Our commitment in the coming year – and in the coming five years – is to dramatically strengthen our ability to deliver results in countries.
First, to support countries to make an urgent paradigm shift towards promoting health and well-being and preventing disease by addressing its root causes. The pandemic has demonstrated that we must elevate protecting and promoting health as top priority, with significantly increased investment in countries, and at WHO.
The second priority is to support a radical reorientation of health systems towards primary health care, as the foundation of universal health coverage. That means restoring, expanding and sustaining access to essential health services, especially for health promotion and disease prevention, and reducing out-of-pocket spending
The third priority is to urgently strengthen the systems and tools for epidemic and pandemic preparedness and response at all levels, underpinned by strong governance and financing to ignite and sustain those efforts, connected and coordinated globally by WHO.
The fourth priority is to harness the power of science, research innovation, data and digital technologies as critical enablers of the other priorities – for health promotion and disease prevention, for early diagnosis and case management, and for the prevention, early detection, and rapid response to epidemics and pandemics.
The fifth priority is to urgently strengthen WHO as the leading and directing authority on global health, at the centre of the global health architecture.
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Your Excellency Dr Patrick Amoth, the Chair of the Executive Board,
Excellencies, Regional Directors, dear colleagues and friends,
Good morning to all EB members who have joined us here in Geneva, and good morning, good afternoon and good evening to all Member States, participants and observers online.
Happy New Year to you all.
I welcome the new members of the Board: Colombia, Guinea Bissau, India, Madagascar, Malaysia, Peru, India, Tonga and Tunisia.
As the Chair said, we send our deepest condolences and concern, our warmest greetings and our best wishes to our sisters and brothers in Tonga, who are facing difficult days as they respond to last week’s volcanic eruption and tsunami.
As we speak, WHO is working with our partners to support the response, providing medical expertise and supplies.
A national Emergency Medical Team, trained by WHO, was deployed almost immediately following the eruption, and we are supporting them with medical items, first aid kits, tents, portable toilets, and water filtration equipment.
Our country liaison officer, Dr Yutaro Setoya, is playing a crucial role in channelling communication between UN agencies, humanitarian partners and the government, including through the use of WHO’s satellite phone, which was one of the few ways to get information in and out of the country in the first few days after the eruption. So, my appreciation to our country office and also to our Regional Director, Dr Takeshi Kasai, who is with us today.
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This Sunday marks two years since I declared a public health emergency of international concern – the highest level of alarm under international law – over the spread of COVID-19.
At the time, there were fewer than 100 cases and no deaths reported outside China.
Two years later, almost 350 million cases have been reported, and more than 5.5 million deaths – and we know these numbers are an underestimate.
On average last week, 100 cases were reported every three seconds, and somebody lost their life to COVID-19 every 12 seconds.
Since Omicron was first identified just nine weeks ago, more than 80 million cases have been reported to WHO - more than were reported in the whole of 2020.
So far, the explosion in cases has not been matched by a surge in deaths, although deaths are increasing in all regions, especially in Africa, the region with the least access to vaccines.
So where do we stand? Where are we headed? And when will it end?
These are the questions many are asking.
It’s true that we will be living with COVID for the foreseeable future, and that we will need to learn to manage it through a sustained and integrated system for acute respiratory diseases, which will provide a platform for preparedness for future pandemics.
But learning to live with COVID cannot mean that we give this virus a free ride.
It cannot mean that we accept almost 50 thousand deaths a week, from a preventable and treatable disease.
It cannot mean that we accept an unacceptable burden on our health systems, when every day, exhausted health workers go once again to the front line.
It cannot mean that we ignore the consequences of long COVID, which we don’t yet fully understand.
It cannot mean that we gamble on a virus whose evolution we cannot control, nor predict.
There are different scenarios for how the pandemic could play out, and how the acute phase could end – but it is dangerous to assume that Omicron will be the last variant, or that we are in the endgame.
On the contrary, globally the conditions are ideal for more variants to emerge.
To change the course of the pandemic, we must change the conditions that are driving it.
We recognize that everyone is tired of this pandemic;
That people are tired of restrictions on their movement, travel and other freedoms;
That economies and businesses are hurting;
And that many governments are walking a tightrope, attempting to balance what is effective with what is acceptable to their people.
Each country is in a unique situation, and must chart its way out of the acute phase of the pandemic with a careful, stepwise approach.
It’s difficult, and there are no easy answers, but WHO continues to work nationally, regionally and globally to provide the evidence, the strategies, the tools and the technical and operational support countries need.
If countries use all of these strategies and tools in a comprehensive way, we can end the acute phase of the pandemic this year – we can end COVID-19 as a global health emergency, and we can do it this year.
What does that look like?
It means achieving our target to vaccinate 70% of the population of every country, with a focus on the most at-risk groups;
It means reducing mortality through strong clinical management, beginning with primary health care, and equitable access to diagnostics, oxygen and antivirals at the point of care;
It means boosting testing and sequencing rates globally to track the virus closely, and monitor the emergence of new variants;
It means the ability to calibrate the use of public health and social measures when needed;
It means restoring and sustaining essential health services;
And it means learning critical lessons and defining new solutions now, not waiting until the pandemic is over.
We can only do this with engaged and empowered communities, sustained financing, a focus on equity, and research and innovation.
Vaccines alone are not the golden ticket out of the pandemic. But there is no path out unless we achieve our shared target of vaccinating 70% of the population of every country by the middle of this year.
We have a long way to go.
As it stands, 86 Member States across all regions have not been able to reach last year’s target of vaccinating 40% of their populations – and 34 Member States, most of them in Africa and the Eastern Mediterranean region, have not been able to vaccinate even 10% of their populations.
85% of the population of Africa is yet to receive a single dose of vaccine.
How can this be acceptable to any of us?
We simply cannot end the emergency phase of the pandemic unless we bridge this gap.
But we can bridge it, and we are making progress.
Just a week ago, COVAX delivered its 1 billionth dose. In the past 10 weeks, COVAX shipped more vaccines than in the previous 10 months combined.
The challenges of supply we have faced in the past year are now being replaced by the challenge of rolling out vaccines as fast and far as possible. WHO and our partners are working with countries around the clock to overcome these challenges.
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Excellencies,
The pandemic has been a severe disruption to health systems, economies and societies the world over, and to much of our shared work to advance towards the “triple billion” targets of the 13th General Programme of Work.
For that reason, the Secretariat is proposing a two-year extension of the GPW to 2025, to give us all a chance to get back on track, apply the lessons of the pandemic, intensify investments and accelerate progress.
Even before the pandemic, the world was off track for the “triple billion” targets. Now, we’re even further behind.
That is particularly the case for our target to see 1 billion more people benefiting from universal health coverage.
As a result of the pandemic, we could now be facing a shortfall of up to 840 million people, mostly in lower-income countries. More than 90% of countries continue to report disruptions to one or more essential health services.
The most recent WHO Global Monitoring Report on UHC shows that while service coverage has improved over the last 20 years, about half the world’s population still lacks access to essential health services, and the proportion of people facing financial hardship due to out-of-pocket health spending has increased.
But despite the ravages of the pandemic, we are demonstrating that with the right strategies and the right tools, we can bring some of the world’s oldest infectious killers under control.
On communicable diseases, 2021 was a historic year, with the WHO recommendation for widespread use of the world’s first malaria vaccine, which could save tens of thousands of young lives each year.
China and El Salvador were certified by WHO as malaria-free last year, and the Islamic Republic of Iran recorded three consecutive years of zero indigenous cases of malaria.
Eight countries achieved the 90–90–90 targets for testing, treatment access, and viral suppression of HIV by the end of 2020; and a further 20 countries are close.
With support from WHO, 15 countries have eliminated mother-to-child transmission of HIV and/or syphilis, and in 2021 Botswana became the first high-burden country in Africa to achieve Silver Tier certification on the path to elimination of mother-to-child transmission of HIV.
We are validating the elimination of hepatitis B and C as a public health threat in five countries: Brazil, Georgia, Mongolia, Rwanda and Thailand, with several other countries nearing validation, including Egypt.
Despite the disruptions of the pandemic, 86 countries globally achieved the End TB Strategy milestone for 2020 of reducing TB incidence.
With WHO support, five countries eliminated a neglected tropical disease: Gambia and Myanmar eliminated trachoma; Côte d’Ivoire and Togo eliminated human African trypanosomiasis, and Malawi eliminated lymphatic filariasis.
Only 14 cases of Guinea worm disease were reported last year from 4 countries, taking us ever closer to the eradication of this ancient disease.
And only 5 children were paralysed by wild polio virus, the lowest level we have ever achieved. We now have a real opportunity to eradicate wild polio virus once and for all this year, and move towards a sustainable transition in countries that are now polio-free.
So, for polio eradication, this is the opportunity.
In November, the first truly nationwide polio vaccination programme in several years was conducted in Afghanistan, protecting more than 2.6 million previously inaccessible children.
On noncommunicable diseases, we launched a new Global Breast Cancer Initiative, to reduce mortality by 2.5% every year until 2040, saving 2.5 million lives.
We launched the Global Platform for Access to Childhood Cancer Medicines, a 200 million US dollar initiative to provide quality-assured medicines to 12 low- and middle-income countries. As you know, in high-income countries, childhood cancer survival is over 80%, while in low-income countries it’s under 30%. We will do everything to narrow this gap.
To support our global strategy to eliminate cervical cancer, we prequalified a fourth HPV vaccine for cervical cancer, to increase access and decrease prices, and several more countries have introduced HPV vaccines into national immunization schedules, including Cameroon, Cabo Verde, El Salvador, Mauritania, Qatar, Sao Tome and Principe, and Tuvalu.
And we are working with 120 countries to integrate interventions for hypertension, diabetes and other NCDs into primary health care.
COVID-19 has taken a heavy toll on mental health and laid bare the gaps in services around the world.
WHO is supporting many countries to expand access to services, including Bangladesh, Jordan, Paraguay, Philippines, Zimbabwe and Ukraine, where we trained health workers in primary care facilities, increasing access to mental health services.
Last year, experts in mental health and psychosocial support were deployed to support scaling up of services in 18 countries and territories in response to public health and humanitarian emergencies.
WHO is also supporting countries to expand access to rehabilitation services, including Solomon Islands, Nepal, Rwanda, Georgia, Jordan and Guyana.
2021 was also a landmark year for WHO’s work to increase access to medicines and health products.
We gave Emergency Use Listing to 10 COVID-19 vaccines, prequalified injection devices and therapeutics, and most recently, we recommended two new drugs for the treatment of COVID-19.
The COVID-19 Technology Access Pool, C-TAP, and the Medicines Patent Pool finalized its first licensing agreement for a COVID-19 serological antibody test.
We established the mRNA technology transfer hub in South Africa to boost vaccine production on the continent.
And more than 100 Member States co-sponsored a World Health Assembly resolution on strengthening local production
On antimicrobial resistance, a recent study estimates that more than 4.9 million deaths were associated with AMR in 2019, making it one of the world’s leading causes of death.
Despite disruptions due to COVID-19, a record 163 countries have responded to the fifth round of Tripartite AMR Country Self-Assessment Survey on the status of their AMR response.
The survey shows that less than one quarter of AMR National Action Plans are costed and funded, so WHO has piloted and launched a costing and budgeting tool to support the implementation of national action plans on AMR.
The Multi-Partner Trust Fund for AMR, established in 2019, is successfully dispersing funds for global and national activities in already 9 countries.
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2021 also saw good progress in our efforts to see 1 billion more people enjoying better health and well-being.
This area has enormous potential: we estimate that at least half of the global disease burden could be prevented by supporting safer and healthier environments that allow people to make healthy choices and adopt healthy behaviours.
Our current estimates suggest that 900 million people will enjoy better health and wellbeing by 2023, making the GPW target within reach.
However, these gains were mostly in high-income countries, and stark and immense inequalities within and between countries highlight the need to read this achievement with caution.
Nevertheless, we have many successes to be proud of:
Tobacco use continues to decline. In line with the WHO Framework Convention on Tobacco Control, we worked with 90 countries to reduce tobacco use last year, and launched a global campaign to encourage at least 100 million tobacco users to quit. Sixty countries are now on track to achieving the voluntary global target of a 30% reduction in tobacco use between 2010 and 2025.
As part of WHO’s initiative to eliminate trans fatty acids from the global food supply, mandatory policies prohibiting the use of trans fats are now in effect for 3.2 billion people in 57 countries. In 2021, best-practice policies came into effect in Brazil, the European Union, Peru, Singapore and Turkey, while India and Philippines became the first lower-middle-income countries to pass a best-practice policy.
We have identified 23 countries to implement the Global Action Plan on the Prevention and Treatment of child wasting, and 57 countries have already reached or are on track to meet the 2025 target of reducing childhood wasting rates to below 5%.
For the first time, the Conference of the Parties to the UN Climate Convention, COP26, included a health programme, in which more than 50 countries committed to strengthening the resilience of their health systems to climate risks, and transition towards zero-carbon healthcare. WHO has already assisted over 30 countries to begin this journey, and will further scale this up over the next five years.
In the past year, new legislation or regulations on the marketing of breastmilk substitutes were approved in Burkina Faso, Côte d’Ivoire, Ethiopia, Kenya, Mauritania, Oman, Sao Tome and Principe and Sierra Leone.
More than 23 thousand facilities in 182 countries participated in WHO’s global campaign on WASH in health care, covering over 14 million health workers and 5.4 million beds.
Since the launch of the Global Plan of Action on Road Safety in October, at least 28 countries have launched local initiatives, with support from WHO.
Four countries established new laws to reduce exposure to lead paint, which causes about 1 million deaths every year: Peru, Morocco, Georgia and Ukraine, and WHO is working with 40 countries to develop and implement lead paint laws.
We hosted the 10th Global Conference on Health Promotion, which endorsed the Geneva Charter for Wellbeing;
We hosted the Small Island Developing States Summit for Health, supporting countries who are most at risk of the impact of climate change to create climate-resilient health systems, and mobilise new resources.
Together with our partners in the tripartite plus, we established a One Health High-Level Expert Panel to provide policy and technical guidance to the four partner agencies.
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On our “triple billion” target to see one billion more people better protected from health emergencies, our current estimates are that we will get close to one billion, but the pandemic shows we need to be much more ambitious, much better prepared, and improve the way we measure protection against health emergencies.
Supporting countries to respond to COVID-19 continues to be the focus of our work, at all three levels of our Organization.
But of course, COVID-19 was far from the only emergency last year.
We responded to 76 health emergencies, from acute crises in Afghanistan, DRC, Ethiopia and Tonga to multiple outbreaks of cholera, yellow fever, meningitis and Ebola, to protracted emergencies in Syria, Yemen and Cox’s Bazaar.
Through the WHO Logistics Hub in Dubai, we have provided almost US$ 50 million of urgent medical supplies to 120 countries.
The operation has increased by a factor of 40 in recent years , and now includes a state-of-the-art cold-chain facility.
We have also taken several steps to put in place new mechanisms for future emergencies.
Reflecting longstanding mandates from the World Health Assembly to strengthen pandemic preparedness, we established pathfinding initiatives with Member States, such as the WHO Hub for Pandemic and Epidemic Intelligence, the WHO BioHub System, and the Universal Health and Preparedness Review, which you will hear more about later this week.
These new initiatives are aligned with many of the recommendations from the various reviews, and provide a solid foundation for strengthening the global health architecture to manage the risks of epidemics and pandemics.
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Underpinning all of these achievements is the core business of developing top-quality norms and standards for which Member States depend on us, and a commitment to strengthen data and health information systems to monitor progress.
In 2021 we produced new guidelines, strategies, action plans and reports across the spectrum of health challenges, from air quality to artificial intelligence; from hepatitis to hypertension; from suicide prevention to sexual and reproductive health, and much more.
All of these technical products have been quality-assured by our Science Division, which was established as part of our transformation to ensure we give you, our Member States, the highest quality norms and standards, and to translate those products into impact in countries.
We also launched the digitalized ICD-11, the “triple billion” dashboard, the World Health Data Hub and more.
We used behavioural science to support the pandemic response in Zambia, Nigeria, Malaysia and other health challenges, from nutrition to antimicrobial resistance and maternal health.
We launched the WHO Academy in Lyon.
Through the Global Action Plan for Healthy Lives and Well-Being for All, 13 partner agencies are collaborating for greater impact in 50 countries, in primary health care, health financing, data and more.
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Excellencies, dear colleagues and friends,
Ending the acute phase of the pandemic must remain our collective priority.
One of the greatest risks now is that we move on to the next crisis and forget the lessons the pandemic has taught us – lessons that have come at a great price.
The most important of those lessons is the centrality of health. COVID-19 is so much more than a pandemic – it is a global crisis that touches every area of life: economics, education, families, employment, business, technology, trade, travel, tourism, politics, security – and so much more. It’s a very long list.
When health is at risk, everything is at risk.
The pandemic is a brutal reminder that health is not a by-product of development;
Not an outcome of prosperous societies;
Not a footnote of history.
It’s the heartbeat; the foundation; the essential ingredient without which no society can flourish. Health is central.
Our forebears knew this when they wrote in the Constitution of this World Health Organization that the health of all peoples is fundamental to the attainment of peace and security, and is dependent upon the fullest cooperation of individuals and States;
That unequal development in different countries in the promotion of health and control of disease, especially communicable disease, is a common danger;
And that the highest attainable standard of health is one of the fundamental human rights of every human being.
That is the vision this Organization was created to fulfil. And that is the vision for which we must continue to strive.
We need a new determination, a new ambition, a new hope to fulfil that vision.
Of course, the world in which we work, and the challenges and opportunities we face, are very different from the world in which our Constitution was written:
Ageing populations in some regions and a youth boom in others; searing inequalities in gender, race and income that harm health and inhibit access to services; historic levels of migration driven by conflict, poverty and the hope of a better life; and a changing climate with profound implications for the future of health.
Our challenge is to reinterpret, revitalize and reimagine our founding vision for our modern world.
Realising this vision requires a paradigm shift in all countries in how health is seen, and how health is financed.
Indeed, that’s why we established the Council on the Economics of Health for All last year, to develop a new vision for the way health is financed.
For far too long, health has been compartmentalised and deprioritised, nationally and internationally.
It’s time to recognize that if we fail to invest in health, we fail to invest in the future.
The “triple billion” targets of the 13th General Programme of Work, and the Sustainable Development Goals on which they are based, remain our guide.
We have made progress against the GPW, and the transformation has positioned us to deliver, but we have more work to do.
In particular, our commitment in the coming year – and in the coming five years – is to dramatically strengthen our ability to deliver results in countries.
Let me outline five key priorities for the world, and for WHO as we move forward:
First, to support countries to make an urgent paradigm shift towards promoting health and well-being and preventing disease by addressing its root causes.
The pandemic has demonstrated that we must elevate protecting and promoting health as a top priority, with significantly increased investment in countries, and at WHO.
The highest attainable standard of health does not only mean the highest attainable standard of care. It means keeping people healthy and preventing the need for care. It means true health care, not sick care.
It requires empowering and enabling individuals, families and communities to make healthy choices;
And it requires governments to create the conditions in which health can thrive by addressing the root causes of disease that lie outside the health sector. All the determinants of health.
In particular, it requires radical action to safeguard the health of the planet on which all life depends, by addressing the existential threat of climate change.
Such a shift could cut the global disease burden in half, but it would also offer massive economic gains, by reducing the burden on health systems and increasing the productivity of populations.
The second priority is to support a radical reorientation of health systems towards primary health care, as the foundation of universal health coverage.
That means restoring, expanding and sustaining access to essential health services, especially for health promotion and disease prevention, and reducing out-of-pocket spending;
It means focusing on the least-served, most vulnerable populations, especially women, children and adolescents, migrants and refugees;
It means ensuring access to vaccines, medicines, diagnostics, devices and other health products;
And it means investing in a health workforce with the training, skills, tools, safe working environment and fair pay to deliver safe, effective, quality care.
The third priority is to urgently strengthen the systems and tools for epidemic and pandemic preparedness and response at all levels, underpinned by strong governance and financing to ignite and sustain those efforts, connected and coordinated globally by WHO.
The decision by Member States at the recent Special Session of the World Health Assembly to negotiate a convention, agreement or other international instrument on pandemic preparedness and response is a giant stride forward.
We urge all Member States to engage in this process constructively.
Such an instrument will be a vital tool, but it will not solve every problem. There are many other steps we must take together to strengthen pandemic preparedness and response, and the architecture to support it. But this agreement, I hope, will be a generational agreement. That will be a gamechanger.
The fourth priority is to harness the power of science, research innovation, data and digital technologies as critical enablers of the other priorities – for health promotion and disease prevention, for early diagnosis and case management, and for the prevention, early detection, and rapid response to epidemics and pandemics.
The Solidarity Trials for vaccines and therapeutics, and the trials supporting the recommendation for widespread use of the world’s first malaria vaccine highlight the key role WHO can play as a convener of research.
And the fifth priority is to urgently strengthen WHO as the leading and directing authority on global health, at the centre of the global health architecture;
To continue our transformation journey to make this Organization – your Organization – more effective, efficient and accountable.
COVID-19 has proven that health is not just a national issue; it’s an international issue.
The scale of challenges we face is immense, and is reflected by the breadth of your agenda this week.
The needs are great, and you are right to have great expectations of your WHO.
You are right to expect top-quality norms and standards, based on the best science;
You are right to expect even more results in countries;
You are right to expect a robust and coordinated international response to emergencies;
You are right to expect enhanced governance, efficiency, accountability and transparency;
You are right to expect the highest standards of conduct, and you are right to expect an Organization that has zero tolerance for sexual exploitation, abuse and harassment.
The thousands of talented, dedicated people around the world who are proud to work for this Organization share your expectations – and so do I.
They are committed not just to meeting your expectations, but exceeding them – and so am I.
Just as health workers need the resources and tools to do their jobs, so your Secretariat needs the sustainable, predictable and flexible funds to do ours.
So, I ask Member States to ensure the quality and quantity of your investments match your expectations.
Entrust us with the resources to deliver the results you rightly expect.
Let me put it plainly: if the current funding model continues, WHO is being set up to fail.
The paradigm shift in world health that is needed now must be matched by a paradigm shift in funding the world’s health organization.
We must look to the future. We must raise our eyes, and our ambitions.
What do we want the world to look like in 2030, or when WHO turns 100, in 2048? We will be 75 next year.
We all want a healthier world: a world in which the air people breathe, the food they eat, the water they drink and the conditions in which they live and work nurture health, instead of harming it.
We all want a safer world, in which all countries work together to prevent, detect and respond rapidly to outbreaks and other health emergencies;
We all want a fairer world, in which all people can access the health services they need, without having to make life-and-death decisions between paying for care and feeding their families.
The world has the resources. It is not because we don’t have resources.
We all want a world in which science triumphs over misinformation; solidarity triumphs over division; and equity is a reality, not an aspiration.
How many times have we said “equity, equity, equity”? It can be a reality. If there is a will, there is a way.
If that’s the world we want, we must start working for that world now.
It will take vision and partnership;
It will take negotiation, compromise and sacrifice;
Most of all, it will take hope.
We are one world, we have one health, and we have one WHO.
Thank you so much. Merci beaucoup.
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 Director-General welcomed the Committee members and advisers. He highlighted the challenges posed by the high transmission levels of the SARS CoV-2 Omicron variant of concern (VOC) and the corresponding burden on public health systems and health service delivery. The Director-General emphasized the importance of vulnerable populations in all countries getting timely and equitable access to COVID-19 vaccination. The Director-General encourages all efforts to expand access to and uptake of vaccination, with the expectation that those who have access to vaccines get vaccinated and continued adherence to PHSM. The DG expressed hope that, by working together, the world can bring an end to the acute phase of the COVID-19 pandemic.
Representatives of the Office of Legal Counsel (LEG) and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities. The Ethics Officer from CRE provided the members and advisers with an overview of the WHO Declaration of Interests process. The members and advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the Committee. Each member who was present was surveyed. No conflicts of interest were identified.
The Secretariat turned the meeting over to the Chair, Professor Didier Houssin. Professor Houssin noted the continuing challenges caused by SARS-CoV-2 nearly two years after the first meeting of this Committee. He reviewed the objectives and agenda of the meeting.
The Secretariat presented on the current status of the COVID-19 pandemic and a vision for how to optimize the 2022 response to the COVID-19 pandemic. The presentation focused on:
the global epidemiological context including an overview of the Omicron VOC;
factors that continue to drive transmission, potential future scenarios which may involve variants that are more or less severe, and challenges posed by the continued evolution of SARS-CoV-2 in animal and human reservoirs;
the status of COVID-19 vaccines and vaccination targets for 2022; and
updates on international traffic and progress on the Temporary Recommendations issued following the 9th meeting of the Emergency Committee.
challenges and opportunities to harmonize national and global response efforts within the context of the synchronous outbreaks of Omicron VOC, including in relation to international travel;
drivers for emergence of new VOCs as well as differences in the characteristics of Delta and Omicron VOCs and their respective lineages;
the evolution of SARS-CoV-2 testing strategies as well as accessibility and affordability of medical countermeasures;
vaccination strategies and the use of heterologous vaccine combinations;
the challenges to maintain continued community buy-in for public health and social measures after two years of the pandemic and the risk of overly optimistic statements regarding the state of the pandemic;
the increasing levels of threat and concerns about personal safety faced by frontline responders, advisors and leaders of the pandemic response;
the focus of response efforts on a combination of suppression of transmission and mitigation of severe outcomes; and
the need for an on-going integrated One Health approach to SARS-CoV-2 surveillance, research, and response efforts.
The Committee praised South Africa for their rapid identification, and transparent and rapid sharing of information on the Omicron VOC. The Committee was concerned about the reaction of States Parties in implementing blanket travel bans, which are not effective in suppressing international spread (as clearly demonstrated by the Omicron experience), and may discourage transparent and rapid reporting of emerging VOC.
The Committee noted with concern reports of violence against health workers, public health officials, and expert advisors engaged in the COVID-19 response. The Committee condemns these acts that undermine national and global response efforts.
The Committee expressed deep concern that countries not eligible for the COVAX Facility Advance Market Commitment (AMC) are experiencing challenges affording COVID-19 vaccines. In addition, they noted challenges posed by the high prices of certain therapeutics, the lack of equity in access, and limited data availability on cost-effectiveness of these treatments. The Committee urged WHO to continue its work with the pharmaceutical sector to address barriers to access and affordability, by expanding tiered pricing, voluntary license agreements and other approaches to increase access to vaccines, therapeutics, and diagnostic tests for all countries, possibly looking at the Pandemic Influenza Preparedness Framework for guidance.
While current vaccines continue to be effective in reducing risk of severe disease and death due to COVID-19, they do not completely eliminate the risk of transmission of SARS-CoV-2 (all variants). A coordinated global strategy is critical for assuring protection of high-risk populations everywhere, with particular focus in countries that have low vaccination rates, especially those with a rate below 10%. To derive the optimal vaccination strategy for reducing infection, morbidity and mortality, the Committee stressed the importance of coordinating research on heterologous vaccine combinations, considering also the natural immunity following infection, and the need for manufacturers to produce and share the relevant data. In addition, the Committee noted the importance of expediting research and development on novel vaccine technologies. The current vaccination technology is dependent on syringes which are in limited supply, presenting a significant logistical and programmatic burden. Rapid development of alternative vaccine formulations, such as intranasal vaccines, could increase the ease of delivery in low resource and/or hard to reach areas. Also, there is a clear need for continued work on vaccines that confer broader immunity across variants. The Committee acknowledged the work of other WHO technical advisory groups such as the Scientific and Technical Advisory Group on Infectious Hazards (STAG-IH), the Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC), the Strategic Advisory Group of Experts on Immunization (SAGE), the Research and Development Blueprint for Epidemics working groups and the Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE) that are having on-going in-depth discussions on the key elements of vaccine composition, strategy development, and virus evolution, and are regularly reporting on their findings.
The Committee recognized the challenges in sensitivity and quality posed by the multitude of existing SARS-CoV-2 diagnostic tests in light of the evolving virus, and the lack of appropriate approval for some of their uses, for example testing for access to facilities. This highlighted the need for coherent testing strategies, with clear articulation of what type of tests are to be used for what purposes. The Committee noted the need for regulatory authorities to ensure diagnostic tests meet the WHO standards on specificity and sensitivity for the different applications, including use of assays for testing for access. Continued coordination amongst States Parties is needed to ensure availability and use of high-quality rapid antigen tests in all countries for an effective global response to the pandemic.
The Committee recognized the challenges to maintain continued community buy in for public health and social measures (PHSM) after nearly two years of the COVID-19 pandemic and the risk of overly optimistic statements regarding the state of the pandemic. The Committee further emphasized the need to uphold the ethical and human rights considerations in the application of individualized PHSM, as per WHO guidance.
The Committee unanimously agreed that the COVID-19 pandemic still constitutes an extraordinary event that continues to adversely affect the health of populations around the world, poses a risk of international spread and interference with international traffic, and requires a coordinated international response. As such, the Committee concurred that the COVID-19 pandemic remains a PHEIC and offered its advice to the Director-General.
The Director-General determined that the COVID-19 pandemic continues to constitute a PHEIC. He accepted the advice of the Committee and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR
The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General. The Director-General thanked the Committee for its work.
The Committee identified the following actions as critical for all countries:
1. MODIFIED: Continue to use evidence-informed public health and social measures, therapeutics, diagnostics, and vaccines for COVID-19, and to share response experiences with WHO. States Parties are advised to regularly adjust their response strategies by monitoring their epidemiological situation, assessing their vulnerabilities including their health system capacity, as well as considering the adherence to and attributable impact of individual and combined PHSM. Where isolation and quarantine of large numbers of cases and contacts is potentially disrupting critical infrastructure (including heath care services), States Parties may need to modify isolation and quarantine periods, with the introduction of testing, to balance the risks with the continuation of key functions, using a risk-based approach. Technical Brief on enhancing Readiness for Omicron and Considerations for implementing and adjusting public health and social measures in the context of COVID-19.
2. MODIFIED: Take a risk-based approach to mass gathering events by evaluating, mitigating, and communicating risks. Recognizing that there are different drivers and risk tolerance for mass gatherings and mass migrations, and the particular challenges for fragile and vulnerable States Parties, it is critical to consider the epidemiological context (including the prevalence of variants of concern and the intensity of transmission), surveillance, contact tracing and testing capacity, as well as adherence to PHSM when conducting this risk assessment in line with WHO guidance. Key planning recommendations for mass gatherings in the context of COVID-19.
3. MODIFIED: Achieve the WHO call to action to have at least 70% of all countries’ populations vaccinated by the start of July 2022 and integrate COVID-19 vaccination into routine health services. In accordance with advice from SAGE and WHO interim statements, States Parties are requested to share vaccine doses to increase global equity and to use a stepwise approach to vaccination, prioritizing those at highest risk from COVID-19, considering an evidence-informed use of booster vaccination, and taking into account evolving data on population level immunity. To enhance vaccine uptake, States Parties are encouraged to assess enablers and barriers to vaccination. Vaccination programmes should continue to prioritize vulnerable populations, including health workers, older people, people with underlying conditions, immunocompromised individuals with insufficient access to treatment, migrants, refugees, people living in fragile settings, sea farers, and air crews. Interim Statement on COVID-19 vaccines in the context of the circulation of the Omicron SARS-CoV-2 Variant from the WHO Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC); Link to WHO SAGE Prioritization Roadmap; Interim Statement on COVID-19 vaccines in the context of the circulation of the Omicron SARS-CoV-2 Variant from the WHO Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC)
4. MODIFIED: Enhance surveillance of SARS-CoV-2 and continue to report to WHO to enable rapid identification, tracking, and evaluation of variants and continued monitoring of the pandemic’s evolution and its control. States Parties should strengthen systems to collect and publicly share indicators to monitor the burden of COVID-19, such as hospitalization rates, severe disease, and excess mortality. States Parties are particularly encouraged to increase efforts to increase detection of infections in individuals where variants of interest and variants of concern may emerge. States Parties should strengthen mechanisms to link individual-level clinical, vaccination and genomic data to facilitate assessment of the impact of and vaccine effectiveness against VOC. States Parties should leverage and enhance existing systems such as the Global Influenza Surveillance and Response System (GISRS), as well as other national, regional, and global networks to integrate respiratory disease surveillance and prioritize monitoring circulation of SARS-CoV-2, relative proportions of SARS-CoV-2 variants, and circulation of other co-circulating respiratory viruses, including influenza. Guidance for surveillance of SARS-CoV-2 variants; SARS-CoV-2 genomic sequencing for public health goals: Interim guidance
5. MODIFIED: States Parties should ensure that there is sufficient surge capacity for critical SARS-CoV-2 clinical care and post COVID-19 condition, and for the maintenance of essential health services, and should plan for the restoration of health services at all levels with sufficient funding, supplies, and human resources. Specific to the risk of evolving new lineages, special attention may be needed for ensuring access to treatment for treatable immunosuppressive disease. States Parties should enhance access to health for all by strengthening health and social systems to cope with the impacts of the pandemic, especially on children. Building health systems resilience for universal health coverage and health security during the COVID-19 pandemic and beyond: WHO position paper
6. MODIFIED: Lift or ease international traffic bans as they do not provide added value and continue to contribute to the economic and social stress experienced by States Parties. The failure of travel restrictions introduced after the detection and reporting of Omicron variant to limit international spread of Omicron demonstrates the ineffectiveness of such measures over time. Travel measures (e.g. masking, testing, isolation/quarantine, and vaccination) should be based on risk assessments and avoid placing the financial burden on international travellers in accordance with Article 40 of the IHR. WHO advice for international traffic in relation to the SARS-CoV-2 Omicron variant
7. EXTENDED: Do NOT require proof of vaccination against COVID-19 for international travel as the only pathway or condition permitting international travel given limited global access and inequitable distribution of COVID-19 vaccines. State Parties should consider a risk-based approach to the facilitation of international travel by lifting or modifying measures, such as testing and/or quarantine requirements, when appropriate, in accordance with the WHO guidance. Interim position paper: considerations regarding proof of COVID-19 vaccination for international travellers; Policy considerations for implementing a risk-based approach to international travel in the context of COVID-19
8. MODIFIED: Recognize all vaccines that have received WHO Emergency Use Listing and all heterologous vaccine combinations as per SAGE recommendations, including in the context of international travel. States Parties are also requested to support research to derive the optimal vaccination strategy for reducing infection, morbidity and mortality. Interim Recommendations for heterologous COVID-19 Vaccine Schedules ; WHO Emergency Use Listing
9. MODIFIED: Address community engagement and communications gaps and challenges posed by infodemics at national and local levels to reduce COVID-19 transmission, counter misinformation and threats to frontline workers, and improve COVID-19 vaccine acceptance, where applicable. This will require reinforcing messages that a comprehensive public health response is needed, including the continued use of PHSM alongside increasing vaccination coverage. Given the rapidly evolving situation and to promote trust and adherence, States Parties should explain clearly and transparently the rationale for the changes of policies and PHSM, with a view to balance risks and benefits of such changes. These communications need to be tailored to different population groups, including those considered as most vulnerable. Link to WHO risk communications resources.
10. MODIFIED: Support timely uptake and monitoring of WHO recommended therapeutics by addressing challenges with accessibility and appropriate use. Local production and technology transfer can contribute to global equitable access to therapeutics. States Parties are advised to establish COVID-19 therapeutics resistance monitoring systems, using appropriate testing strategies and strengthening their surveillance system. In addition, States Parties are requested to support pharmacovigilance cohort studies and reporting systems to detect adverse events following administration of new therapeutics. Therapeutics and COVID-19: living guideline
11. NEW: Conduct epidemiological investigations of SARS-CoV-2 transmission at the human-animal interface and targeted surveillance on potential animal hosts and reservoirs. Real time monitoring and data sharing on SARS-Cov-2 infection, transmission and evolution in animals will assist global understanding of the virus epidemiology and ecology, the potential for evolution of new variants in animal populations, their timely identification, and assessment of their public health risks. Statement from the Advisory Group on SARS-CoV-2 Evolution in Animals
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.
Agreement recognizes the increased environmental and public health risks from the warming global climate and prioritizes environmental justice This week, the U.S. Environmental Protection Agency (EPA) and World Health Organization (WHO) signed a five-year Memorandum of Understanding (MOU). The agreement continues EPA-WHO collaboration on a wide range of specific and crosscutting environment and health issues, particularly air pollution, water and sanitation, children’s health, and health risks due to climate change. The updated agreement includes exciting new actions on crosscutting issues including infrastructure and environmental justice.
“I am proud to renew EPA’s commitment to working with the WHO to protect the public from the health risks of pollution,” said EPA Administrator Michael S. Regan. “The United States is committed to working closely with WHO, a global leader in protecting human health for all, with a particular focus on addressing the needs of vulnerable and underserved communities. As we face new challenges from climate change and the COVID-19 pandemic, this collaboration with the WHO has never been more critical.”
EPA’s mission to protect human health and the environment fully aligns with WHO’s charge to lead global efforts to promote health for everyone, everywhere. The WHO estimates that 24% of all global deaths, and 28% of deaths among children under five, are linked to the environment, and people in low- and middle-income countries bear the greatest disease burden.
“The COVID-19 pandemic has highlighted the intimate links between humans and our environment,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Addressing those links is essential to prevent diseases, including future pandemics, to promote health, drive the global recovery and reduce health risks associated with climate change, especially for the most vulnerable. WHO looks forward to continuing its longstanding collaboration with US EPA, and to tapping EPA’s expertise to advance our mission to support countries in meeting the challenges of environmental health.”
EPA and WHO have a long history of collaboration on the most pressing public health issues of our time. Over three decades, this cooperation has included work on climate change, indoor and outdoor air quality, children’s environmental health, chemicals and toxics, water and sanitation, and quantifying the environmental burden of disease.
Over the next five years, EPA and WHO will focus on addressing the health impacts of climate change. Ongoing efforts will address many environmental determents of health affected by climate change, including clean air and safe drinking water. Collaboration will also continue to focus on protecting children by reducing exposure to toxic substances, in particular lead-based paint.
In this MOU, EPA and WHO have established new areas of cooperation to advance shared priorities around crosscutting issues including addressing the disproportionate impacts of environmental challenges on underserved and vulnerable communities. Protecting these populations and increasing access to decision-making is at the core of Administrator Regan’s vision for the EPA. WHO’s Triple Billion targets outline an ambitious plan for the world to achieve good health for all. Both EPA and WHO prioritize using science as the basis for policies and programs to address environmental health impacts.
WHO also overseas global coordination efforts to respond to the COVID-19 pandemic. EPA is also contributing to COVID-19 response with efforts to register disinfectants for SARS-CoV-2 and researching into antimicrobial products and studies of ways to disinfect personal protective equipment so that it could be reused. EPA has worked to early warning systems by monitoring wastewater for the presence of SARS-Cov-2. The two agencies will continue to advance science to respond to the current pandemic and be better prepared for all biothreats in the future.
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.
Good morning, good afternoon and good evening,
The volcanic eruption near Tonga and subsequent tsunami requires an urgent response.
With telecommunications down, WHO is on the ground in Tonga helping coordinate the response by channelling information between UN agencies, humanitarian partners and the Tongan government.
Information on the degree of destruction is still being gathered but WHO will do all it can to support the people and government of Tonga.
I visited Tonga myself in 2019. I recognize how vulnerable to natural disaster and the climate crisis the country is but also how resilient and resourceful the people are.
We will do everything we can to support Tonga.
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Omicron continues to sweep the world.
Last week, there were more than 18 million reported cases.
The number of deaths remains stable for the moment but we are concerned about the impact Omicron is having on already exhausted health workers and overburdened health systems.
In some countries, cases seem to have peaked, which gives hope that the worst of this latest wave is done with, but no country is out of the woods yet.
I remain particularly concerned about many countries that have low vaccination rates, as people are many times more at risk of severe illness and death if they’re unvaccinated.
Omicron may be less severe, on average of course, but the narrative that it is mild disease is misleading, hurts the overall response and costs more lives.
Make no mistake, Omicron is causing hospitalizations and deaths, and even the less severe cases are inundating health facilities.
The virus is circulating far too intensely with many still vulnerable.
For many countries, the next few weeks remain really critical for health workers and health systems.
I urge everyone to do their best to reduce risk of infection so that you can help take pressure off the system.
Now is not the time to give up and wave the white flag.
We can still significantly reduce the impact of the current wave by sharing and using health tools effectively and implementing public health and social measures that we know work.
I am proud COVAX delivered its one-billionth dose over the weekend.
Of course it’s not enough and we should do more.
At a time of Omicron, it remains more important than ever to get vaccines to the unvaccinated.
Vaccines may be less effective at preventing infection and transmission of Omicron than they were for previous variants, but they still are exceptionally good at preventing serious disease and death.
This is key to protecting hospitals from becoming overwhelmed.
We’ve been able to track new variants like Omicron and this virus’ evolution in real time thanks to efforts of thousands of scientists and experts around the world.
More than 7 million whole genome sequences from 180 countries have now been submitted to GISAID, which was initially set up to track flu.
This pandemic is nowhere near over and with the incredible growth of Omicron globally, new variants are likely to emerge, which is why tracking and assessment remain critical.
New formulations of vaccines are being developed and assessed for how they perform against Omicron and other strains.
I am concerned that unless that if we change the current model we’ll enter a second and even more destructive phase of vaccine inequity.
We need to make sure we share current vaccines equitably and we develop distributed manufacturing around the world.
We can only beat this virus if we work together and share health tools equitably. It’s really that simple.
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On Friday, WHO recommended two new COVID-19 treatments, based on data from seven trials, again increasing the arsenal of tools used to fight severe illness and death: a rheumatoid arthritis drug called baricitinib and a monoclonal antibody called sotrovimab.
Again, the challenge is that high prices and limited supply means access is limited.
WHO is working with our partners in ACT-Accelerator to negotiate lower prices with manufacturers and ensure supply will be available for low- and middle-income countries.
We urge manufacturers to use WHO’s COVID-19 Technology Access Pool to share technology, know-how and voluntary licensing in order to facilitate increased production capacity globally, which would save the most lives.
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WHO’s COVID-19 clinical management guidelines have been critical to policy makers and health workers so that they can access the latest information on how best to treat patients with COVID-19.
Sharing clinical data remains critical so that WHO can generate up-to-date scientific evidence regarding Omicron.
WHO invites all Member States, health facilities and research networks to voluntarily contribute to the WHO Global Clinical Platform for COVID-19, which is available through our website.
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Next week, the WHO Executive Board, which is made up of 34 Member States, will meet to discuss the world’s health challenges.
The pandemic will remain at the forefront, particularly how to more effectively share tests, treatments and vaccines equitably and to meet the 70 per cent vaccine target by July 2022.
However, the impact of the pandemic on other health issues has also been devastating and Member States will be discussing how we can stop the backsliding and recover together.
WHO will be working to accelerate progress on negotiations around a pandemic accord, as well as sustainable financing.
If we’re serious about strengthening health systems, preparing for future pandemics and tackling the litany of health challenges we collectively face in a heating world, WHO and the whole global health infrastructure will need to be sustainably financed.
Reports from the Global Pandemic Monitoring Board, the Independent Panel for Pandemic Preparedness and Response and the Review Committee on the Functioning of the International Health Regulations all recognized the need for predictable and sustainable financing at all levels of the organization.
We don’t need more reports or speeches, now is the moment for financing that fits the health challenges of our time.
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This month is Cervical Cancer Awareness month and I am pleased to see both action and advocacy taking place.
Yesterday, Serbia announced that this year they would introduce vaccination against human papillomavirus, or HPV, the pathogen responsible for 99% of cervical cancers.
Serbia will join 116 countries worldwide that are vaccinating against this cancer causing virus.
And my sister Princess Dina Mired, who is a Member of WHO Expert Group for the Elimination of Cervical Cancer marked the anniversary of WHO’s global strategy by calling for a comprehensive approach to vaccination, screening and treatment.
Princess Mired rightly concluded that cervical cancer elimination is both possible and smart economics.
Christian, back to you.
I thank you.
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.
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Happy New Year!
The dawn of a new year offers an opportunity to renew our collective response to a shared threat.
I hope global leaders who have shown such resolve in protecting their own populations will extend that resolve to make sure that the whole world is safe and protected.
And this pandemic will not end until we do that!
Last week, I asked everyone to make a New Year’s resolution to get behind the campaign to vaccinate 70% of people in every country by the middle of 2022.
And on top of that, to ensure that breakthrough treatments, as well as reliable tests, are available in all countries.
To end the acute stage of the pandemic, the highly effective tools science has given us need to be shared fairly and quickly with all countries of the world.
Vaccine inequity and health inequity overall were the biggest failures of last year.
While some countries have had enough personal protective equipment, tests and vaccines to stockpile throughout this pandemic, many countries do not have enough to meet basic baseline needs or modest targets, which no rich country would have been satisfied with.
Vaccine inequity is a killer of people and jobs and it undermines a global economic recovery.
Alpha, Beta, Delta, Gamma and Omicron reflect that in part because of low vaccination rates, we’ve created the perfect conditions for the emergence of virus variants.
Last week, the highest number of COVID-19 cases were reported so far in the pandemic.
And we know, for certain, that this is an underestimate of cases because reported numbers do not reflect the backlog of testing around the holidays, the number of positive self-tests not registered, and burdened surveillance systems that miss cases around the word.
While Omicron does appear to be less severe compared to Delta, especially in those vaccinated, it does not mean it should be categorized as ‘mild’.
Just like previous variants; Omicron is hospitalizing people and it is killing people.
In fact, the tsunami of cases is so huge and quick, that it is overwhelming health systems around the world.
Hospitals are becoming overcrowded and understaffed, which further results in preventable deaths from not only COVID-19 but other diseases and injuries where patients cannot receive timely care.
First-generation vaccines may not stop all infections and transmission but they remain highly effective in reducing hospitalization and death from this virus.
So as well as vaccination, public health social measures, including the wearing of well fitting masks, distancing, avoiding crowds and improving and investing in ventilation are important for limiting transmission.
At the current pace of vaccine rollout, 109 countries would miss out on fully vaccinating 70% of their populations by the start of July 2022.
The essence of the disparity is that some countries are moving toward vaccinating citizens a fourth time, while others haven’t even had enough regular supply to vaccinate their health workers and those at most risk.
Booster after booster in a small number of countries will not end a pandemic while billions remain completely unprotected.
But we can and must turn it around. In the short-term we can end the acute stage of this pandemic while preparing now for future ones.
First, we must effectively share the vaccines that are being produced.
Throughout most of 2021 this was not the case but toward the end, supply increased.
Now it’s crucial that manufacturers and dose-donating countries share delivery timings ahead of time so that countries have adequate preparation to roll them out effectively.
Second, let’s take a ‘never again’ approach to pandemic preparedness and vaccine manufacturing so that as soon as the next generation of COVID-19 vaccines become available, they are produced equitably and countries don’t have to beg for scarce resources.
A few countries have provided a blueprint for how high quality vaccines and other health tools can be mass produced quickly and distributed effectively. And now we need to build on it.
WHO will continue to invest in vaccine manufacturing hubs and work with any and all manufacturers who are willing to share know-how, technology and licenses.
I’m encouraged by some of the vaccines currently going through trial where innovators have already committed to waiving patents and sharing licenses, technology and know how.
It reminds me of how Jonas Salk did not patent his polio vaccine and in doing so saved millions of children from the disease.
Lets also invest and build the public health and health systems we need with strong surveillance, adequate testing, a strengthened, supported and protected health workforce, and an empowered, engaged and enabled global population.
And finally, I call on citizens of the world, including civil society, scientists, business leaders, economists and teachers to demand that governments and pharmaceutical companies to share health tools globally and bring an end to the death and destruction of this pandemic.
We need vaccine equity, treatment equity, test equity and health equity and we need your voices to drive that change.
Equity, equity, equity.
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No place is this message of equity more true than in countries or regions dealing with humanitarian crises and conflict zones.
In these areas, tackling the pandemic, as well as keeping health services on track is extremely challenging.
The base requirement for lifesaving intervention is humanitarian access.
And we are on the ground in every humanitarian crisis and in all instances have found ways to reach populations with aid and supplies.
For example, in Afghanistan, until recently, over three quarters of health facilities reported stock-outs of essential medicines and there was a threat to sustaining health workers in their posts.
But as of December, over 2,300 health facilities had received new supplies and 25,000 health workers have been paid ensuring the functionality of 96% of the health system through a joint WHO-UNICEF effort.
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In Ethiopia, WHO was able to dispatch 14 metric tonnes of medical supplies to Afar and 70 metric tonnes to Amhara in December.
In Tigray, WHO has not been permitted to deliver medical supplies since mid-July of last year.
This is despite repeated requests from WHO to provide medical supplies to the Tigray region, which would help meet some of the humanitarian and health needs in Tigray.
Even in the toughest periods of conflict in Syria, South Sudan, Yemen and others, WHO and partners have had access to save lives.
However, in Tigray the defacto blockade is preventing access to humanitarian supplies, which is killing people.
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At the top, I spoke of how the New Year is a time to renew.
I urge all leaders and key stakeholders in conflict to remember that those who work for peace are the heroes history remembers.
We need health for peace and peace for health.
To build trust and save lives, a good starting point is to ensure humanitarian and health corridors are open in all conflict zones so international agencies and civil society groups can do what they do best – save lives.
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And to those celebrating Orthodox Christmas tomorrow, may your homes be filled with peace, happiness and good health.
Margaret, back to you.
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 issued an emergency use listing (EUL) for Nuvaxovid™, following its assessment and approval by the European Medicines Agency (EMA) earlier today.
The new vaccine was developed by Novavax and the Coalition for Epidemic Preparedness Innovations (CEPI), and is the originator product for the Covovax™ vaccine that received WHO emergency use listing on 17 December.
Both vaccines are made using the same technologies. They require two doses and are stable at 2 to 8 °C refrigerated temperatures.
WHO’s Strategic Advisory Group of Experts on Immunization has also issued policy recommendations for Nuvaxovid™ / Covovax™.
The emergency use listing (EUL) procedure assesses the suitability of novel health products during public health emergencies. The objective is to make medicines, vaccines and diagnostics available as rapidly as possible to address the emergency while adhering to stringent criteria of safety, efficacy and quality. The assessment weighs the threat posed by the emergency as well as the benefit that would accrue from the use of the product against any potential risks.
The EUL pathway involves a rigorous assessment of late phase II and phase III clinical trial data, as well as substantial additional data on safety, efficacy, quality and a risk management plan. These data are reviewed by independent experts and WHO teams who consider the current body of evidence on the vaccine under consideration, the plans for monitoring its use, and plans for further studies.
As part of the EUL process, the company producing the vaccine must commit to continue to generate data to enable full licensure and WHO prequalification of the vaccine. The WHO prequalification process will assess additional clinical data generated from vaccine trials and deployment on a rolling basis to ensure the vaccine meets the necessary standards of quality, safety and efficacy for broader availability.
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 Ebola outbreak that erupted in the Democratic Republic of the Congo’s North Kivu Province in October – the second in 2021 – was today declared over, the national health authorities announced after no new cases were reported at the end of a 42-day countdown, or two incubation periods after the last confirmed case was discharged.
In total, 11 cases (eight confirmed, three probable), including six deaths were reported in the outbreak that was declared on 8 October after a new case was confirmed in Beni health zone in the country’s North Kivu Province. This was the country’s 13th outbreak and occurred in the same area as the 2018 outbreak which lasted two years.
More than 1800 people were vaccinated in a campaign that kicked off just five days after the first case was detected. The outbreak marks the first time the recently-licensed ERVEBO vaccine against Ebola was used in the country. ERVEBO is the same as the compassionate-use vaccine, but as a licensed vaccine, rollout is less cumbersome operationally.
“Stronger disease surveillance, community engagement, targeted vaccination and prompt response are making for more effective Ebola containment in the region,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “During this outbreak, the Democratic Republic of Congo was able to limit widespread infections and save lives. Crucial lessons are being learned and applied with every outbreak experience.”
Swift response comprising key outbreak control measures such as contact tracing, testing, disease surveillance as well as community collaboration efforts helped contain the outbreak within Beni, where the initial case was detected. In support of the country, WHO deployed experts, supplies, and contributed funds to help contain the outbreak.
However, unpredictable and sometimes volatile security in parts of Beni hampered response in some localities, with health workers and other frontline responders unable to access insecure areas to monitor high-risk contacts or administer vaccines.
The prevention of sexual abuse and exploitation was a core pillar of the response. An expert was deployed to train WHO personnel and partners on preventing inappropriate and abusive behaviour. Every person involved in field work received training and each partner agency signed a code of conduct. Trainers engaged directly with community members where health authorities were working to raise awareness about sexual exploitation and abuse and how to report it safely. Radio spots and pamphlets in local languages also helped spread the message.
With the outbreak now declared over, the health authorities are maintaining surveillance and are ready to respond quickly to any flare-ups. It is not unusual for sporadic cases to occur following a major outbreak. Results from genome sequencing conducted by the country’s National Institute of Biomedical Research found that the first Ebola case detected in the just-ended outbreak likely represented a new flare-up of the 2018–2020 Ebola outbreak due persistence of the virus in the community.
The country has set up an Ebola Survivor Programme which currently has more than 1100 people from previous outbreaks in North Kivu Province. The two survivors from the now-ended outbreak have been enrolled in the survivor programme. For the next 18 months they will receive monthly check-ups, which include medical evaluations, psychological and nutritional support.
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 St. Jude Children’s Research Hospital today announced plans to establish a platform that will dramatically increase access to childhood cancer medicines around the world.
The Global Platform for Access to Childhood Cancer Medicines, the first of its kind, will provide an uninterrupted supply of quality-assured childhood cancer medicines to low-and middle-income countries. St. Jude is making a six-year, US$ 200 million investment to launch the platform, which will provide medicines at no cost to countries participating in the pilot phase. This is the largest financial commitment for a global effort in childhood cancer medicines to date.
“Close to nine in ten children with cancer live in low-and middle-income countries,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Survival in these countries is less than 30%, compared with 80% in high-income countries. This new platform, which builds on the success of the Global Initiative for Childhood Cancer launched with St. Jude in 2018, will help redress this unacceptable imbalance and give hope to many thousands of parents faced with the devastating reality of a child with cancer.”
Each year, an estimated 400 000 children worldwide develop cancer. The majority of children living in low-and middle-income countries are unable to consistently obtain or afford cancer medicines. As a result, nearly 100 000 children die each year.
The new platform aims to provide safe and effective cancer medicines to approximately 120 000 children between 2022 and 2027, with the expectation to scale up in future years. This platform will provide end-to-end support ̶consolidating global demand to shape the market; assisting countries with the selection of medicines; developing treatment standards; and building information systems to track that effective care is being provided and to drive innovation.
“St. Jude was founded on the mission to advance research and treatment of childhood cancer and other catastrophic pediatric diseases. Nearly 60 years later, we stand with the World Health Organization, partner organizations and our Global Alliance collaborators to expand that promise for children worldwide," said James R. Downing, M.D., president and CEO of St. Jude. “With this platform, we are building the infrastructure to ensure that children everywhere have access to safe cancer medicines.”
This innovative approach will open a new chapter in access to cancer care by addressing medicine availability in low-and middle-income countries that is often complicated by higher prices, interruptions in supply and out-of-pocket expenditures that result in financial hardship.
According to a WHO Noncommunicable Disease Country Capacity survey published in 2020, only 29% of low-income countries report that cancer medicines are generally available to their populations compared to 96% of high-income countries. By consolidating the needs of children with cancer globally, the new platform will curtail the purchasing of sub-standard and falsified medicines that results from unauthorized purchases and the limited capacity of national regulatory authorities.
“Unless we address the shortage and poor quality of cancer medicines in many parts of the world, there are very few options to cure these children,” said Carlos Rodriguez-Galindo, M.D., executive vice president and chair of the St. Jude Department of Global Pediatric Medicine and director of St. Jude Global. “Health-care providers must have access to a reliable source of cancer medicines that constitute the current standard of care. We at St. Jude, with our co-founding partners at WHO and many vital partners around the world, can help achieve that.”
“WHO, St Jude and partners will spare no efforts to get children’s access to cancer medicines on track,” added Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO. “WHO is on the ground, working with governments to deliver support and services to ensure that all children have access to the best cancer treatment possible.”
During an initial two-year pilot phase, medicines will be purchased and distributed to 12 countries through a process involving governments, cancer centers and nongovernmental organizations already active in providing cancer care. Discussions are already ongoing with governments to determine the countries which will participate in this pilot phase. By the end of 2027, it is expected that 50 countries will receive childhood cancer medicines through the platform
. Kathy Pritchard-Jones, president of the International Society of Paediatric Oncology, said; “We look forward to working with St. Jude and WHO on this journey to ensure all children, everywhere, have access to quality cancer medicines. The platform is bringing forth a dream of our more than 2600 global members.”
João Bragança, president of Childhood Cancer International, added: “Cancer should not be a death sentence, no matter where a child lives. By developing this platform, St. Jude is helping families get access to lifesaving medicines for their children. Working together, we can change the outcome for cancer-afflicted children around the world.”
The World Health Organization and St. Jude Children’s Research Hospital first collaborated in 2018, when St. Jude became the first WHO Collaborating Centre for Childhood Cancer and committed US$ 15 million for the creation of the Global Initiative for Childhood Cancer. This Initiative supports more than 50 governments in building and sustaining local cancer programmes and aims to increase survival to 60% by 2030.The platform synergizes with the Global Initiative, with activities implemented through this new effort expected to contribute substantially to the achievement of the Initiative’s goals.
The Global Platform for Access to Childhood Cancer Medicines is part of the Six-Year St. Jude Strategic Plan focused on accelerating progress on catastrophic childhood diseases on a global scale through the institution’s largest investment in research and patient care.
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.
DUBAI/GENEVA/WASHINGTON DC — 12 December 2021 — New evidence compiled by the World Health Organization and the World Bank shows that the COVID-19 pandemic is likely to halt two decades of global progress towards Universal Health Coverage. The organizations also reveal that more than half a billion people are being pushed into extreme poverty because they have to pay for health services out of their own pockets.
The findings are contained in two complementary reports, launched on Universal Health Coverage Day, highlighting the devastating impact of COVID-19 on people’s ability to obtain health care and pay for it.
In 2020, the pandemic disrupted health services and stretched countries’ health systems beyond their limits as they struggled to deal with the impact of COVID-19. As a result, for example, immunization coverage dropped for the first time in ten years, and deaths from TB and malaria increased.
The pandemic also triggered the worst economic crisis since the 1930s, making it increasingly difficult for people to pay for care. Even before the pandemic, half a billion people were being pushed (or pushed still further) into extreme poverty because of payments they made for health care. The organizations expect that that number is now considerably higher.
“There is no time to spare,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “All governments must immediately resume and accelerate efforts to ensure every one of their citizens can access health services without fear of the financial consequences. This means strengthening public spending on health and social support, and increasing their focus on primary health care systems that can provide essential care close to home.”
He added: “Prior to the pandemic, many countries had made progress. But it was not robust enough. This time we must build health systems that are strong enough to withstand shocks, such as the next pandemic and stay on course towards universal health coverage.”
The new WHO/World Bank reports also warn that financial hardship is likely to become more intense as poverty grows, incomes fall, and governments face tighter fiscal constraints.
“Even before the COVID-19 pandemic struck, almost 1 billion people were spending more than 10 per cent of their household budget on health,” said Juan Pablo Uribe, Global Director for Health, Nutrition and Population, World Bank. “This is not acceptable, especially since the poorest people are hit hardest. Within a constrained fiscal space, governments will have to make tough choices to protect and increase health budgets,” he added.
In the first two decades of this century, many governments had made progress on service coverage. In 2019, prior to the pandemic, 68 per cent of the world’s population was covered by essential health services, such as pre-and post-natal care and reproductive health services; immunization services; treatment for diseases like HIV, TB and malaria; and services to diagnose and treat noncommunicable diseases like cancer, heart conditions, and diabetes.
But they had not made such advances in ensuring affordability. As a result, the poorest groups and those living in rural areas are the least able to obtain health services, and the least likely to be able to cope with the consequences of paying for them. Up to 90 percent of all households incurring impoverishing out-of-pocket health spending are already at or below the poverty line - underscoring the need to exempt poor people from out-of-pocket health spending, backing such measures with health financing policies that enable good intentions to be realized in practice.
Besides the prioritizing of services for poor and vulnerable populations, supported through targeted public spending and policies that protect individuals from financial hardship, it will also be crucial to improve the collection, timeliness and disaggregation of data on access, service coverage, out-of-pocket health spending and total expenditure. Only when countries have an accurate picture of the way that their health system is performing, can they effectively target action to improve the way it meets the needs of all people.
Together, these two new reports offer both a warning and guideposts to all countries as they strive to build back better from COVID-19 and keep their populations safe, healthy, and financially secure.
Since the start of the COVID-19 pandemic, the World Bank Group has deployed over $157 billion to fight the health, economic, and social impacts of the pandemic, the fastest and largest crisis response in its history. The financing is helping more than 100 countries strengthen pandemic preparedness, protect the poor and jobs, and jump start a climate-friendly recovery. The Bank is also supporting over 60 low- and middle-income countries, more than half of which are in Africa, with the purchase and deployment of COVID-19 vaccines, and is making available $20 billion in financing for this purpose until the end of 2022.
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 WHO interim recommendations on the use of the Janssen Ad26.COV2.S (COVID-19) vaccine (updated on 9 December) were developed on the basis of advice issued by the Strategic Advisory Group of Experts (SAGE) on Immunization and the evidence summary included in the background document.
Summary of the recommendations:
Countries can now consider using either a one- or two-course of the Janssen vaccine. The one-dose schedule is an EUL authorized regimen.
In some circumstances, using one dose may have advantages. Many countries face severe vaccine supply constraints, combined with a high disease burden. A single dose of the vaccine is efficacious and makes it possible to increase vaccine coverage rapidly, which in turn will reduce the burden on health care systems by preventing severe disease outcomes. A single dose may also be a preferred option for vaccinating hard-to-reach populations or populations living in conflict or insecure settings.
A second dose may be appropriate as vaccine supplies and/or accessibility increases. Countries should consider offering a second dose, beginning with the highest priority populations (e.g. healthcare workers, older people, people with comorbidities) as indicated in the WHO Prioritization Roadmap. The administration of the second dose will result in increased protection against symptomatic infection, and against severe disease.
A heterologous vaccine (e.g., a COVID-19 vaccine from another vaccine platform that has received EUL) can also be considered for the second dose.
Countries can also consider a longer interval between doses. A second dose 2 months after the initial dose substantially increases efficacy, especially against symptomatic infections, including when caused by SARS-CoV-2 variants of concern. An even longer interval between the two doses with Ad26.COV2.S (6 months rather than 2 months) has been shown to result in a larger increase in immune responses in adults. Countries could therefore consider an interval of up to 6 months based on their epidemiological situation, and needs of sub-populations.
The full text of the interim recommendations is available here: < href="https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-SAGE-recommendation-Ad26.COV2.S-2021.1" target="_blank">https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-SAGE-recommendation-Ad26.COV2.S-2021.1
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.