The World Health Organization (WHO) has published its first-ever guidance on antibiotic pollution from manufacturing. The new guidance on wastewater and solid waste management for antibiotic manufacturing sheds light on this important but neglected challenge ahead of the United Nations General Assembly (UNGA) High-Level Meeting on antimicrobial resistance (AMR) taking place on 26 September 2024.
The emergence and spread of AMR caused by antibiotic pollution could undermine the effectiveness of antibiotics globally, including the medicines produced at the manufacturing sites responsible for the pollution.
Despite high antibiotic pollution levels being widely documented, the issue is largely unregulated and quality assurance criteria typically do not address environmental emissions. In addition, once distributed, there is a lack of information provided to consumers on how to dispose of antibiotics when they are not used, for example, when they expire or when a course is finished but there is still antibiotic left over.
“Pharmaceutical waste from antibiotic manufacturing can facilitate the emergence of new drug-resistant bacteria, which can spread globally and threaten our health. Controlling pollution from antibiotic production contributes to keeping these life-saving medicines effective for everyone," said Dr Yukiko Nakatani, WHO Assistant Director-General for AMR ad interim.
Globally, there is a lack of accessible information on the environmental damage caused by manufacturing of medicines. “The guidance provides an independent and impartial scientific basis for regulators, procurers, inspectors, and industry themselves to include robust antibiotic pollution control in their standards,” said Dr Maria Neira, Director, Department of Environment, Climate Change and Health, WHO. “Critically, the strong focus on transparency will equip buyers, investors and the general public to make decisions that account for manufacturers’ efforts to control antibiotic pollution.”
A range of international bodies have called for this guidance, including the WHO Executive Board, the G7 health ministers and UNEP. “The role of the environment in the development, transmission and spread of antimicrobial resistance needs careful consideration since evidence is mounting. There is a widespread agreement that action on the environment must become more prominent as a solution. This includes pollution prevention and control from municipal systems, manufacturing sites, healthcare facilities and agri-food systems,” said Jacqueline Alvarez, Chief of Branch for the Industry and Economy Division at the United Nations Environment Programme (UNEP).
The guidance was developed in close collaboration with a diverse group of international experts representing academia, regulators, inspectors, international organizations such as UNEP, and other sectors. The draft also underwent public consultation, receiving valuable input from industry and other stakeholders. Industry has also taken up this challenge, though a voluntary industry-led initiative which can be updated in some areas to align with the new guidance.
The guidance provides human health-based targets to reduce the risk of emergence and spread of AMR, as well as targets to address risks for aquatic life caused by all antibiotics intended for human, animal or plant use. It covers all steps from the manufacturing of active pharmaceutical ingredients (APIs) and formulation into finished products, including primary packaging.
AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to medicines, making people sicker and increasing the risk of spread of infections that are difficult to treat, illness and deaths. AMR is driven largely by the misuse and overuse of antimicrobials, yet, at the same time, many people around the world do not have access to essential antimicrobial medicines.
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.
This is the third WHO report summarizing the multi-country health situation and WHO’s response across the regional emergency caused by the conflict in Sudan. As of July 2024, famine is ongoing in Zamzam camp near El Fasher town, Sudan, according to the latest reports. Many other areas throughout Sudan remain at risk of famine as long as the conflict and limited humanitarian access continue.
At least 12 of the 18 states of Sudan are experiencing three or more outbreaks simultaneously. Following a report on 22 July 2024, an officially declared and notified cholera outbreak is ongoing in Kassala and several other states. The rainy season ushers in severe rains and flooding in floods in different states in Sudan, exacerbating the public health risk.
With intense renewed fighting, additional displacement within Sudan and into neighbouring countries could further impact access to health care. Neighbouring countries’ healthcare systems continue to be strained by the influx of refugees from Sudan, compounded by poor water, sanitation and hygiene conditions, and a high burden of infectious diseases and other health conditions.
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 14 August 2024, the WHO Director-General determined that the upsurge of mpox in the Democratic Republic of the Congo and a growing number of countries in Africa constitutes a Public Health Emergency of International Concern (PHEIC) under the International Health Regulations (2005) (IHR), the highest level of alarm under the IHR.
Here we describe the latest countries in the region newly reporting cases since the start of the multi-country outbreak in 2022. The clade Ib MPXV outbreak, which began in September 2023 in the Democratic Republic of the Congo, is having an increasing number of cases in the country and also expanding to neighbouring countries. Burundi, Kenya, Rwanda and Uganda have each reported their first mpox cases. Several of these cases have travel links to eastern parts of the Democratic Republic of the Congo and each of these countries has identified clade Ib monkeypox virus (MPXV).
Based on available epidemiological data, this clade has been spreading rapidly among adults through close physical contact, including sexual contact identified within networks of sex workers and their clients. As the virus spreads further, the affected groups are changing, with the virus also taking hold within households and other settings. Additionally, Cote d’Ivoire is reporting cases of clade II mpox for the first time since the start of the multi-country outbreak in 2022.
Described below are the latest countries in the African region newly affected by mpox, either clade I or clade II, since the start of the multi-country outbreak in 2022. Additional countries in the region are continuing to report cases, please refer to the latest situation report published for an update on these countries including the latest epidemiological trends.
Central and East Africa
Burundi
On 25 July 2024, the Ministry of Health of Burundi declared an outbreak of mpox following the confirmation of three cases by the National Reference Laboratory of the National Institute of Public Health. These cases were identified on 22 July; one case from Kamenge University Hospital, a second case from Kamenge Military Hospital, and the third case from Isare Health District. They reported symptom onset on 24 July including fever, joint pain, and a widespread rash. Samples collected during a multidisciplinary investigation tested positive for mpox on 25 July with PCR. These are the first confirmed mpox cases ever identified in Burundi.
As of 17 August 2024, there had been 545 alerts of mpox cases since the outbreak declaration, of which 474 suspected cases (86.9%) had been investigated and validated. Of 358 suspected cases tested, 142 (39.7%) tested positive for MPXV. Genomic sequencing analysis has confirmed clade Ib MPXV. No deaths were reported as of 17 August.
Confirmed cases have been reported from 26 of the 49 districts (53.1%). The most affected district is Bujumbura Nord, an urban area, with 54 of the 142 confirmed cases (38%). No deaths had been documented at the time of reporting.
Males account for 55.6% of the cases and females for 44.4%. Children under the age of five years make up 60.3% of the cases, followed by those aged from 11 to 20 years (42.6%), and those aged from 21 to 30 years (38.2%).
Kenya
On 29 July 2024, the Ministry of Health confirmed a case of mpox in Taita Taveta County bordering Tanzania. The patient is a 42-year-old Kenyan male residing in Kiambu County (neighbouring Nairobi). The case has a history of travel from Kampala, Uganda, to Mombasa, Kenya, and at the time of identification, the patient was travelling to Rwanda through Tanzania.
As of 13 August, a total of 14 suspected cases had been identified, one case had tested positive for MPXV Clade Ib,12 suspected cases had tested negative, and the test result for one case was pending. This is the first mpox case ever identified in Kenya. No deaths had been reported as of 13 August.
Rwanda
On 24 July 2024, IHR National Focal Point (NFP) for Rwanda notified WHO of two laboratory-confirmed mpox cases in Rwanda, and on 27 July, the Ministry of Health declared an outbreak of mpox in the country. The cases included a 33-year-old female (case 1) who frequently travels to the Democratic Republic of the Congo, and a 34-year-old male (case 2) with a recent travel history to the Democratic Republic of the Congo. Case 1 was identified at a point of entry (PoE) and isolated in Rusizi district, and case 2 was identified at Kibagabaga hospital of Gasabo district. Both cases were reported to be in stable condition and under continuous medical follow-up. These are the first confirmed mpox cases ever identified in Rwanda.
As of 7 August 2024, four confirmed mpox cases and zero deaths had cumulatively been reported by the country. Among the two new cases, one is a 34-year-old male, residing in Gasabo District in Kigali. His symptoms started on 15 July 2024 with fever, swollen lymph nodes, sore throat, and rashes on the arms, face and genitals. He had travelled back from Burundi on 12 July 2024 and is currently in isolation. Five close contacts are under follow up. The other case is a 39-year-old Rwandan male, resident of Kicukiro District with travel history to the Democratic Republic of the Congo. He had similar symptoms, along with headache, which started on 12 July 2024. Four of his close contacts have been identified and they are under follow up. Sequencing analysis has confirmed MPXV Clade Ib.
Uganda
In June and early July 2024, Kasese District enhanced surveillance for mpox disease along the border with the Democratic Republic of the Congo in light of reported increasing cases in the neighbouring country. Following the orientation of screeners at the Bwera point of entry and Bwera Hospital, six suspected cases were identified on 11 July. Samples were collected for laboratory testing from the suspected cases, two of which tested positive for MPXV Clade Ib on 15 July. The first of the confirmed cases is a 37-year-old female and the second case is a 22-year-old female national of the Democratic Republic of the Congo. These are the first mpox cases identified in the country. Both cases had onset of symptoms on 11 July and were confirmed by a PCR test at the Uganda Virus Research Institute on 15 July 2024.
Investigations revealed that transmission occurred outside Uganda and no secondary transmission has been linked to the two cases as of 12 August 2024. By the same date, 39 suspected cases had been reported. Furthermore, 37 contacts of the confirmed cases were under follow-up. No deaths have been reported as of 20 August.
West Africa
Côte d’Ivoire
In July 2024, Côte d’Ivoire confirmed two non-fatal cases of mpox. The first case is a 46-year-old patient who consulted a doctor on 1 July with a fever, headache and skin rash, in Tabou district, San Pedro region, on the border with Liberia. Mpox was confirmed by the Institut Pasteur de Côte d'Ivoire laboratory on 3 July and again on 14 July by the Institute Pasteur in Dakar. The second case is a 20-year-old patient, in the Koumassi health district in Abidjan, who presented with skin rash and oral mucosal lesions on 14 July. No epidemiological link between these first two cases has been identified.
As of 7 August 2024, seven mpox cases had been confirmed in three health districts: Koumassi (one case), Tabou (one case), and Yopougon-Ouest-Songon (five cases). Four of the confirmed cases (57%) are male, and all seven cases are above 15 years of age. Forty contacts have been identified and are being followed up. The country has previously reported mpox, but no cases had been notified since the start of the multi-country outbreak in 2022. The newly detected cases in 2024 belong to clade II MPXV.
Mpox is an infectious disease caused by the monkeypox virus (MPXV). There are two known clades of MPXV: clade I, previously called the Congo Basin clade, which includes subclades Ia and the recently identified Ib; and clade II, previously called the West African clade, which includes subclades IIa and IIb. Subclades Ia and Ib have been defined based on the emergence of subclade Ib in the South Kivu province of the Democratic Republic of the Congo, where it has predominantly spread through sexual contact. Subclade Ia is currently considered to encompass all other strains of Clade I that are not Ib.
MPXV transmits between humans through close contact with lesions, body fluids, infectious respiratory particles or contaminated materials, or from animals to humans through contact with live animals or consumption of contaminated bushmeat. Mpox causes signs and symptoms which usually begin within a week of exposure but can start one to 21 days later. Symptoms typically last for two to four weeks but may last longer in someone with a weakened immune system. Normally, fever, muscle aches and sore throat appear first, followed by skin and mucosal rash. Lymphadenopathy (swollen lymph nodes) is also a typical feature of mpox, present in most cases. Transmission through sexual contact has been observed to lead to the appearance sometimes of only genital lesions. Children, pregnant women and people with weak immune systems are at risk of developing complications and dying of mpox.
It is important to distinguish mpox from chickenpox, measles, bacterial skin infections, scabies, herpes, syphilis, other sexually transmissible infections, and medication-associated allergies. Someone with mpox may also concurrently have another sexually transmissible infection such as herpes. Alternatively, a child or adult with suspected mpox may have chickenpox. For these reasons, laboratory testing is important for confirmation of mpox, particularly for the first cases in an outbreak or new geographic area.
The primary diagnostic test for MPXV infection is polymerase chain reaction (PCR). The best diagnostic specimens are taken directly from the rash – skin, fluid or crusts – collected by vigorous swabbing. In the absence of skin lesions, testing can be done on oropharyngeal, anal or rectal swabs. However, while a positive result of oropharyngeal, anal or rectal sample confirms mpox, a negative result is not enough to rule out MPXV infection. Testing of blood is not recommended. Serology does not distinguish between different orthopoxviruses and is therefore restricted to reference laboratories where antibody detection methods may be applied for retrospective case classification or in special studies.
Treatment is based primarily on managing clinical symptoms, ensuring skin care, reducing pain, and preventing and managing complications. Where available through emergency or compassionate use programmes, specific antiviral medications such as tecovirimat can also be used in the treatment of mpox, particularly for severe cases or individuals at higher risk of complications.
Three vaccines are currently available for use to prevent mpox in different countries (MVA-BN, LC16-KMB, and OrthopoxVac - the latter not yet commercialized). WHO recommends use of MVA-BN or LC16 vaccines when the others are not available.
Vaccination is recommended by WHO for individuals at high risk of exposure.
Coordination
The WHO African Regional Office (AFRO) reviewed and expanded the regional incident management support team to ensure that Member States receive the necessary support for managing the mpox outbreak. A critical meeting held in South Africa discussed urgent measures to address the rising number of mpox cases. It also proposed a review of the regional risk assessment given the acute situation. WHO has engaged in technical coordination meetings with the Africa Centres for Disease Control and Prevention (Africa CDC) to develop a joint mpox taskforce. Additionally, both organizations agreed on actions to accelerate the operational response, particularly in strengthening the technical working group on vaccines and enhancing cross-border readiness and surveillance.
Risk Communication and Community Engagement (RCCE)
There is ongoing development of an RCCE operational plan in Sud-Kivu, with regular partner meetings to coordinate efforts. Online social listening software called DIGIMIND has been employed to capture discussions and rumours about mpox. This data is analysed to produce reports that inform risk communication strategies. A series of briefings were conducted for 141 stakeholders, including journalists, social mobilizers, and community leaders in South-Kivu and Sankuru Provinces.
WHO has produced and broadcast interactive programs in multiple regions and languages, conducted public sensitization, and engaged in home visits and advocacy with political authorities to raise awareness and manage the outbreak.
Infection Prevention and Control (IPC)
An IPC Rapid Assessment Tool (RAT) for health facilities has been developed and disseminated to countries that are experiencing an active outbreak of mpox, in order to rapidly assess IPC and WASH capacities to care for mpox patients safely in health facilities. Countries are encouraged to work with partners to support improvements as identified through this rapid assessment. WHO has also published posters for health and care workers on how to put on and remove personal protective equipment. WHO is also coordinating actions with IPC focal points in countries currently experiencing an active outbreak of mpox. WHO is supporting South Africa through a review of protocols, national IPC guidelines for mpox and strengthening the capacity of health and care workers through training.
Preparedness and Readiness WHO is supporting Member States to increase their preparedness and readiness capacities. Additionally, South Africa has undergone subnational readiness assessments, focusing on non-affected provinces. The organization is supporting the development of contingency plans in priority and bordering countries and will continue to provide technical support to address gaps in readiness.
Surveillance
WHO continuously collects and analyses data from affected countries to monitor the spread and impact of the mpox outbreak, utilizing epidemiological tools to identify trends and transmission patterns. WHO also provides real-time situation reports and implements dashboards to help stakeholders interpret complex data. Training sessions and workshops are conducted for national surveillance teams, along with the development and distribution of guidelines and Standard Operating Procedures (SOPs) to ensure consistent surveillance activities.
WHO supports the upgrading of surveillance infrastructure and the implementation of community-based surveillance programs, particularly in high-risk areas such as Internally Displaced People’s (IDP) camps. In the short term, WHO’s focus is on implementing standardized protocols, deploying real-time reporting systems, enhancing data integration and sharing, building local capacity, and strengthening early warning systems.
Laboratory
WHO has supported the procurement of laboratory reagents for South Africa and Liberia, and aims to improve logistics for specimen collection and transportation, ensuring timely delivery and adequate supplies across all health facilities. Countries are encouraged to sequence a subset of samples to monitor evolutionary trends and transmission partners.
Vaccination
WHO supports countries in obtaining regulatory approval for vaccine products, identifying target populations, and developing vaccination strategies. WHO provided technical support for a vaccination strategy workshop took place in Kinshasa in the Democratic Republic of the Congo, ahead of anticipated deployment of mpox vaccines in the country. WHO is assisting countries in developing research protocols to address existing data gaps.
Case Management
WHO is supporting the distribution of mpox therapeutics (tecovirimat) to South Africa. Participation in clinical webinars and review of guidelines for mpox dead body management are ongoing. Future efforts include engaging with WHO Country Offices in the Democratic Republic of the Congo and South Africa to develop clinical case identification job aids, creating home-based care guidelines for mild mpox cases, and collaborating with neighbouring countries to enhance regional preparedness.
Response measures by country
Burundi
The national Emergency Operations Centre (EOC) has been activated, with support from WHO.
An alert system is in place and surveillance field visits are taking place for validation of alerts, investigation of suspected mpox cases, and contact tracing for confirmed cases. However, the current resources are limited and not sufficient for all surveillance activities.
Laboratory sample analysis is performed at the National Reference Laboratory which has received technical and reagent support from WHO and partners but, nevertheless, faces resource challenges.
Most cases are treated and isolated in hospitals because of the absence of isolation conditions in other health facilities. Case management consists of syndromic treatment of mpox.
RCCE activities are ongoing to advise the population on protecting themselves from contracting the disease. Nevertheless, the awareness about the disease among patients and healthcare workers is limited and must be enhanced at all levels.
Kenya
Following the confirmation of the mpox case in Kenya, the Ministry of Health has undertaken various response measures, including:
Public Health Emergency Operations has been activated. Incident Management Teams have been established to coordinate the response activities.
Draft national mpox response plan and case management guidelines have been developed.
Contact tracing of all patient’s close contacts along the travel itinerary in the country is ongoing.
There is heightened surveillance in all counties along the Busia to Mombasa highway and the Mombasa to Taveta Road, to identify all contacts and any other unidentified cases.
Mpox case definition has been developed and shared with all counties.
Cross-border communication with health authorities in neighbouring countries where the patient travelled to trace all potential contacts is ongoing.
Rapid Response Teams have been deployed to support affected counties with detailed investigations.
The evolution of outbreaks in neighbouring countries is being monitored to assess the risk of regional transmission and adjust response measures accordingly.
Public sensitization in all counties is ongoing to sensitize on the outbreak, necessary preventive measures, and steps to take if they contract the disease, including frequent handwashing with soap and water or hand sanitizer, seeking early treatment, and avoiding close contact with sick persons.
Emergency Hotline Numbers have been provided for the public to report suspected cases and seek further information about the outbreak.
The Ministry of Health issued advisories to the health workers and the public, risk communication messages have been developed and disseminated to the public and at the Points of Entry (PoEs).
Rwanda
After the confirmation of two mpox cases, the Ministry of Health and relevant stakeholders went to Rusizi and Rubavu Districts, which are bordering the Democratic Republic of the Congo where mpox cases are increasing, to conduct a situation analysis which led to the investigations of the confirmed cases. Efforts to contain cases are actively underway, with thorough contact tracing and active case search in high-risk groups in Rubavu, Rusizi, Kicukiro and Gasabo districts. The Ministry of Health, in collaboration with its partners, is continuing to implement the following response interventions:
Coordination leadership:
National Rapid Response Team (RRT) was deployed to support Rusizi and Rubavu Districts and conduct a rapid situation assessment.
A national mpox contingency plan and management guidelines were developed.
Stakeholders' dissemination meeting was held on 1 August.
A functional mpox Command Post was set up.
Surveillance:
Surveillance has been heightened at PoEs, community, and at health facilities.
Data collection for suspected and confirmed cases and their contacts.
Contact tracing and follow-up of close contacts to confirmed cases.
RCCE:
Audio and video spots development.
TV and radio program on mpox outbreak.
Translated mpox awareness materials at PoEs.
Social media assets on mpox awareness and social media influencer engagement on mpox awareness.
Case Management and IPC:
Isolation and case management of confirmed cases are ongoing.
Training of Trainers (ToT) for healthcare providers on case management, IPC and referral of suspected cases for testing.
ToT for community health workers on case identification, IPC and referral of suspected cases at health facilities.
Diagnostic and laboratory capacity:
Ongoing testing of suspected cases and the country has capacity to conduct PCR and genomic sequencing.
ToT for laboratory technicians on mpox sampling.
Uganda
Following the confirmation of the mpox cases in Uganda, various response measures have been undertaken, including:
The Ministry of Health and partners, including the WHO, have deployed members of the national and district RRTs.
A preparedness and response plan are in place, having been approved by the National Task Force of the Ministry of Health.
The country has employed the Incident Management System (IMS) to respond to all public health emergencies, including the current mpox outbreak.
Active case-finding is ongoing in all the high-risk and moderate-risk local sub-counties and health facilities, samples are being collected from suspected cases and shipped to both the field-based and national laboratory for testing.
Côte d’Ivoire
The government activated the Public Health Emergency Operations Center on 15 July 2024.
Epidemiological surveillance has been strengthened, including preparation and distribution of surveillance guidance, as well as contact tracing and contact follow-up. All cases are being investigated and active case and contact search is ongoing.
Diagnostic capacity has been strengthened and sampling kits have been provided.
Treatment and isolation are ongoing in hospitals and in the community, and IPC measures around cases and health facilities have been strengthened.
Public awareness campaigns have also been implemented to inform citizens about preventive measures through mass media channels.
The current expansion of mpox in the African continent is unprecedented. At least four countries have identified cases for the first time and others, such as Côte d’Ivoire, are reporting re-emerging outbreaks. The modes of transmission in these countries are not fully described yet and are likely to include exclusive human-to-human transmission.
Clade I mpox is being identified for the first time outside of the countries that had been previously affected. Initial transmission in the newly affected countries in East Africa and beyond has been linked to travel to or from the Democratic Republic of Congo, but the expansion of the outbreak in Burundi suggests that in some settings, there may already be sustained community transmission. Epidemiological links between confirmed cases are not always known, therefore, multiple transmission chains might be ongoing in the different countries, and more undetected cases in the community are likely. Based on available epidemiological data, this clade has been spreading rapidly among adults through close physical contact, including sexual contact identified within networks of sex workers and their clients. As the virus spreads further, the affected groups are changing, with the virus also taking hold within households and other settings.
In areas or congregate settings with high population density as well in high-risk sexual networks, transmission could lead to explosive outbreaks, further compounded by population movements or insecurity. Conversely, the virus can also spread silently along commercial travel routes as in some cases symptoms may be less severe, access to health services in transit may be limited or concerns about stigma may cause persons affected to avoid seeking care.
While vaccination against smallpox was shown in the past to be cross-protective against mpox, any immunity from smallpox vaccination will only be present in persons over the age of 42 to 50 years or older, since natural exposure to smallpox and smallpox vaccination programmes ended in 1980 after smallpox eradication. None of the four newly affected countries has access to mpox vaccines or antivirals.
Based on the above, WHO has separately assessed the risk of mpox in the eastern Democratic Republic of the Congo and neighbouring countries as high and in Cote d’Ivoire, and other West African countries as moderate. This risk applies to the general population, especially those who have sexual contact with a mpox case, as well as health workers if they are not taking appropriate precautions when examining, testing and treating mpox cases.
Currently no deaths have been reported in the five above mentioned countries, however, there is the potential for increased health impact with wider spread among vulnerable groups such as children, immunocompromised individuals, including persons with uncontrolled HIV infection or advanced HIV disease, or pregnant women in whom mpox can be more severe.
There is concern that the mpox outbreak in Africa will continue to evolve given:
The evidence of possible under-detection and under-reporting of local transmission. Many reported cases have no established epidemiological link and have been identified in different countries and in different locations within each country.
While all of the governments have activated emergency responses in the countries, with support from in-country and global partners, resources to respond remain limited in some of the countries, and resource mobilization may be slow. Technical and financial support is needed to ensure a robust response at national and provincial/local levels.
Although the governments and partners are all mobilized to support adequate patient care for affected patients and introduce vaccines for people at risk, these measures are currently not in place in most countries in Africa, and their acquisition and roll-out will still require some time for implementation.
Since some of the countries have not reported mpox before, public awareness of the disease, as well as knowledge about and capacity for identifying it among health and care workers in newly affected countries remains limited.
Concurrently, the global multi-country outbreak of mpox is still ongoing. Countries outside of Africa that seemed to have achieved control of human-to-human transmission continue to detect sporadic cases ` outbreaks, and an unprecedented increase of cases and reporting countries has been observed in the African Region, especially in the Democratic Republic of the Congo, increasing the risk of further transmission in the region and the whole world.
General Health authorities and clinicians/health and care workers of all countries should be aware that the global mpox outbreak linked to clade IIb MPXV is ongoing in all WHO regions, and Clade I monkeypox virus (MPXV) outbreaks are increasing in Central and East Africa, therefore, the risk of cross-border and international spread persists.
WHO strongly advises that countries continue to follow the Standing Recommendations of the Director-General of the WHO issued in August 2023 and extended for another year, as well as the Temporary Recommendations issued by the Director General after the declaration of the PHEIC.
Countries need to have in place mpox epidemiological surveillance and strengthen laboratory diagnostic capacities in line with updated WHO interim guidance, including genomic sequencing of viruses. Additionally, countries need to have diagnostic capacities capable of detecting both MPXV clades.
There must be sustained implementation of risk communication and community engagement appropriate to each context, maintenance or initiation of vaccination (where available) for persons at risk, optimal case management, adherence to infection control measures, strengthening research to better appreciate modes of transmission in different contexts, and sustained support for the development of rapid diagnostic methods and treatments adapted to the needs of patients.
Where circulation remains low, health authorities should strive to achieve the elimination of human-to-human transmission of mpox and ensure the maintenance of capacity for outbreak response.
Anyone with a clinical or laboratory-confirmed diagnosis of mpox should follow the instructions of health authorities according to the local context, possibly including isolation during the infectious period. Mpox cases should avoid travel, including international travel, unless the reason for travel is seeking mpox medical care, until they do not present any mpox symptoms and the scabs of their lesions have fallen off. Contacts of a confirmed case are asked to limit their movements (and, if necessary, to abstain from sexual relations) for 21 days, the monitoring period for the appearance of possible symptoms.
Smallpox vaccines composed of vaccinia virus also protect against mpox, cross-protecting due to the antigenic similarity of the viruses. Vaccination against mpox is recommended for people possibly at risk of contracting the disease. Mass vaccination is not required nor recommended for mpox at this time.
For specific antiviral treatments currently being assessed for effectiveness against mpox, such as tecovirimat, access is possible through a request from WHO for compassionate use, application for use under the WHO MEURI protocol or direct purchase from the manufacturer.
It is essential to deepen knowledge in different contexts on the epidemiological links between mpox and HIV infection, their respective and common risk factors for infection and progression to severe disease, optimal case management in the event of co-infection and the effectiveness of vaccines and therapeutic approaches.
In the community
RCCE activities are vital in motivating affected communities to become aware of the risks and protective behaviours, as well as to understand, prevent and combat stigma and discrimination. Key audiences should be identified, which depending on the context may include health professionals, commercial sex workers, men who have sex with men, trans- and gender-diverse individuals, people working at or attending venues and events where sexual activity takes place, and people at risk of more serious illness (including persons living with untreated or poorly controlled HIV infection).
Please refer to the WHO RCCE toolkit for mpox for further guidance on risk communication and community engagement.
It is also crucial that IPC and WASH measures be followed within the community to prevent and control transmission of mpox. Patients diagnosed with non-severe mpox can be isolated at home for the duration of the infectious period, provided a home assessment confirms that IPC and WASH conditions are met in the home setting. Patients being cared for at home should remain in a dedicated, well-ventilated room (e.g., with frequently opened windows) separate from other household members. Items such as eating utensils, linens, towels, electronic devices, and beds should be used exclusively by the person with mpox. Personal items should not be shared. If a health or care worker provides care at home, they should wear appropriate personal protective equipment (PPE) (gloves, gown, eye protection, and respirator), perform hand hygiene using soap and water or alcohol-based hand rub (ABHR) according to WHO's 5 moments, and clean and disinfect any patient care equipment used and frequently touched surfaces or items. Contaminated laundry from an infected person should not be mixed with other laundry and should be managed in a way that does not produce splashes and particles in the air. Contaminated laundry can be washed in a washing machine using detergent.[1] Waste generated in the infected person’s area should be placed in a strong bag, securely tied before disposal into the general waste stream (not recycling). Hand hygiene should be performed immediately after disposing of waste.
Please refer to “Clinical management and infection prevention and control for monkeypox: Interim rapid response guidance” for further guidance on IPC measures in community settings.
In healthcare settings
Implementing IPC and WASH measures in healthcare settings is necessary to prevent and control the transmission of mpox. It is important to train health and care workers on the modes of transmission for mpox and the control measures, including following standard and transmission-based precautions to prevent and control transmission of mpox. Screening of patients for mpox followed by appropriate patient placement and isolation should be in place. Health-care facilities should ensure health and care workers have access to and appropriately wear PPE (gloves, gown, eye protection, and respirator), adhere to WHO's Five Moments for hand hygiene using soap and water or alcohol-based hand rub and ensure frequent cleaning and disinfection of the patient environment. Health and care workers should be reminded to handle and dispose of sharps safely and where possible and avoid the use of sharps on lesions (e.g. avoid deroofing) when collecting specimens. All bodily fluids and solid waste from patients with mpox should be treated as infectious waste. For further guidance on IPC measures that are required when caring for patients with mpox, please refer to the Clinical Management and infection prevention and control for mpox: Interim rapid response guidance.
Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of IPC practices and ensuring patient safety and quality of care. To ensure that the health care facility is compliant with imperative WASH standards, please refer to WASH FIT: A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities.[2]
While protecting themselves with recommended measures, health and care workers should also ensure that the stigmatization of patients with mpox presenting for care is avoided, and that psychological support is provided when needed.
At points of entry
States Parties are recommended to encourage authorities, health and care workers and community groups to provide travellers with relevant information to protect themselves and others before, during and after travel to events or gatherings where mpox may present a risk.
WHO does not recommend any restrictions for travel to and trade with these countries, or any other mpox-affected country.
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.
From 1 January 2024 to 28 July 2024, a cumulative total of 307 433 cholera cases and 2326 deaths were reported from 26 countries across five WHO regions, with the Eastern Mediterranean Region recording the highest numbers, followed by the African Region, the South-East Asia Region, the Region of the Americas, and the European Region. No outbreaks were reported in the Western Pacific Region during this time.
The cholera response continues to be affected by a critical shortage of Oral Cholera Vaccines (OCV) as demand continues to outpace supply, with 105 million doses requested by 18 countries since January 2023, nearly double the 55 million doses produced in this period.
WHO classified the global resurgence of cholera as a grade 3 emergency in January 2023, the highest internal level for emergencies in WHO. Based on the number of outbreaks and their geographic expansion, alongside the shortage of vaccines and other resources, WHO continues to assess the risk at the global level as very high and the event remains classified as a grade 3 emergency.
After decades of progress against cholera, cases are again on the rise, even in countries that had not seen the disease in years.
Cholera is an acute intestinal infection that spreads through food and water contaminated with the bacterium Vibrio cholerae, often from faeces. With safe water and sanitation, cholera can be prevented. It can kill within hours when not treated, but immediate access to treatment saves lives.
While the triggers for cholera outbreaks—like poverty and conflict—are enduring, climate change and conflict are now compounding the problem. Extreme climate events like floods, cyclones and droughts reduce access to clean water and create an ideal environment for cholera to thrive.
In 2022, 44 countries reported cholera cases, a 25% increase from the 35 countries that reported cases in 2021. This trend continues into 2023. The recent outbreaks have also been more deadly, with case fatality rates being the highest recorded in over a decade.
This increase in outbreaks and cases is stretching the global capacity to respond. There is a shortage of cholera tools, including vaccines.
WHO considers the current global risk from cholera as very high and is responding with urgency to reduce deaths and contain outbreaks in countries around the world.
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.
3WHO urges broader research strategy for countries to prepare for the next pandemic
WHO has today issued an invitation for manufacturers of mpox vaccines to submit an Expression of Interest for Emergency Use Listing (EUL).
The WHO Director-General announced on 7 August 2024 that he had triggered the process for EUL of mpox vaccines given worrying trends in the disease’s spread. There is a serious and growing outbreak in the Democratic Republic of the Congo (DRC) that has now expanded outside the country. A new viral strain, which first emerged in September 2023, has for the first time been detected outside DRC.
The EUL procedure is an emergency use authorization process, specifically developed to expedite the availability of unlicensed medical products like vaccines that are needed in public health emergency situations. This is a time-limited recommendation, based on a risk-benefit approach.
WHO is requesting manufacturers to submit data to ensure that the vaccines are safe, effective, of assured quality and suitable for the target populations.
Granting of an EUL will accelerate vaccine access particularly for those lower-income countries which have not yet issued their own national regulatory approval. The EUL also enables partners including Gavi and UNICEF to procure vaccines for distribution.
Mpox is a viral illness caused by the monkeypox virus, a species of the genus Orthopoxvirus. Mpox can be transmitted to humans through physical contact with someone who is infectious, with contaminated materials, or with infected animals.
There are currently two vaccines in use against the disease, both of which have been recommended for use by the WHO Strategic Advisory Group of Experts on Immunization, or SAGE.
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.
1 August 2024 - Geneva -- The Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO) today called on researchers and governments to strengthen and accelerate global research to prepare for the next pandemic.
They emphasized the importance of expanding research to encompass entire families of pathogens that can infect humans–regardless of their perceived pandemic risk–as well as focusing on individual pathogens. The approach proposes using prototype pathogens as guides or pathfinders to develop the knowledge base for entire pathogen families.
At the Global Pandemic Preparedness Summit 2024 held in Rio de Janeiro, Brazil, WHO R&D Blueprint for Epidemics issued a report urging a broader-based approach by researchers and countries. This approach aims to create broadly applicable knowledge, tools and countermeasures that can be rapidly adapted to emerging threats. This strategy also aims to speed up surveillance and research to understand how pathogens transmit and infect humans and how the immune system responds to them.
The report’s authors likened its updated recommendation to imagining scientists as individuals searching for lost keys on a street (the next pandemic pathogen). The area illuminated by the streetlight represents well-studied pathogens with known pandemic potential. By researching prototype pathogens, we can expand the lighted area, gaining knowledge and understanding of pathogen families that might currently be in the dark. The dark spaces in this metaphor include many regions of the world, particularly resource-scarce settings with high biodiversity, which are still under monitored and understudied. These places might harbour novel pathogens, but lack the infrastructure and resources to conduct comprehensive research.
“WHO’s scientific framework for epidemic and pandemic research preparedness is a vital shift in how the world approaches countermeasure development, and one that is strongly supported by CEPI. As presented at the Global Pandemic Preparedness Summit 2024 in Rio de Janeiro, Brazil, this framework will help steer and coordinate research into entire pathogen families, a strategy that aims to bolster the world’s ability to swiftly respond to unforeseen variants, emerging pathogens, zoonotic spillover, and unknown threats referred to as pathogen X”, said Dr Richard Hatchett, CEO of CEPI.
The prioritization work underpinning the report involved over 200 scientists from more than 50 countries, who evaluated the science and evidence on 28 virus families and one core group of bacteria, encompassing 1652 pathogens. The epidemic and pandemic risk was determined by considering available information on transmission patterns, virulence, and availability of diagnostic tests, vaccines, and treatments.
CEPI and WHO also called for globally coordinated, collaborative research to prepare for potential pandemics.
“History teaches us that the next pandemic is a matter of when, not if. It also teaches us the importance of science and political resolve in blunting its impact,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We need that same combination of science and political resolve to come together as we prepare for the next pandemic. Advancing our knowledge of the many pathogens that surround us is a global project requiring the participation of scientists from every country.”
To facilitate this, WHO is engaging research institutions across the world to establish a Collaborative Open Research Consortium (CORC) for each pathogen family, with a WHO Collaborating Centre acting as the research hub for each family.
These CORCs around the world will involve researchers, developers, funders, regulators, trial experts and others, with the aim to promote greater research collaboration and equitable participation, particularly from places where the pathogens are known to or highly likely to circulate.
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.
In early 2024, the Global Antimicrobial Resistance and Surveillance System on Emerging Antimicrobial Resistance Reporting (GLASS-EAR) issued a request for information to assess the current global situation given the increased identification of isolates of hypervirulent Klebsiella pneumoniae (hvKp) sequence type (ST) 23 carrying resistant genes to the carbapenem antibiotics – carbapenemase genes. K. pneumoniae strains that can cause severe infections in healthy individuals and have been identified with increasing frequency in recent years are considered hypervirulent compared to classical strains because of their ability to infect both healthy and immunocompromised individuals and because of their increased tendency to produce invasive infections.The presence of hvKp ST23 was reported in at least one country in all six WHO Regions. The emergence of these isolates with resistance to last-line antibiotics like carbapenems necessitates the administration of alternative antimicrobial treatment, which may not be available in many contexts. WHO recommends that Member States progressively increase their laboratory diagnostic capacity to allow for the early and reliable identification of hvKp, as well as reinforce laboratory capacities in molecular testing and detection and analyses of relevant virulence genes in addition to resistance genes. The assessment of risk at the global level is moderate given the challenges with surveillance, lack of information on laboratory testing rates, track and scale of community transmission, the gap in the available data on infections, hospitalization, and the overall burden of the disease.
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.
Jerusalem, Cairo, Geneva, 30 July 2024 - Today, 85 sick and severely injured patients from Gaza were evacuated to Abu Dhabi, United Arab Emirates (UAE), for specialized care. This extremely complex joint evacuation was supported by the World Health Organization (WHO) in partnership with the Government of the UAE and other partners. This is the largest medical evacuation outside Gaza since October 2023.
“I am immensely grateful to the United Arab Emirates for evacuating sick and severely injured patients from Gaza and providing them with lifesaving medical care,” said Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean. “This initiative is a clear demonstration of the intra-regional solidarity that is urgently needed. Support to people in the Region must start from the Region. Thousands more inside Gaza remain at risk without access to advanced medical care. I urge Member States who are able to receive and care for more patients to do so.”
The patients include 35 children and 50 adults, who were transferred from Gaza via Kerem Shalom to Ramon Airport in Israel, with support from WHO. Fifty-three patients have cancer, including four children, 20 have trauma injuries, three have blood diseases, including thalassemia, three have congenital conditions, two have fanconi anaemia, one has a neurological condition, one has cardiac disease, one has liver disease, and one has renal failure. Sixty-three family members and care givers accompanied the patients.
“We are thankful to the UAE for supporting the evacuation of these patients to receive the urgent care they need,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "We hope this paves the way for the establishment of evacuation corridors via all possible routes, including the Kerem Shalom and Rafah crossings to Egypt and Jordan, and from there to other countries. We also call for evacuations to the West Bank, including East Jerusalem, to be restored. Thousands of sick people are suffering needlessly. Above all, and as always, we call for a ceasefire.”
The evacuation, originally scheduled for 29 July, was postponed, adding significant challenges to the operation, and diverting scarce resources.
Despite damaged roads, insecurity, and risks to their own safety, the WHO team organized and managed the transfer of patients from various areas in Gaza to the Kerem Shalom crossing under extremely challenging conditions.
Prior to the evacuation, nine patients were transferred by WHO and partners on July 27 from northern Gaza to the Palestine Red Crescent Society (PRCS) field hospital in Deir al-Balah for stabilization and further movement. Other patients were picked up from five locations in Deir al-Balah and Khan Younis. Some critically injured patients, who had already been relocated to the final departure point in the south, were accommodated and cared for at the Médecins Sans Frontières (MSF) field hospital in Deir al-Balah, in coordination with WHO, following the postponement of the mission. WHO and the International Medical Corps team provided medical supplies, electricity, safe water and sanitation facilities at the hospital as it is still being set up.
During the evacuation, patients underwent back-to-back transfer at Kerem Shalom, where they boarded buses, organized by WHO, heading to the airport after security checks. WHO provided wheelchairs to ensure patients could safely switch buses at the crossing, arranged access to food, water and medical professionals during the entire journey within Gaza and en route to the airport, and supported patient documentation.
Other partners supporting the evacuation included the emergency medical teams Cadus and International Medical Corps, MSF Belgium and PRCS.
Since October 2023, around 5 000 people have been evacuated for treatment outside Gaza, with over 80% receiving care in Egypt, Qatar and the UAE. Over 10 000 more people in Gaza still need medical evacuation. Today’s evacuation follows previous ones to Spain and Belgium from Cairo, coordinated by WHO. Twenty patients have been evacuated to these countries in the past few days.
The WHO continues to call on the international community to intensify efforts to ensure safe, sustained, timely, and organized medical evacuations.
Multimedia:
A video package and a broll edit have been sent to UNIFEED
The link to the photographs will be shared shortly
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.
29 July 2024, Geneva, Switzerland: A new project aiming to accelerate the development and accessibility of human avian influenza (H5N1) messenger RNA (mRNA) vaccine candidates for manufacturers in low- and middle-income countries has been launched today. The Argentinian manufacturer Sinergium Biotech will lead this effort leveraging the World Health Organization (WHO) and the Medicines Patent Pool (MPP) mRNA Technology Transfer Programme.
The mRNA Technology Transfer Programme, jointly developed by WHO and MPP, was launched in July 2021 with the aim to build capacity in low- and middle-income countries (LMICs) for the development and production of mRNA-based vaccines. Sinergium Biotech, a partner in the mRNA Technology Transfer Programme, has developed candidate H5N1 vaccines and aims to establish proof-of-concept in preclinical models. Once the preclinical data package is concluded, the technology, materials, and expertise will be shared with other manufacturing partners, aiding the acceleration of the development of H5N1 vaccine candidates, and bolstering pandemic preparedness efforts.
"This initiative exemplifies why WHO established the mRNA Technology Transfer Programme – to foster greater research, development and production in low- and middle-income countries, so that when the next pandemic arrives, the world will be better prepared to mount a more effective and more equitable response," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
"When we created the mRNA Technology Transfer Programme with WHO, our goal was to enable low- and middle-income countries to lead development efforts, foster collaboration, share resources, and disseminate knowledge,” said Charles Gore, Executive Director of MPP. “This project embodies our vision and demonstrates a strong commitment to future pandemic preparedness and response."
Avian influenza viruses are a significant public health risk due to their widespread circulation in animals and potential to cause a future pandemic. This development supplements ongoing work under the Pandemic Influenza Preparedness Framework to improve and strengthen the sharing of influenza viruses with human pandemic potential and increasing LMIC access to vaccines.
“This announcement underscores the importance of not only geographically diversifying the innovation and production of health technologies including and recognizing the capacities in Latin American and the Caribbean, but also the importance of early planning for access and the sharing of knowledge and technologies during the research and development processes," said Dr Jarbas Barbosa, Director of the Pan American Health Organization.
Dr Alejandro Gil, Chief Executive Officer of Sinergium, said: " Sinergium’s enhanced capacity and readiness to apply our expertise to H5N1 will play a vital role in this effort towards global pandemic preparedness. I would also like to thank PAHO who have also been instrumental through the strong support it offers to regional manufacturers in the Americas. We are excited to tackle this public health challenge and our R&D team will continue to work closely with the Programme Partners."
Since its inception, the mRNA Technology Transfer Programme has developed and implemented a platform that was used to establish the immunogenicity, efficacy, and safety of a COVID-19 vaccine candidate in preclinical animal models. Afrigen is the centre where the platform was created and is being validated and this technology is now being transferred to manufacturing partners to adapt and enhance it for other critical disease targets. The progress made by the mRNA Technology Transfer Programme is a vital part of WHO and MPP’s efforts to improve the availability, access, and use of mRNA vaccines for better vaccine equity globally.
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.
30 July 2024 --- Among adolescent girls who have been in a relationship, nearly a quarter (24%) – close to 19 million - will have experienced physical and/or sexual intimate partner violence by the time they turn 20 years old, as highlighted by a new analysis from the World Health Organization (WHO) published today in The Lancet Child & Adolescent Health. Almost 1 in 6 (16%) experienced such violence in the past year.
“Intimate partner violence is starting alarmingly early for millions of young women around the world,” said Dr Pascale Allotey, Director of WHO’s Sexual and Reproductive Health and Research department. “Given that violence during these critical formative years can cause profound and lasting harms, it needs to be taken more seriously as a public health issue – with a focus on prevention and targeted support.”
Partner violence can have devastating impacts on young people’s health, educational achievement, future relationships, and lifelong prospects. From a health perspective, it heightens the likelihood of injuries, depression, anxiety disorders, unplanned pregnancies, sexually transmitted infections, and many other physical and psychological conditions.
This study draws on existing data to provide, for the first time, a detailed analysis of the prevalence of physical and/or sexual partner violence experienced by 15–19-year-old girls who have been in intimate relationships. It also identifies broader social, economic and cultural factors that increase their risks.
While violence against adolescent girls occurs everywhere, the authors highlight significant differences in prevalence. Based on WHO’s estimates, the worst affected regions are Oceania (47%) and central sub-Saharan Africa (40%), for instance, while the lowest rates are in central Europe (10%) and central Asia (11%). Between countries, there is also a substantive range: from an estimated 6% adolescent girls subjected to such violence in the least affected countries, to 49% in those with the highest rates.
The new analysis found that intimate partner violence against adolescent girls is most common in lower-income countries and regions, in places where there are fewer girls in secondary school, and where girls have weaker legal property ownership and inheritance rights compared to men. Child marriage (before the age of 18 years) significantly escalates risks, since spousal age differences create power imbalances, economic dependency, and social isolation – all of which increase the likelihood of enduring abuse.
The study highlights the urgent need to strengthen support services and early prevention measures tailored for adolescents, alongside actions to advance women’s and girls’ agency and rights – from school-based programmes that educate both boys and girls on healthy relationships and violence prevention, to legal protections, and economic empowerment. Since many adolescents lack their own financial resources, they can face particular challenges in leaving abusive relationships.
“The study shows that to end gender-based violence, countries need to have policies and programmes in place that increase equality for women and girls,” said study author Dr Lynnmarie Sardinha, Technical Officer for Violence against Women Data and Measurement at WHO. “This means ensuring secondary education for all girls, securing gender-equal property rights and ending harmful practices such as child marriage, which are often underpinned by the same inequitable gender norms that perpetuate violence against women and girls.”
Currently, no country is on track to eliminate violence against women and girls by the 2030 Sustainable Development Goal target date. Ending child marriage – which affects 1 in 5 girls globally– and expanding girls’ access to secondary education will be critical factors for reducing partner violence against adolescent girls.
WHO supports countries to measure and address violence against women, including efforts to strengthen prevention and response within the health care sector. New WHO guidelines on prevention of child marriage are planned for release by the end of 2024.
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.