Republic of the Congo.
The commission will be co-chaired by Her Excellency Aïchatou Mindaoudou, former minister of foreign affairs and of social development of Niger, who has held senior United Nations posts in Côte d’Ivoire and in Darfur.
She will be joined by co-chair Julienne Lusenge of the Democratic Republic of the Congo, an internationally recognized human rights activist and advocate for survivors of sexual violence in conflict.
The role of the Independent Commission will be to swiftly establish the facts, identify and support survivors, ensure that any ongoing abuse has stopped, and hold perpetrators to account.
It will comprise up to seven members, including the co-chairs, with expertise in sexual exploitation and abuse, emergency response, and investigations.
The co-chairs will choose the other members of the Commission, which will be supported by a Secretariat based at WHO.
To support the Independent Commission’s work, the Director-General has decided to use an open process to hire an independent and external organization with experience in conducting similar inquiries.
The tenth epidemic of Ebola Virus Disease in the provinces of North Kivu and Ituri – the world’s second largest Ebola outbreak on record – was declared over on 25 June 2020, after persisting for nearly two years in an active conflict zone, and causing 2,300 deaths.
WHO has a zero tolerance policy with regard to sexual exploitation and abuse. We reiterate our strong commitment to preventing and protecting against sexual exploitation and abuse in all our operations around the world.
In just six months, the world’s largest randomized control trial on COVID-19 therapeutics has generated conclusive evidence on the effectiveness of repurposed drugs for the treatment of COVID-19.
Interim results from the Solidarity Therapeutics Trial, coordinated by the World Health Organization, indicate that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appeared to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.
The study, which spans more than 30 countries, looked at the effects of these treatments on overall mortality, initiation of ventilation, and duration of hospital stay in hospitalized patients. Other uses of the drugs, for example in treatment of patients in the community or for prevention, would have to be examined using different trials.
The progress achieved by the Solidarity Therapeutics Trial shows that large international trials are possible, even during a pandemic, and offer the promise of quickly and reliably answering critical public health questions concerning therapeutics.
The results of the trial are under review for publication in a medical journal and have been uploaded as preprint at medRxiv available at this link: https://www.medrxiv.org/content/10.1101/2020.10.15.20209817v1
The global platform of the Solidarity Trial is ready to rapidly evaluate promising new treatment options, with nearly 500 hospitals open as trial sites.
Newer antiviral drugs, immunomodulators and anti-SARS COV-2 monoclonal antibodies are now being considered for evaluation.
On 24 September 2020, the Friends of the Task Force met in the margins of the high-level segment of the 75thsession of the United Nations General Assembly. Participants included Member States, UN agencies and non-State actors.
The meeting was co-hosted by the Government of the Russian Federation and the World Health Organization, and co-sponsored by the United Nations Development Programme, the International Development Law Organization, and the Secretariat of the WHO Framework Convention on Tobacco Control.
The meeting provided an opportunity to review the contribution of the Task Force to global efforts to scale up prevention and control NCDs, with a special focus on NCDs during the COVID-19 pandemic. The WHO Director-General also announced the fifteen winners of the 2020 UNIATF Awards.
The Task Force Secretariat provided a brief overview of Task Force activities over the last year.
Mikhail Murashko, Minister of Health of the Russian Federation, highlighted the importance of a systematic approach to combating NCDs and expressed his appreciation of the work done by the Task Force in promoting multi-sectoral collaboration in the area of NCDs, including through the development of the national NCD investment cases under the WHO-UNDP joint programme. The Russian Federation is now providing an additional $ 5 million over the next five years to build on this work. Minister Murashko welcomed contributions from Italy, the European Commission and the Gulf Health Council for the work of the Task Force.
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized the importance of strengthening NCD response during and beyond COVID-19. He highlighted the impact of the pandemic on NCDs and mental health and that strong action on NCDs must be an integral part of the COVID-19 response and recovery. The Director-General reminded participants that he had recently launched a joint WHO, UNDP and Task Force publication, Responding to NCDs during and beyond the COVID-19 pandemic. Dr Tedros described WHO’s commitment to work with Task Force members to establish the NCD and Mental Health Multi-Partner Trust Fund. Once established, Dr Tedros said that he would be calling on partners to mobilize additional resources beyond WHO’s budget to scale up support to countries for their response to NCDs.
“There’s no doubt that COVID-19 is a setback to our efforts to beat NCDs, but we cannot allow it to become an excuse for failing to deliver on our commitments. On contrary, we must use it as motivation to work all the harder!” Dr Tedros.
Aksel Jacobsen, State Secretary of International Development for the Norwegian Ministry of Foreign Affairs, described Norway’s NCD Development Policy (2020-2024), which will support low-income countries in their efforts to address NCDs. He underscored the high burden of NCD and COVID-19 comorbidity. The State Secretary called upon countries to ensure that NCD prevention, detection, and treatment is included in their COVID-19 response plans, highlighting the importance of political commitment to achieve equality and equity in access to health protection.
“The long-time global underinvestment in NCD prevention and control is part of the reason behind this tragic development.” Hon Jakobsen.
Dr Osagie Ehanire, Minister of Health of Nigeria, thanked the Task Force for its mission to Nigeria earlier this year, indicating that the mission’s recommendations have been approved by the President, and an implementation unit to implement the recommendations has been established.
Dr Jennifer Harries, Deputy Chief Medical Officer of the United Kingdom, spoke about the UK’s experience in fighting major NCD risk factors, as well as obesity, and the UK’s efforts to support people to stay mentally well during the pandemic. Dr Harries emphasized the importance of multilateral approaches to address NCDs, highlighting national WHO Framework Convention on Tobacco Control (FCTC) investment cases that the UK has been supporting.
“The UK would support further joint programming across multilaterals through the Multi-Partner Trust Fund to catalyse action on NCDs in low- and middle-income countries at such a critical time.” Dr Harries.
Mr Rafael Mariano Grossi, Director General of the International Atomic Energy Agency described IAEA’s collaboration with WHO over many years, especially with regards the Human Health Programme to address NCD challenges across a range of medical issues. Mr Grossi highlighted IAEA’s work in building capacity for NCD and COVID-19 detection, which has involved the provision of thousands of health professionals with resources on the use of radiology for diagnosis and treatment.
“Medical imaging has had a significant impact on our understanding of COVID-19-related signs and symptoms.” Mr Grossi.
Emanuela Del Re, Deputy Minister of Foreign Affairs of Italy, shared the experience of Italy in dealing with NCDs though promotion of healthy diets and food quality assurance.
“Healthy lifestyles and balanced diet not only prevent NCDs, but also have a positive impact on people's general health, especially children in the first years of life.” Hon Del Re.
Ahmed Mohammed Obaid Al Saidi, Minister of Health of the Sultanate of Oman, highlighted the increased use of innovative digital technology solutions for NCD care which emerged from the constraints imposed by COVID-19.
“In Oman service pathways for those seeking NCD care have been rearranged to ensure safety for patients and safe delivery of services and medications. This had undoubtedly invited innovation and the introduction of new measures that rely on technology." Hon Al Saidi.
Ms Jan Beagle, Director General of the International Development Law Organization, stressed the importance of the rule of law and functioning of legal and regulatory frameworks for adequate and equitable NCD and COVID-19 care for all.
“Now, more than ever, COVID-19 has exposed and is being aggravated by the entrenched injustices and equalities under which too many people still live and from which no nation can claim to be exempt.” Ms. Beagle.
Ms Katie Dain, Chief Executive Officer of the NCD Alliance welcomed the Task Force's recent attention on NCD treatment and management as well as the development of the Multi-Partner Trust Fund.
“COVID-19 must be a wake-up call for governments and political leaders to value, prioritize, and invest in health, NCDs, and prevention. We simply won't be prepared for the next pandemic, or any other health threat unless we really get to grips with the burden of NCDs.” Ms. Dain.
Dr Adriana Blanco Marquizo, Head of Secretariat of the FCTC spoke about the threat posed by tobacco industry in the context of COVID-19 and NCDs, and the important role that the WHO FCTC plays in directing national and international effort at reducing global tobacco prevalence. Dr Blanco highlighted the urgent need to support tobacco users who want to quit, pointing to sensitization of population about importance of health that occurred due to COVID-19.
Ms Lena Nanushyan, from the Ministry of Health in Armenia, highlighted the experience of Armenia in working with the Task Force on development and implementation of a national NCD investment case. Ms Nanushyan underscored that the results of the investment case were used to argue for the adoption of a stricter tobacco control law earlier this year.
Dr Douglas Webb, Cluster Leader, HIV Health and Development Group at the United Nations Development Programme,spoke about the opportunity to address NCDs through national COVID-19 response and recovery plans, which increasingly reveal synergies with NCD-related action within and beyond the health sector. Dr Webb endorsed the Multi-Partner Trust Fund, noting the significant funding gap in responding to NCDs.
“The Multi-Partner Trust Fund is a critical technical tool to allow member states to advance on strengthening their NCD response.” Dr Webb.
Mr Yahya Alfasi, from the Gulf Health Council, informed the participants about the ongoing work to develop NCD investment cases for six countries across the region through the WHO-UNDP joint programme under the Task Force.
Mr William Twomey, from Johnson and Johnson, praised the Access Initiative for Quitting Tobacco (AIQT) to improve global access to tobacco cessation support, stating that it was an important step to curbing the very high economic and social costs that tobacco imposes on our society.
Each year, more than 700 000 people die from vector-borne diseases (VBDs) such as malaria, dengue, schistosomiasis, leishmaniasis, Chagas disease, yellow fever and Japanese encephalitis, among others. More than 80% of the global population lives in areas at risk of at least one major vector-borne disease. Taken together, these diseases exact an immense toll on economies and can impede both rural and urban development.
Recognizing the urgent need for new tools to combat VBDs, and in the spirit of fostering innovation, WHO supports the investigation of all potentially beneficial technologies, including genetically modified mosquitoes (GMMs). A new position statement, launched today in a WHO seminar, clarifies WHO’s stance on the evaluation and use of GMMs for the control of vector-borne diseases.
“These diseases are not going away,” noted Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, as he presented the position statement in the seminar. “We really do need to think about new tools that could make an impact.”Position statement
In recent years, there have been significant advances in GMM approaches aimed at suppressing mosquito populations and reducing their susceptibility to infection, as well as their ability to transmit disease-carrying pathogens. These advances have led to an often polarized debate on the benefits and risks of genetically modified mosquitoes.
According to the WHO statement, computer simulation modelling has shown that GMMs could be a valuable new tool in efforts to eliminate malaria and to control diseases carried by Aedes mosquitoes. WHO cautions, however, that the use of GMMs raises concerns and questions around ethics, safety, governance, affordability and cost–effectiveness that must addressed.
The statement notes that GMM research should be conducted through a step-wise approach and supported by clear governance mechanisms to evaluate any health, environmental and ecological implications. It underscores that any effective approach to combating vector-borne diseases requires the robust and meaningful engagement of communities. This is especially important for area-wide control measures such as GMMs, as the risks and benefits may affect large segments of the population.
Countries and other stakeholders are encouraged to provide feedback on the new position statement by contacting WHO at: [email protected]New guidance
Despite the growing threat of vector-borne diseases to individuals, families and societies, the ethical issues raised by vector-borne diseases have received only limited attention. Recognizing this gap, WHO has issued new guidance to support national VBD control programmes in their efforts to identify and respond to the core ethical issues at stake.
The new guidance, titled Ethics & vector-borne diseases, was issued today alongside the position statement on genetically modified mosquitoes. Grounded in a multidisciplinary framework, the guidance emphasizes the critical role of community engagement in designing and implementing an appropriate, sustainable public health response.
UN Women and WHO are publishing the RESPECT implementation package for preventing violence against women. This implementation package comprises of a suite of practical resources and tools to support the implementation of the RESPECT women: preventing violence against women framework, which was developed by WHO, with UN Women, in 2019 and is endorsed by 12 other UN agencies and bilateral partners.
The RESPECT implementation package is aimed at helping policy makers and practitioners to design and implement evidence-based, ethical and effective national and sub-national, policies, programmes and interventions for preventing violence against women based on each of the seven strategies of RESPECT.
It distills programming knowledge based on existing and up-to-date global evidence. It is divided into a series of standalone materials, which include:
The package is presented in a user-friendly design to cater to the busy schedules of policy makers, enabling easy access and reference to relevant materials. It can be used as a resource to support policy dialogues or as a capacity building tool. It can be used in its entirety or as individual strategy and programme summaries.
Prior to the COVID-19 pandemic, many countries were making steady progress in tackling tuberculosis (TB), with a 9% reduction in incidence seen between 2015 and 2019 and a 14% drop in deaths in the same period. High-level political commitments at global and national levels were delivering results. However, a new report from WHO shows that access to TB services remains a challenge, and that global targets for prevention and treatment will likely be missed without urgent action and investments.
Approximately 1.4 million people died from TB-related illnesses in 2019. Of the estimated 10 million people who developed TB that year, some 3 million were not diagnosed with the disease, or were not officially reported to national authorities.
The situation is even more acute for people with drug-resistant TB. About 465 000 people were newly diagnosed with drug-resistant TB in 2019 and, of these, less than 40% were able to access treatment. There has also been limited progress in scaling up access to treatment to prevent TB.
“Equitable access to quality and timely diagnosis, prevention, treatment and care remains a challenge,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “Accelerated action is urgently needed worldwide if we are to meet our targets by 2022.”
About 14 million people were treated for TB in the period 2018-2019, just over one-third of the way towards the 5-year target (2018-2022) of 40 million, according to the report. Some 6.3 million people started TB preventive treatment in 2018-2019, about one-fifth of the way towards the 5-year target of 30 million.
Funding is a major issue. In 2020, funding for TB prevention, diagnosis, treatment and care reached
US$ 6.5 billion, representing only half of the US$ 13 billion target agreed by world leaders in the UN Political Declaration on TB.
The COVID-19 pandemic and TB
Disruptions in services caused by the COVID-19 pandemic have led to further setbacks. In many countries, human, financial and other resources have been reallocated from TB to the COVID-19 response. Data collection and reporting systems have also been negatively impacted.
According to the new report, data collated from over 200 countries has shown significant reductions in TB case notifications, with 25-30% drops reported in 3 high burden countries – India, Indonesia, the Philippines – between January and June 2020 compared to the same 6-month period in 2019. These reductions in case notifications could lead to a dramatic increase in additional TB deaths, according to WHO modelling.
However, in line with WHO guidance, countries have taken measures to mitigate the impact of COVID-19 on essential TB services, including by strengthening infection control. A total of 108 countries – including 21 countries with a high TB burden – have expanded the use of digital technologies to provide remote advice and support. To reduce the need for visits to health facilities, many countries are encouraging home-based treatment, all-oral treatments for people with drug-resistant TB, provision of TB preventive treatment, and ensuring people with TB maintain an adequate supply of drugs.
“In the face of the pandemic, countries, civil society and other partners have joined forces to ensure that essential services for both TB and COVID-19 are maintained for those in need,” said Dr Tereza Kaseva, Director of WHO’s Global TB Programme. “These efforts are vital to strengthen health systems, ensure health for all, and save lives.”
A recent progress report from the UN Secretary General outlines 10 priority actions for Member States and other stakeholders to close gaps in TB care, financing and research, as well as advance multisectoral action and accountability, including in the context of the COVID-19 pandemic.
Note for the editors
In 2014 and 2015, all Member States of WHO and the UN adopted the UN Sustainable Development Goals (SDGs) and WHO’s End TB Strategy. The SDGs and End TB Strategy both include targets and milestones for large reductions in TB incidence, TB deaths and costs faced by TB patients and their households.
TB is included under Goal 3 Target 3.3 of the SDGs which aims to “end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases” by the year 2030.
The WHO End TB Strategy aims for a 90 per cent reduction in TB deaths and an 80 per cent reduction in the TB incidence rate by 2030, compared to the 2015 baseline. Milestones for 2020 include a 20% reduction in the TB incidence rate and a 35% reduction in TB deaths.
Efforts to step up political commitment in the fight against TB intensified in 2017 and 2018 culminating, in September 2018, in the first-ever high-level meeting on TB at the UN General Assembly. The outcome was a political declaration in which commitments to the SDGs and End TB Strategy were reaffirmed. The UN Political Declaration on TB also included 4 new targets for the period 2018-2022:
Progress towards global targets
According to the new report, the WHO European Region is on track to achieve key 2020 targets of the WHO End TB Strategy, with reductions in incidence and deaths of 19% and 31%, respectively, over the last 5-year period. The African Region has also made impressive gains, with corresponding reductions of 16% and 19% in the same timeframe. On a global scale, however, the pace of progress has lagged, and critical 2020 milestones of the End TB Strategy will be missed.
As in previous years, most available TB funding (85%) in 2020 came from domestic sources, with Brazil, Russian Federation, India, China and South Africa providing 57% of the global total. International donor funding, as reported by national TB programmes (NTPs), increased from US$ 0.9 billion in 2019 to US$ 1.0 billion in 2020. The Global Fund to Fight AIDS, Tuberculosis and Malaria was the single largest source of international TB financing in 2020, while the United States remains the biggest bilateral funder of efforts to end TB.
Research and innovation
Reaching the 2030 global TB targets will require technological breakthroughs by 2025. The world needs affordable and accessible rapid point-of-care tests, as well as new, safer and more effective treatments and vaccines. To meet these challenges, Member States called on WHO in 2018 to develop a Global strategy for TB research and innovation that lays out key steps that governments and non-state actors can undertake. The strategy was adopted by the World Health Assembly in August 2020.
Multisectoral action and accountability
Further progress towards ending TB will depend on action across sectors, underscoring the importance of the implementation of WHO’s multisectoral accountability framework on TB. In 2019 and 2020, WHO worked with high TB-burden countries to ensure the inclusion of accountability mechanisms in national budget planning and pursuing assessment during high-level missions and joint TB programme reviews with engagement of civil society representatives.
Tuberculosis (TB) , the world’s deadliest infectious killer, is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. It can spread when people who are sick with TB expel bacteria into the air – for example, by coughing.
Approximately 90 percent of those who fall sick with TB each year live in 30 countries. Most people who develop the disease are adults, and there are more cases among men than women.
TB is preventable and curable. About 85% of people who develop TB disease can be successfully treated with a 6-month drug regimen; treatment has the added benefit of curtailing onward transmission of infection.
Since 2000, TB treatment has averted more than 60 million deaths – although with access to universal health coverage still falling short, many millions have also missed out on diagnosis and care.
With the right approach and effective investment, digital health interventions can be successful long-term solutions that help to improve the health and well-being of the people they were designed to reach. A new guide has been launched by WHO today to help ensure that digital health investments are effective, sustainable, and equitable – and that they are implemented in a coordinated way and appropriate for the local context.
The Digital implementation investment guide: integrating digital interventions into health systems, (also known as the DIIG), has been published by WHO and HRP in collaboration with partners UNICEF, UNFPA and PATH. This guidance will be particularly useful for donors and ministries of health who make decisions on digital investments for health – in government, in technical bodies, and in national health and/or digital systems.
Ian Askew, Director of WHO Department of sexual and reproductive health and research and HRP comments, “No matter where you live, there are unique health needs which digital technologies can help to meet. But these technologies can only be effective if they recognize these unique needs, if they are appropriate to the context – and if they receive sustained and informed investment.”How-to guide on digital health The guide gives a step-by-step approach to planning, costing and implementing digital health investments. Users learn from diverse experiences covering the past ten years, from institutions who have been deeply involved with planning and implementing digital health technologies with national governments. In using the guide, readers learn how to design, cost, and implement meaningful digital health isystems with the confidence in a well-defined plan that will facilitate further collaboration and investment. Realising the potential of digital health
Digital health tools have the potential to transform health services and help accomplish universal health coverage. With sustainable and robust governance structures in place, It can reform public health systems by improving its reach, impact, and efficiency.Investing wisely and well
Wiser investment in digital health technologies is needed however, in order to fully realise their potential, and to enhance the integral role that they can play within health systems – but it is crucial that such investment is responsible and well-thought through.
Dr Soumya Swaminathan, Chief Scientist at WHO remarks in the foreword to the guide that, “Investment must be carefully and thoughtfully coordinated for equitable access to meet the full spectrum of health needs leveraging mature digital public goods, and building on digital development and donor principles to maximize the benefits of digital investments.”
Responsible and informed investment in the right technologies, appropriate for the context and health system and for the existing digital architecture, is critical for ensuring their success.Coordination of digital health
Good planning and governance on digital health or by investors, governments, and technical bodies is needed when working to integrate digital investments into health systems. Coordination of digital health systems is key for ensuring that digital investments are effective, promote equitable access to health, and address the health needs of the local context.
The DIIG aims to help all people involved with decision making related to digital technologies for health coordinate effectively, in order to harmonise their efforts in investing in and integrating digital health technologies.
Mr.Bernardo Mariano, Director of WHO Digital Health Department and Innovation, comments, “The DIIG is a tool that encourages strategic collaboration and governance. It helps decision-makers make ethical and evidence-based decisions, with sustainability and equity at their core, in coordination with people working across sectors.”Principles at heart
The guide is underpinned by a set of 9 principles known as The principles for digital development to help stakeholders effectively and appropriately apply digital technologies in their health programmes.
Dr Garrett Mehl, Scientist in WHO Department of Sexual and Reproductive Health and Research including HRP comments, “If implemented in a strategically harmonized manner, leveraging the key principles and messages presented in the DIIG, these digital health systems are powerful tools that will help us achieve the ultimate goal of health and well-being for all. “
The DIIG is rooted in evidence and WHO guidance, and is part of a growing suite of digital health tools to help countries effectively put into place, scale-up, maintain, and evaluate the impact of, digital health interventions. It complements the WHO
guidance on digital health interventions, which examined the evidence for and issues to consider around implementing digital health.
The WHO and UNICEF recently published a module to guide policy makers and programme implementers working in quality improvement in maternal, newborn and child health, to support making comprehensive and meaningful stakeholder and community engagement an integral part of quality improvement (QI) initiatives.Publications
This module compliments the implementation guide developed by The Network for Improving Quality of care for Maternal, Newborn and Child Health (QoC Network). Four key topics are covered, including: rationale for engagement; building and strengthening partnerships; strategies for information, communication and advocacy; and monitoring, evaluation and learning.
Mapping of tools
The mapping of tools identified 70 tools to further support implementation of stakeholder and community engagement across the seven steps of the Quality of Care Network’s Implementation Framework*. The tools are available through an online portal, which allows uses to filter based on the different topic focus and phase of implementation.
* 1) establish leadership group, 2) situation analysis, 3) adapt standards of care, 4) identify QI interventions, 5) implementation of QI interventions, 6) continuous measurement of quality outcomes and 7) refinement of strategies.