On 8 July 2021, a Zika virus (ZIKV) infection was laboratory-confirmed in a resident of Kerala state, south-west India. This represents the first Zika virus disease case ever reported from Kerala. ZIKV viral RNA was detected through RT-PCR testing at the National Institute of Virology (NIV) Pune, in a blood sample collected from the patient, a 24-year-old pregnant woman in her third trimester of pregnancy resident in Trivandrum district. On 28 June 2021, she was admitted to a private hospital with arbovirus like symptoms of fever, headache and general rash. Laboratory results were negative for dengue virus (DENV) and chikungunya virus (CHIKV). The woman delivered on 7 July, she was reportedly in good health and there were no apparent birth defects in the new-born. In the 3 months before delivery, she had resided in Trivandrum district not having traveled during that period. Among her close contacts, her mother reported having fever and similar symptoms one week before ZIKV confirmation in her daughter.
Retrospective testing was conducted among 19 hospital staff and patients at the same private hospital who had previously presented with fever, myalgia, arthralgia and petechial lesions in May 2021. Blood samples collected from these 19 ZIKV suspected cases were sent to NIV Pune, and on 10 July the laboratory results confirmed that 13 of the 19 samples tested positive for ZIKV by RT-PCR, indicating cryptic transmission of ZIKV in Kerala state since May 2021.
During the period from 8 to 26 July 2021, 590 blood samples were collected in Kerala state through active case finding and passive surveillance. Of them, 70 (11.9%) tested positive for ZIKV by RT-PCR at NIV Pune, including four additional pregnant women. All these cases were from Trivandrum district, except two cases reported from Ernakulam and Kottayam districts, who both had recent travel history to Trivandrum district.
On 31 July 2021, Maharashtra state also reported its first Zika laboratory-confirmed case from Belsar, a village of 3500 inhabitants located in Purandar Taluka administrative unit, Pune district. The case, a 50-year-old women, tested positive for both ZIKV (by RT-PCR and sero-neutralization) and CHIKV (by RT- PCR and IgM ELISA) at NIV Pune. Fifty-one additional samples from ZIKV suspected cases were collected from Belsar village, of them 40 tested negative for ZIKV and 11 are still pending for results.
So far, no cases of microcephaly and/or Guillain-Barre syndrome (GBS) have been linked with this outbreak.
The Kerala Health department, along with local self-government health departments has implemented the following response activities:
On 8 July 2021, the State of Kerala issued guidelines on enhanced surveillance for ZIKV disease and sent guidance to all 14 districts.
Information, Education and Communication activities pertaining to ZIKV disease have been strengthened immediately throughout the State. Sensitization activities across the State for both health care workers and the general public are ongoing.
All ultrasound scanning centers have been directed to report incidences of microcephaly during regular antenatal scans to the Reproductive and Child Health Officer.
Currently, four laboratories (National Institute of Virology Alappuzha, Medical College laboratories of Trivandrum, Thrissur and Kozhikode) in Kerala state are equipped to perform RT-PCR testing for ZIKV infection. The State is also planning to start testing in another public health laboratory in Trivandrum district. So far, the State has received 2100 RT-PCR kits from NIV Pune to detect Zika cases, which have been distributed to the four laboratories mentioned above.
Measures to ensure strict deferral of blood donors with a history of fever in the previous two weeks, have been undertaken.
A central team visited the Trivandrum district and collected samples of mosquitoes and larvae from the residential area of the cases and sent them for testing at the Vector Control Research centre, Kottayam field station in Kerala state. The results are pending.
The State Health Minister has conducted multiple rounds of reviews, and all the districts have been alerted to carry out active surveillance, mosquito control and information, education, and communication activities related to control of ZIKV.
In Trivandrum district, which has been declared as having a cluster of ZIKV disease cases, intensified vector control activities have been conducted for a week including; extensive fogging, spraying, use of larvicides, source reduction and sanitization of the surrounding areas. Additionally, field teams visited each household to conduct active case finding, ensure elimination of mosquito breeding sites, and sensitize the community to preventive mosquito control measures and identification of ZIKV disease symptoms to seek timely medical assistance.
WHO was requested to support the country’s updates on standard operating procedures and guidelines for: syndromic and case-based surveillance; laboratory surveillance; vector surveillance; enhanced surveillance among antenatal women; microcephaly surveillance; surveillance of Acute Flaccid Paralysis (AFP) and GBS.
ZIKV can cause large epidemics with a substantial demand on the public health system including surveillance, case management, and laboratory capacity to differentiate ZIKV disease from illness due to co-circulating mosquito-borne viruses like dengue and chikungunya. Although 60-80% of the Zika virus infected cases are asymptomatic or only have mild symptoms, ZIKV can cause microcephaly, congenital Zika syndrome (CZS) and GBS. Moreover, although ZIKV is primarily transmitted by Aedes species mosquitoes, it can also be transmitted from mother to foetus during pregnancy, through sexual contact, transfusion of blood and blood products, and organ transplantation.
In India, ZIKV disease cases/infections have been detected in Gujarat, Madhya Pradesh and Rajasthan states in 2018 (South-East Asian lineage), but no ZIKV-associated microcephaly has been reported. Although this event is not unexpected, given the wide distribution of the primary mosquito vector, Aedes aegypti, and competent vector, Aedes albopictus, in Kerala and Maharashtra states, this is unusual as it is the first time that ZIKV disease cases have been confirmed in these states.
The overall risk is considered low at the regional level and global level, while at the national level (Kerala and Maharashtra States) is currently assessed as moderate, given that:
The actual ZIKV transmission might be higher due to the undetermined population immunity in the two affected states and the asymptomatic clinical presentation in most of the ZIKV infections;
The primary vector Aedes aegypti, and competent vector Aedes albopictus, are established in the area, often in high densities, and the ecological conditions are favourable for ZIKV transmission and potential endemicity;
The current evidence suggests that the main source of infection is due to vector-borne transmission; however, epidemiological and entomological investigations are ongoing and the outbreak magnitude might change;
Although appropriate control measures have been implemented, and travel is currently limited under COVID-19 pandemic conditions, further spread of the disease cannot be excluded through asymptomatic and mildly symptomatic infected persons;
The ongoing monsoon season could increase the vector density and the likelihood of further transmission via mosquitos;
Kerala is a tourist destination with frequent travel to and from other areas of the country and other countries; however, there are current travel restrictions because of the COVID-19 pandemic.
The exportation within India and to other states and countries cannot be ruled out due the presence of competent vector (Ae. aegypti) in other states where mosquitos can become infected by biting infected returning travellers leading to potential further spread of the disease.
The region as a whole remains at risk for ZIKV transmission because of the presence of competent vectors, often in high densities and vector control activities might have been interrupted in other countries because of the pandemic.
Protection against mosquito bites during the day and early evening is a key measure to prevent ZIKV infection. Special attention should be given to the prevention of mosquito bites among pregnant women, women of reproductive age, and young children.
Aedes mosquitoes breed in small collections of water around homes, schools, and workplaces. It is important to eliminate these mosquito breeding sites by appropriate methods, including: covering water storage containers, removing standing water in flower pots, and cleaning up trash and used tires. Community initiatives are essential to support local government and public health programmes to reduce mosquito breeding sites. Health authorities may also advise the use of larvicides and insecticides to reduce mosquito populations and disease spread. Semi-urban areas should prevent the breeding of Aedes spp., in rubber plantations and other stagnant pools of water.
Basic precautions for protection from mosquito bites should be taken by people traveling to high-risk areas, especially pregnant women. These include the use of repellents, wearing light coloured, long-sleeved shirts and pants, ensuring rooms are fitted with screens to prevent mosquitoes from entering.
For regions with active transmission of ZIKV, all persons with suspected ZIKV infection and their sexual partners (particularly pregnant women) should receive information about the risks of sexual transmission of ZIKV.
WHO recommends that sexually active men and women be correctly counselled about ZIKV infection and offered a full range of contraceptive methods to be able to make an informed choice about whether and when to become pregnant in order to prevent congenital Zika syndrome and other possible adverse pregnancy and foetal outcomes.
Women who have had unprotected sex and do not wish to become pregnant due to concerns about ZIKV infection should have ready access to emergency contraceptive services and counselling. Pregnant women should practice safer sex (including correct and consistent use of condoms) or abstain from sexual activity for the entire duration of pregnancy. Pregnant women should be encouraged to attend scheduled appointments and enhanced antenatal care and follow-up, including ultrasound imaging to detect microcephaly and other developmental anomalies associated with ZIKV infection in pregnancy, in accordance with the state/national response plan.
For regions with no active transmission of ZIKV, WHO recommends practicing safer sex or abstinence for a period of six months for men and two months for women who are returning from areas of active ZIKV transmission to prevent infection of their sex partners. Sexual partners of pregnant women, living in or returning from areas where local transmission of ZIKV occurs, should practice safer sex or abstain from sexual activity throughout pregnancy.
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.
Each year, the WHO Global TB Report provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets.
The 2021 edition of the report has been produced in a new and more web-centric format. This is designed to make the content available in smaller (more “bite-sized”) chunks that are easier to read, digest, navigate and use. There is a short and slim report PDF with 30 pages of main content plus six short annexes. This is accompanied by expanded and more detailed digital content on web pages. The total amount of content remains similar to that of previous years.
Please note that direct comparisons between estimates of TB disease burden in the latest report and previous reports are not appropriate. The most recent time-series of estimates are published in this global TB report.
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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 8 October 2021, the Ministry of Health of the Democratic Republic of the Congo (DRC) announced that a new laboratory confirmed case of Ebola virus disease (EVD) had been detected in Butsili Health Area, Beni Health Zone in North Kivu Province. Earlier this year, an EVD outbreak affected North Kivu Province which was declared over on 3 May 2021.
The case was a 3-year-old male who, in early October, developed symptoms including physical weakness, loss of appetite, abdominal pain, breathing difficulty, dark stool and blood in their vomit. He died on 6 October.
On 7 October 2021, samples were tested at the National Institute of Biomedical Research (INRB) laboratory in Beni for molecular analysis. These were later sent to the Rodolphe Mérieux INRB Laboratory, Goma on 8 October and EVD was confirmed by reverse transcription polymerase chain reaction (RT-PCR) on the same day.
This follows a cluster of three deaths (two children and their father) who were neighbours of the case. These three patients died on 14, 19 and 29 September after developing symptoms consistent with Ebola, however, none were tested for the virus.
The first of these cases, a child, was taken to a local health center for fever, physical weakness and headache between 5-7 September 2021 in the Butsili Health Area. Her condition improved and she returned home. However, on 12 September, she was re-admitted to the same health center with diarrhoea and vomiting and tested positive for malaria by Rapid Diagnostic Test (RDT). She died on the 14 September.
The child’s father had onset of symptoms on 10 September. He consulted another health facility on 14 September and later was admitted to a hospital in Beni. He died on 19 September.
On 27 September, the child's sister developed similar symptoms. She was taken to a local health centre and later referred to another health facility where she tested positive for malaria by RDT and was treated for severe malaria. She died on 29 September.
The Beni Health Zone was informed about these three deaths on 30 September. A joint investigation team, comprising members of the Beni Health Zone and WHO, was deployed to further investigate and list the contacts. Two samples were collected to test for COVID-19 but no samples were taken for EVD testing. No safe and dignified burials were conducted. Severe malaria, EVD, measles and meningitis were retrospectively listed as potential causes.
Butsili Health Area is close to Beni city, which was one of the epicentres of the 2018–2020 Ebola outbreak in the country with 736 probable and confirmed cases reported. It is about 50 km from Butembo city, which experienced a new Ebola outbreak earlier this year. It is not unusual for sporadic cases to occur following a major outbreak, but it is too early to say whether this case is related to the previous outbreaks. The city of Beni is a commercial hub with links to the neighbouring countries of Uganda and Rwanda.
The North Kivu Provincial health authorities are leading the current response. The Ministry of Health, with support from WHO and partners, is investigating the most recent case. During the previous outbreaks in North Kivu, WHO helped build the capacity of local laboratory technicians, contact tracers, vaccination teams, and reached out to community groups to raise Ebola awareness and engaged them in response interventions, as well as in establishing an Ebola survivor care programme. Among the WHO staff supporting the response is a focal point for the prevention of sexual exploitation and abuse. In addition, WHO will ensure mandatory pre-deployment training and refresher training for any further deployments; reporting channels for alerts or complaints; prompt investigation of complaints; and monitoring.
As of 9 October, a total of 148 contacts have been identified and are under follow up by the response team.
According to the available information, the three suspected cases and the confirmed case were admitted in several health facilities where infection prevention and control measures (IPC) might not have been optimal, which increases the risk of spread. In addition, they were buried without following safe and dignified burials protocols. Additionally, as mentioned above, the cases are from a health zone that is located within the densely populated city of Beni. Therefore, there is a risk of EVD spread to other health zones.
WHO is closely monitoring the situation and the risk assessment will be updated as more information becomes available.
The current resurgence is not unexpected given that EVD is enzootic (present in animal reservoirs) in the DRC including this region. The risk of re-emergence through exposure to an animal host or body fluids of Ebola survivors cannot be excluded. In addition, it is not unusual for sporadic cases to occur following a major outbreak.
Re-emergence of EVD is a major public health issue in the DRC and there are gaps in the country’s capacity to prepare for and respond to outbreaks. A confluence of environmental and socioeconomic factors including poverty, community mistrust, weak health systems, and political instability is accelerating the rate of the emergence of EVD in the DRC.
Another challenge stretching the limited resources is the concurrent COVID-19 outbreak. The first confirmed COVID-19 case was registered in DRC on 14 March 2020. As of 5 October 2021, DRC had reported 57 197 confirmed cases of COVID-19 and 1 087 deaths.
WHO considers that ongoing challenges in terms of access and security, epidemiological surveillance, coupled with the emergence of COVID-19, as well as cholera, meningitis, and measles outbreaks may jeopardize the country’s ability to rapidly detect and respond to the re-emergence of EVD cases.
WHO advises the following risk reduction measures as an effective way to reduce EVD transmission in humans:
Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
Reducing the risk of human-to-human transmission from direct or close contact with people with EVD symptoms, particularly with their bodily fluids. Appropriate personal protective equipment (PPE) should be worn when taking care of ill patients. Regular hand washing is required after visiting patients in a hospital, as well as after touching or coming into contact with any body fluids.
Reducing the risk of possible sexual transmission based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of EVD practice safe sex for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus. Contact with body fluids should be avoided and hand washing with soap and water is recommended. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for the Ebola virus.
Continue training and re-training of the health workforce for early detection, isolation, and treatment of EVD cases as well as re-training on safe and dignified burials and the IPC ring approach.
Ensure availability of PPE and IPC supplies to manage ill patients and for decontamination.
Conduct health facility assessments (“Scorecard”) of adherence to IPC measures in preparedness for managing Ebola patients (this includes WASH, waste management, PPE supplies, triage/screening capacity, etc) and continue to support facilities in developing and implementing action plans to address identified gaps.
Prepare for ring vaccination of contacts and contacts of contacts of confirmed cases and of frontline workers.
Engage with communities to reinforce safe and dignified burial practices.
Based on the current risk assessment and prior evidence on Ebola outbreaks, WHO advises against any restriction of travel and trade to the Democratic Republic of the Congo.
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.
Brazzaville/Kinshasa, 8 October 2021 – The Ministry of Health of the Democratic Republic of the Congo today announced that a new case of Ebola has been detected in the health zone of Butsili in North Kivu Province, where a previous outbreak was declared over 3 May 2021.
The Goma branch of the National Institute of Biomedical Research (INRB) confirmed Ebola in samples taken from a young child who died after suffering from Ebola-like symptoms on 6 October.
Butsili is close to Beni, a town which was one of the epicentres of the 2018–2020 Ebola outbreak in eastern Democratic Republic of the Congo and about 50 km from Butembo city which experienced a new Ebola outbreak earlier this year. It is not unusual for sporadic cases to occur following a major outbreak, but it is too soon to say whether this case is related to the previous outbreaks. The city of Beni is a commercial hub with links to the neighboring countries of Uganda and Rwanda.
“WHO is supporting health authorities to investigate the new Ebola case,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “North Kivu has been battered by Ebola outbreaks during the past few years, but this has built up local expertise and community awareness, paving the way for a fast-moving response.”
The North Kivu Provincial health authorities are leading the current response with support from the Ministry of Health and WHO. During the previous outbreaks in North Kivu, WHO helped build the capacity of local laboratory technicians, contact tracers, vaccination teams and reached out to community groups to raise Ebola awareness, as well as put in place an Ebola survivor programme.
The Democratic Republic of the Congo’s 10th Ebola outbreak which lasted for nearly two years was the second largest in the world and by the time it ended there were 3481 cases, 2299 deaths and 1162 survivors. The country’s 12th Ebola outbreak which occurred in and around Butembo was over after three months with 11 confirmed cases, one probable case and six deaths.
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’s new Mental Health Atlas paints a disappointing picture of a worldwide failure to provide people with the mental health services they need, at a time when the COVID-19 pandemic is highlighting a growing need for mental health support.
The latest edition of the Atlas, which includes data from 171 countries, provides a clear indication that the increased attention given to mental health in recent years has yet to result in a scale-up of quality mental services that is aligned with needs.
Issued every three years, the Atlas is a compilation of data provided by countries around the world on mental health policies, legislation, financing, human resources, availability and utilization of services and data collection systems. It is also the mechanism for monitoring progress towards meeting the targets in WHO’s Comprehensive Mental Health Action Plan.
“It is extremely concerning that, despite the evident and increasing need for mental health services, which has become even more acute during the COVID-19 pandemic, good intentions are not being met with investment,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “We must heed and act on this wake-up call and dramatically accelerate the scale-up of investment in mental health, because there is no health without mental health.”
None of the targets for effective leadership and governance for mental health, provision of mental health services in community-based settings, mental health promotion and prevention, and strengthening of information systems, were close to being achieved.
In 2020, just 51% of WHO’s 194 Member States reported that their mental health policy or plan was in line with international and regional human rights instruments, way short of the 80% target. And only 52% of countries met the target relating to mental health promotion and prevention programmes, also well below the 80% target. The only 2020 target met was a reduction in the rate of suicide by 10%, but even then, only 35 countries said they had a stand-alone prevention strategy, policy or plan.
Steady progress was evident, however, in the adoption of mental health policies, plans and laws, as well as in improvements in capacity to report on a set of core mental health indicators. However, the percentage of government health budgets spent on mental health has scarcely changed during the last years, still hovering around 2%. Moreover, even when policies and plans included estimates of required human and financial resources, just 39% of responding countries indicated that the necessary human resources had been allocated and 34% that the required financial resources had been provided.
While the systematic decentralization of mental health care to community settings has long been recommended by WHO, only 25% of responding countries met all the criteria for integration of mental health into primary care. While progress has been made in training and supervision in most countries, the supply of medicines for mental health conditions and psychosocial care in primary health-care services remains limited.
This is also reflected in the way that government funds to mental health are allocated, highlighting the urgent need for deinstitutionalization. More than 70% of total government expenditure on mental health was allocated to mental hospitals in middle-income countries, compared with 35% in high-income countries. This indicates that centralized mental hospitals and institutional inpatient care still receive more funds than services provided in general hospitals and primary health-care centres in many countries.
There was, however, an increase in the percentage of countries reporting that treatment of people with specific mental health conditions (psychosis, bipolar disorder and depression) is included in national health insurance or reimbursement schemes – from 73% in 2017 to 80% (or 55% of Member States) in 2020.
Global estimates of people receiving care for specific mental health conditions (used as a proxy for mental health care as a whole) remained less than 50%, with a global median of 40% of people with depression and just 29% of people with psychosis receiving care.
Increase in mental health promotion, but effectiveness questionable More encouraging was the increase in countries reporting mental health promotion and prevention programmes, from 41% of Member States in 2014 to 52% in 2020. However, 31% of total reported programmes did not have dedicated human and financial resources, 27% did not have a defined plan, and 39% had no documented evidence of progress and/or impact.
The global median number of mental health workers per 100 000 population has increased slightly from nine workers in 2014 to 13 workers per 100 000 population in 2020. However, there was a very high variation between countries of different income levels, with the number of mental health workers in high-income countries more than 40 times higher than in low-income countries.
The global targets reported on in the Mental Health Atlas are from WHO’s Comprehensive Mental Health Action Plan, which contained targets for 2020 endorsed by the World Health Assembly in 2013. This Plan has now been extended to 2030 and includes new targets for the inclusion of mental health and psychosocial support in emergency preparedness plans, the integration of mental health into primary health care, and research on mental health.
“The new data from the Mental Health Atlas shows us that we still have a very long way to go in making sure that everyone, everywhere, has access to quality mental health care,” said Dévora Kestel, Director of the Department of Mental Health and Substance Use at WHO. “But I am encouraged by the renewed vigour that we saw from governments as the new targets for 2030 were discussed and agreed and am confident that together we can do what is necessary to move from baby steps to giant leaps forward in the next 10 years.”
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.
Historic RTS,S/AS01 recommendation can reinvigorate the fight against malaria
GENEVA, October 6th 2021 --- The World Health Organization (WHO) is recommending widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine among children in sub-Saharan Africa and in other regions with moderate to high P. falciparum malaria transmission The recommendation is based on results from an ongoing pilot programme in Ghana, Kenya and Malawi that has reached more than 800 000 children since 2019.
“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”
Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. More than 260 000 African children under the age of five die from malaria annually.
In recent years, WHO and its partners have been reporting a stagnation in progress against the deadly disease.
"For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We have long hoped for an effective malaria vaccine and now for the first time ever, we have such a vaccine recommended for widespread use. Today’s recommendation offers a glimmer of hope for the continent which shoulders the heaviest burden of the disease and we expect many more African children to be protected from malaria and grow into healthy adults.”
Based on the advice of two WHO global advisory bodies, one for immunization and the other for malaria, the Organization recommends that:
WHO recommends that in the context of comprehensive malaria control the RTS,S/AS01 malaria vaccine be used for the prevention of P. falciparum malaria in children living in regions with moderate to high transmission as defined by WHO. RTS,S/AS01 malaria vaccine should be provided in a schedule of 4 doses in children from 5 months of age for the reduction of malaria disease and burden.
Key findings of the pilots informed the recommendation based on data and insights generated from two years of vaccination in child health clinics in the three pilot countries. Findings include:
o Feasible to deliver: Vaccine introduction is feasible, with good and equitable coverage of RTS,S seen through routine immunization systems.
o Reaching the unreached: RTS,S increases equity in access to malaria prevention.
§ Data from the pilot programme showed that more than two-thirds of children in the 3 countries who are not sleeping under a bednet are benefitting from the RTS,S vaccine.
§ Layering the tools results in over 90% of children benefitting from at least one preventive intervention (insecticide treated bednets or the malaria vaccine).
o Strong safety profile: To date, more than 2.3 million doses of the vaccine have been administered in 3 African countries – the vaccine has a favorable safety profile.
o No negative impact on uptake of bednets, other childhood vaccinations, or health seeking behavior for febrile illness. In areas where the vaccine has been introduced, there has been no decrease in the use of insecticide-treated nets, uptake of other childhood vaccinations or health seeking behavior for febrile illness.
o High impact in real-life childhood vaccination settings: Significant reduction (30%) in deadly severe malaria, even when introduced in areas where insecticide-treated nets are widely used and there is good access to diagnosis and treatment.
o Highly cost-effective: Modelling estimates that the vaccine is cost effective in areas of moderate to high malaria transmission.
Next steps for the WHO-recommended malaria vaccine will include funding decisions from the global health community for broader rollout, and country decision-making on whether to adopt the vaccine as part of national malaria control strategies.
Financing for the pilot programme has been mobilized through an unprecedented collaboration among three key global health funding bodies: Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid.
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.
More than 6.4 billion vaccine doses have now been administered globally, and almost one-third of the world’s population is fully vaccinated against COVID-19. But those numbers mask a horrifying inequity. Low-income countries have received less than half of one percent of the world’s vaccines. In Africa, less than 5% of people are fully vaccinated.
Today, WHO is launching the Strategy to Achieve Global COVID-19 Vaccination by mid-2022. The strategy outlines the road we must all take together to achieve our targets of vaccinating 40% of the population of every country by the end of this year, and 70% by the middle of next year.
With global vaccine production now at nearly 1.5 billion doses per month, there is enough supply to achieve our targets, provided they are distributed equitably.
We can only achieve our targets if the countries and companies that control vaccine supply put contracts for COVAX and the African Vaccine Acquisition Trust – or AVAT – first for deliveries and donated doses. Vaccine equity will accelerate the end of the pandemic.
Yesterday, after a global consultation with patients and experts, WHO published a clinical case definition for post COVID-19 condition. This standardized definition will help clinicians to identify patients more easily and provide them the appropriate care, and is crucial for advancing recognition and research. WHO encourages all national authorities, policy makers and clinicians to adopt this definition.
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Good morning, good afternoon and good evening.
At this press conference almost exactly one year ago, I said that the world was eagerly anticipating the results of trials of vaccines against COVID-19.
And I said that once we had a vaccine, we must use it effectively, by making sure it’s available to all countries equitably.
The development and approval of vaccines in record time took us to the summit of scientific achievement; now we stand on the precipice of failure, if we don’t make the benefits of science available to all people in all countries, right now.
More than 6.4 billion vaccine doses have now been administered globally, and almost one-third of the world’s population is fully vaccinated against COVID-19.
But those numbers mask a horrifying inequity.
High- and upper-middle income countries have used 75% of all vaccines produced so far.
Low-income countries have received less than half of one percent of the world’s vaccines. In Africa, less than 5% of people are fully vaccinated.
As you know, earlier this year WHO set a target for all countries to vaccinate 10% of their populations by the end of September. 56 countries didn’t make it, through no fault of their own.
Today, WHO is launching the Strategy to Achieve Global COVID-19 Vaccination by mid-2022.
The strategy outlines the road we must all take together to achieve our targets of vaccinating 40% of the population of every country by the end of this year, and 70% by the middle of next year.
Achieving these targets will require at least 11 billion vaccine doses.
This is not a supply problem; it’s an allocation problem.
By the end of September, almost 6-and-a-half billion doses had already been administered worldwide. With global vaccine production now at nearly 1.5 billion doses per month, there is enough supply to achieve our targets, provided they are distributed equitably.
Contracts are in place for the remaining 5 billion doses. But it’s critical that those doses go where they are needed most – with priority given to older people, health workers and other at-risk groups.
We can only achieve our targets if the countries and companies that control vaccine supply put contracts for COVAX and the African Vaccine Acquisition Trust – or AVAT – first for deliveries and donated doses.
We have the tools to bring the pandemic under control, if we use them properly and share them fairly. And we must remember that vaccines are a powerful tool, but not the only one – all countries must continue with a comprehensive, risk-based approach of public health and social measures, in combination with equitable vaccination.
Vaccine equity will accelerate the end of the pandemic. Achieving WHO’s vaccine equity targets will substantially increase population immunity globally, protect health systems, enable economies to fully restart, and reduce the risk of new variants emerging.
Today I’m delighted to be joined by the United Nations Secretary-General, António Guterres, who like us, has long called for global vaccine equity.
Secretary-General, thank you for your support and advocacy throughout the pandemic, and your special focus on vaccine equity. Welcome, and you have the floor.
[SECRETARY-GENERAL GUTERRES ADDRESSED THE MEDIA]
Thank you so much, Secretary-General Guterres, thank you for your leadership. As you said, this plan can only succeed with everyone’s cooperation.
We call on all countries to update their national COVID-19 vaccine targets and plans, to guide manufacturing investment and vaccine distribution;
We call on countries with high vaccine coverage to swap delivery schedules with COVAX and AVAT, and to fulfil their dose-sharing pledges immediately;
We call on vaccine-producing countries to allow free cross-border flow of finished vaccines and raw materials, and to enable sharing of know-how, technology and licenses;
We call on vaccine manufacturers to prioritize and fulfil contracts with COVAX and AVAT as a matter of urgency, to be more transparent on what is going where, and to share know-how and non-exclusive licenses to enable all regions to increase manufacturing capacity;
We call on civil society, community organizations and the private sector to continue to advocate local, nationally and globally for equitable access not just to vaccines, but also to tests and treatments;
We call on all countries to ensure they have the capacities in place to use all doses as rapidly and efficiently as possible;
And we call on global and regional multilateral development banks to support countries to more rapidly access the capital they need to fund vaccine delivery programmes.
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Finally, although equitable distribution of vaccines will help to end the pandemic, its effects will continue to be felt for many years – especially for the people who have been infected and will continue to suffer from the effects of post COVID-19 condition, also known as “long COVID”.
Yesterday, after a global consultation with patients and experts, WHO published a clinical case definition for post COVID-19 condition.
The definition says that post COVID-19 condition usually occurs 3 months from the onset of COVID-19, with symptoms that last for at least 2 months, and which cannot be explained by an alternative diagnosis. Some patients have reported symptoms of post COVID-19 condition for much longer than 2 months.
Common symptoms include fatigue, shortness of breath, cognitive dysfunction, and others that have an impact on everyday functioning.
This standardized definition will help clinicians to identify patients more easily and provide them the appropriate care, and is crucial for advancing recognition and research.
WHO encourages all national authorities, policy makers and clinicians to adopt this definition.
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.
High prices and low availability still a major barrier for patients’ access to new and old medicines
Geneva, 1 October, 2021 -- WHO today published the new edition of its Model Lists of Essential Medicines and Essential Medicines for Children, which include new treatments for various cancers, insulin analogues and new oral medicines for diabetes, new medicines to assist people who want to stop smoking, and new antimicrobials to treat serious bacterial and fungal infections.
The listings aim to address global health priorities, identifying the medicines that provide the greatest benefits, and which should be available and affordable for all. However, high prices for both new, patented medicines and older medicines, like insulin, continue to keep some essential medicines out of reach for many patients.
“Diabetes is on the rise globally, and rising faster in low- and middle-income countries,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Too many people who need insulin encounter financial hardship in accessing it or go without it and lose their lives. Including insulin analogues in the Essential Medicines List, coupled with efforts to ensure affordable access to all insulin products and expand use of biosimilars, is a vital step towards ensuring everyone who needs this life-saving product can access it.”
Insulin was discovered as a treatment for diabetes 100 years ago and human insulin has been on WHO’s List of Essential Medicines since it was first published in 1977. Unfortunately, limited insulin supply and high prices in several low- and middle-income countries are currently a significant barrier to treatment. For example, in Ghana’s capital, Accra, the amount of insulin needed for a month would cost a worker the equivalent of 5.5 days of pay per month. Insulin production is concentrated in a small number of manufacturing facilities, and three manufacturers control most of the global market, with the lack of competition resulting in high prices that are prohibitive for many people and health systems.
The move to list long-acting insulin analogues (insulin degludec, detemir and glargine) and their biosimilars, along with human insulin, is intended to increase access to diabetes treatment by expanding the choice of treatment. Inclusion in the List means that biosimilar insulin analogues can be eligible for WHO’s prequalification programme; WHO prequalification can result in more quality-assured biosimilars entering the international market, creating competition to bring prices down and giving countries a greater choice of products.
Long-acting insulin analogues offer some extra clinical benefits for patients through their prolonged duration of action, which ensures that blood glucose levels can be controlled over longer periods of time without needing a booster dose. They offer particular benefit for patients who experience dangerously low blood glucose levels with human insulin. The greater flexibility in timing and dosing of insulin analogues has been shown to improve quality of life for patients living with diabetes. However, human insulin remains a staple in the treatment of diabetes and access to this life-saving medicine must continue to be supported through better availability and affordability.
The list also includes Sodium-Glucose Co-transporter-2 (SGLT2) inhibitors empagliflozin, canagliflozin and dapagliflozin as second line therapy in adults with type 2 diabetes. These orally administered medicines have been shown to offer several benefits, including a lower risk of death, kidney failure and cardiovascular events. Because SGLT2 inhibitors are still patented and high-priced, their inclusion in the list comes with the recommendation that WHO work with the Medicines Patent Pool to promote access through potential licencing agreements with the patent-holders to allow generic manufacturing and supply in low- and middle-income countries.
Improving access to diabetes medicines including insulin and SGLT2 inhibitors is one of the workstreams of the Global Diabetes Compact, launched by WHO in April 2021, and a key topic under discussion with manufacturers of diabetes medicines and health technologies.
Cancers are among the leading causes of illness and death worldwide, accounting for nearly 10 million deaths in 2020, with seven out of 10 occurring in low- and middle-income countries. New breakthroughs have been made in cancer treatment in the last years, such as medicines that target specific molecular characteristics of the tumour, some of which offer much better outcomes than “traditional” chemotherapy for many types of cancer. Four new medicines for cancer treatment were added to the Model Lists:
- Enzalutamide, as an alternative to abiraterone, for prostate cancer;
- Everolimus, for subependymal giant cell astrocytoma (SEGA), a type of brain tumour in children;
- Ibrutinib, a targeted medicine for chronic lymphocytic leukaemia; and
- Rasburicase, for tumour lysis syndrome, a serious complication of some cancer treatments.
The listing for imatinib was extended to include targeted treatment of leukaemia. New childhood cancer indications were added for 16 medicines already listed, including for low-grade glioma, the most common form of brain tumour in children.
A group of antibodies that enhance the immune response to tumour cells, called PD-1 / PD-L1 immune-checkpoint inhibitors, were not recommended for listing for the treatment of a number of lung cancers, despite being effective, mainly because of their exceedingly high price and concerns that they are difficult to manage in low-resourced health systems. Other cancer medicines were not recommended for listing due to uncertain additional clinical benefit compared with already listed medicines, high price, and management issues in low-resource settings. These included osimertinib for lung cancer, daratumumab for multiple myeloma, and three types of treatment (CDK4/6 inhibitors, fulvestrant and pertuzumab) for breast cancer.
Infectious diseases - New medicines listed include cefiderocol, a ‘Reserve’ group antibiotic effective against multi-drug resistant bacteria, echinocandin antifungals for severe fungal infections and monoclonal antibodies for rabies prevention – the first monoclonal antibodies against an infectious disease to be included on the Model Lists. The updated lists also see new formulations of medicines for common bacterial infections, hepatitis C, HIV and tuberculosis, to better meet dosing and administration needs of both children and adults. An additional 81 antibiotics were classified as Access, Watch or Reserve under the AWaRe framework, to support antimicrobial stewardship and surveillance of antibiotic use worldwide.
Smoking cessation – Two non-nicotine-based medicines – bupropion and varenicline – join nicotine-replacement therapy on the Model List, providing alternative treatment options for people who want to stop smoking. Listing aims to support the race to reach WHO’s ‘Commit to Quit’ campaign goal that would see 100 million people worldwide quitting smoking over the coming year.
The updated Essential Medicines Lists include 20 new medicines for adults and 17 for children and specify new uses for 28 already-listed medicines. The changes recommended by the Expert Committee bring the number of medicines deemed essential to address key public health needs to 479 on the EML and 350 on the EMLc. While these numbers may seem high, they are only a small proportion of the total number of medicines available on the market.
Governments and institutions around the world continue to use the WHO Model Lists to guide the development of their own essential medicines lists, because they know that every medicine listed has been vetted for efficacy and safety and delivers value for money for the health outcomes they produce.
The Model Lists are updated every two years by an Expert Committee, made up of recognized specialists from academia, research and the medical and pharmaceutical professions. This year, the Committee underscored the urgent need to take action to promote equitable and affordable access to essential medicines through the list and complementary measures such as voluntary licensing mechanisms, pooled procurement, and price negotiation.
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.
As you know, in October last year, I appointed an Independent Commission to investigate allegations of sexual exploitation and abuse during the response to the tenth Ebola Virus Disease epidemic in North Kivu and Ituri, in the Democratic Republic of the Congo.
The commission was co-chaired by Her Excellency Aïchatou Mindaoudou, the former Minister of Foreign Affairs and Social Development of Niger, and Madame Julienne Lusenge, an internationally recognized human rights activist and advocate for survivors of sexual violence in conflict, from DRC.
Today, the commission publishes its report. It makes for harrowing reading. I will make my comments shortly, but first I would like to welcome the co-chairs to present their findings.
I would also like to recognize the presence of the other members of the convention, Madame Dikéré Marie Christine Bocoum, Madame Carole Doucet, and Former Minister Malick Coulibaly.
Before I give the floor to the Commission to present, I would like to invite my colleague and sister, Dr Tshidi Moeti, the WHO Regional Director for Africa, to make her remarks. Tshidi, you have the floor.
[DR MOETI ADDRESSED THE MEDIA]
Thank you, Tshidi. Now I would like to invite Madame Julienne Lusenge, one of the co-chairs of the Commission, to make her remarks. Madame Lusenge, you have the floor.
[MADAME LUSENGE ADDRESSED THE MEDIA]
Merci beaucoup, Madame Lusenge. I would now like to invite Mr Malick Coulibaly, former Minister of Justice and former President of the National Human Rights Commission of Mali. Mr Coulibaly, you have the floor.
[MR COULIBALY ADDRESSED THE MEDIA]
Thank you, Mr Coulibaly.
Finally, I would like to invite the other co-chair, Madame Aïchatou Mindaoudou, the other co-chair and former Foreign Minister of Niger, to make her remarks. Madame Mindaoudou, you have the floor.
[MADAME MINDAOUDOU ADDRESSED THE MEDIA]
Thank you Madame Aïchatou, and thank you all once again for the commission’s work, and for your briefing today.
The first thing I want to say is to the victims and survivors of the sexual exploitation and abuse described in the commission’s report.
I’m sorry. I’m sorry for what was done to you by people who were employed by WHO to serve and protect you.
I’m sorry for the ongoing suffering that these events must cause.
I’m sorry that you have had to relive them in talking to the commission about your experiences.
Thank you for your courage in doing so.
What happened to you should never happen to anyone. It is inexcusable.
It is my top priority to ensure that the perpetrators are not excused, but are held to account.
As the Director-General, I take ultimate responsibility for the behaviour of the people we employ, and for any failings in our systems that allowed this behaviour.
And I will take personal responsibility for making whatever changes we need to make to prevent this happening in future.
The commission has done outstanding work to get the voices of victims and survivors heard. But the investigation is not complete, and will require further work.
But we must act immediately, and we will, in three areas:
First, support, protection and justice for the victims and survivors;
Second, actions to address management and staff failures;
And third, wholesale reform of our structures and culture.
First, support, protection and justice for victims and survivors.
As you have heard, the commission has identified dozens of potential victims of sexual exploitation and abuse, and 21 alleged perpetrators, who were employed by WHO at the time of the events.
The victims were only able to provide first names for several other alleged perpetrators, whom we are yet to fully identify. For those cases, WHO is engaging an external investigative service to assess what additional steps are required.
Based on the information we have, the Organization will ban the identified perpetrators from future employment with WHO, and we will notify the broader UN system.
We are terminating the contracts of four people identified as perpetrators who were still employed by the Organization when we were made aware of the allegations against them.
WHO will also refer the allegations of rape to national authorities in DRC for investigation, and in the country of nationality of the alleged perpetrators, where applicable.
We have requested confirmation from the Independent Commission that the victims of rape have provided consent for WHO to refer their cases to the relevant national authorities.
Providing services and support to victims and survivors is our central concern.
WHO is not yet aware of the identity of the victims and survivors.
As we receive more information from the Commission on their identity and location, we will ensure that they all have access to the services they need, including medical and psychosocial support, and assistance for education for their children. These services are available in DRC from our partners across the UN system.
We are committed to a survivor- and victim-centred approach that prioritises their needs, preferences and participation, as we expand services in DRC and around the world.
Although the Commission’s work has ended, we have provided continued access to anonymous reporting mechanisms for incidents of sexual exploitation and abuse. Anyone who calls to complain will be referred to services.
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Second, actions to address management and staff failures.
The commission has identified negligence on the part of certain individuals that may amount to professional misconduct in the management of some of the incidents reported.
In my view, the failure of WHO employees to respond adequately to reports of sexual exploitation and abuse is as bad as the events themselves.
We must have zero tolerance for sexual exploitation and abuse, and zero tolerance for inaction against it.
I deeply regret that the suffering of victims may have been exacerbated by the apparent failings in the way the Organization handled reports.
The Commission has recommended an investigation to identify individual responsibilities for the failure to activate investigation procedures, and we are taking immediate steps to initiate that investigation, using an external investigative service.
While that investigation proceeds, the Organization has placed two senior staff on administrative leave, and we’re taking steps to ensure that others who may be implicated are temporarily relieved of any decision-making role in respect of allegations of sexual exploitation and abuse.
It is important to be clear that these actions do not in any way prejudge the outcome of the investigation and are not a disciplinary measure or attribution of guilt.
The Organization will initiate appropriate disciplinary action in respect of findings of misconduct from the investigation.
We have also asked the Independent Expert Oversight Advisory Committee to engage an external body to conduct an audit into cases processed by WHO’s Internal Oversight Services, to establish whether any further cases of incidents of possible sexual exploitation and abuse were subject to procedural failings.
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Third, we will undertake wholesale reform of policies and processes to address sexual exploitation and abuse.
But we must go further, to identify and address any shortcomings in our culture or leadership that fail to adequately protect the people we serve, or that create opportunities for abusers to exploit.
The commission has identified the need for fundamental changes in our structures and institutional capacity for preventing, detecting and responding to sexual exploitation and abuse in the communities we serve.
We will engage external experts and services to make sure this happens.
We need to make sure that victims and survivors of sexual exploitation and abuse have safe and easily accessible reporting mechanisms, anywhere in the world.
As you know, the Ebola response in North Kivu and Ituri was a large and complex operation in a highly insecure region, requiring large-scale recruitment of local and international personnel.
But none of that is an excuse for sexual exploitation and abuse.
We accept that we should have taken stronger measures to screen candidates and ensure more effective human resources processes.
Already we have taken several steps to improve our HR practices in recruitment, onboarding, induction and training. We will also take steps to integrate standards of behaviour relating to sexual exploitation and abuse in performance management, starting with leaders and managers.
We have also initiated special briefings for managers, especially at the country level.
Going forward, WHO country representatives, incident managers, health cluster coordinators and directors will be required to participate in additional training to ensure that they are able to create an environment for the prevention of sexual exploitation, abuse and harassment, and to take managerial action without delay in case of any suspected incident.
I will ensure we provide sufficient resources and staff for the work ahead of us.
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The commission has made 7 recommendations, with 20 specific actions.
Many of these actions are already underway, and we will expand our work to include other priorities recommended by the commission.
We plan to provide a comprehensive management action plan with our Member States within the next 10 days, and transparency will be at the centre.
To further strengthen accountability, we have asked the Independent Oversight and Advisory Committee of the WHO Health Emergencies Programme to monitor and report transparently on our progress.
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Once again, I would like to thank the Commission for its work, as well as the journalists who first reported the allegations that led to the initiation of the Independent Commission’s investigation and report. Thank you.
We value the role of the media in covering and uncovering these issues, and in holding WHO accountable.
I struggle to find the words to describe my feelings when I first read the Commission’s report.
The conduct it describes is a sickening betrayal of the people we serve. But it’s also a betrayal of our colleagues who put themselves in harm’s way to serve others, including those who paid the ultimate price, killed by armed groups in North Kivu, while working to protect the health of vulnerable communities from Ebola.
This is a dark day for WHO. But by shining a light on the failures of individuals and the Organization, we hope that the victims feel that their voices have been heard and acted on;
We want the perpetrators to know there will be severe consequences for their actions;
We expect and demand that all our staff at all levels understand the heightened responsibility that comes with working for WHO;
We will hold all leaders accountable for inaction in any suspected incident of sexual exploitation and abuse.
We are acutely conscious that we need to rebuild trust with the people we serve, with our Member States, with our partners and with our workforce.
Only then can we succeed in our mission to promote health, keep the world safe and serve the vulnerable.
I thank you. Fadela, 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.
Resource for parents, teachers and health professionals follows hugely successful first edition News release of the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings
A new book published today aims to help children stay hopeful and positive during the COVID-19 pandemic. The story is a sequel to ‘My Hero is You: how kids can fight COVID-19!’, published in April 2020.
Both books have been released by a collaboration of 60 organizations working in the humanitarian sector, including the World Health Organization, UNICEF, the United Nations High Commissioner for Refugees, the International Federation of Red Cross and Red Crescent Societies and the MHPSS Collaborative for Children & Families in Adversity.
‘My Hero is You 2021: how kids can hope with COVID-19!’ draws on the daily realities of millions of children since the beginning of the pandemic. For many, the pandemic continues to disrupt their education, recreation, and time with friends, family and teachers.
The story – aimed primarily at children aged 6-11 years – sees the return of Ario, a fantasy creature who travels the world helping children to find hope in the future and joy in simple pleasures. Together with old and new friends, Ario addresses the fears, frustrations and concerns children are facing in the current phase of the pandemic, and explores the various coping mechanisms that they can use when faced with difficult emotions like fear, grief, anger and sadness.
The new story drew from responses to a survey of more than 5000 children, parents, caregivers and teachers from around the world who described the challenges they continue to face in the second year of the pandemic.
Reaching children everywhere
The book is currently available in Arabic, Bengali, Chinese, English, French, Portuguese, Russian, Spanish and Swahili. Its predecessor is now available in more than 140 languages, including sign language and Braille, and in more than 50 adaptations, in animated video, read-aloud, theatre, activity books and audio formats. Examples include an adaptation for Native Americans, a colouring book for children in Syria, and an animation developed by a team led by Stanford Medicine in the USA.
Since April 2020, governments, universities, nongovernmental organizations, media outlets and celebrities have joined forces with the United Nations to facilitate a truly global distribution of the first book in the series. Initiatives include the roll-out of audio versions and workshops relating to the book among refugees in Cox’s Bazar, Bangladesh; the broadcasting of an animated version on Mongolian national television; and the inclusion of the book as a free supplement with a national newspaper in Greece.
The new storybook can be used by parents and teachers in conjunction with a guide entitled ‘Actions for Heroes’, released by the same group in February 2021. Already available in more than a dozen languages, the guide advises parents, caregivers and teachers on how to create the right conditions for children to openly share their feelings and worries related to the pandemic and includes activities based on the books in the series.
Quotes
Mr Martin Griffiths, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, United Nations:
“Addressing the consequences of the pandemic on the mental health of young people is crucial to help them recover faster from the COVID-19 crisis. This new storybook is one of the tools to help them do so.”
Dr Tedros Adhanom Ghebreyesus Director-General of the World Health Organization:
“As we collectively weather the COVID-19 crisis and find our own ways to cope, we must strive to safeguard the mental health and well-being of children who continue to grapple with disrupted childhoods. The ‘My Hero is You’ storybooks help us to do just that. I encourage parents, teachers and caregivers everywhere to share the sequel to the immensely popular original to help the children in their care build resilience and hang on to a sense of hope for the future.”
Henrietta Fore, UNICEF Executive Director:
“Almost two years into the pandemic, millions of children are still seeing their lives and routines disrupted. The ‘My Hero is You’ series is an essential and wonderful tool for parents and teachers to help children understand today’s new world and cope with their changing emotions.”
Filippo Grandi, UN High Commissioner for Refugees
“The pandemic has profoundly impacted the life and well-being of millions of children around the world, including many living in situations of forced displacement as a result of conflict, violence and persecution. In this period of fear, losses and uncertainties for so many children and their caregivers, initiatives such as the ‘My Hero is You’ series can play a crucial role in helping them cope, heal and maintain hope for the future.”
Audrey Azoulay, UNESCO Director-General:
“COVID-19 has separated millions of children from friends, teachers and schools, with devastating socio-emotional consequences. UNESCO fully supports the My Hero is You initiative, which uses the universal magic of storytelling and reading to open children’s hearts to hope – a top priority in the educational recovery.”
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.