OIE endorsement of official control programmes for dog-mediated rabies

12 Aug

A new milestone in the journey towards rabies elimination

It is well recognized that by developing and implementing organised disease control strategies, countries reduce their related public health and economic burdens. To encourage countries’ use of such strategies, and as part of its continued efforts to support dog-mediated rabies elimination by 2030, the OIE invites its Members, on a voluntary basis, to apply by 18 September 2020 to have their official control programmes for dog-mediated rabies endorsed.

Controlling dog-mediated rabies at the national level

The effective control of dog-mediated rabies requires a coordinated multisectoral approach. The key to success in control efforts is to break the disease transmission cycle at its animal source (i.e. in dogs). In this regard, the development of control programmes at the national level best rely on multi faceted activities, including mass dog vaccination campaigns, improved rabies diagnosis and surveillance, t he effective management of stray-dog populations, and increased awareness of the disease through educational campaigns and community engagement. Moreover, at the heart of the efficient implementation of such strategies is political commitment and the availability of funding.

What a re the benefits of having an endorsed official control programme?

By compiling evidence that their national programmes comply with the requirements of OIE International Standards (and more specifically with the recommendations of Article 8.14.11. of the Terrestrial Animal Health Code), it will be easier for national Veterinary Services to advocate for support from their governments and hence to progressively prevent and control the disease until they can eventually prove its absence on their territories. This will be a preliminary step before countries can self-declare freedom from dog-mediated rabies on their territories to OIE.

The numerous benefits of the endorsement for OIE Members include:

  • wider access to international expertise and capacity-building activities;
  • increased engagement of governments in rabies elimination;
  • facilitated access to international funding;
  • stronger coordination at the regional level to eliminate the disease;
  • support to WHO validation on rabies elimination.

To learn more about the application process, national authorities are invited to visit the dedicated OIE webpage. A questionnaire has been developed to provide them with guidelines on how to prepare their application by 18 September 2020.The first group of countries’ national rabies programmes will be endorsed in May 2021 at the next General Session of the World Assembly of OIE Delegates.

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International Youth Day 2020

11 Aug

Meaningful youth engagement to improve adolescent sexual and reproductive health and rights  

Every day, young people are enriching institutions and processes at the local, national, and global levels.  

This year, the theme of International Youth Day is "Youth Engagement for Global Action." It highlights the importance and value of young people’s contributions and draws lessons on how their representation and engagement in formal institutional politics can be significantly enhanced.  

The theme of the day raises three questions: 

  1. What is meaningful youth engagement? 

  1. What are the benefits and challenges of meaningful youth engagement? 

  1. How does WHO strive to practice meaningful youth engagement in its work? 

What is meaningful youth engagement? 

Meaningful youth engagement, as defined by the 2018 Global Consensus Statement, is an inclusive, intentional, mutually-respectful partnership between young people and adults.  Power is shared and respective contributions are valued. 

Young people’s ideas, perspectives, skills, and strengths are integrated into the design and delivery of programs, strategies, policies, funding mechanisms - and organizations that affect their lives and their communities, countries, and world. 

What are the benefits and challenges of meaningful youth engagement? 

Meaningful youth engagement ensures that young people are equal and valuable partners – not only beneficiaries – in efforts to improve their health and wellbeing. It increases the likelihood that policies and programmes will be acceptable, appropriate, and responsive to their needs and preferences.  

Although global rhetoric increasingly acknowledges the value of meaningful youth engagement, it often remains more of an aspiration than a reality. There is still considerable resistance to giving young people a place at the table. 

When young people are given opportunities to contribute, it is most often older, urban, educated, and well-connected young people that are selected. Their engagement is often tokenistic and their responsibilities small, for instance leading energizer activities at conferences, taking notes during meetings, or formatting references in reports). Additionally, young people’s contributions are rarely measured effectively to demonstrate their value, and their contributions are often not appropriately acknowledged, either with authorship or compensation.  

This must not be the case. Meaningful youth engagement is central to the success of policies and programmes aimed at improving young people’s health and wellbeing, and can provide young people with opportunities to develop skillsets they will need as the next generation of leaders.  

How does the WHO strive to practice meaningful youth engagement in its work? 

The WHO Department of Sexual and Reproductive Health and Research and the Human Reproduction Programme (HRP) strive to apply the principles of meaningful youth engagement, as defined in the Global Consensus Statement, particularly with work on adolescent sexual and reproductive health and rights (ASRHR).  

For example, it put meaningful youth engagement into practice with the WHO and UNFPA-led supplement of the Journal of Adolescent Health. This supplement takes stock of progress made in ASRHR in the 25 years since the International Conference on Population and Development and sets out priorities for the future.  

The process of developing the supplement was: 

Transparent and informative. Seven young people from Botswana, Fiji, India, Lithuania, Mexico, Pakistan, and Turkey were identified using a structured selection process, in collaboration with the Partnership for Maternal, Newborn, and Child (PMNCH). Their selection was based on profiles with specific criteria, the same as for representatives from international organizations, governments, academia, civil society, and funding agencies. 

Rights-based. The young people engaged actively and as equal partners with the other contributors throughout the process. They played a key role in ensuring that young people’s rights were front and center in the content of the supplement.  

Voluntary and free from coercion. The young people were issued formal contracts, assuring co-authorship and compensation for their time and effort. These contracts were developed with and approved by the young people, themselves.  

Safe. The contracts spelled out clear expectations regarding their roles and responsibilities, which were fully in line with their abilities. Additionally, throughout the process, they had a focal person they could turn to for support.  

Respectful of young people’s views, backgrounds, and identities. The young people began by sharing their individual ideas and perspectives, and then worked collaboratively with each other and with the broader group of co-authors to pull together key themes and messages and develop the papers. Next, they worked with an artist to develop an illustrated video to bring the supplement to life, highlighting what they felt to be the most important messages of the supplement.  

The International Federation of Medical Students Associations (IFMSA) and the International Youth Alliance for Family Planning (IYAFP), two of the organizations represented by the young people, are contributing to upcoming regional webinars to disseminate the supplement and draw out its particular relevance for each WHO region.  

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Member States adopt the Global Strategy for TB Research and Innovation at 73rd World Health Assembly

10 Aug

Member States have adopted the global strategy for TB research and innovation through an unprecedented silent-written procedure of the 73rd session of the World Health Assembly (WHA) last week. The global strategy was developed to support efforts by governments and other partners to accelerate TB research and innovation, and to improve equitable access to the benefits of research in line with the commitments made in the WHO End TB Strategy, the Moscow Declaration to End TB and the political declaration of the United Nations high-level meeting on TB. The development of the strategy was requested by Member States during the 71st WHA with a view “to make further progress in enhancing cooperation and coordination in respect of tuberculosis research and development”.

Four major areas for action are highlighted in the strategy: creating an enabling environment for TB research and innovation; increasing financial investments in TB research and innovation; promoting and improving approaches to data sharing; and promoting equitable access to the benefits of research and innovation. In the spirit of fast-tracking efforts to end TB, a prerequisite for success is that all stakeholders make concerted efforts and collaborate. Hence, the strategy also makes the case for a unified and aligned response in which key national and international partners and affected communities support Member States by undertaking the investments and partnerships that are necessary for accelerating innovation. The primary audiences for the document are Member States, particularly ministries of health, science and technology, finance and education.

“Research and innovation are vital if we are to break the stronghold of TB - the world’s top infectious killer -that continues to claim millions of lives each year. This global strategy will guide Member States and other relevant stakeholders in translating political commitments on TB research and innovation into concrete action backed by investment, as an integral part of efforts to end TB” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme “We welcome this renewed commitment by Member States at a time where the COVID-19 pandemic has exposed many gaps in TB service provision that need to be addressed through innovation”.

Under the leadership of WHO, the strategy was developed during the past two years through a consultative process with Member States including managers of national tuberculosis programmes (NTPs) and other officials from within and beyond ministries of health such as ministries of science and technology; the WHO Strategic and Technical Advisory Group for Tuberculosis (STAG-TB); the WHO Global TB Research Task Force; representatives of civil society and affected communities; research funding institutions; and other stakeholders in TB research and innovation. The strategy has also benefited from an open web consultation, where extensive comments were received on a zero draft of the strategy.

The Assembly also passed a resolution requesting WHO to provide a report on the implementation of the strategy to WHA, biennially until 2030.  The resolution also called for the support of the scientific community, international partners and other relevant stakeholders to undertake research and innovation aligned to the needs of the countries most affected by TB; to strengthen public-private partnerships; and to facilitate knowledge sharing. Furthermore, it requested WHO to provide technical and strategic assistance to Member States in the implementation of the strategy.

“This resolution reflects Member States’ recognition of research and innovation as a key priority for ending TB, and their commitment to take concerted action to address unmet needs. It will help pave the way for the successful implementation of the strategy,” said Dr Matteo Zignol, a.i. Unit Head, Prevention, Care and Innovations at WHO’s Global TB Programme.

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WHO at the virtual High-level Political Forum (HLPF) 2020

10 Aug

The United Nations High-level Political Forum (HLPF), a mechanism that tracks and advances the implementation of the 2030 Agenda for Sustainable Development, was convened virtually due to the COVID-19 pandemic, on 7–16 July 2020, on the theme "Accelerated action and transformative pathways: realizing the decade of action and delivery for sustainable development ". Given the considerable impact of the pandemic on human health and the global economy, the Forum strongly focused on the potential impact of the pandemic on the implementation of the SDGs and the 2030 Agenda, and how the international community can respond and get back on track to achieving the sustainable development agenda. 

 

WHO actively participated in the Forum, by contributing to the background materials and agenda for four of the six official thematic sessions (Advancing human well-being; Ending hunger and achieving food security for all; Protecting the planet and building resilience; Sharing economic benefits) as well as in the virtual special events, side events and the Voluntary National Reviews (VNRs).  The 47 countries that presented VNRs, echoed the need to undertake substantial measures to contain the spread of COVID-19 and to ensure the proper functioning, preparedness and strengthening of health systems.

 

The eight WHO co-sponsored side events, focused on UHC and investing in health; tobacco control, COVID-19 and children; global strategy to leave no one behind during the COVID-19 pandemic; COVID-19 vaccines, Nutrition, as well as education in time of COVID-19, among others.

 

WHO’s main side event, co-hosted by Dr. Nata Menabde of the WHO office at the UN, focused on Investing in Health: the Key to Building Back Better from COVID-19 and Accelerating Progress for UHC and Sustainable Development, was organized in collaboration with the Group of Friends of UHC and Global Health and UHC2030. It addressed the extent to which COVID-19 has endangered global health and human security, threatening the progress made on the SDGs, as well as best practices and lessons learned to help accelerate response and recovery. Dr. Tedrosaddressed the meeting in a video message, urging leaders to fulfil the commitments made in the UHC Political Declaration to build back better, accelerate action to achieve the SDGs, and leave no one behind.

 

WHO was also represented by Mr. Stewart Simonson, Head of the WHO Office at the UN, at a side event on “Education and the Trying Times of COVID-19”, organized by theMission of the State of Qatar to the UN. He highlighted the vulnerability of children and young people due to the health and socioeconomic impacts resulting from the pandemic and stressed the need for national health system reform to be led by a strong multi-sectoral and whole-of-government approach.

 

The WHO VNR lab event cosponsored by the Financing for Sustainable Development Office of UNDESA and UHC2030, featuring Dr. Agnes Soucat, Director of Health Systems Governance and Financing at WHO, raised awareness of the health financing gaps as well as showcased solutions to financing health systems and build on lessons learned from COVID-19.

 

WHO also participated in thevirtualSDG Media Zone focusing on sustainability, solidarity and solutions, as the pillars for recovering back better. Dr Bruce Aylward, Epidemiologist and Senior Advisor to the WHO Director-General, highlighted the importance of vaccines in the global response efforts to COVID-19 and the crucial need for equitable access to them, once they become available.

 

Prior to officially concluding the Forum, the ECOSOC President, unveiled new UN stamps which pay tribute to frontline workers in the pandemic. Proceeds from an added surcharge will go directly to the COVID-19 Solidarity Response Fund to support the WHO and partners.

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Plane carrying WHO trauma and surgical supplies arrives in Beirut, Lebanon

7 Aug

A plane carrying 20 tonnes of WHO health supplies has landed in Beirut, Lebanon, to support the treatment of patients injured by the massive blast that occurred in the city on 4 August. The supplies will cover 1000 trauma interventions and 1000 surgical interventions for people suffering from injuries and burns resulting from the blast.

The shipment was airlifted from WHO’s logistics hub in Dubai earlier this afternoon using a plane donated by the Government of the United Arab Emirates, a key WHO partner in health emergency response.

“Our hearts and prayers are with all those affected by this tragic event as we continue our mission to serve all people in Lebanon with life-saving and essential health care services. We are working closely with national health authorities, health partners and hospitals treating the wounded to identify additional needs and ensure immediate support,” said WHO Representative in Lebanon Dr Iman Shankiti.

As a result of the blast, 3 hospitals in Beirut are now non-functional and 2 hospitals are partially damaged, leaving a critical gap in hospital bed capacity. Injured patients are being transferred to hospitals across the country, as far as south Saida and north Tripoli, and many facilities are overwhelmed. WHO will distribute the supplies to priority hospitals across Lebanon receiving and treating injured patients.

This latest emergency comes in the context of recent civil unrest, a major economic crisis, COVID-19 outbreak and heavy refugee burden. The legendary resilience of the Lebanese people has rarely been so severely tested. Ensuring that there is continuity of the response to COVID-19 – including targeting the most vulnerable for assistance – is a priority for both the Ministry of Public Health and WHO.

“With the emergence of new challenges due to the latest devastating event, the United Nations in Lebanon and partners have been mobilized to provide immediate humanitarian assistance to the Lebanese people in support of the Government’s response to this tragedy. We are in this together, and we are committed to supporting Lebanon in this very difficult time,” said Dr Najat Rochdi, UN Resident Coordinator in Lebanon.

 

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Plane carrying WHO trauma and surgical supplies arrives in Beirut, Lebanon

7 Aug

A plane carrying 20 tonnes of WHO health supplies has landed in Beirut, Lebanon, to support the treatment of patients injured by the massive blast that occurred in the city on 4 August. The supplies will cover 1000 trauma interventions and 1000 surgical interventions for people suffering from injuries and burns resulting from the blast.

The shipment was airlifted from WHO’s logistics hub in Dubai earlier this afternoon using a plane donated by the Government of the United Arab Emirates, a key WHO partner in health emergency response.

“Our hearts and prayers are with all those affected by this tragic event as we continue our mission to serve all people in Lebanon with life-saving and essential health care services. We are working closely with national health authorities, health partners and hospitals treating the wounded to identify additional needs and ensure immediate support,” said WHO Representative in Lebanon Dr Iman Shankiti.

As a result of the blast, 3 hospitals in Beirut are now non-functional and 2 hospitals are partially damaged, leaving a critical gap in hospital bed capacity. Injured patients are being transferred to hospitals across the country, as far as south Saida and north Tripoli, and many facilities are overwhelmed. WHO will distribute the supplies to priority hospitals across Lebanon receiving and treating injured patients.

This latest emergency comes in the context of recent civil unrest, a major economic crisis, COVID-19 outbreak and heavy refugee burden. The legendary resilience of the Lebanese people has rarely been so severely tested. Ensuring that there is continuity of the response to COVID-19 – including targeting the most vulnerable for assistance – is a priority for both the Ministry of Public Health and WHO.

“With the emergence of new challenges due to the latest devastating event, the United Nations in Lebanon and partners have been mobilized to provide immediate humanitarian assistance to the Lebanese people in support of the Government’s response to this tragedy. We are in this together, and we are committed to supporting Lebanon in this very difficult time,” said Dr Najat Rochdi, UN Resident Coordinator in Lebanon.

 

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73rd World Health Assembly Decisions

7 Aug

The Member States of the World Health Organization (WHO) have adopted a number of decisions to advance global public health that had been proposed to the 73rd World Health Assembly in May 2020, via a "Written Silence Procedure".

The proposals relate to: strengthening global immunization efforts; cervical cancer prevention and control; a global strategy for tuberculosis research and innovation; eye care - including preventing vision impairment and blindness; strengthening efforts on food safety, a global strategy and plan of action on public health, innovation and intellectual property; a decade of healthy ageing; and influenza preparedness.

Strengthening global immunization efforts to leave no one behind

The Immunization Agenda 2030 strategic proposal envisions a world where everyone, everywhere, at every age, fully benefits from vaccines to improve health and well-being. The key goal is to extend the benefits of vaccines to everyone, everywhere. The strategy is people-centric, led by countries, implemented through broad partnerships and driven by data. It systematically applies these 4 core principles across a set of key priorities, highlighting that immunization is an investment for the future, creating a healthier, safer and more prosperous world for all. 

Vaccines are available to prevent more than 20 life-threatening diseases, helping people of all ages live longer, healthier lives. Immunization currently prevents well over 3 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles; yet far too many people around the world – including nearly 20 million infants each year – have insufficient access to vaccines.

Cervical cancer prevention and control

The WHO global strategy to accelerate the elimination of cervical cancer as a public health problem establishes goals and targets for 2020 to 2030. It focuses on 3 key pillars: prevention through HPV vaccination; screening and treatment of pre-cancerous lesions; and management of invasive cervical cancer, including access to palliative care. All pillars must be pursued collectively to reach elimination.

To eliminate cervical cancer, all countries must reach (and maintain) an incidence below 4 per 100 000 women-years.  To get on the path to elimination, the strategy urges all countries to achieve the following targets by 2030: 90% of girls fully vaccinated (by 15 years of age); 70% coverage of screening with a high-performance test (once by the age of 35 and again by 45 years); and 90% of women who are identified with cervical disease receive treatment (90% of women with pre-cancer treated; 90% of women with invasive cancer managed). Achieving the 90-70-90 targets will yield impact on 2 fronts: we will see reductions in incidence and in mortality.  By 2030, the median cervical cancer incidence rate would fall by 10%, setting the world on the path to avert 70 million cases in the century.

Cervical cancer currently kills more than 300 000 women each year. The fourth most common cancer among women globally, its burden is greatest in low- and middle-income countries, where access to public health services is limited.

Tuberculosis research and innovation

The global strategy for TB research and innovation was developed to support efforts by governments and other partners to accelerate progress and to improve equitable access to the benefits of research in line with the commitments made in the WHO End TB Strategy, the Moscow Declaration to End TB and the political declaration of the United Nations high-level meeting on TB

It highlights 4 major areas for action are highlighted in the strategy: creating an enabling environment for TB research and innovation; increasing financial investments in TB research and innovation; promoting and improving approaches to data sharing; and promoting equitable access to the benefits of research and innovation. The strategy also makes the case for a unified and aligned response in which key partners and affected communities support Member States by undertaking the investments and partnerships that are necessary for accelerating innovation.

The resolution requests WHO to report biennially, until 2030, on the implementation of the strategy.  The resolution calls for the support of the scientific community, international partners and other relevant stakeholders to undertake research and innovation aligned with the needs of the countries most affected by TB; to strengthen public-private partnerships; and to facilitate knowledge sharing. Furthermore, it calls on WHO to provide technical and strategic assistance to Member States in the implementation of the strategy.

Integrated people centred eye care

A new World Health Assembly resolution focuses on the need to integrate people-centred eye care services into health systems. The first ever WHO report on vision (published in 2019) predicts a substantial increase in the number of people with eye conditions and vision impairment in the coming years. The resolution highlights 4 key strategies for Member States to improve access to services and reduce inequities.  The first is to better engage people and communities by raising awareness of the importance of early identification of eye conditions and simplifying access to care for underserved populations. The second is to strengthen eye care in primary health care so people can access services closer to their homes. The third is to improve coordination of eyecare services with other health services and with other sectors such as education and labour. The final recommendation is to integrate eye care into national health strategic plans and universal health coverage schemes. Member States recalled that preventing and addressing vision impairment not only improves quality of life for patients, it also enables them to remain economically productive.

Strengthening efforts on Food Safety 

A new resolution urges Member States to apply a “One Health” approach that promotes the sustainability and availability of safe, sufficient and nutritious food for all populations. Recognizing food safety threats, including foodborne antimicrobial resistance and climate change, the resolution also calls upon Member States to invest in national food safety systems and innovations, and to share timely data and evidence on foodborne disease outbreaks and hazards to the International Network of Food Safety Authorities (INFOSAN).

The Secretariat is requested to update the Global strategy for food safety to address current and emerging challenges and incorporate new technologies and innovative strategies for strengthening food safety systems. It also calls on the WHO Director-General to strengthen the Organization’s leadership in the Codex Alimentarius Commission and INFOSAN, and produce updated foodborne disease estimates by 2025. 

Around the world, an estimated 600 million - almost 1 in 10 people – fall ill after eating contaminated food each year, resulting in 420 000 deaths and the loss of 33 million healthy life years (DALYs). The burden of disease falls disproportionately on the most vulnerable, especially children and those living in developing countries.

Global strategy and plan of action on public health, innovation and intellectual property

The Global strategy and plan of action on public health, innovation and intellectual property urges Member States to reinforce implementation in line with the recommendations of an overall programme review panel. The decision also calls on Member States to further discuss, in informal consultations to be convened by the Director-General, the recommendations of the review panel on promoting and monitoring transparency of medicines prices and actions to prevent shortages. The decision emphasizes the necessity to allocate resources for WHO Secretariat implementation and further requests the Director-General to submit a report on progress made in implementing the decision to the Seventy-fourth World Health Assembly in 2021, through the Executive Board.

Decade of Healthy Ageing

Member States endorsed a proposal for a Decade of Healthy Ageing 2020–2030 and asked the Director-General to report back on progress on its implementation every 3 years during the Decade. The Health Assembly also asked the Director-General to transmit this decision to the Secretary-General of the United Nations for consideration of the proposal for the Decade by the United Nations General Assembly.

Populations around the world are ageing at a faster pace than in the past and this demographic transition will have an impact on almost all aspects of society. Already, there are more than 1 billion people aged 60 years or older, with most living in low- and middle-income countries. Many do not have access to even the basic resources necessary for a life of meaning and dignity. Many others confront multiple barriers that prevent their full participation in society.

The Decade of Healthy Ageing is an opportunity to bring together governments, civil society, international agencies, academia, the media, and the private sector for ten years of concerted, catalytic and collaborative action to improve the lives of older people, their families, and the communities in which they live.

Influenza Preparedness

Member States requested the Secretariat to continue its support for WHO’s Global Influenza Strategy 2019–2030. They also requested the promotion of synergies, where relevant and appropriate, with the International Health Regulations (2005), implementation of national plans for influenza preparedness and response, and immunization programmes. The Secretariat is requested to report back on progress through the Executive Board to the 75th World Health Assembly.

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Mexico’s feat against rabies through cross-sectoral collaboration is possible in other countries

7 Aug

 

As part of the global strategy to achieve zero human deaths from rabies by 2030, the World Health Organization (WHO) and its main partners are encouraging countries to accelerate cross-sectoral collaboration through the One Health approach.

Both WHO and the World Organisation for Animal Health (OIE) have jointly developed procedures to enable recognition of countries in which progress has been made against rabies through One Health and those that are on the verge of eliminating the disease as a public health problem.

There are many countries that have stepped up rabies control programmes in dogs and we want to increase the recognition of such efforts,” said Dr Gregorio Torres, Head of the OIE Science Department. “With our updated international standards on rabies1, countries’ veterinary services can seek endorsement from OIE of their national dog-rabies control programme2, and declare3 freedom from dog-mediated rabies or freedom from rabies.

In 2018, WHO established a validation procedure for countries reaching zero human deaths from dog-mediated rabies.4 The procedure involves several steps, including close collaboration between the Ministry of Health of the WHO Member State and the WHO Country and Regional Office as well as WHO headquarters, in the preparation, submission and review of the dossier.

The WHO procedure involves review of evidence by an international expert group, followed by an official announcement of the country’s achievement,” explained Dr Bernadette-Abela Ridder, WHO rabies focal point. “Both WHO or OIE procedures assist countries in gaining recognition of the progress made by their rabies programmes.

Mexico’s success can be emulated by other countries

To date, Mexico is the first and only country to be validated by WHO for eliminating rabies as a public health problem.5

The process started when the Mexican Ministry of Health compiled a dossier demonstrating evidence of elimination as a public health problem in accordance with the WHO validation requirements for rabies (See chart). The dossier was submitted to the Pan American Health Organization (PAHO) and the WHO Country Office in Mexico. It was reviewed also by PAHO's Department of Communicable Diseases and Environmental Health, which hosts the regional veterinary public health unit (PANAFTOSA) responsible for the rabies elimination programme in the Region of the Americas. There followed a field visit by an international group of independent experts to review and assess the evidence submitted and national rabies elimination efforts. The experts concluded that Mexico had met the requirements for validation of elimination of rabies as a public health problem, and the Director-General of WHO officially endorsed the decision.

Example of Progress towards elimination

This achievement is not just an effort of a national agency or the Government,” said Dr Hugo Lopez-Gatell Ramirez, Deputy Director, Mexican Ministry of Public Health. “It required a vision and full commitment from all states in Mexico and the determination of the nation in getting rid of this problem.

The core elements of the process for validation of elimination of rabies as a public health problem and OIE declarations of rabies-freedom include that:

  • rabies is notifiable,
  • state of the art surveillance is in operation,
  • 2 years of absence of rabies cases (human and/or animal),
  • prevention of importation of rabies-infected animals is in place, and,
  • presence of an effective national rabies control strategy.

To avoid duplication of efforts, WHO and OIE agreed to mutually recognize supporting evidence that a country submits for either procedure and organization. For example:

  • An OIE endorsement of a national rabies control programme will be considered, if a country submits a request for WHO validation on rabies elimination.
  • A WHO validation for elimination of rabies as a public health problem can support a self-declaration to OIE for dog-mediated rabies freedom.
  • Finally, if a country has successfully self-declared freedom from dog-mediated rabies to OIE, it will be considered also to have validated elimination of dog-mediated rabies as a public health problem by WHO.

Combined with technical guidance from international organizations, these procedures strengthen the capacity of countries to implement rabies elimination programmes.

Sustained political will and community engagement are among the measures necessary to reach the goal of "Zero by 30" and, eventually, freedom from dog-mediated rabies.

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1Infection with rabies virus. In: Terrestrial Animal Health Code (Chapter 8.14). Paris: World Organisation for Animal Health.
2Official recognition of disease status. In: Official recognition policy and procedures. Paris: World Organisation for Animal Health.
3Self-declaration. In: Self‐declared disease status. Paris: World Organisation for Animal Health.
4Reaching zero human deaths from rabies. In: WHO Expert Consultation on Rabies (Chapter 12 and Annex 14). Geneva: World Health Organization (WHO Technical Report Series, No. 1012.
5Mexico is free from human rabies transmitted by dogs. Washington (DC): Pan American Health Organization; 2019. 

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WHO Information Notice for Users of Medical Devices 2020/3

7 Aug

Date: 7 August 2020

Subject: Substandard/Falsified medical devices and personal protective equipment (PPE) used in the context of the COVID-19 pandemic

WHO-identifier: 2020/3, version 1

Type of action: Advice to users of medical devices and PPE used for prevention, treatment and care for COVID-19.

Attention: Users of medical devices and PPE[1], procurement entities and customs officials, national programme managers and their implementing partners, laboratories, ministry of health and national regulatory authorities for medical devices and PPE.

Purpose: To advise on actions to be taken to identify and prevent circulation of substandard/falsified medical devices and PPE for COVID-19.  

Description of the problem:

WHO continues to be made aware of circulation of substandard/falsified medical devices and PPE for prevention of COVID-19 and in the treatment and case management of people with COVID-19.

WHO uses the following definitions:

  • Substandard, also called "out of specification", are authorized medical devices that fail to meet either their quality or safety performance specifications.
  • Falsified medical device that deliberately/fraudulently misrepresent their identity, composition or source.
  • Unregistered/unlicensed medical devices that have not undergone evaluation and/or approval by the national regulatory authority for the market in which they are marketed/distributed or used, subject to permitted conditions under national regulation and legislation.


Any adverse event or product problem for a medical device may reveal that a product is substandard or falsified.  

Advice on action to be taken by buyers/donors of medical devices and PPE for COVID-19:

  1. Purchase products that have been authorized/approved/listed by the responsible institution: the national regulatory authority (NRA) or any other institution that has the mandate to oversee quality, safety and performance of such medical devices and PPE in your country.
  2. Review registration status by checking your NRA’s website for lists/databases of authorized/approved/listed products, and list of withdrawn/non-approved products. If such information is not publicly available on their websites, communication with your NRA is encouraged.
  3. Ensure donated medical devices and PPE are registered (see WHO guidelines).
  4. Purchase products from the legal manufacturer, or their designated economic operator (agent, distributor, supplier, authorized representative).
  5. Request from the manufacturer if any obsolescence plans are in place.

Advice on action to be taken by users of medical devices and PPE for COVID-19:

  1. Follow guidance from WHO on appropriate use of medical devices for COVID-19 T and use technical specifications provided by WHO or the final user to select the appropriate, safe and qualified medical device.
  2. Avoid purchasing medical devices online from an unknown source.
  3. Request a copy of the certificate of safety and performance depending on the functionality of the product from the manufacturer for each lot/serial number of product.
  4. Cross-reference the labelling of product received against your NRA’s authorization/approval/listing letter and labelling on your NRA’s website and the manufacturer’s website.
  5. Conduct incoming inspection for certain categories of medical devices.
  6. Read the instructions for use to understand the intended use of the product and taking note of any limitations.
  7. Ascertain, within reasonable doubt, that the product is genuine. Contact WHO, if in doubt[2].
  8. Run all required calibration and preventive maintenance procedures as instructed by the manufacturer in their instructions for use and operation manuals.
  9. Report any product problems and/or adverse events as complaints to the manufacturer as soon as you become aware using a complaint form and copy to WHO and your NRA. The contact details for the manufacturer can be found in both primary and secondary packaging materials and instructions for use.

Adverse events may be:

  • Death of the patient, end-user or any other person occurred or may have occurred
  • Death of the patient, end-user or any other person occurred or may have occurred

 

 

 

 

 

 

 

 

 

 

Product problems may be:

  • Packaging – damaged, defective, suspect tampered
  • Labelling – insufficient instructions for use, illegible
  • Sampling – device does not collect/transfer specimen
  • Liquid – leak, splash
  • Mechanical – misalignment, jam
  • Electrical – unable to charge, power loss or fluctuation
  • Data – capture, display, or storage affecting product     functionality
  • Software – network, program, algorithm, or security affecting product functionality
  • Environmental – noise, temperature, humidity/moisture, fungal/bacterial growth, or dust affecting product functionality
  • Failure to calibrate
  • Increased rate of invalid or unreturnable test results
  • Obviously incorrect, inadequate or imprecise result or readings
  • Unable to obtain reading

 

 

 

Advice for action to be taken by national regulators of medical devices and PPE for COVID-19:
  1. Assess products (full assessment or through reliance/recognition mechanisms) and share approval/authorization/listing on your website or any other platform which is accessible to stakeholders. Ensure such assessment is conducted before issuance of import permit for non-domestically manufactured product.  
  2. Conduct inspection of imported products in collaboration with customs officials at the point of entry to detect substandard/falsified devices and products. The following information can be checked; import certificate issued by the NRA, certificate of analysis (translated) which needs to be compared with the imported products. Physical examination of products including labelling information and details of the importer (authorized representatives or approved suppliers), matching of product details with certificate of analysis, evidence of tampering of labels, language, product description such as size, shape, colour, product code and batch, cracks, abrasion, erosion, breaks and seal integrity.
  3. Collect samples for further investigation if there is any suspicion about the product and take appropriate regulatory actions such as quarantine and testing.
  4. Ensure that users are aware that they should report any adverse event and product problems to the manufacturer.  
  5. Post field safety notices issued by manufacturers for medical devices and PPE supplied within your jurisdiction on your website.
  6. Exchange information with other regulators if your market surveillance detects product problems or adverse events. 

 

Note: For many jurisdictions, emergency use/approval mechanisms have been put in place for certain medical devices. These products should be the subject of increased monitoring by device users for adverse events and product problems.


[1] WHO previously published a WHO Information Notice for Users for falsified in vitro diagnostics (IVDs) used to diagnose COVID-19, seeWHO Information for Users n°2/2020.

Some PPE elements are classified as medical devices in some jurisdictions.

[2] Contact for further information: Anita SANDS, Regulation and Safety, e-mail: sandsa@who.int

 

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New Science Council to be established

6 Aug

As a science-based institution, WHO is always striving to be at the forefront of scientific progress and its potential to improve health for all. A new WHO Science Council comprising international experts from a broad range of disciplines will support WHO in interpreting cutting-edge scientific and medical knowledge, as well as the latest advances in technology.

The Science Division’s Research for Health department will facilitate the Council’s work in advising on WHO’s top science, research, and innovation priorities, focusing on areas of greatest urgency and identifying the biggest gaps in evidence. The Council’s recommendations will be given to the Director-General as part of an expansion of the scope of the science underpinning WHO’s public health work.

New global health challenges are increasingly accompanied by rapid advances in science and  technology, including solutions that arise in nonmedical fields and which employ innovative techniques. In accordance with WHO’s directing and coordinating role in health, the Organization is seeking advice from the Science Council on state-of-the-art evidence-based responses to health challenges.

The terms of reference for the Science Council, along with information on the call for nominations, are here. 

 

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