WHO and MPP announce agreement with NIH for COVID-19 health technologies

12 May

WHO’s COVID-19 Technology Access Pool (C-TAP) and the Medicines Patent Pool (MPP) today finalized a licensing agreement with the United States National Institutes of Health (NIH) for the development of several innovative therapeutics, early-stage vaccines and diagnostic tools for COVID-19.

The licenses, which are transparent, global and non-exclusive, will allow manufacturers from around the world to work with MPP and C-TAP to make these technologies accessible to people living in low- and middle-income countries and help put an end to the pandemic.

The 11 COVID-19 technologies offered under two licences include the stabilized spike protein used in currently available COVID-19 vaccines, research tools for vaccine, therapeutic and diagnostic development as well as early-stage vaccine candidates and diagnostics. The full list of the NIH COVID-19 technologies covered in the agreement is here.

“I welcome the generous contribution NIH has made to C-TAP and its example of solidarity and sharing,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Whether it’s today’s pandemic or tomorrow’s health emergency, it’s through sharing and empowering lower-income countries to manufacture their own health tools that we can ensure a healthier future for everyone.”

“We are honoured to sign these public health-driven licence agreements with NIH under the auspices of C-TAP with the goal of providing equitable access to life-saving health products for the most vulnerable in the world,” said Charles Gore, MPP Executive Director.

“NIH were the first to share their patents with MPP for an HIV product back in 2010 when we were created, and we are delighted to continue strengthening our partnership. It is clear that MPP’s model works across different health technologies.”

The announcement was made today by the US Government at the second Global COVID-19 Summit, co-hosted by the United States, Belize, Germany, Indonesia and Senegal.

Licensing the NIH technologies to MPP under the auspices of C-TAP will allow greater access to these technologies and hopefully lead to the development of commercial products that can address current and future public health needs. In most circumstances, NIH will not collect royalties on sales of products licensed in 49 countries classified by the United Nations as Least Developed Countries.

Launched in 2020 by the WHO Director-General and the President of Costa Rica, and supported by 43 Member States, C-TAP aims to facilitate timely, equitable and affordable access to COVID-19 health products by boosting their production and supply through open, transparent and non-exclusive licensing agreements. MPP provides the licensing expertise to this initiative and holds the licences.

The 11 technologies include: 

  1. Prefusion spike proteins  (Vaccine Development) 
  2. Structure-Based Design of Spike Immunogens  (Research Tool for Vaccine Development) 
  3. Pseudotyping Plasmid (Research Tool for Vaccine Development) 
  4. ACE2 Dimer construct (Research Tool for Drug Development) 
  5. Synthetic humanized llama nanobody library and related use  (Research Tool for Drug and Diagnostic Development)
  6. Newcastle Disease Virus-Like Particles Displaying Prefusion-Stabilized  Spikes (Vaccine Candidate) 
  7. Parainfluenza virus 3 based vaccine (Vaccine Candidate)
  8. A VSV-EBOV-Based Vaccine (Vaccine Candidate)
  9. RNASEH-Assisted Detection Assay for RNA (Diagnostic)
  10. Detection of SARS-CoV-2 and other RNA Virus (Diagnostic)
  11. High-Throughput Diagnostic Test  (Diagnostic)

 

WHO highlights glaring gaps in regulation of alcohol marketing across borders

10 May

A new report from the World Health Organization highlights the increasing use of sophisticated online marketing techniques for alcohol and the need for more effective regulation. It shows that young people and heavy drinkers are increasingly targeted by alcohol advertising, often to the detriment of their health.

Reducing the harm from alcohol – by regulating cross-border alcohol marketing, advertising and promotion is the first report from WHO to detail the full extent of the way that alcohol is today being marketed across national borders – often by digital means – and in many cases regardless of the social, economic or cultural environment in receiving countries.

Worldwide, 3 million people die each year as a result of harmful use of alcohol – one every 10 seconds – representing about 5% of all deaths. A disproportionate number of these alcohol--related deaths occur among younger people, with 13.5% of all deaths among those who are 20–39 years of age being alcohol-related.

“Alcohol robs young people, their families and societies of their lives and potential,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Yet despite the clear risks to health, controls on the marketing of alcohol are much weaker than for other psychoactive products. Better, well enforced and more consistent regulation of alcohol marketing would both save and improve young lives across the world.”

A digital revolution in marketing and promotion

One of the biggest changes in recent years to alcohol marketing is the use of sophisticated online marketing. The collection and analysis of data on users’ habits and preferences by global Internet providers has created new and growing opportunities for alcohol marketers to target messages to specific groups across national borders. Targeted advertising on social media is especially effective at using such data, with its impact strengthened by social influencers and sharing of posts between social media users.

One data source quoted in the report calculated that over 70% of media spending of leading alcohol marketers based in the USA in 2019 was through promotions, product placement and online advertisements in social media.

“The rising importance of digital media means that alcohol marketing has become increasingly cross-border”, said Dag Rekve of the Alcohol, Drugs and Addictive Behaviours Unit at the World Health Organization. “This makes it more difficult for countries that are regulating alcohol marketing to effectively control it in their jurisdictions. More collaboration between countries in this area is needed.”

Sponsorship of sporting events

Sponsorship of major sporting events at global, regional and national levels is another key strategy used by transnational alcohol companies (which are gaining increasing dominance in the production and branding of alcohol beverages). Such sponsorship can significantly increase awareness of their brands to new audiences. In addition, alcohol producers engage in partnership with sports leagues and clubs to reach viewers and potential consumers in different parts of the world.

The increasing market of e-sports, including competitive gaming events, is another opportunity to sponsor events and increase brand recognition and international sales. So is product placement in movies and serials, many of which are streamed on international subscription channels. According to an analysis of the 100 highest-grossing box office U.S. movies between 1996 and 2015, branded alcohol was shown in almost half of them.

A focus on marketing to specific audiences

The lack of regulation to address cross-border marketing of alcohol is of particular concern for children and adolescents, women, and heavy drinkers.

Studies have shown that starting to drink alcohol at a young age is a predictor of hazardous drinking in young adulthood and beyond. Furthermore, teenage drinkers are more vulnerable to harm from alcohol consumption than older drinkers. Areas of the world with young and growing populations, such as Africa and Latin America, are being particularly targeted. 

In addition, alcohol consumption among women is an important growth sector for alcohol production and sales. While three quarters of the alcohol that the world drinks is consumed by males, alcohol marketers tend to see the lower rate of women drinking as an opportunity to grow their market, often depicting drinking by women as a symbol of empowerment and equality. They organize corporate social responsibility initiatives, on topics such as breast cancer and domestic violence, and engage with women known for their success in areas such as sports or the arts to promote brands of alcohol.

Heavy and dependent drinkers are another target for marketing efforts, since in many countries just 20% of current drinkers drink well over half of all alcohol consumed. Alcohol-dependent people frequently report a stronger urge to drink alcohol when confronted with alcohol-related cues, yet they rarely have an effective way to avoid exposure to the content of the advertising or promotion.

Existing regulation primarily limited to individual states

While many countries have some form of restrictions on alcohol marketing in place, generally they tend to be relatively weak. In a WHO 2018 study, it was found that, while most countries have some form of regulation for alcohol marketing in traditional media, almost half have no regulation in place for Internet (48%) and social media (47%) marketing of alcohol.

Meanwhile, sustained attention and work by national governments, the public health community and WHO to limit the availability and promotion of tobacco products, with specific attention to the cross-border aspects of tobacco production and marketing, has led to life-saving reductions in global tobacco use and exposure.

International cooperation required

The report concludes that national governments need to integrate comprehensive restrictions or bans of alcohol marketing, including its cross-border aspects, in public health strategies. It highlights key features and options for the regulation of cross-border marketing of alcohol and stresses the need for strong collaboration between states in this area.  

Note for editors:

Drinking alcohol is causally linked to an array of health problems such as mental and behavioural disorders, including alcohol dependence; major noncommunicable diseases such as liver cirrhosis, some cancers and cardiovascular diseases; and injuries and deaths resulting from violence and road traffic crashes.

WHO delivers 20 ambulances to Ukraine

9 May

To support emergency health needs in Ukraine, World Health Organization (WHO) today gave 20 all-terrain ambulances able to function in even the most damaged and inaccessible areas to the Ministry of Health of Ukraine. 

“We bring not just supplies but support based on your needs. Today we are handing to you 20 ambulances, along with generators and blood refrigerators to hospitals wherever they  are needed.'' said Dr Tedros Adhanom Ghebreyesus, the WHO Director-General handing over the keys to the Deputy Minister of Health Iryna Mykychak in Lviv, Ukraine. “But the most important thing  we want to see delivered is peace.”

“Today, as we consolidate our efforts with WHO, we need to strengthen our national health care system. And these are very effective ways to support our doctors, who heroically provide medical care in Ukraine in difficult times. Today we received modern off-road vehicles from the WHO to ensure medical evacuation. These ambulances can drive to the most important places available, even where the roads have been most damaged” said Deputy Minister Mykychak as she looked over the new addition to the emergency relief team’s fleet. “We are infinitely grateful to all our international partners for such important and significant support of Ukraine. We worked closely with the WHO team in Ukraine for a long time, long before the war in health care reform in Ukraine. I am confident that together we will provide necessary support people of Ukraine and address health needs. We need peace.”

Dr Tedros has been in Ukraine for 3 days of meetings with senior government leaders and to assess the current health needs in Ukraine. During this time he visited health facilities damaged during the war and spoke with health care workers who worked tirelessly, providing care by torchlight and eventually evacuating all patients when it became too dangerous to continue.

Two months into the war, the medical infrastructure in Ukraine has been significantly damaged due to the continuous attacks on health care, and access to health care in many areas has been severely impacted. This donation of 20  ambulances will help bring vital lifesaving care to people in Ukraine and improve the national emergency medical teams' timeliness and quality of health services.

“WHO is committed to supporting people in Ukraine in accessing much-needed health services. The donation of 20 ambulances will bring lifesaving care as Ukraine’s health services have been significantly stretched and access to health care remains a challenge for many people,” said Dr Jarno Habicht, WHO Representative and Head of the WHO Country Office in Ukraine. “One of the health workers we spoke to remembered how during the days of constant shelling in their city, ambulances continued to operate even during curfew to ensure people received the care they needed. We are inspired by the bravery of Ukrainian health workers and hope this donation will contribute to their work.”

WHO has so far delivered 393 metric tonnes of emergency and medical supplies and equipment to Ukraine. Of that amount, 167 metric tonnes have reached their intended destinations, mostly in the east, south and north of the country where the need is greatest.

Notes to editors:

● Barely a week after the war started in Ukraine, WHO launched an appeal for three months (March – May 2022) for US$ 57.5 million to address the needs of 6 million people: US$45 million for health response in Ukraine and another US$12.5 million for the health needs of Ukrainian people affected by the conflict in neighbouring countries. This is WHO’s first appeal to respond to the ongoing war in Ukraine, and it has been fully funded.

● WHO is the United Nations agency that connects nations, partners and people to promote health, keep the world safe and serve the vulnerable – so everyone, everywhere can attain the highest level of health. WHO leads global efforts to expand universal health coverage. We direct and coordinate the world’s response to health emergencies. We promote healthier lives – from pregnancy care through old age. WHO works across 194 countries in 6 regions of the world, including the European Region which encompasses 53 countries across Europe and Central Asia. WHO staff include the world’s leading public health experts, bringing together doctors, epidemiologists, scientists and managers – all champions for healthier, safer lives everywhere.  

WHO launches first ever global report on infection prevention and control

6 May

The COVID-19 pandemic and other recent large disease outbreaks have highlighted the extent to which health care settings can contribute to the spread of infections, harming patients, health workers and visitors, if insufficient attention is paid to infection prevention and control (IPC). But a new report from the World Health Organization (WHO) shows that where good hand hygiene and other cost-effective practices are followed, 70% of those infections can be prevented. 

Today, out of every 100 patients in acute-care hospitals, seven patients in high-income countries and 15 patients in low- and middle-income countries will acquire at least one health care-associated infection (HAI) during their hospital stay. On average, 1 in every 10 affected patients will die from their HAI.

People in intensive care and newborns are particularly at risk. And the report reveals that approximately one in four hospital-treated sepsis cases and almost half of all cases of sepsis with organ dysfunction treated in adult intensive-care units are health care-associated.

Today, on the eve of World Hand Hygiene Day, WHO is previewing the first ever Global Report on Infection Prevention and Control which brings together evidence from scientific literature and various reports, and new data from WHO studies.

“The COVID-19 pandemic has exposed many challenges and gaps in IPC in all regions and countries, including those which had the most advanced IPC programmes,” said Dr Tedros Adhanom Ghebreyesus, WHO Director General. “It has also provided an unprecedented opportunity to take stock of the situation and rapidly scale up outbreak readiness and response through IPC practices, as well as strengthening IPC programmes across the health system. Our challenge now is to ensure that all countries are able to allocate the human resources, supplies and infrastructures this requires.”

The new WHO report provides the first-ever global situation analysis of how IPC programmes are being implemented in countries around the world, including regional and country focuses. While highlighting the harm to patients and healthcare workers caused by HAIs and antimicrobial resistance, the report also addresses the impact and cost-effectiveness of infection prevention and control programmes and the strategies and resources available to countries to improve them.

The impact of healthcare associated infections and antimicrobial resistance on people’s lives is incalculable. Over 24% of patients affected by health care-associated sepsis and 52.3% of those patients treated in an intensive care unit die each year. Deaths are increased two to threefold when infections are resistant to antimicrobials.

In the last five years, WHO has conducted global surveys and country joint evaluations to assess the implementation status of national IPC programmes. Comparing data from the 2017–18 and the 2021–22 surveys, the percentage of countries having a national IPC programme did not improve; furthermore in 2021–22 only four out of 106 assessed countries (3.8%) had all minimum requirements for IPC in place at the national level. This is reflected in inadequate implementation of IPC practices at the point of care, with only 15.2% of health care facilities meeting all of the IPC minimum requirements, according to a WHO survey in 2019.

However, encouraging progress has been made in some areas, with a significant increase being seen in the percentage of countries having an appointed IPC focal point, a dedicated budget for IPC and curriculum for front-line health care workers’ training; developing national IPC guidelines and a national programme or plan for HAI surveillance; using multimodal strategies for IPC interventions; and establishing hand hygiene compliance as a key national indicator.

Many countries are demonstrating strong engagement and progress in scaling-up actions to put in place minimum requirements and core components of IPC programmes. Progress is being strongly supported by WHO and other key players. Sustaining and further expanding this progress in the long-term is a critical need that requires urgent attention and investments.

The report reveals that high-income countries are more likely to be progressing their IPC work, and are eight times more likely to have a more advanced IPC implementation status than low-income countries. Indeed, little improvement was seen between 2018 and 2021 in the implementation of IPC national programmes in low-income countries, despite increased attention being paid generally to IPC due to the COVID-19 pandemic. WHO will continue to support countries to ensure IPC programmes can be improved in every region.

WHO is calling on all countries around the globe to increase their investment in IPC programmes to ensure quality of care and patient and health workers’ safety. This will not only protect their populations, increased investment in IPC has also demonstrated to improve health outcomes and reduce health-care costs and out-of-pocket expenses.

# # #

Notes to Editors

IPC is a clinical and public health specialty based on a practical, evidence-based approach which prevents patients, health workers, and visitors to health care facilities from being harmed by avoidable infections, including those caused by antimicrobial-resistant pathogens, acquired during the provision of health care services. It occupies a unique position in the field of patient and health workers’ safety and quality of care, as it is universally relevant to every health worker and patient, at every health care interaction.

 

About WHO

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 149 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. 

For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on TwitterFacebookInstagramLinkedInTikTokPinterestSnapchatYouTubeTwitch.

 

14.9 million excess deaths associated with the COVID-19 pandemic in 2020 and 2021

5 May

New estimates from the World Health Organization (WHO) show that the full death toll associated directly or indirectly with the COVID-19 pandemic (described as “excess mortality”) between 1 January 2020 and 31 December 2021 was approximately 14.9 million (range 13.3 million to 16.6 million).  

“These sobering data not only point to the impact of the pandemic but also to the need for all countries to invest in more resilient health systems that can sustain essential health services during crises, including stronger health information systems,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO is committed to working with all countries to strengthen their health information systems to generate better data for better decisions and better outcomes.”

Excess mortality is calculated as the difference between the number of deaths that have occurred and the number that would be expected in the absence of the pandemic based on data from earlier years. 

Excess mortality includes deaths associated with COVID-19 directly (due to the disease) or indirectly (due to the pandemic’s impact on health systems and society). Deaths linked indirectly to COVID-19 are attributable to other health conditions for which people were unable to access prevention and treatment because health systems were overburdened by the pandemic. The estimated number of excess deaths can be influenced also by deaths averted during the pandemic due to lower risks of certain events, like motor-vehicle accidents or occupational injuries. 

Most of the excess deaths (84%) are concentrated in South-East Asia, Europe, and the Americas. Some 68% of excess deaths are concentrated in just 10 countries globally. Middle-income countries account for 81% of the 14.9 million excess deaths (53% in lower-middle-income countries and 28% in upper-middle-income countries) over the 24-month period, with high-income and low-income countries each accounting for 15% and 4%, respectively. 

The estimates for a 24-month period (2020 and 2021) include a breakdown of excess mortality by age and sex. They confirm that the global death toll was higher for men than for women (57% male, 43% female) and higher among older adults. The absolute count of the excess deaths is affected by the population size. The number of excess deaths per 100,000 gives a more objective picture of the pandemic than reported COVID-19 mortality data.

“Measurement of excess mortality is an essential component to understand the impact of the pandemic. Shifts in mortality trends provide decision-makers information to guide policies to reduce mortality and effectively prevent future crises. Because of limited investments in data systems in many countries, the true extent of excess mortality often remains hidden,” said Dr Samira Asma, Assistant Director-General for Data, Analytics and Delivery at WHO. “These new estimates use the best available data and have been produced using a robust methodology and a completely transparent approach.”

“Data is the foundation of our work every day to promote health, keep the world safe, and serve the vulnerable. We know where the data gaps are, and we must collectively intensify our support to countries, so that every country has the capability to track outbreaks in real-time, ensure delivery of essential health services, and safeguard population health,” said Dr Ibrahima Socé Fall, Assistant Director-General for Emergency Response. 

The production of these estimates is a result of a global collaboration supported by the work of the Technical Advisory Group for COVID-19 Mortality Assessment and country consultations. 

This group, convened jointly by the WHO and the United Nations Department of Economic and Social Affairs (UN DESA), consists of many of the world’s leading experts, who developed an innovative methodology to generate comparable mortality estimates even where data are incomplete or unavailable. 

This methodology has been invaluable as many countries still lack capacity for reliable mortality surveillance and therefore do not collect and generate the data needed to calculate excess mortality. Using the publicly available methodology, countries can use their own data to generate or update their own estimates. 

“The United Nations system is working together to deliver an authoritative assessment of the global toll of lives lost from the pandemic. This work is an important part of UN DESA’s ongoing collaboration with WHO and other partners to improve global mortality estimates,” said Mr Liu Zhenmin, United Nations Under-Secretary-General for Economic and Social Affairs. 

Mr Stefan Schweinfest, Director of the Statistics Division of UN DESA, added: “Data deficiencies make it difficult to assess the true scope of a crisis, with serious consequences for people’s lives. The pandemic has been a stark reminder of the need for better coordination of data systems within countries and for increased international support for building better systems, including for the registration of deaths and other vital events.”

 

Note for editors:

The methods were developed by the Technical Advisory Group for COVID-19 Mortality Assessment, co-chaired by Professor Debbie Bradshaw and Dr. Kevin McCormack with extensive support from Professor Jon Wakefield at the University of Washington. The methods rely on a statistical model derived using information from countries with adequate data; the model is used to generate estimates for countries with little or no data available. The methods and estimates will continue to be updated as additional data become available and in consultation with countries.

WHO reveals shocking extent of exploitative formula milk marketing

28 Apr

Formula milk companies are paying social media platforms and influencers to gain direct access to pregnant women and mothers at some of the most vulnerable moments in their lives. The global formula milk industry, valued at some US$ 55 billion, is targeting new mothers with personalized social media content that is often not recognizable as advertising.

A new World Health Organization (WHO) report titled Scope and impact of digital marketing strategies for promoting breast-milk substitutes has outlined the digital marketing techniques designed to influence the decisions new families make on how to feed their babies.

Through tools like apps, virtual support groups or ‘baby-clubs’, paid social media influencers, promotions and competitions and advice forums or services, formula milk companies can buy or collect personal information and send personalized promotions to new pregnant women and mothers.

The report summarizes findings of new research that sampled and analyzed 4 million social media posts about infant feeding published between January and June 2021 using a commercial social listening platform. These posts reached 2.47 billion people and generated more than 12 million likes, shares or comments.

Formula milk companies post content on their social media accounts around 90 times per day, reaching 229 million users; representing three times as many people as are reached by informational posts about breastfeeding from non-commercial accounts. 

This pervasive marketing is increasing purchases of breast-milk substitutes and therefore dissuading mothers from breastfeeding exclusively as recommended by WHO.

“The promotion of commercial milk formulas should have been terminated decades ago,” said Dr Francesco Branca, Director of the WHO Nutrition and Food Safety department. “The fact that formula milk companies are now employing even more powerful and insidious marketing techniques to drive up their sales is inexcusable and must be stopped.”

The report compiled evidence from social listening research on public online communications and individual country reports of research that monitors breast-milk substitute promotions, as well as drawing on a recent multi-country study of mothers’ and health professionals’ experiences of formula milk marketing. The studies show how misleading marketing reinforces myths about breastfeeding and breast milk and undermines women’s confidence in their ability to breastfeed successfully. 

The proliferation of global digital marketing of formula milk blatantly breaches the International Code of Marketing of Breast-milk Substitutes (the Code), which was adopted by the 1981 World Health Assembly. The Code is a landmark public health agreement designed to protect the general public and mothers from aggressive marketing practices by the baby food industry that negatively impact breastfeeding practices.

Despite clear evidence that exclusive and continued breastfeeding are key determinants of improved lifelong health for children, women and communities, far too few children are breastfed as recommended. If current formula milk marketing strategies continue, that proportion could fall still further, boosting companies’ profits.

The fact that these forms of digital marketing can evade scrutiny from national monitoring and health authorities means new approaches to Code-implementing regulation and enforcement are required. Currently, national legislation may be evaded by marketing that originates beyond borders.

WHO has called on the baby food industry to end exploitative formula milk marketing, and on governments to protect new children and families by enacting, monitoring and enforcing laws to end all advertising or other promotion of formula milk products.

# # #

Notes to Editors

About the research

Evidence of exposure to and impact of digital breast-milk substitutes marketing was collected from several sources for this report. These include a systematic review of the literature, social listening research, a multi-country study of mothers’ and health professionals’ experience of breast-milk substitutes marketing, individual country reports of breast-milk substitutes promotions and an analysis of existing legal measures to implement the Code.

WHO created an external steering committee of experts from across WHO regions to advise on the design and methodology of the review and the report. Subject matter experts were selected for their expertise in social science, epidemiology, marketing, global health, nutrition, psychology and consumer behavior, human rights law, Code monitoring and implementation policy. Subject matter experts were drawn from all WHO regions, with the exception of the Eastern Mediterranean Region.

This is the first time WHO has used a social media intelligence platform to generate insight into the marketing practices of multi-national formula milk manufacturers and distributors. Social media intelligence platforms monitor social media for mentions of defined key words or phrases, which they gather, organize and analyze. This industry standard approach “listens” to the billions of daily exchanges and conversations that take place amongst social media users around the world and on other digital platforms, such as websites and forums.

This investigation captured digital interactions that occurred between 1 January and 30 June 2021, referenced infant feeding across 11 languages and 17 countries, which together account for 61% of the global population and span all six WHO regions.


About WHO

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 149 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. 

For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on TwitterFacebookInstagramLinkedInTikTokPinterestSnapchatYouTube and Twitch 

UNICEF and WHO warn of perfect storm of conditions for measles outbreaks, affecting children

27 Apr

 

An increase in measles cases in January and February 2022 is a worrying sign of a heightened risk for the spread of vaccine-preventable diseases and could trigger larger outbreaks, particularly of measles affecting millions of children in 2022, warn WHO and UNICEF.

Pandemic-related disruptions, increasing inequalities in access to vaccines, and the diversion of resources from routine immunization are leaving too many children without protection against measles and other vaccine-preventable diseases.

The risk for large outbreaks has increased as communities relax social distancing practices and other preventive measures for COVID-19 implemented during the height of the pandemic. In addition, with millions of people being displaced due to conflicts and crises including in Ukraine, Ethiopia, Somalia and Afghanistan, disruptions in routine immunization and COVID-19 vaccination services, lack of clean water and sanitation, and overcrowding increase the risk of vaccine-preventable disease outbreaks.

Almost 17 338 measles cases were reported worldwide in January and February 2022, compared to 9665 during the first two months of 2021. As measles is very contagious, cases tend to show up quickly when vaccination levels decline. The agencies are concerned that outbreaks of measles could also forewarn outbreaks of other diseases that do not spread as rapidly.

Apart from its direct effect on the body, which can be lethal, the measles virus also weakens the immune system and makes a child more vulnerable to other infectious diseases like pneumonia and diarrhoea, including for months after the measles infection itself among those who survive.  Most cases occur in settings that have faced social and economic hardships due to COVID-19, conflict or other crises, and have chronically weak health system infrastructure and insecurity.

“Measles is more than a dangerous and potentially deadly disease. It is also an early indication that there are gaps in our global immunization coverage, gaps vulnerable children cannot afford,” said Catherine Russell, UNICEF Executive Director. “It is encouraging that people in many communities are beginning to feel protected enough from COVID-19 to return to more social activities. But doing so in places where children are not receiving routine vaccination creates the perfect storm for the spread of a disease like measles.”  

In 2020, 23 million children missed out on basic childhood vaccines through routine health services, the highest number since 2009 and 3.7 million more than in 2019.

Top 5 countries with reported measles cases in the last 12 months, until April 2022 1
Country Reported Measles cases Rate per million cases First dose measles coverage (%), 20192First dose measles coverage (%), 20203
Somalia 9068 554 46 46
Yemen 3629 119 67 68
Afghanistan 3628 91 64 66
Nigeria 12 341 58 54 54
Ethiopia 3039 26 60 58

As of April 2022, the agencies report 21 large and disruptive measles outbreaks around the world in the last 12 months. Most of the measles cases were reported in Africa and the East Mediterranean region. The figures are likely higher as the pandemic has disrupted surveillance systems globally, with potential underreporting.

Countries with the largest measles outbreaks since the past year include Somalia, Yemen, Nigeria, Afghanistan and Ethiopia. Insufficient measles vaccine coverage is the major reason for outbreaks, wherever they occur.

“The COVID-19 pandemic has interrupted immunization services, health systems have been overwhelmed, and we are now seeing a resurgence of deadly diseases including measles. For many other diseases, the impact of these disruptions to immunization services will be felt for decades to come,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Now is the moment to get essential immunization back on track and launch catch-up campaigns so that everybody can have access to these life-saving vaccines.”

As of 1 April 2022, 57 vaccine-preventable disease campaigns in 43 countries that were scheduled to take place since the start of the pandemic are still postponed, impacting 203 million people, most of whom are children. Of these, 19 are measles campaigns, which put 73 million children at risk of measles due to missed vaccinations. In Ukraine, the measles catch-up campaign of 2019 was interrupted due to the COVID-19 pandemic and thereafter due to the war. Routine and catch-up campaigns are needed wherever access is possible to help make sure there are not repeated outbreaks as in 2017–2019, when there were over 115 000 cases of measles and 41 deaths in the country – this was the highest incidence in Europe.

Coverage at or above 95% with 2 doses of the safe and effective measles vaccine can protect children against measles. However, COVID-19 pandemic related disruptions have delayed the introduction of the second dose of the measles vaccine in many countries.

As countries work to respond to outbreaks of measles and other vaccine-preventable diseases, and recover lost ground, UNICEF and WHO, along with partners such as Gavi, the Vaccine Alliance, the partners of the Measles & Rubella Initiative (M&RI), Bill & Melinda Gates Foundation and others are supporting efforts to strengthen immunization systems by:

  • restoring services and vaccination campaigns so countries can safely deliver routine immunization programmes to fill the gaps left by the backsliding;
  • helping health workers and community leaders communicate actively with caregivers to explain the importance of vaccinations;
  • rectifying gaps in immunization coverage, including identifying communities and people who have been missed during the pandemic;
  • ensuring that COVID-19 vaccine delivery is independently financed and well-integrated into overall planning for immunization services so that it is not carried out at the cost of childhood and other vaccination services; and
  • implementing country plans to prevent and respond to outbreaks of vaccine-preventable diseases and strengthening immunization systems as part of COVID-19 recovery efforts.

__________________________________________________

Source: Provisional data based on monthly data reported to WHO as of April 2022

2 Source: WHO/UNICEF estimates of national immunization coverage, 2020 revision.

3 Source: WHO/UNICEF estimates of national immunization coverage, 2020 revision.

 

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About UNICEF

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children, visit www.unicef.org.

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About WHO

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, 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 well-being. 

Visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube and Twitch.



 

 

WHO recommends highly successful COVID-19 therapy and calls for wide geographical distribution and transparency from originator

21 Apr

Today, WHO made a strong recommendation for nirmatrelvir and ritonavir, sold under the name Paxlovid, for mild and moderate COVID-19 patients at highest risk of hospital admission, calling it the best therapeutic choice for high-risk patients to date. However, availability, lack of price transparency in bilateral deals made by the producer, and the need for prompt and accurate testing before administering it, are turning this life-saving medicine into a major challenge for low- and middle-income countries.

Pfizer’s oral antiviral drug (a combination of nirmatrelvir and ritonavir tablets) is strongly recommended for patients with non-severe COVID-19 who are at highest risk of developing severe disease and hospitalization, such as unvaccinated, older, or immunosuppressed patients.

This recommendation is based on new data from two randomized controlled trials involving 3078 patients. The data show that the risk of hospitalization is reduced by 85% following this treatment. In a high-risk group (over 10% risk of hospitalization), that means 84 fewer hospitalizations per 1000 patients.

WHO suggests against its use in patients at lower risk, as the benefits were found to be negligible.

One obstacle for low- and middle-income countries is that the medicine can only be administered while the disease is at its early stages; prompt and accurate testing is therefore essential for a successful outcome with this therapy. Data collected by FIND show that the average daily testing rate in low-income countries is as low as one-eightieth the rate in high-income countries. Improving access to early testing and diagnosis in primary health care settings will be key for the global rollout of this treatment.

WHO is extremely concerned that -- as occurred with COVID-19 vaccines -- low- and middle-income countries will again be pushed to the end of the queue when it comes to accessing this treatment.

Lack of transparency on the part of the originator company is making it difficult for public health organizations to obtain an accurate picture of the availability of the medicine, which countries are involved in bilateral deals and what they are paying. In addition, a licensing agreement made by Pfizer with the Medicines Patent Pool limits the number of countries that can benefit from generic production of the medicine.

The originator product, sold under the name Paxlovid, will be included in the WHO prequalification list  today, but generic products are not yet available from quality-assured sources. Several generic companies (many of which are covered by the licensing agreement between the Medicines Pool and Pfizer) are in discussion with WHO Prequalification but may take some time to comply with international standards so that they can supply the medicine internationally.

WHO therefore strongly recommends that Pfizer make its pricing and deals more transparent and that it enlarge the geographical scope of its licence with the Medicines Patent Pool so that more generic manufacturers may start to produce the medicine and make it available faster at affordable prices.

Along with the strong recommendation for the use of nirmatrelvir and ritonavir, WHO has also updated its recommendation on remdesivir, another antiviral medicine.

Previously, WHO had suggested against its use in all COVID-19 patients regardless of disease severity, due to the totality of the evidence at that time showing little or no effect on mortality. Following publication of new data from a clinical trial looking at the outcome of admission to hospital, WHO has updated its recommendation. WHO now suggests the use of remdesivir in mild or moderate COVID-19 patients who are at high risk of hospitalization.

The recommendation for use of remdesivir in patients with severe or critical COVID-19 is currently under review.

Walk the Talk is back in Place des Nations this year – here’s how we’re doing it safely

21 Apr

The Walk the Talk event returns on Sunday, 22 May 2022 to Geneva, Switzerland on the morning of the 75th World Health Assembly. WHO is joining with the UN family and the Geneva community to celebrate the importance of healthy lifestyles and demonstrate measures to safely conduct public events.

The third edition of the Walk the Talk: The Health for All Challenge, and the first since the onset of the COVID-19 pandemic, the event is an opportunity to gather safely and to promote solidarity and a health lifestyle.

There is no “zero risk” when it comes to any kind of gathering – especially events that bring groups of people together. Regardless of the size of the event, we are at risk from COVID-19 whenever we get together with people.

Safety precautions will be taken for this event including the following measures:

  • Proper crowd management including safe distancing - employing physical barriers (cones, ropes, poles, etc.) to maintain distance between people, separating accesses and way outs, adopting one-way pathways and corridors to enforce unidirectional flow, establishing spacious waiting areas to complement crowd control measures.
  • Adequate ventilation of spaces, either by natural means or mechanical means (i.e. by supplying air to or removing air from an indoor space by powered air movement components)
  • Ensuring availability of handwashing facilities with water and soap and/or hand sanitizer dispensers
  • Availability of close bins to ensure safe disposal of water bottles and other items
  • Make available public health and safely measure messages on the website and onsite for prospective participants
  • Train volunteers and inform them on what is expected from them, especially if they will be required of actively disseminate health messages or enforce any PHSM


Participants are also advised to observe the following health protocols:

  • If you don’t feel well, show any symptoms suggestive of COVID-19, or test positive for COVID-19, stay home.
  • Get the COVID-19 vaccine as soon as it’s your turn.
  • If you choose to attend a public event, always follow precautionary measures, regardless of your COVID-19 vaccination status or history of prior infection.
  • Keep at least a 1-metre distance from others at all times.
  • Wear a well-fitting mask that covers the nose and mouth when physical distancing of at least 1-metre is not possible and in poorly ventilated indoor settings.
  • Do not remove the mask to speak.
  • Avoid crowded or poorly ventilated areas
  • When coughing and sneezing - cover with bent elbow or tissues.
  • Clean your hands frequently with alcohol-based hand rub or wash with soap & water


To learn more and register, go to www.who.int/global-walk-the-talk

Over 1 million African children protected by first malaria vaccine

19 Apr

As World Malaria Day approaches, more than 1 million children in Ghana, Kenya and Malawi have received one or more doses of the world’s first malaria vaccine, thanks to a pilot programme coordinated by WHO. The malaria vaccine pilots, first launched by the Government of Malawi in April 2019, have shown that the RTS,S/AS01 (RTS,S) vaccine is safe and feasible to deliver, and that it substantially reduces deadly severe malaria. 

These findings paved the way for the historic October 2021 WHO recommendation for the expanded use of RTS,S among children living in settings with moderate to high malaria transmission. If widely deployed, WHO estimates that the vaccine could save the lives of an additional 40 000 to 80 000 African children each year. 

More than US$ 155 million has been secured from Gavi, the Vaccine Alliance to support the introduction, procurement and delivery of the malaria vaccine for Gavi-eligible countries in sub-Saharan Africa. WHO guidance is available to countries as they consider whether and how to adopt RTS,S as an additional tool to reduce child illness and deaths from malaria.

“As a malaria researcher in my early career, I dreamed of the day we would have an effective vaccine against this devastating disease,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This vaccine is not just a scientific breakthrough, it’s life-changing for families across Africa. It demonstrates the power of science and innovation for health. Even so, there is an urgent need to develop more and better tools to save lives and drive progress towards a malaria-free world.”

Prospects for new interventions

RTS,S is a first-generation vaccine that could be complemented in the future by other vaccines with similar or higher efficacy. WHO welcomes progress in the development of R21/Matrix-M and other malaria vaccine candidates in early clinical development. The successful completion of clinical trials for these vaccines will be important to assess their safety and efficacy profiles. WHO also welcomes the news from BioNTech, manufacturer of the Pfizer-BioNTech COVID-19 vaccine, that it aims to develop a malaria vaccine using mRNA technology. 

In the field of vector control, a number of new tools and technologies have been submitted to WHO for evaluation. Should they demonstrate efficacy in controlling the disease, WHO will formulate new recommendations or amend existing ones to support their deployment. These include, for example, new types of insecticide-treated nets, spatial mosquito repellents, gene-drive approaches and sugar baits designed to attract and kill Anopheles mosquitoes. 

There are also new medicines in the pipeline. WHO welcomes the recent approval by the Australian Therapeutic Goods Administration of dispersible tablets of single-dose tafenoquine for the prevention of P. vivax malaria among children. Tafenoquine has also been approved for use in adults by the US Federal Drug Administration and by drug regulatory bodies in other countries, including Brazil, Peru and Thailand. As a single dose, tafenoquine is expected to support patient adherence to treatment. The current standard of care requires a 7- or 14-day course of medication. 

A number other antimalarial medicines with new modes of action are being developed for the treatment of uncomplicated and severe malaria. Ganaplacide-Lumefantrine, currently in a Phase II clinical trial, is the first non-artemisinin combination therapy and could be an asset in fight against emerging drug-resistant malaria in Africa.

In addition to drug resistance, WHO has reported other pressing threats in the fight against malaria, such as mosquito resistance to insecticides, an invasive malaria vector that thrives in urban and rural areas, and the emergence and spread of mutated P. falciparum parasites that are undermining the effectiveness of rapid diagnostic tests. Innovation in tools and strategies will be critical to contain these threats, together with a more strategic use of the tools that are available today.

More investment needed

According to the 2021 World malaria report, global progress in reducing malaria cases and deaths has slowed or stalled in recent years, particularly in countries hardest hit by the disease. The report notes the need for continued innovation in the research and development of new tools if the world is to achieve the 2030 targets of the WHO malaria strategy.

Funding for malaria-related research and development reached just over US$ 619 million in 2020. An average annual R&D investment of US$ 851 million will be needed in the period 2021–2030.

Making better use of the tools we have now

Reaching global malaria targets will also require innovations in the way that currently available tools are deployed. Through the “ High burden to high impact” approach, launched by WHO and the RBM Partnership to End Malaria in 2018, countries hardest hit by malaria have been collecting and analysing malaria data to better understand the geographical spread of the disease. 

Instead of applying the same approach to malaria control everywhere, they are considering the potential impact of tailored packages of interventions informed by local data and the local disease setting. These analyses will enable countries to use available funds in a more effective, efficient and equitable way.

Note to the editor:

For more information on the WHO World Malaria Day campaign, visit:  https://www.who.int/campaigns/world-malaria-day/2022

More on the RTS,S malaria vaccine and the pilot programme

WHO guidance is now available to countries as they consider whether and how to adopt the RTS,S vaccine into their national malaria control strategies. The WHO recommendation for the vaccine was recently added to WHO’s consolidated malaria guidelines, and WHO has also published an updated position paper on the vaccine.

To date, in routine use, the vaccine has been well accepted by African communities. Demand for the vaccine is expected to outstrip supply in the near to medium term; current vaccine production capacity stands at a maximum of 15 million doses per year, while demand is estimated to exceed 80 million doses annually. 

WHO is working with partners to increase supply through increased manufacturing capacity of RTS,S and by facilitating the development of other first-generation and next-generation malaria vaccines. To guide where initial doses of the vaccine will be deployed, WHO is coordinating the development of a framework for the allocation of limited malaria vaccine supply; the aim is to prioritize areas of greatest need and highest malaria burden until supply meets demand. 

The RTS,S pilot programme is made possible by an unprecedented collaboration between in-country and international partners, including Ministries of Health of Ghana, Kenya and Malawi; in-country evaluation partners; PATH, GSK, UNICEF and others; and the funding bodies of Gavi, the Global Fund and Unitaid. 

The RTS,S malaria vaccine is the result of 30 years of research and development by GSK and through a partnership with PATH, with support from a network of African research centres.