28 August 2023, Gaborone, Botswana -- The Republic of Botswana and the World Health Organization today announced designation of the Botswana National HIV Reference Laboratory as a WHO Collaborating Centre of Excellence, in recognition of the laboratory’s excellence in the field of HIV diagnosis and the potential of deeper collaboration with WHO in advancing the health and well-being of people living with HIV.
Botswana has made tremendous strides in improving its diagnostic and laboratory systems, particularly in the areas of human capacity building, health event and outbreak detection and management, reduction of the turnaround time of laboratory results, expansion of the national public health laboratory testing menus, genomic sequencing for detection of newly discovered strong signals, as well as accreditation of its laboratories for improved and quality services.
Accreditation to these standards does not only allow Botswana’s public laboratories to be compared with the world’s best laboratories, but it also gives confidence to both patients and clinicians that patient management and care are based on correct disease diagnosis.
The Botswana National HIV Reference Laboratory is not only accredited to ISO 15189, but was also designated as a WHO HIV Drug resistance laboratory (WHO HIV ResNet-HIV Drug Resistance Network) in 2019. The WHO HIV drug resistance laboratory operational framework offers guidance on how WHO HIVResNet laboratories function to support national, regional and global HIV drug resistance surveillance, by providing accurate genotyping results in a standardized format in line with WHO specifications.
In view of these developments, the Government of Botswana made a deliberate decision to designate the Botswana National HIV Reference Laboratory as a WHO Collaborating Centre for HIV drug resistance and other diagnostic testing. This was confirmed through the signing of the designation by His Excellency Dr Mokgweetsi Eric Keabetswe Masisi, President of the Republic of Botswana, and the WHO Director-General Dr Tedros Adhanom Ghebreyesus in Gaborone, Botswana this morning.
“Designation of this laboratory as a WHO Collaborating Centre of Excellence gives our country the confidence that we are on the right track in the road to achieving the WHO 2030 goal for epidemic control,” said Dr Masisi.
Dr Tedros said, “The Botswana National HIV Reference Laboratory has long been a centre of excellence in responding to the challenges posed by HIV, and in supporting the health sector and communities at large to provide the diagnoses and details needed to make informed, patient-centred choices. WHO is proud to count the laboratory as a Collaborating Centre and looks forward to working together even more closely in providing the support and care needed for people living with HIV.”
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.
WHO launched the WHO Civil Society Commission and held the inaugural meeting of its Steering Committee in Geneva today. The Commission provides, for the first time, the ability to channel advice and recommendations in a more structured and systematic manner from civil society to WHO on health priorities and related issues. The historical role of civil society organizations (CSO) in bringing about change in public health is well-known. While WHO has a long-standing tradition of working with CSOs, the establishment of the Commission takes the collaboration to a new level.
Today’s meeting was opened by Dr Tedros Adhanom Ghebreyesus, WHO Director-General, and brought together the members of the Steering Committee (consisting of 22 diverse civil society organizations from the Commission, working on health and other sectors. Full membership of the Commission itself will be announced in the coming days.
The Commission’s mandate is to strengthen dialogue and foster collaboration with WHO and among one another. It will also provide recommendations to support WHO in this engagement at all levels (global, regional and national) towards the achievement of universal health coverage (health for all) as well as the Sustainable Development Goals. The launch of the Commission is the Director-General’s response to civil society requests to explore better and more meaningful ways to engage with WHO above and beyond those which already exist.
“We know from our experience in so many areas that listening to and responding to the voices of the communities we serve is essential to properly addressing the health challenges they face,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. ”We have set up the WHO Civil Society Commission to bring civil society from different backgrounds together to advise us and work with us so that we can learn from you and be guided by your ideas.”
The Steering Committee will provide overall strategic direction for the full Commission and lead the development of its main deliverables. It will also convey advice and recommendations from civil society through regular engagement with the Director-General and senior WHO leadership.
During the meeting, the WHO Director-General encouraged the Steering Committee to consult with all Commission members and set priorities based on what they learn. He also asked for guidance in developing a WHO civil society engagement strategy and in such r key organizational priorities as WHO’s next -three-year plan: the 14th General Programme of Work will be approved by Member States in May 2024 and guide the work of the organization from 2025-2028.
Over 350 Organizations have so far applied to be part of the Commission. Today, WHO, will begin to notify the 120 organizations that have been accepted so far. Others will be notified in the coming weeks. A list of participants can be found of the WHO website and will be regularly updated.
The application process will remain open and organizations that wish to apply to join the Commission are encouraged to do so.
“This is an historic opportunity for close collaboration between WHO and CSOs around the world, and we are excited that many organizations will have an active role.” Said the Steering Committee civil society co-chairs Lisa Hilmi (CORE group) and Ravi Ram (Medwise Solutions) “We welcome all civil society organizations committed to improve global health to join the WHO CSO Commission and look forward to their engagement and thought leadership for addressing critical health issues.”
Organizations that meet the criteria in the Terms of Reference for the Civil Society Commission may apply to join the WHO Civil Society Commission. The application can be accessed on the WHO website for the Civil Society Commission; there is no cut-off date for applications.
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.
New study has been published today in The Lancet Global Health showing that almost one in three men over the age of 15 are infected with at least one genital human papillomavirus (HPV) type and one in five are infected with one or more of what are known as high risk, or oncogenic, HPV types.
These estimates show that men frequently harbour genital HPV infections and emphasize the importance of incorporating men in efforts to control HPV infection and to reduce the incidence of HPV related disease in both men and women.
Most HPV infections cause no symptoms and clear without intervention, but certain types of HPV can lead to anogenital warts or cancer. HPV is the leading cause of cervical cancer in women and each year more than 340,000 women die of cervical cancer related to HPV. In men, IARC estimated that in 2018 there were more than 69,400 of cases of cancer caused by HPV. HPV related cancers in men include penile, anal, oral and throat cancers.
The epidemiology of human papillomavirus (HPV) in women has been well documented. Less is known about the epidemiology of HPV in men. We aim to provide updated global and regional pooled overall, type-specific, and age-specific prevalence estimates of genital HPV infection in men.
We conducted a systematic review and meta-analysis to assess the prevalence of genital HPV infection in the general male population. We searched Embase, Ovid MEDLINE, and the Global Index Medicus for studies published between Jan 1, 1995, and June 1, 2022. Inclusion criteria were population-based surveys in men aged 15 years or older or HPV prevalence studies with a sample size of at least 50 men with no HPV-related pathology or known risk factors for HPV infection that collected samples from anogenital sites and used PCR or hybrid capture 2 techniques for HPV DNA detection. Exclusion criteria were studies conducted among populations at increased risk of HPV infection, exclusively conducted among circumcised men, and based on urine or semen samples. We screened identified reports and extracted summary-level data from those that were eligible. Data were extracted by two researchers independently and reviewed by a third, and discrepancies were resolved by consensus. We extracted only data on mucosal α-genus HPVs. Global and regional age-specific prevalences for any HPV, high-risk (HR)-HPV, and individual HPV types were estimated using random-effects models for meta-analysis and grouped by UN Sustainable Development Goals geographical classification.
We identified 5685 publications from database searches, of which 65 studies (comprising 44 769 men) were included from 35 countries. The global pooled prevalence was 31% (95% CI 27–35) for any HPV and 21% (18–24) for HR-HPV. HPV-16 was the most prevalent HPV genotype (5%, 95% CI 4–7) followed by HPV-6 (4%, 3–5). HPV prevalence was high in young adults, reaching a maximum between the ages of 25 years and 29 years, and stabilised or slightly decreased thereafter. Pooled prevalence estimates were similar for the UN Sustainable Development Goal geographical regions of Europe and Northern America, Sub-Saharan Africa, Latin America and the Caribbean, and Australia and New Zealand (Oceania). The estimates for Eastern and South-Eastern Asia were half that of the other regions.
Almost one in three men worldwide are infected with at least one genital HPV type and around one in five men are infected with one or more HR-HPV types. Our findings show that HPV prevalence is high in men over the age of 15 years and support that sexually active men, regardless of age, are an important reservoir of HPV genital infection. These estimates emphasise the importance of incorporating men in comprehensive HPV prevention strategies to reduce HPV-related morbidity and mortality in men and ultimately achieve elimination of cervical cancer and other HPV-related diseases.
Instituto de Salud Carlos III, European Regional Development Fund, Secretariat for Universities and Research of the Department of Business and Knowledge of the Government of Catalonia, and Horizon 2020.
Human papillomavirus (HPV) is the most common sexually transmitted viral infection worldwide, and previous research has shown that most sexually active men and women will acquire at least one genital HPV infection during their lives.1 There are more than 200 HPV types that can be transmitted sexually, and at least 12 types are oncogenic.2 The majority of HPV infections in men and women are asymptomatic, but they can lead to long-term sequelae and mortality. Each year, more than 340 000 women die of cervical cancer.3 In men, HPV infection tends to manifest clinically as anogenital warts, which cause significant morbidity and increase HPV transmission rates.4, 5 HPV infections are also associated with penile, anal, and oropharyngeal cancers, which are commonly linked to HPV type 16.6, The International Agency for Research on Cancer estimated that there were about 69 400 cases of cancer in men caused by HPV in 2018.
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.
The World Health Organization (WHO) is convening the Traditional Medicine Global Summit on 17 and 18 August 2023 in Gandhinagar, Gujarat, India. Co-hosted by the Government of India, the Summit will explore the role of traditional, complementary, and integrative medicine in addressing pressing health challenges and driving progress in global health and sustainable development.
High-level participants will include the WHO Director-General and Regional Directors, G20 health ministers and high-level invitees from countries across WHO’s six regions. Scientists, practitioners of traditional medicine, health workers and members of the civil society organizations will also take part.
The Summit will explore ways to scale up scientific advances and realize the potential of evidence-based knowledge in the use of traditional medicine for people’s health and well-being around the world. Scientists and other experts will lead technical discussions on research, evidence and learning; policy, data and regulation; innovation and digital health; and biodiversity, equity and Indigenous knowledge.
“Traditional medicine can play an important and catalytic role in achieving the goal of universal health coverage and meeting global health-related targets that were off-track even before the disruption caused by the COVID-19 pandemic,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Bringing traditional medicine into the mainstream of health care -- appropriately, effectively, and above all, safely based on the latest scientific evidence -- can help bridge access gaps for millions of people around the world. It would be an important step toward people-centered and holistic approaches to health and well-being.”
Heads of State and government at the 2019 UN high-level meeting on universal health coverage acknowledged the need to include evidence-based traditional and complementary medicine services particularly in primary health care, a cornerstone of health systems, in pursuit of health for all. Today, traditional and complementary medicine is well established in many parts of the world, where it plays an important role in the culture, health and well-being of many communities. In some countries, it represents a significant part of the health sector’s economy, and for millions of people around the world it is the only available source of health care.
Traditional medicine has contributed to breakthrough medical discoveries and continues to hold out great promise. Research methods such as ethnopharmacology and reverse pharmacology could help identify new, safe and clinically effective drugs, while the application of new technologies in health and medicine -- for example genomics, new diagnostic technologies, and artificial intelligence -- could open new frontiers of knowledge on traditional medicine.
Amid an expansion in the use of traditional medicine worldwide, safety, efficacy and quality control of traditional products and procedure-based therapies remain important priorities for health authorities and the public. Natural doesn’t always mean safe, and centuries of use are not a guarantee of efficacy; therefore, scientific method and process must be applied to provide the rigorous evidence required for the recommendation of traditional medicines in WHO guidelines.
“Advancing science on traditional medicine should be held to the same rigorous standards as in other fields of health. This may require new thinking on the methodologies to address these more holistic, contextual approaches and provide evidence that is sufficiently conclusive and robust to lead to policy recommendations,” said Dr John Reeder, WHO Director of Special Programme for Research and Training in Tropical Diseases and Director of the Department of Research for Health.
The Summit will explore research and evaluation of traditional medicine, including methodologies that can be used to develop a global research agenda and priorities in traditional medicine, as well as challenges and opportunities based on 25 years of research in traditional medicine. Findings from the systematic reviews of traditional medicine and health, evidence maps of clinical effectiveness, and an artificial intelligence global research map on traditional medicine will be presented.
A stronger evidence base will enable countries to develop appropriate mechanisms and policy guidance for regulating, ensuring quality control and monitoring traditional medicine practices, practitioners and products, according to national contexts and needs.
At the Summit, WHO will present emerging findings from the third global survey on traditional medicine, which, for the first time, includes questions on financing of traditional and complementary medicine, health of Indigenous Peoples, quality assurance, traditional medicine knowledge, biodiversity, trade, integration, patient safety, and more. The complete survey, which will be released later in the year, first on an interactive online dashboard and then as a report, will inform the development of WHO’s updated traditional medicine strategy 2025-2034 as requested by the World Health Assembly in May 2023.
Standardization of traditional medicine condition documentation and coding in routine health information system is a pre-requisite for effective management and regulation of traditional medicine in healthcare systems. This includes consideration of forms, incidence rates, and outcomes associated with traditional medicine healthcare. The Summit will be an opportunity to showcase countries’ experiences, explore regional trends and discuss best practices, including in the implementation of the traditional medicine chapter in the latest International Classification of Diseases, the ICD-11.
Participants in the Summit will examine a global overview of policy, legal and regulatory landscapes; formal structures and policies to collect data and establish systems for information management; an assessment of educational and training programmes for the development of traditional medicine workforce; and experiences and best practices on training, accreditation and regulation of traditional medicine practitioners, which can substantially advance patient safety and minimize patient harm in the provision of traditional medicine services.
Biodiversity and indigenous knowledge are foundational pillars of traditional medicine and health and well-being, especially for Indigenous Peoples; 80 per cent of the world’s remaining biodiversity is in Indigenous territories or lands, while conservation of biodiversity is a key issue related to the sustainable use of traditional medicines.
In preparation for the Summit, a WHO global workshop on biodiversity, indigenous knowledge, health, and well-being was held in Brazil from 25 to 28 July, to better understand the invaluable connection between biodiversity, traditional knowledge, and human health. Meeting outcomes, in the form of recommendations, will be presented at the Summit, and will contribute to the biodiversity and One Health workstream.
The Summit’s focus on sustainable biodiversity management in the face of the climate crisis will drive the identification and sharing of best practices, initiatives, and legislative frameworks on the protection of traditional knowledge, innovation, and access and equitable benefit-sharing by countries. The discussions at the Summit will focus on the rising prospect of global economic activities related to traditional medicine, Indigenous knowledge-based innovations in health care, application of intellectual property laws and regulations, and the use and promotion of indigenous and ancestral medicine through intercultural dialogues to support community 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.
On 4 July 2023, the Ministry of Health of the United Republic of Tanzania notified WHO of the detection of circulating vaccine-derived poliovirus type 2 (cVDPV2) in the country. The virus was isolated from a case of acute flaccid paralysis (AFP) in the Rukwa region, southwestern Tanzania bordering Lake Tanganyika to the west and Zambia to the south. Gene sequencing of the isolated virus has indicated close linkage with the cVDPV2 circulating in South Kivu, Demographic Republic of the Congo (DRC).
The public health authorities of the Ministry of Health are conducting further field investigations including strengthening the AFP surveillance for the detection of additional AFP cases and subnational level immunity gap analysis to identify potential un-or under-immunized populations and/or areas to guide public health response activities.
WHO assesses the overall risk at the national level to be high due to the sub-optimal surveillance performance in some districts, sub-optimal vaccination coverage resulting in low population immunity and the ongoing population movement across neighbouring countries.
On 4 July 2023, the health authorities of the United Republic of Tanzania confirmed and notified WHO of the detection of circulating vaccine-derived poliovirus type 2 (cVDPV2) in the country. The case is a child under two years old and has received three doses of bOPV vaccine, one dose of IPV vaccine for routine immunization and two doses of bOPV during supplementary immunization activities (SIA) in 2022 with no documented travel history. The child was initially reported as a case of AFP from Rukwa region of southwestern Tanzania who experienced paralysis in late May 2023.
Two stool samples were collected from the case on 30 and 31 May 2023 respectively and were confirmed to be cVDPV2 on 30 June 2023. Gene sequencing results showed that the isolated virus has undergone 15 nucleotide changes and is closely related to the strain circulating in South Kivu, Demographic Republic of the Congo in 2023.1
Since 2022, Tanzania has been actively participating in a multi-country outbreak response across south-east Africa, in response to detection of different strains of poliovirus in the sub-region, including boosting immunity levels through mass vaccination campaigns and strengthening subnational surveillance capacity.
According to the WHO-UNICEF estimates of national immunization coverage, the oral polio vaccine third dose (OPV3) and the inactivated polio vaccine first dose (IPV1) was 88% in 2022 in Tanzania.
Polio is a highly infectious disease that largely affects children under five years of age, causing permanent paralysis (approximately 1 in 200 infections) or death (2-10% of those paralyzed).
The virus is transmitted from person-to-person, mainly through the fecal-oral route or, less frequently, by a common vehicle (e.g., contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and cause paralysis. The incubation period is usually 7-10 days but can range from 4-35 days. Up to 90% of those infected are either asymptomatic or experience mild symptoms and the disease usually goes unrecognized.
Vaccine-derived poliovirus is a well-documented strain of poliovirus mutated from the strain originally contained in OPV. OPV contains a live, weakened form of poliovirus that replicates in the intestine for a limited period, thereby developing immunity by building up antibodies. On rare occasions, when replicating in the gastrointestinal tract, OPV strains genetically change and may spread in communities that are not fully vaccinated against polio, especially in areas where there is poor hygiene, poor sanitation, or overcrowding. The lower the population's immunity, the longer this virus survives and the more genetic changes it undergoes.
In very rare instances, the vaccine-derived virus can genetically change into a form that can cause paralysis as does the wild poliovirus – this is what is known as a vaccine-derived poliovirus (VDPV). The detection of VDPV in at least two different sources and at least two months apart, that are genetically linked, showing evidence of transmission in the community, is classified as ‘circulating’ vaccine-derived poliovirus type 2 (cVDPV2).
The last recorded case of indigenous wild poliovirus (WPV) in Tanzania was in 1996, and the cVPDV2 case in 2023 is the first case detected in the country.
A risk assessment is being conducted, led by the Ministry of Health and supported by Global Polio Eradication Initiative partners, along with a field investigation and planning of appropriate response.
The capacity of the country’s AFP surveillance has been strengthened to detect additional AFP cases.
Subnational immunity levels are being analysed to identify potential un-or under-immunized populations and/or areas.
WHO assesses the overall risk at the national level to be high due to the sub-optimal AFP surveillance performance in some districts, the sub-optimal vaccination coverage resulting in low population immunity and more susceptible children, and the ongoing population movement across neighbouring countries.
WHO considers this event to be of high risk of international spread and/or emergence of cVDPV2 of this strain across the region, particularly across other areas of central and south-east Africa, due to the low population immunity and inadequate routine immunization levels in some areas, and large-scale population movements. In all instances, the continued spread of existing outbreaks as well as the emergence of new outbreaks of cVDPV2 point to gaps in routine immunization coverage and inadequate outbreak response vaccination.
While new WHO and UNICEF data show promising signs of immunization services rebounding in some countries, coverage still falls short of pre-pandemic levels putting children at risk from disease outbreaks, particularly in low-income countries. In response to these latest published data, the members of the Immunization Agenda 2030 Partnership Council called for further strengthened efforts (Immunization Agenda 2030) for immunization recovery.
It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for AFP cases and commence planned expansion of environmental surveillance to rapidly detect any new virus importation and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.
WHO’s International Travel and Health recommends that all travelers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or IPV within 4 weeks to 12 months of travel.
As per the advice of an Emergency Committee convened under the International Health Regulations (2005), the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC). Countries affected by poliovirus transmission are subject to Temporary Recommendations. To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency, ensure the vaccination of residents and long-term visitors and restrict at the point of departure travel of individuals, who have not been vaccinated or cannot prove the vaccination status.
The latest epidemiological information on cVDPVs is updated on a weekly basis.
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.
The World Health Organization (WHO) is sharing its latest guidance on sexually transmitted infections (STI) at the STI & HIV 2023 World Congress taking place in Chicago, the United States of America, on 24-27 July 2023. With STIs on the rise, WHO is calling for better access to testing and diagnostic services. At the congress, WHO will also discuss its latest STI research agenda and antimicrobial resistance (AMR) in gonorrhoea.
During the COVID-19 pandemic, many countries had reported low coverage for prevention, testing and treatment services for STIs, which has led to a resurgence of STIs globally. Countries with good STI surveillance, such as the United States of America and United Kingdom, are reporting increasing STIs. Emerging outbreaks of new infections, such as mpox, and the re-emergence of neglected STIs pose challenges for prevention and control efforts.
Several countries are increasingly reporting failures of current treatment recommendations for gonorrhoea. Of concern, the spread of a Neisseria gonorrhoea clone that is highly resistant to ceftriaxone is increasingly being reported in countries in Asia such as China, Japan, Singapore and Vietnam as well as in Australia, Austria, Canada, Denmark, France, Ireland and the United Kingdom. The enhanced gonorrhoea AMR surveillance (EGASP) suggests high rates of resistance in gonorrhoeae to current treatment options such as ceftriaxone, cefixime and azithromycin in Cambodia, for instance. Syphilis, as well as congenital syphilis, are on the rise, and the lack of benzathine penicillin poses a considerable challenge to effectively treat them.
Every day, more than 1 million new sexually transmitted infections (STIs) are acquired, posing a significant global health challenge. However, monitoring and understanding the trends of new STIs in low- and middle-income countries (LMIC) are hindered by limited access to diagnostic tests. “Early testing and diagnosis are key in stopping the spread of STIs. When left untreated, certain STIs can lead to long-term irreversible outcomes and some can be potentially fatal, “said Dr Teodora Wi, Lead for Sexually transmitted infections of the WHO Global HIV, Hepatitis and STIs Programmes. “Our new guidance can help make low-cost point of care tests for STIs more accessible, enabling improved data collection and quality delivery of STI services for people in need”.
WHO’s new guidance includes target product profiles (TPPs) for point-of-care diagnostic technologies for diagnosing syphilis (treponema pallidum), Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis, which aim to facilitate development of quality STI diagnostics. TPPs help to ensure that products are designed and manufactured to meet the clinical needs of populations at risk and are “fit-for-use” -- meaning they are safe, effective and adapted to the use environment. Point-of-care tests can lower health-care costs, reduce waiting times, speed up initiation of and increase the accuracy of treatment, and improve patient follow-up.
A new fourth edition of the Laboratory and point-of-care diagnostic testing for STIs including HIV provides up-to-date information on how to isolate, detect, and diagnose STIs, including HIV. The scope of the manual has been expanded to include information on the use of molecular tests, rapid point-of-care tests, and quality management of diagnostic tests.
A new product on the Diagnostics Landscape for Sexually Transmitted Infections (STIs) highlights diagnostics available to support scale-up of screening for syphilis, chlamydia, gonorrhoea, trichomoniasis, mycoplasma, herpes, and human papillomavirus (HPV) to meet the growing test demands in low-and-middle income countries. It complements the aforementioned manual.
“New models of STIs services need to be resilient and adaptive to current and future threats”, said Dr Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programmes. “Recent scientific advances in STIs treatment and technologies, and innovative service delivery methods, provide an important opportunity to end STIs as a public health concern by 2030. However, large variations in investment, maturity and performance of STI surveillance systems between countries continues to be a challenge”.
The 75th World Health Assembly (in May 2022) approved the implementation of the new Global Health Sector Strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030 (GHSS), which provides strategic directions to address current challenges in STI control.
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.
BRISBANE, 23 July 2023 – The World Health Organization (WHO) is releasing new scientific and normative guidance on HIV at the 12th International IAS (the International AIDS Society) Conference on HIV Science.
New WHO guidance and an accompanying Lancet systematic review released today describe the role of HIV viral suppression and undetectable levels of virus in both improving individual health and halting onward HIV transmission. The guidance describes key HIV viral load thresholds and the approaches to measure levels of virus against these thresholds; for example, people living with HIV who achieve an undetectable level of virus by consistent use of antiretroviral therapy, do not transmit HIV to their sexual partner(s) and are at low risk of transmitting HIV vertically to their children. The evidence also indicates that there is negligible, or almost zero, risk of transmitting HIV when a person has a HIV viral load measurement of less than or equal to 1000 copies per mL, also commonly referred to as having a suppressed viral load.
Antiretroviral therapy continues to transform the lives of people living with HIV. People living with HIV who are diagnosed and treated early, and take their medication as prescribed, can expect to have the same health and life expectancy as their HIV-negative counterparts.
“For more than 20 years, countries all over the world have relied on WHO’s evidence-based guidelines to prevent, test for and treat HIV infection,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The new guidelines we are publishing today will help countries to use powerful tools have the potential to transform the lives of millions of people living with or at risk of HIV.”
At the end of 2022, 29.8 million of the 39 million people living with HIV were taking antiretroviral treatment (which means 76% of all people living with HIV) with almost three-quarters of them (71%) living with suppressed HIV. This means that for those virally suppressed their health is well protected and they are not at risk of transmitting HIV to other people. While this is a very positive progress for adults living with HIV, viral load suppression in children living with HIV is only 46% - a reality that needs urgent attention.
Here is an overview of other key scientific and normative updates being released by WHO at IAS 2023 conference:
An analysis of global surveillance data reported to WHO during the multi-country outbreak of mpox, identified that among more than 82 000 mpox cases, around 32 000 cases had information on HIV status. Among those, 52% were living with HIV, most being men who have sex with men (MSM); and more than 80% reported sex as the most probable route of getting infected with mpox.
Among 16 000 people diagnosed with mpox and living with HIV, around one quarter (25%) had advanced HIV disease or immunosuppression – leading to an increased risk of hospitalization and death. People living with HIV who were taking HIV treatment and with good immunity had similar hospitalization and death outcomes as those who were HIV negative.
In the light of these findings, WHO recommends countries integrate mpox detection, prevention, and care with existing and innovative HIV and sexually transmitted infection prevention and control programmes.
To understand how to better prepare for and respond to future increases in mpox transmission, WHO led a rapid electronic survey[RNS1] in May 2023 to assess community experiences of the 2022-2023 mpox outbreak in Europe and the Americas.
More than 24 000 people participated in the survey which focused on men who have sex with men, and trans and gender-diverse people, with 16 875 eligible individuals completing the survey. Almost 51% changed their sexual behaviour (such as reducing the number of sexual partners), and 35% had maintained these changes one year later. Findings from this survey provide valuable insights into the experiences and needs of affected communities and emphasize the importance of increasing access to mpox vaccination and diagnostics globally.
An updated analysis from WHO global clinical platform for COVID-19 up through May 2023 revealed a persistent high risk of death in people living with HIV hospitalized for COVID-19 across pre-Delta, Delta and Omicron variant waves, with an overall in-hospital mortality rate of 20%-24%. For people without HIV, the risk of death fell during the Omicron variant wave by 53%—55% compared to pre-Delta and Delta variant waves; but for people living with HIV, the percentage decline in mortality during the Omicron wave period compared to the other waves was modest (16%-19%). This difference resulted in a 142 times increased risk of death among people living with HIV when compared with people without HIV during the Omicron wave period.
Risk factors for in-hospital death that were common across all variant waves of the pandemic were low CD4 count (less than 200 cells per m3), and severe or critical COVID-19 illness at hospital admission.
“Uncontrolled HIV remains a risk factor for poor outcomes and death in the mpox outbreak and COVID-19 pandemic”, said Dr Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programmes. "We must ensure the integration of HIV considerations in pandemic preparedness and response. Protecting people living with HIV from future pandemics is vital and reinforces the need to ensure access to HIV testing and treatment and preventive vaccines for mpox and COVID-19 to save lives; community-led responses that work for HIV will also be beneficial for addressing future pandemics."
With new recommendations on HIV testing, WHO is calling on countries to expand use of HIV self-testing and promote testing through sexual and social networks to increase testing coverage and strengthen uptake of HIV prevention and treatment services in high-burden settings and in regions with the greatest gaps in testing coverage.
The recommendation comes at a pivotal time, where self-care and self-testing are increasingly being recognized as ways to increase access, efficiency, effectiveness and acceptability of health care across many different disease areas, including HIV.
A new policy framework on primary health care (PHC) and HIV will help decision-makers optimize work and collaboration underway to advance primary health care and disease-specific responses, including HIV. In the second year of implementation, the Global Health Sector Strategies on HIV, viral hepatitis and sexually transmitted infections for 2022-2030 actively advocate for synergies within the framework of universal health coverage and primary health care.
“Ending AIDS is impossible without optimizing opportunities across and within health systems, including with communities and in the context of primary health care”, said Dr Jérôme Salomon, WHO Assistant Director-General, Universal Health Coverage, Communicable and Noncommunicable Diseases.
This latest research and guidance are being presented at a time when progress towards ending the global AIDS epidemic has lagged, after the COVID-19 pandemic; but the response is rapidly catching up, with some countries now charting a path to end AIDS, including Australia, Botswana, Eswatini, Rwanda, United Republic of Tanzania, and Zimbabwe and 16 other countries that are close to reaching the 95-95-95 global targets, which aim for 95% of people living with HIV knowing their status, 95% of those diagnosed receiving ART and 95% of those on treatment having suppressed viral loads.
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.
Over 122 million more people are facing hunger in the world since 2019 due to the pandemic and repeated weather shocks and conflicts, including the war in Ukraine, according to the latest State of Food Security and Nutrition in the World (SOFI) report published today jointly by five United Nations specialized agencies.
If trends remain as they are, the Sustainable Development Goal of ending hunger by 2030 will not be reached, the Food and Agriculture Organization of the United Nations (FAO), the International Fund for Agricultural Development (IFAD), the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO) and the World Food Programme (WFP) warn.
The 2023 edition of the report reveals that between 691 and 783 million people faced hunger in 2022, with a mid-range of 735 million. This represents an increase of 122 million people compared to 2019, before the COVID-19 pandemic.
While global hunger numbers have stalled between 2021 and 2022, there are many places in the world facing deepening food crises. Progress in hunger reduction was observed in Asia and Latin America, but hunger was still on the rise in Western Asia, the Caribbean and throughout all subregions of Africa in 2022. Africa remains the worst-affected region with one in five people facing hunger on the continent, more than twice the global average.
“There are rays of hope, some regions are on track to achieve some 2030 nutrition targets. But overall, we need an intense and immediate global effort to rescue the Sustainable Development Goals. We must build resilience against the crises and shocks that drive food insecurity-from conflict to climate, said UN Secretary-General António Guterres through a video message during the launch of the report at the UN Headquarters in New York.
The heads of the five UN agencies, FAO Director-General QU Dongyu; IFAD President Alvaro Lario; UNICEF Executive Director Catherine Russell; WFP’s Executive Director Cindy McCain; and WHO Director-General Dr. Tedros Adhanom Ghebreyesus write in the report’s Foreword: “No doubt, achieving the Sustainable Development Goal target of Zero Hunger by 2030 poses a daunting challenge. Indeed, it is projected that almost 600 million people will still be facing hunger in 2030. The major drivers of food insecurity and malnutrition are our “new normal”, and we have no option but to redouble our efforts to transform agrifood systems and leverage them towards reaching the Sustainable Development Goal 2 (SDG 2) targets.”
The food security and nutrition situation remained grim in 2022. The report finds that approximately 29.6 percent of the global population, equivalent to 2.4 billion people, did not have constant access to food, as measured by the prevalence of moderate or severe food insecurity. Among them, around 900 million individuals faced severe food insecurity.
Meanwhile, the capacity of people to access healthy diets has deteriorated across the world: more than 3.1 billion people in the world – or 42 percent – were unable to afford a healthy diet in 2021. This represents an overall increase of 134 million people compared to 2019.
Millions of children under five continue to suffer from malnutrition: in 2022, 148 million children under five years of age (22.3 percent) were stunted, 45 million (6.8 percent) were wasted, and 37 million (5.6 percent) were overweight.
Progress has been seen in exclusive breastfeeding with 48 percent of infants under 6-months of age benefiting from this practice, close to the 2025 target. However, more concerted efforts will be required to meet the 2030 malnutrition targets.
The report also looks at increased urbanization as a ‘megatrend’ affecting how and what people eat. With almost seven in ten people projected to live in cities by 2050, governments and others working to tackle hunger, food insecurity and malnutrition must seek to understand these urbanization trends and account for them in their policymaking.
In particular, the simple rural and urban divide concept is no longer sufficient to understand the ways in which urbanization is shaping agrifood systems. A more complex rural-urban continuum perspective is needed considering both the degree of connectivity that people have and types of connections that exist between urban and rural areas.
For the first time, this evolution is documented systematically across eleven countries. The report illustrates that food purchases are significant not only among urban households but also across the rural-urban continuum, including those residing far from urban centers. The new findings also show how consumption of highly processed foods is also increasing in peri-urban and rural areas of some countries.
Unfortunately, spatial inequalities remain. Food insecurity affects more people living in rural areas. Moderate or severe food insecurity affected 33 percent of adults living in rural areas and 26 pe in urban areas.
Children’s malnutrition also displays urban and rural specificities: the prevalence of child stunting is higher in rural areas (35.8 percent) than in urban areas (22.4 percent). Wasting is higher in rural areas (10.5 percent) than in urban areas (7.7 percent), while overweight is slightly more prevalent in urban areas (5.4 percent) compared to rural areas (3.5 percent).
The report recommends that to effectively promote food security and nutrition, policy interventions, actions and investments must be guided by a comprehensive understanding of the complex and changing relationship between the rural-urban continuum and agrifood systems.
FAO Director-General, QU Dongyu: “Recovery from the global pandemic has been uneven, and the war in Ukraine has affected the nutritious food and healthy diets. This is the ‘new normal’ where climate change, conflict, and economic instability are pushing those on the margins even further from safety. We cannot take a business-as-usual approach.”
IFAD President, Alvaro Lario: “A world without hunger is possible. What we are missing is the investments and political will to implement solutions at scale. We can eradicate hunger if we make it a global priority. Investments in small-scale farmers and in their adaptation to climate change, access to inputs and technologies, and access to finance to set up small agribusinesses can make a difference. Small-scale producers are part of the solution. Properly supported, they can produce more food, diversify production, and supply both urban and rural markets - feeding rural areas and cities nutritious and locally grown food.’’
UNICEF Executive Director, Catherine Russell: “Malnutrition is a major threat to children’s survival, growth and development. The scale of the nutrition crisis demands a stronger response focused on children, including prioritizing access to nutritious and affordable diets and essential nutrition services, protecting children and adolescents from nutrient-poor, ultra-processed foods, and strengthening food and nutrition supply chains including for fortified and therapeutic foods for children.”
WFP Executive Director, Cindy McCain: “Malnutrition is a major threat to children’s survival, growth and development. The scale of the nutrition crisis demands a much stronger response focused on children. Solutions include prioritizing access to nutritious and affordable diets and essential nutrition services, protecting children and adolescents from nutrient-poor, ultra-processed foods, and strengthening food and nutrition supply chains, including for fortified and therapeutic foods for children.”
WHO Director-General, Dr. Tedros Adhanom Ghebreyesus: “Child wasting remains unacceptably high and there has been no progress in reducing child overweight. We need targeted public policies, investments and actions to create healthier food environments for all.”’
The State of Food Security and Nutrition in the World is an annual report jointly prepared by the Food and Agriculture Organization of the United Nations (FAO), the International Fund for Agricultural Development (IFAD), the United Nations Children’s Fund (UNICEF), the World Food Programme (WFP) and the World Health Organization (WHO).
Since 1999, it monitors and analyses the world’s progress towards ending hunger, achieving food security and improving nutrition. It also provides an in-depth analysis of key challenges for achieving these goals in the context of the 2030 Agenda for Sustainable Development. The report targets a wide audience, including policymakers, international organizations, academic institutions and the general public.
This year’s theme is aligned with the UN General Assembly “New Urban Agenda” and will complement and guide the discussions at the 2023 High Level Political Forum – particularly on sustainable cities and communities (SDG 11), and especially during the three-day ministerial segment of the forum held from 17 to 19 July 2023 and in the lead-up to the SDG.
Acute food insecurity: food insecurity found in a specified area at a specific point in time and of a severity that threatens lives or livelihoods, or both, regardless of the causes, context or duration. Has relevance in providing strategic guidance to actions that focus on short-term objectives to prevent, mitigate or decrease severe acute food insecurity. This indicator is used in the Global Report on Food Crisis (FSIN and Global Network Against Food Crises. 2023).
Hunger: an uncomfortable or painful sensation caused by insufficient energy from diet. In this report, the term hunger is synonymous with chronic undernourishment and is measured by the prevalence of undernourishment (PoU).
Malnutrition: an abnormal physiological condition caused by inadequate, unbalanced or excessive intake of macronutrients and/or micronutrients. Malnutrition includes undernutrition (child stunting and wasting, and vitamin and mineral deficiencies) as well as overweight and obesity.
Moderate food insecurity: a level of severity of food insecurity at which people face uncertainties about their ability to obtain food and have been forced to reduce, at times during the year, the quality and/or quantity of food they consume due to lack of money or other resources. It refers to a lack of consistent access to food, which diminishes dietary quality and disrupts normal eating patterns. It is measured with the Food Insecurity Experience Scale and contributes to track the progress towards SDG Target 2.1 (Indicator 2.1.2).
Severe food insecurity: a level of severity of food insecurity at which, at some time during the year, people have run out of food, experienced hunger and at the most extreme, gone without food for a day or more. It is measured with the Food Insecurity Experience Scale and contributes to track the progress towards SDG Target 2.1 (Indicator 2.1.2).
Undernourishment: a condition in which an individual’s habitual food consumption is insufficient to provide the amount of dietary energy required to maintain a normal, active, healthy life. The prevalence of undernourishment is used to measure hunger and progress towards SDG Target 2.1 (Indicator 2.1.1).
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.
The World Health Organization (WHO) has published the first in a series of WHO public-benefit target product profiles (TPPs) for snakebite treatments, in order to improve the quality of antivenoms available in the market. This is the first-ever guidance to improve the quality of such products. The TPP is a document that provides regulators, manufacturers, researchers and procurement agencies with essential information about the minimum and optimum characteristics of specific products for specific use cases, in this case, antivenoms used for the treatment of snakebites caused by various types of sub-Saharan African snakes. TPPs help to ensure that products are designed and manufactured to meet the match the clinical needs of populations at risk, and are “fit-for-use” – e.g., are safe, effective and adapted to the use environment,
A high-quality antivenom provides the best available treatment for approximately 5.4 million people who are bitten by snakes each year. Safe, effective antivenoms could prevent many of the 83 000-138 000 deaths caused by snakebites and reduce the severity of serious disabilities that impact many thousands more victims.
“Access to high quality, safe and effective antivenom is an issue of equity and this critical work brings us one step forward in being able to make this a reality” Dr Socé Fall, Director of the WHO Global NTD Programme.
Antivenoms have been made for some 130 years and yet, remarkably, there has been until now, no guidance on how to design and manufacture a product of high quality that meets the correct requirements for safety, effectiveness, and functional use.
The first of these is for products that are intended for widespread use throughout sub-Saharan Africa, for treatment of snakebites irrespective of the species of snake causing the bite. The second is for treatment of bites from a single species (or group) of snake(s). Products in both these categories are currently on the market.
The other two categories are for products that do not yet exist in sub-Saharan Africa, but evidence from other parts of the world suggests that if developed they may have a useful role to play. One of these new product types is for antivenoms where the snakebite mainly causes a syndrome dominated by neurotoxic effects, while the other is intended for non-neurotoxic snakebite syndromes that involve effects on blood clotting or tissue necrosis without paralytic effects.
These TPPs, are intended to provide guidance to manufacturers, regulators, procurement agencies, clinicians and researchers and will contribute to improvements in the quality, safety and effectiveness of antivenoms and thus better treatment of snakebites.
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.
The World Health Organization and UNFPA, the United Nations sexual and reproductive health agency, today warned that the continuing attacks on healthcare facilities, equipment and workers in Sudan are depriving women and girls of life-saving healthcare, with pregnant women hardest hit.
Some 67 percent of hospitals in areas affected by fighting are closed, and several maternity hospitals are out of action, including Omdurman Hospital, the largest referral hospital in Sudan. Among the 11 million people in Sudan who need urgent health assistance are 2.64 million women and girls of reproductive age. Some 262,880 of them are pregnant and over 90,000 will give birth in the next three months. All of them need access to critical reproductive health services.
Since April, when the fighting began, WHO has verified 46 attacks on health workers and facilities which have killed eight people and injured 18 others. Facilities and health assets have also been looted, and health workers have been subjected to violence. A number of health facilities are being used by armed forces.
There are reports of a military occupation of the National Medical Supply Funds (NMSF) warehouses in the capital, Khartoum, where medicines for the entire country, including malaria medicines, are kept, and where the national pharmacy for chronic diseases is located. WHO’s stock of emergency medical supplies and development products is kept at its warehouse on the premises. UNFPA’s stocks of medicines and equipment for obstetric care, post-rape treatment, as well as a wide range of contraceptives, which are stored at warehouses in Khartoum, South Darfur, West Darfur and elsewhere are also inaccessible. Health facilities in several states, including the Darfurs, have warned that they are facing critical shortages of medical supplies.
In a worrying development, hospitals are running out of fuel to power generators that provide electricity. Six newborns died at a hospital in the city of Eld’aeen in East Darfur in the space of a week due to issues including a lack of oxygen amid electricity blackouts and local doctors estimated that more than 30 newborns have died at the hospital since the start of the fighting. In May, UNFPA and local partner, the CAFA Development Organization, provided fuel for seven maternity hospitals in Khartoum to ensure health services were available for women and newborns. In just one week, more than 1,000 deliveries and caesarean sections were safely carried out. But more support is desperately needed to secure fuel and supplies for key hospitals to sustain essential services. Some 15 percent of pregnant women experience pregnancy- and birth-related complications and need access to emergency obstetric and newborn care.
UNFPA provides sexual and reproductive healthcare through health facilities and hospitals throughout Sudan. UNFPA-trained midwives continue to support women to give birth safely at home and at functioning health facilities. There are approximately 27,000 midwives working across Sudan; around 2,330 in the capital. Most of them attend three to four births a day, according to the head of a UNFPA-supported midwife network. UNFPA is also setting up safe spaces for women to provide gender-based violence (GBV) prevention and response services, including post-rape treatment, counselling and case management; as well as providing remote services. UNFPA also trains service providers and community-based protection networks in GBV prevention and response.
WHO is working closely with the Ministry of Health and other partners to ensure provision of essential sexual, reproductive, maternal and paediatric care as well as emergency obstetric and neo-natal care in Khartoum and Gezira, and in states sheltering internally displaced people. WHO is providing life-saving medicines and supplies, and covering the running cost of health facilities that provide these services. WHO is also training health workers on first-line support, provision of post-rape treatment and mental health care to survivors of sexual and gender-based violence (GBV), and is backing national NGOs that provide GBV services.
“Health workers are putting their lives at risk to provide emergency, maternity, paediatric and chronic disease treatment services and we stand with them,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “We call on the warring parties to honour the commitments they made in Jeddah in May, including the restoration of essential services and the withdrawal of forces from hospitals and essential public facilities.”
“The conflict must stop, health facilities, health workers and patients must be protected, humanitarian and medical aid must be allowed through,” said UNFPA Executive Director Dr. Natalia Kanem. “People who need urgent healthcare should not be afraid to step out of their homes for fear of their safety, and women’s right to reproductive healthcare must be upheld, conflict or no conflict,” she added.
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.