Following further investigation and information sharing by national authorities in Mexico, this is an update to the Disease Outbreak News (DON) on human infection caused by avian influenza A(H5N2) published on 5 June 2024. Link(https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON520).
As was previously reported, on 23 May 2024, the Mexico International Health Regulations (IHR) National Focal Point (NFP) reported to PAHO/WHO a confirmed case of human infection with avian influenza A(H5N2) virus in a patient with underlying co-morbidities who subsequently died. This is the first laboratory-confirmed human case of infection with an influenza A(H5N2) virus reported globally and the first avian A(H5) virus infection in a person reported in Mexico. Although the source of exposure to the virus in this case is currently unknown, A(H5N2) viruses have been reported in poultry in Mexico. In their update, Mexican authorities informed WHO that a national group of experts determined on 6 June that the patient died due to complications related to his co-morbidities and that genetic analysis performed by the national authorities identified that this virus has a 99% similarity with the strain obtained during 2024 in birds in Texcoco State of Mexico. Based on available information, WHO’s risk assessment is unchanged: the current risk to the general population posed by this virus is low. The risk assessment will be reviewed should further epidemiological or virological information become available.
As summarized in the previous DON, on 23 May 2024, the Mexico IHR NFP reported to PAHO/WHO a confirmed case of infection with avian influenza A(H5N2) virus detected in a 59-year-old resident of the State of Mexico who was hospitalized on 24 April 2024 in Mexico City. The case had no known history of exposure to poultry or other animals. He had multiple underlying medical conditions. His relatives reported that he had been bedridden for three weeks, for other reasons, prior to the onset of acute symptoms. On 22 May, sequencing of the sample by the national authorities confirmed the influenza subtype was A(H5N2). The genetic analysis by the national authorities identified that this virus has a 99% similarity with the low pathogenicity (in birds) avian influenza A/chicken/Texcoco, México/CPA-01654/2024 (H5N2) strain, obtained during 2024 from birds in Texcoco State of Mexico. The detailed H5N2 virus genetic sequence from the patient specimen has been uploaded to GISAID.
A national multidisciplinary group of experts was formed to investigate the cause of death. It included infectious disease specialists, pneumonologists, microbiologists and intensive care professionals. Upon review of the patient’s clinical history and records, the national multidisciplinary team concluded on 6 June that, although the patient had a laboratory-confirmed infection with avian influenza A(H5N2) virus, he died due to complications of his co-morbidities.
No further cases were reported during the epidemiological investigation. The 17 contacts identified and monitored at the hospital where the man died and 12 additional contacts near his residence, were tested and the results were negative for influenza viruses. Samples from these persons were taken a month after the acute disease onset in the patient with confirmed influenza A(H5N2) infection. The results of the serological samples are pending.
In March 2024, an outbreak of low pathogenicity avian influenza (LPAI) A(H5N2) was identified in poultry in Texcoco, State of Mexico, and a second outbreak of LPAI A(H5N2) in April in the municipality of Temascalapa in the same state (1).
Additionally, in March 2024, a high pathogenicity avian influenza A(H5N2) outbreak was detected in a backyard poultry farm in the state of Michoacán. A study describing the continuous circulation of low pathogenicity avian influenza H5N2 viruses in Mexico and spread to several other countries was published in 2022 (2), indicating that both LPAI and HPAI A(H5) subtypes were reported in avian species in Mexico recently and in past years.
Animal influenza viruses normally circulate in animals but can also infect humans. Infections in humans have primarily been acquired through direct contact with infected animals or contaminated environments. Depending on the original host, influenza A viruses can be classified as avian influenza, swine influenza, or other types of animal influenza viruses.
Avian influenza virus infections in humans may cause mild to severe upper respiratory tract infections and influenza-associated deaths have been reported in persons with or without comorbidities. Conjunctivitis, gastrointestinal symptoms, encephalitis and encephalopathy have also been reported.
Laboratory tests are required to diagnose human infection with influenza. WHO periodically updates technical guidance protocols for the detection of zoonotic influenza using molecular methods, e.g. RT-PCR. Evidence suggests that some antiviral drugs, notably neuraminidase inhibitors (oseltamivir, zanamivir), can reduce the duration of viral replication and improve survival prospects for some cases.
ALocal and national health authorities report implementing the following public health measures:
Conducting an ongoing investigation into the source of infection.
Formed a multi-disciplinary group experts to determine the cause of death. It comprised of professionals from Secretaría de Salud: Comisión Coordinadora de Institutos Nacionales de Salud y Hospitales de Alta Especialidad (CCINSHAE) of the Centro Nacional de Programas Preventivos y Control de Enfermedades (CENAPRECE); Dirección General de Información en Salud (DGIS), Dirección General de Epidemiología (DGE-InDRE) and Dirección General de Promoción de la Salud (DGPS); Secretarías de la Defensa Nacional (SEDENA); Secretaría de Marina Armada de México (SEMAR); and Instituto Mexicano del Seguro Social.
Issued official press releases including updates of national investigations and actions with a multisectoral approach, as well as general information and recommendations for the population.
The below actions were previously reported
Epidemiological investigation of case and contacts.
Monitoring of health care workers with a history of contact with the patient.
Monitoring and surveillance of influenza-like respiratory illness (ILI) and severe acute respiratory illness (SARI) in neighbouring municipalities (within the same health region), in order to analyze the behaviour and trends of respiratory syndromes and viruses in the region.
Analysis of the trends of pneumonia and bronchopneumonia, acute respiratory infections, and conjunctivitis by the health services of Mexico City and the State of Mexico.
Identification of transmission chains and risk factors in the municipality where the case resided, the State of Mexico and surrounding areas.
Training on the National Guide for preparedness, prevention and response to an outbreak or zoonotic influenza event at the animal-human interface.
Communicated with animal and environmental health authorities to strengthen surveillance activities in poultry and wild birds near the case's residence and areas with a history of low pathogenic avian influenza A(H5N2) outbreaks.
PAHO/WHO implemented the following measures:
Strengthening routine and event surveillance on the human-animal interface with WHO Collaborating Centers and strategic partners.
Improvement of molecular diagnostic capacity for detection of zoonotic diseases through knowledge transfer, training and technical support with recent emphasis in avian influenza A(H5N1).
Strengthening national capacity for the prompt shipment of human and animal samples to WHO collaborating centers for additional characterization and/or vaccine composition analysis.
Regular risk assessment for transmissibility and severity for zoonotic viruses.
Update of guidelines on influenza surveillance and response at the human-animal interface.
Revision of experiences in response and lessons learned from countries that experienced zoonotic influenza outbreaks.
Technical strengthening of risk communication capacities for events at the human-animal interface.
Clinical management training on zoonotic influenza treatment, infection prevention and control (IPC), and reorganization of health services.
Animal carcass handling training, including IPC technical aspects.
PAHO published recommendations to strengthen intersectoral work in surveillance, early detection, and research at the human animal interface.
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.
Following further investigation and information sharing by national authorities in Mexico, this is an update to the Disease Outbreak News (DON) on human infection caused by avian influenza A(H5N2) published on 5 June 2024. Link(https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON520).
As was previously reported, on 23 May 2024, the Mexico International Health Regulations (IHR) National Focal Point (NFP) reported to PAHO/WHO a confirmed case of human infection with avian influenza A(H5N2) virus in a patient with underlying co-morbidities who subsequently died. This is the first laboratory-confirmed human case of infection with an influenza A(H5N2) virus reported globally and the first avian A(H5) virus infection in a person reported in Mexico. Although the source of exposure to the virus in this case is currently unknown, A(H5N2) viruses have been reported in poultry in Mexico. In their update, Mexican authorities informed WHO that a national group of experts determined on 6 June that the patient died due to complications related to his co-morbidities and that genetic analysis performed by the national authorities identified that this virus has a 99% similarity with the strain obtained during 2024 in birds in Texcoco State of Mexico. Based on available information, WHO’s risk assessment is unchanged: the current risk to the general population posed by this virus is low. The risk assessment will be reviewed should further epidemiological or virological information become available.
As summarized in the previous DON, on 23 May 2024, the Mexico IHR NFP reported to PAHO/WHO a confirmed case of infection with avian influenza A(H5N2) virus detected in a 59-year-old resident of the State of Mexico who was hospitalized on 24 April 2024 in Mexico City. The case had no known history of exposure to poultry or other animals. He had multiple underlying medical conditions. His relatives reported that he had been bedridden for three weeks, for other reasons, prior to the onset of acute symptoms. On 22 May, sequencing of the sample by the national authorities confirmed the influenza subtype was A(H5N2). The genetic analysis by the national authorities identified that this virus has a 99% similarity with the low pathogenicity (in birds) avian influenza A/chicken/Texcoco, México/CPA-01654/2024 (H5N2) strain, obtained during 2024 from birds in Texcoco State of Mexico. The detailed H5N2 virus genetic sequence from the patient specimen has been uploaded to GISAID.
A national multidisciplinary group of experts was formed to investigate the cause of death. It included infectious disease specialists, pneumonologists, microbiologists and intensive care professionals. Upon review of the patient’s clinical history and records, the national multidisciplinary team concluded on 6 June that, although the patient had a laboratory-confirmed infection with avian influenza A(H5N2) virus, he died due to complications of his co-morbidities.
No further cases were reported during the epidemiological investigation. The 17 contacts identified and monitored at the hospital where the man died and 12 additional contacts near his residence, were tested and the results were negative for influenza viruses. Samples from these persons were taken a month after the acute disease onset in the patient with confirmed influenza A(H5N2) infection. The results of the serological samples are pending.
In March 2024, an outbreak of low pathogenicity avian influenza (LPAI) A(H5N2) was identified in poultry in Texcoco, State of Mexico, and a second outbreak of LPAI A(H5N2) in April in the municipality of Temascalapa in the same state (1).
Additionally, in March 2024, a high pathogenicity avian influenza A(H5N2) outbreak was detected in a backyard poultry farm in the state of Michoacán. A study describing the continuous circulation of low pathogenicity avian influenza H5N2 viruses in Mexico and spread to several other countries was published in 2022 (2), indicating that both LPAI and HPAI A(H5) subtypes were reported in avian species in Mexico recently and in past years.
Animal influenza viruses normally circulate in animals but can also infect humans. Infections in humans have primarily been acquired through direct contact with infected animals or contaminated environments. Depending on the original host, influenza A viruses can be classified as avian influenza, swine influenza, or other types of animal influenza viruses.
Avian influenza virus infections in humans may cause mild to severe upper respiratory tract infections and influenza-associated deaths have been reported in persons with or without comorbidities. Conjunctivitis, gastrointestinal symptoms, encephalitis and encephalopathy have also been reported.
Laboratory tests are required to diagnose human infection with influenza. WHO periodically updates technical guidance protocols for the detection of zoonotic influenza using molecular methods, e.g. RT-PCR. Evidence suggests that some antiviral drugs, notably neuraminidase inhibitors (oseltamivir, zanamivir), can reduce the duration of viral replication and improve survival prospects for some cases.
ALocal and national health authorities report implementing the following public health measures:
Conducting an ongoing investigation into the source of infection.
Formed a multi-disciplinary group experts to determine the cause of death. It comprised of professionals from Secretaría de Salud: Comisión Coordinadora de Institutos Nacionales de Salud y Hospitales de Alta Especialidad (CCINSHAE) of the Centro Nacional de Programas Preventivos y Control de Enfermedades (CENAPRECE); Dirección General de Información en Salud (DGIS), Dirección General de Epidemiología (DGE-InDRE) and Dirección General de Promoción de la Salud (DGPS); Secretarías de la Defensa Nacional (SEDENA); Secretaría de Marina Armada de México (SEMAR); and Instituto Mexicano del Seguro Social.
Issued official press releases including updates of national investigations and actions with a multisectoral approach, as well as general information and recommendations for the population.
The below actions were previously reported
Epidemiological investigation of case and contacts.
Monitoring of health care workers with a history of contact with the patient.
Monitoring and surveillance of influenza-like respiratory illness (ILI) and severe acute respiratory illness (SARI) in neighbouring municipalities (within the same health region), in order to analyze the behaviour and trends of respiratory syndromes and viruses in the region.
Analysis of the trends of pneumonia and bronchopneumonia, acute respiratory infections, and conjunctivitis by the health services of Mexico City and the State of Mexico.
Identification of transmission chains and risk factors in the municipality where the case resided, the State of Mexico and surrounding areas.
Training on the National Guide for preparedness, prevention and response to an outbreak or zoonotic influenza event at the animal-human interface.
Communicated with animal and environmental health authorities to strengthen surveillance activities in poultry and wild birds near the case's residence and areas with a history of low pathogenic avian influenza A(H5N2) outbreaks.
PAHO/WHO implemented the following measures:
Strengthening routine and event surveillance on the human-animal interface with WHO Collaborating Centers and strategic partners.
Improvement of molecular diagnostic capacity for detection of zoonotic diseases through knowledge transfer, training and technical support with recent emphasis in avian influenza A(H5N1).
Strengthening national capacity for the prompt shipment of human and animal samples to WHO collaborating centers for additional characterization and/or vaccine composition analysis.
Regular risk assessment for transmissibility and severity for zoonotic viruses.
Update of guidelines on influenza surveillance and response at the human-animal interface.
Revision of experiences in response and lessons learned from countries that experienced zoonotic influenza outbreaks.
Technical strengthening of risk communication capacities for events at the human-animal interface.
Clinical management training on zoonotic influenza treatment, infection prevention and control (IPC), and reorganization of health services.
Animal carcass handling training, including IPC technical aspects.
PAHO published recommendations to strengthen intersectoral work in surveillance, early detection, and research at the human animal interface.
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.
14 June 2024 Geneva, Switzerland: The World Health Organization (WHO) today released its latest report on antibacterial agents, including antibiotics, in clinical and preclinical development worldwide. Although the number of antibacterial agents in the clinical pipeline increased from 80 in 2021 to 97 in 2023, there is a pressing need for new, innovative agents for serious infections and to replace those becoming ineffective due to widespread use.
First released in 2017, this annual report evaluates whether the current research and development (R&D) pipeline properly addresses infections caused by the drug-resistant bacteria most threatening to human health, as detailed in the 2024 WHO bacterial priority pathogen list (BPPL). Both documents aim to steer antibacterial R&D to better counter the ever-growing threat of antimicrobial resistance (AMR).
AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to medicines, making people sicker and increasing the risk of spread of infections that are difficult to treat, illness and deaths. AMR is driven largely by the misuse and overuse of antimicrobials, yet, at the same time, many people around the world do not have access to essential antimicrobial medicines.
“Antimicrobial resistance is only getting worse yet we’re not developing new trailblazing products fast enough to combat the most dangerous and deadly bacteria,” said Dr Yukiko Nakatani, WHO’s Assistant Director-General for Antimicrobial Resistance ad interim. “Innovation is badly lacking yet, even when new products are authorized, access is a serious challenge. Antibacterial agents are simply not reaching the patients who desperately need them, in countries of all income levels."
Not only are there too few antibacterials in the pipeline, given how long is needed for R&D and the likelihood of failure, there is also not enough innovation. Of the 32 antibiotics under development to address BPPL infections, only 12 can be considered innovative. Furthermore, just 4 of these 12 are active against at least 1 WHO ‘critical’ pathogen – critical being the BPPL’s top risk category, over ‘high’ and ‘medium’ priority. There are gaps across the entire pipeline, including in products for children, oral formulations more convenient for outpatients, and agents to tackle rising drug resistance.
Encouragingly, non-traditional biological agents, such as bacteriophages, antibodies, anti-virulence agents, immune-modulating agents and microbiome-modulating agents, are increasingly being explored as complements and alternatives to antibiotics. However, studying and regulating non-traditional agents is not straightforward. Further efforts are needed to facilitate clinical studies and assessments of these products, to help determine when and how to use these agents clinically.
Looking at newly approved antibacterials, since 1 July 2017, 13 new antibiotics have obtained marketing authorization but only 2 represent a new chemical class and can be termed innovative, underscoring the scientific and technical challenge in discovering novel antibacterials that are both effective against bacteria and safe for humans.
In addition, 3 non-traditional agents have been authorized, all are faecal-based products for restoring the gut microbiota, to prevent recurrent Clostridioides difficile infection (CDI) following antibiotic treatment in adults.
The preclinical pipeline is active and innovative, with many non-traditional approaches, as part of a stable number of preclinical candidates over the last 4 years. Its focus remains Gram-negative pathogens, which are resistant to last-resort antibiotics. Gram-negative bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug resistant as well.
The shift towards antibacterial agents targeting a single pathogen appears to have plateaued. Agents targeting a single pathogen increase the need for widely available and affordably priced rapid diagnostics, to ensure the relevant bacteria are present in the infections to be treated.
Greater transparency in the pipeline would: facilitate collaboration around potentially innovative but challenging projects, help scientists and drug developers, and generate more interest and funding for drug development for novel antibacterial agents.
Efforts to develop new antibacterial agents need to be accompanied by parallel efforts to ensure they can be equitably accessed, particularly in low- and middle-income countries. Universal access to quality and affordable tools for preventing, diagnosing and treating infections is key to mitigating AMR’s impact on public health and the economy, as per WHO’s Strategic and Operational Priorities for Addressing AMR in the Human Health Sector, the AMR resolution adopted by the 77th World Health Assembly and the People-centred approach to addressing AMR and core package of AMR interventions.
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.
Geneva---Gavi, the Vaccine Alliance, in collaboration with partners, is announcing support for human rabies vaccines for post exposure prophylaxis (PEP) as part of routine immunisation. Eligible countries are receiving guidance on how to access these vaccines under Gavi’s cofinancing policy. The first round of applications will be accepted by mid- July 2024. Ninety-five percent of human rabies deaths occur in Africa and Asia, most often in marginalised communities that lack access to care.
This development complements ongoing global efforts of the Zero by 30 campaign, led by United Against Rabies partners including the Food and Agriculture Organization (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH, formerly OIE) with the goal of eliminating dog-mediated human rabies by 2030.
“This commitment from Gavi is crucial and will expedite efforts to halt human fatalities caused by dog-mediated rabies,” said Dr Jérôme Salomon, Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases at WHO. “WHO will provide technical assistance to countries, not only to support their funding applications to Gavi but to draw up comprehensive plans of action that can deliver real progress towards the Zero by 30 goal.”
In more than 150 countries where dog rabies remains a serious public health problem, stocks of human rabies vaccines in public health systems are often extremely limited, especially in marginalised communities. Where human rabies vaccine is available through private facilities, the cost of PEP can impose a catastrophic financial burden on families and communities.
“Gavi’s aim with this program is to contribute to global rabies efforts and save lives by helping countries ensure that human rabies vaccines are available to anyone who needs them and that vulnerable and marginalised communities have equal access to these essential medicines,” said Aurélia Nguyen, the Chief Programme Officer at Gavi, the Vaccine Alliance.
Rabies is a viral disease that causes severe inflammation of the brain. In 99% of cases, it is transmitted to humans by a rabid dog. Once the virus reaches the central nervous system and an infected person shows clinical symptoms, rabies infection is near 100% fatal.
The deadly nature of rabies and its traumatic symptoms make it one of the world’s most feared diseases. However, rabies infection is preventable by prompt PEP, which consists of thorough wound washing, administration of a course of good quality human rabies vaccine, and immunoglobulins if needed.
Gavi initially agreed to include human rabies vaccines for PEP in its 2021-25 Vaccine Investment Strategy, however the COVID-19 pandemic led to postponement of the program until mid-2023, when the decision to restart was made by Gavi’s Board.
“Gavi’s investment is hugely important and underpins a key pillar of the global strategy to stop people dying from this terrible disease,” said Professor Lucille Blumberg, Chair of United Against Rabies. “But to stop human rabies deaths completely, we urgently need better data and surveillance, dog populations must be vaccinated, and people must be educated about what to do if bitten, and how to avoid being bitten in the first place. Stopping human deaths from rabies is within our reach, but it will take multiple sectors working together to achieve it.”
All Gavi-eligible countries can apply for support to invest in human rabies vaccines for PEP. Funding will be available for vaccine procurement and associated supplies. Rabies immunoglobulins (RIG) and dog vaccines are not covered by this program. Countries are not required to have a national rabies control plan in place to apply for the first round of multiyear funding, but a national plan will be mandatory for all subsequent applications.
Funding applications will be accepted by Gavi in 2024 by 15 July and by 23 September 2024, with subsequent funding windows open three times every year.
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.
Geneva---Gavi, the Vaccine Alliance, in collaboration with partners, is announcing support for human rabies vaccines for post exposure prophylaxis (PEP) as part of routine immunisation. Eligible countries are receiving guidance on how to access these vaccines under Gavi’s cofinancing policy. The first round of applications will be accepted by mid- July 2024. Ninety-five percent of human rabies deaths occur in Africa and Asia, most often in marginalised communities that lack access to care.
This development complements ongoing global efforts of the Zero by 30 campaign, led by United Against Rabies partners including the Food and Agriculture Organization (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH, formerly OIE) with the goal of eliminating dog-mediated human rabies by 2030.
“This commitment from Gavi is crucial and will expedite efforts to halt human fatalities caused by dog-mediated rabies,” said Dr Jérôme Salomon, Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases at WHO. “WHO will provide technical assistance to countries, not only to support their funding applications to Gavi but to draw up comprehensive plans of action that can deliver real progress towards the Zero by 30 goal.”
In more than 150 countries where dog rabies remains a serious public health problem, stocks of human rabies vaccines in public health systems are often extremely limited, especially in marginalised communities. Where human rabies vaccine is available through private facilities, the cost of PEP can impose a catastrophic financial burden on families and communities.
“Gavi’s aim with this program is to contribute to global rabies efforts and save lives by helping countries ensure that human rabies vaccines are available to anyone who needs them and that vulnerable and marginalised communities have equal access to these essential medicines,” said Aurélia Nguyen, the Chief Programme Officer at Gavi, the Vaccine Alliance.
Rabies is a viral disease that causes severe inflammation of the brain. In 99% of cases, it is transmitted to humans by a rabid dog. Once the virus reaches the central nervous system and an infected person shows clinical symptoms, rabies infection is near 100% fatal.
The deadly nature of rabies and its traumatic symptoms make it one of the world’s most feared diseases. However, rabies infection is preventable by prompt PEP, which consists of thorough wound washing, administration of a course of good quality human rabies vaccine, and immunoglobulins if needed.
Gavi initially agreed to include human rabies vaccines for PEP in its 2021-25 Vaccine Investment Strategy, however the COVID-19 pandemic led to postponement of the program until mid-2023, when the decision to restart was made by Gavi’s Board.
“Gavi’s investment is hugely important and underpins a key pillar of the global strategy to stop people dying from this terrible disease,” said Professor Lucille Blumberg, Chair of United Against Rabies. “But to stop human rabies deaths completely, we urgently need better data and surveillance, dog populations must be vaccinated, and people must be educated about what to do if bitten, and how to avoid being bitten in the first place. Stopping human deaths from rabies is within our reach, but it will take multiple sectors working together to achieve it.”
All Gavi-eligible countries can apply for support to invest in human rabies vaccines for PEP. Funding will be available for vaccine procurement and associated supplies. Rabies immunoglobulins (RIG) and dog vaccines are not covered by this program. Countries are not required to have a national rabies control plan in place to apply for the first round of multiyear funding, but a national plan will be mandatory for all subsequent applications.
Funding applications will be accepted by Gavi in 2024 by 15 July and by 23 September 2024, with subsequent funding windows open three times every year.
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.
On 22 May 2024, the International Health Regulations (IHR) National Focal Point (NFP) for India reported to WHO a case of human infection with avian influenza A(H9N2) virus detected in a child resident of West Bengal state in India. This is the second human infection of avian influenza A(H9N2) notified to WHO from India, with the first in 2019. The child has recovered and was discharged from hospital. According to the IHR (2005), a human infection caused by a novel influenza A virus subtype is an event that has the potential for high public health impact and must be notified to the WHO. Most human cases of infection with avian influenza A(H9N2) viruses are exposed to the virus through contact with infected poultry or contaminated environments. Human infection tends to result in mild clinical illness. Based on available information, further sporadic human cases could occur as this virus is one of the most prevalent avian influenza viruses circulating in poultry in different regions. With the currently available evidence, WHO assesses the current public health risk to the general population posed by this virus as low. However, the risk assessment will be reviewed should further epidemiological or virological information become available.
On 22 May 2024, WHO received a notification from the IHR NFP regarding a human case of avian influenza A(H9N2) virus infection in West Bengal state, India.
The patient is a 4-year-old child residing in West Bengal state. The case, previously diagnosed with hyperreactive airway disease, initially presented to the paediatrician with fever and abdominal pain on 26 January 2024. On 29 January, the patient developed seizures and was brought to the same paediatrician. On 1 February, the patient was admitted to the pediatric intensive care unit (ICU) of a local hospital due to the persistence of severe respiratory distress, recurrent high-grade fever and abdominal cramps. The patient was diagnosed with post-infectious bronchiolitis caused by viral pneumonia. On 2 February, the patient tested positive for influenza B and adenovirus at the Virus Research and Diagnostic Laboratory at the local government hospital. The patient was discharged from the hospital on 28 February 2024.
On 3 March, with a recurrence of severe respiratory distress, he was referred to another government hospital and was admitted to the pediatric ICU and intubated. On 5 March, a nasopharyngeal swab was sent to the Kolkata Virus Research and Diagnostic Laboratory and tested positive for influenza A (not sub-typed) and rhinovirus. The same sample was sent to the National Influenza Centre at the National Institute of Virology in Pune for subtyping. On 26 April, the sample was sub-typed as influenza A(H9N2) through a real-time polymerase chain reaction. On 1 May, the patient was discharged from the hospital with oxygen support. Information on the vaccination status and details of antiviral treatment were not available at the time of reporting.
The patient had exposure to poultry at home and in the surroundings. There were no known persons reporting symptoms of respiratory illness in the family, the neighbourhood, or among healthcare workers at health facilities attended by the case at the time of reporting.
This is the second human infection of avian influenza A(H9N2) virus infection notified to WHO from India, with the first in 2019. Further sporadic human cases could occur as this virus is one of the most prevalent avian influenza viruses circulating in poultry in different regions.
Animal influenza viruses normally circulate in animals but can also infect humans. Infections in humans have primarily been acquired through direct contact with infected animals or through indirect contact with contaminated environments. Depending on the original host, influenza A viruses can be classified as avian influenza, swine influenza, or other types of animal influenza viruses.
Avian influenza virus infections in humans may cause diseases ranging from mild upper respiratory tract infection to more severe diseases and can be fatal. Conjunctivitis, gastrointestinal symptoms, encephalitis and encephalopathy have also been reported.
Laboratory tests are required to diagnose human infection with influenza. WHO periodically updates technical guidance protocols for the detection of zoonotic influenza using molecular methods.
WHO is providing continued support to the Government of India through technical advice, updates on risk assessment and updating contingency plans- both in the human and animal sectors in line with the global guidance.
The Government of India has implemented the following coordination activities in response to the incident:
A team composed of a public health specialist, a paediatrician, and veterinary officials from the Animal Husbandry Department and Veterinary College, and the Government of West Bengal was constituted to investigate the occurrence of influenza-like illness (ILI) in local poultry.
Surveillance of ILI in humans was enhanced in the reporting district and in neighbouring areas.
The District Veterinary Department enhanced surveillance of animals.
The Animal Husbandry Department will share information regarding surveillance of avian influenza viruses (all subtypes under surveillance) in poultry, wild birds, etc., in the affected and adjoining areas with State Health authorities and at the central level with the Ministry of Health and Family Welfare, Government of India.
WHO continues to support the strengthening of country IHR core capacities, ensuring that Ministry of Health and Department of Animal Husbandry colleagues, along with partners, are kept informed about emerging global risks of avian influenza at the animal-human interface.
In accordance with the One Health Joint Plan of Action (OH JPA), WHO is actively working to enhance the One Health approach by building capacity for joint risk assessments. WHO is providing technical support to update country-specific avian/pandemic influenza contingency plans, as requested.
Most human cases of infection with avian influenza A(H9N2) viruses are exposed to the virus through contact with infected poultry or contaminated environments. Human infection tends to result in mild clinical illness. However, globally, there have been some hospitalized cases and two fatal cases reported in the past. Given the continued detection of the virus in poultry populations, sporadic human cases can be expected.
No additional confirmed cases have been reported in the local area based on joint investigations.
Currently, available epidemiological and virological evidence suggests that this virus has not acquired the ability to be sustained in transmission among humans. Thus, the likelihood of human-to-human spread is low. However, the risk assessment will be reviewed should further epidemiological or virological information become available.
International travellers from affected regions may present with infections either during their travels or after arrival in other countries. Even if this were to occur, further community-level spread is considered unlikely as this virus has not acquired the ability to transmit easily among humans.
This case does not change the current WHO recommendations on public health measures and influenza surveillance at the human-animal and environmental interface. A thorough investigation of every human infection is essential.
The public should avoid unprotected contact with live poultry, high-risk environments such as live animal markets or farms, and surfaces that might be contaminated by poultry droppings.
Infection prevention and control (IPC) measures should be applied including performing hand hygiene frequently either by washing with soap and water or using alcohol hand rub solutions ensuring that the hands are visibly clean, in addition to environmental cleaning and disinfection.
WHO advice on implementing early infection control and prevention measures to prevent the nosocomial spread of the disease (that is, spread originating in a health care setting) include;
Raise awareness among healthcare workers regarding suspected cases.
Implement a screening and triaging (patient categorization) system in hospitals.
Implement standard and droplet precautions, and airborne precautions (N95/FFP2/FFP3), when aerosol-generating procedures are being carried out on suspected cases. Monitor healthcare workers for fever and influenza-like illness.
Provide personal protective equipment and appropriate training in its use.
All human infections caused by a new subtype of influenza virus are notifiable under the IHR (2005). State Parties to the IHR (2005) are required to immediately notify WHO of any laboratory-confirmed case of a recent human infection caused by an influenza A virus of pandemic potential (IVPP).
WHO advises against applying any travel or trade restrictions based on the current information available on this event. WHO does not recommend any specific measures for travellers.
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.
Geneva, 28 May 2024 -- The World Health Assembly (WHA) today recognized the progress made over the past two years by Member States to develop a pandemic agreement and strengthen the International Health Regulations (IHR, 2005). Governments meeting in Geneva for the Seventy-seventh World Health Assembly are in talks to advance these two efforts, which aim to boost the world’s ability to better able to prevent and respond to the threat of future pandemics.
WHO Member States agreed to continue to work during the World Health Assembly, which ends on 1 June, with the aim to:
finalize the package of amendments to the IHR (2005) agree the timing, format and process to conclude the pandemic agreement. During today’s session, the WHA first considered agenda item 13.4 on the draft pandemic agreement. Delegates acknowledged the extensive work undertaken by the Member State-led Intergovernmental Negotiating Body (INB), and the Bureau steering the work, since governments launched the process in December 2021 to develop the world’s first pandemic accord to prevent a repeat of the global health, economic and social impacts of the COVID-19 pandemic.
Member States reiterated that the world needs a pandemic agreement built on the principles of equity, sovereignty, and prevention, preparedness and response, and to ensure future generations are safeguarded from the threat of inevitable future pandemics.
WHA delegates also considered agenda item 13.3, which laid out the work undertaken to negotiate the amendments to the International Health Regulations(2005) to build on lessons learned from the global response to the COVID-19 pandemic.
Member States stressed that agreement on updated and stronger International Health Regulations were essential for ensuring global health security.
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.
Geneva, 28 May 2024 -- The World Health Assembly (WHA) today recognized the progress made over the past two years by Member States to develop a pandemic agreement and strengthen the International Health Regulations (IHR, 2005). Governments meeting in Geneva for the Seventy-seventh World Health Assembly are in talks to advance these two efforts, which aim to boost the world’s ability to better able to prevent and respond to the threat of future pandemics.
WHO Member States agreed to continue to work during the World Health Assembly, which ends on 1 June, with the aim to:
finalize the package of amendments to the IHR (2005) agree the timing, format and process to conclude the pandemic agreement. During today’s session, the WHA first considered agenda item 13.4 on the draft pandemic agreement. Delegates acknowledged the extensive work undertaken by the Member State-led Intergovernmental Negotiating Body (INB), and the Bureau steering the work, since governments launched the process in December 2021 to develop the world’s first pandemic accord to prevent a repeat of the global health, economic and social impacts of the COVID-19 pandemic.
Member States reiterated that the world needs a pandemic agreement built on the principles of equity, sovereignty, and prevention, preparedness and response, and to ensure future generations are safeguarded from the threat of inevitable future pandemics.
WHA delegates also considered agenda item 13.3, which laid out the work undertaken to negotiate the amendments to the International Health Regulations(2005) to build on lessons learned from the global response to the COVID-19 pandemic.
Member States stressed that agreement on updated and stronger International Health Regulations were essential for ensuring global health security.
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.
Geneva, 27 May 2024 - The Group of Friends of the WHO Academy was launched today on the sidelines of the 77th World Health Assembly. The event was co-hosted by founding members: France, Indonesia, Japan, Qatar and Rwanda, represented by their minister or vice minister of health.
With 30 Member States in attendance, Dr Tedros Adhanom Ghebreyesus, WHO Director-General, expressed his gratitude to the founding Friends, stating, "As a key initiative of the WHO Transformation that began in 2018, the WHO Academy will be a vital asset for Member States, and a game changer in the way WHO supports countries in building capacities. The support of the Group of Friends will enable the WHO Academy to drive lifelong learning in health as a global priority."
Supported by France, the WHO Academy campus in Lyon will open its doors at the end of 2024. Serving the global health and care workforce, its training delivery will include a portfolio of evidence-based courses available globally online and in-person capacity-building programmes offered in Lyon as well as in Member States.
The Group of Friends will offer political support to promote the Academy and advocate for investment in health workforce training. The group's goal is to help the WHO Academy become the world's leading institution for lifelong learning in health.
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.
Seven winning short films, four special mentions from the Jury
Geneva---The World Health Organization has announced the official selection of this year’s winning films of its 5th Health for All Film Festival. The awards were announced today at a special event launching WHO’s Investment Round on the eve of the Seventy-Seventh World Health Assembly in Geneva.
The event, opened by WHO Director-General, Dr Tedros Adhanom Ghebreyesus, and attended by High-Level Representatives of Member States and celebrities from the cinema and arts domain, saw winning films announced for seven different categories, while four films received special mentions from the jury.
This is the fifth year of the Film Festival which received almost 1000 entries from filmmakers around the world on issues ranging from gender equity and war trauma to burnout, climate change and healthy ageing. Of these, 61 shortlisted films were judged by a panel of distinguished professionals, artists and activists, including renowned actors and advocates, Nandita Das, Sharon Stone and Alfonso Herrera; filmmaker and producer, Apolline Traoré; Olympic swimmer and UNHCR Goodwill Ambassador, Yusra Mardini; multidisciplinary artist, Mário Macilau; and film director, Paul Jerndal. They were joined by senior United Nations officials and WHO staff.
“WHO’s Health for All Film Festival gathers many powerful stories about a variety of health experiences from people from all over the world,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “Listening to the stories of people affected by health issues helps us to understand people’s lived experiences and move towards achieving better health for all.”
From the official selection, one “Grand Prix” is awarded for each of the three main competition categories: Universal health coverage, Health emergencies, and Better health and well-being, which align with WHO’s Triple Billion Targets.
Nandita Das, Indian actor, filmmaker and social advocate, who has served twice on the jury of the Cannes Film Festival and has acted in more than 40 feature films in 10 different languages said: “I am delighted to be a juror for WHO’s Health For All Film Festival. Films can create awareness, challenge prejudices, ask uncomfortable questions and tell stories that need to be told. Health is personally and collectively, our right and responsibility. So to celebrate films that focus on these issues is important. I am glad that l have the opportunity to announce the winners of the 5th edition of this annual event.”
Four special prizes were also given for a Student-produced film, a film on Physical Activity and Health, a film on Migrants and Refugees Health and a Very Short Film.
The theme of mental health featured heavily in this year’s winning entries, including a powerful and moving short film from France about the difficulties of supporting a relative diagnosed with a severe disease. The film depicts a 14-year-old who copes with heavy responsibilities while living alone with her mother, who has cancer.
Another winning film, from Türkiye, captures the survival and recovery of a young Syrian refugee mother in southern Türkiye who spent five days trapped under building rubble in the aftermath of the earthquakes of 6 February 2023. The moving film details her rehabilitation progress including learning to walk again.
List of films awarded Universal Health Coverage "Grand Prix": “The Visionary Women of Indonesia” – Indonesia / Disabilities; Blindness; Rehabilitation
Directed by Nalin Narang (Australia) from The Fred Hollows Foundation / Documentary – Duration 5’10’’
Health Emergencies "Grand Prix": “Journey Beyond the Rubble”– Türkiye / Natural disasters; Earthquake; Internally displaced persons
Directed by Mumen Sayed Issa and Atheer Salem Bahr (Türkiye) from the Independent Doctors Association / Documentary – Duration 7’09’’
Better Health and Well-being "Grand Prix": “Color” – Spain / Gender equity
Directed by Eva Jakubovska (Poland/Spain) / Fiction – Duration 8’
Special Prize Physical Activity and Health Film: "Ping Pong Parkinsons” – United States of America / Mental health; Parkinson; Physical activity
Directed by Dave Steck (United States of America) from Numeric Pictures company / Documentary - Duration 3’06’’
Special Prize Migrants and Refugees Health Film: “Dalal's Story” – Iraq / Trauma; War; Refugees health; Mental health
Directed by Alexandra Cordukes from Laundry Lane Productions (Australia) / Animation – Duration 6’15’’
Student Film Prize: “Mom & Me, and that... (Maman & Moi, et ça...)” – France / NCDs - Cancer; Mental health
Directed by Elisa Tiozzo (France) / Animation – Duration 3’56’’
Special Prize Very Short Film: “Cycle Path” – United Kingdom / Environment; Climate change and health
Directed by Red Wade (United Kingdom) / Fiction – Duration 3’
Films receiving a Special Mention from the Jury Health Emergencies Special Mention: “The Island (ADA)” – Türkiye / Drought; Climate change; Migration
Directed by MAHMUT TAŞ (Türkiye) / Documentary – Duration 5’
Better Health and Well-being Special Mention:“The Pure” – Iran / Social determinants of health; Access to hygiene
Directed by Masoud Mashouf (Iran) / Fiction – Duration 4’37’’
Universal Health Coverage Special Mention: “Beyond The Last Mile - The Story of Rose Magayi” – Malawi / Health workforce; Community
Directed by Carlo Lechea / Village Reach (NGO in Africa) / Documentary – Duration 8’
Very Short Film Special Mention: “Human Being. Handle with Care” – Global / Mental health; Stress; Healthy diet
Directed by Maya Adam (United States of America) from the Stanford School of Medicine / Fiction – Duration 2’21’’
The World Health Assembly is the decision-making body of WHO. Held annually in Geneva, it is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board. The Assembly's main functions are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget.
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.