WHO updates critical medicines list for radiological and nuclear emergencies

24 Jan

The World Health Organization (WHO) today updated its list of medicines that should be stockpiled for radiological and nuclear emergencies, along with policy advice for their appropriate management. These stockpiles include medicines that either prevent or reduce exposure to radiation, or treat injuries once exposure has occurred.

“In radiation emergencies, people may be exposed to radiation at doses ranging from negligible to life-threatening. Governments need to make treatments available for those in need – fast,” said Dr Maria Neira, WHO Acting Assistant Director-General a.i, Healthier Populations Division. “It is essential that governments are prepared to protect the health of populations and respond immediately to emergencies. This includes having ready supplies of lifesaving medicines that will reduce risks and treat injuries from radiation.” 

Key highlights

  • This publication supersedes the 2007 WHO report on the development of national stockpiles for radiation emergencies. It includes updated information on the stockpile formulary based on the developments in radiation emergency medicine in the last decade.
  • It provides policy advice for acquisition of drugs which can prevent or reduce radionuclides uptake or increase elimination of radionuclides from the human body.
  • It looks at the main elements required for developing, maintaining and managing the national stockpiles of specific medical supplies which will be required for radiological and nuclear emergencies. 
  • The report looks at the role of national health authorities in stockpile development as well as the role of WHO. As the leading international organization in public health with both the authority and responsibility to assist in health emergencies, WHO provides advice and guidance to countries on public health preparedness and response to radiation emergencies, including stockpile development. In health emergencies WHO may assist in procuring or sharing medical supplies among countries.
  • This report includes a brief review of selected emerging technologies and drug formulations, including potential repurposing of products previously approved for other indications.
  • Finally, the publication provides examples of practices in establishing and managing a national stockpile in selected countries, namely Argentina, Brazil, France, Germany, Japan, Republic of Korea, Russian Federation and USA.

“This updated critical medicines list will be a vital preparedness and readiness tool for our partners to identify, procure, stockpile and deliver effective countermeasures in a timely fashion to those at risk or exposed in these events,” said Dr Mike Ryan, Executive Director of WHO’s Health Emergencies Programme.

Typically, a national stockpile for all-hazards health emergencies would include generic supplies and materials used for any type of emergencies, such as personal protective equipment (PPE), trauma kits, fluids, antibiotics and painkillers. This publication includes only specific drugs which are known and licensed today to prevent or treat human over-exposure to radiation.

Radiological and nuclear emergencies may result in exposure to radiation doses high enough to lead to severe health consequences or even death. It is therefore extremely important that governments respond rapidly to such threats. Many countries, however, still lack the essential elements of preparedness for radiation emergencies, according to annual reporting to the WHO Secretariat.

Potential scenarios considered in the publication include radiological or nuclear emergencies at nuclear power plants, medical or research facilities, or accidents during transport of radioactive materials, as well as intentional uses of radioactive materials with malicious intent.

Components of a pharmaceutical stockpile for radiation emergencies

This publication focuses on pharmaceuticals for treating radiation exposure and addresses the governance and management of such a stockpile. A typical radiation emergency stockpile will include the following medicines:

  • Stable iodine, administered to prevent or reduce the exposure of the thyroid to radioactive iodine;
  • Chelating sand decorporating agents (Prussian blue, applied to remove radioactive caesium from the body and calcium- / zinc-DTPA used to treat internal contamination with transuranium radionuclides);
  • Cytokines used for mitigation of damage to the bone marrow, in case of acute radiation syndrome (ARS); and
  • Other medicines used to treat vomiting, diarrhoea and infections.

Emerging treatments and countermeasures also discussed in the report give insight to the future medical countermeasures that could be used for managing patients overexposed to radiation. In particular, studies identifying new cellular and molecular pathways and means of administrating drugs may be exploited for novel treatments and new products for use during a radiation emergency.

Emergency preparedness, response and recovery saves lives

Coordination of local, national and international responses is essential for a harmonized response to radiation emergencies. As the agency responsible for guiding healthcare interventions globally, WHO provides advice and ensures access to medicines and health services for countries that are developing national capacity for preparedness and response to radiation emergencies. 

More information

WHO’s global expert network, REMPAN

WHO’s global expert network, REMPAN (Radiation Emergency Medical Preparedness and Assistance Network), is an important asset of the Organization for implementing its work on providing technical guidance and tools for response, delivering activities for building capacity through education and training, and on promoting international cooperation and information-sharing between the members of the network and the professional community in the field of radiation emergency medicine.

WHO is a member of ICARNE, the Inter-Agency Committee on Radiological and Nuclear Emergencies, which provides the coordination mechanism between 20 international organizations with relevant mandates. Members of IACRNE develop, maintain and co-sponsor the Joint Radiation Emergency Management Plan of the International Organizations (JPlan 2017). The JPlan describes a common understanding of each organization’s roles in making preparedness arrangements and during a response and recovery.

WHO launches funding appeal to help a record number of people in complex, intersecting health emergencies

23 Jan

WHO is launching its 2023 health emergency appeal today for US$ 2.54 billion to provide assistance to millions of people around the world facing health emergencies. The number of people in need of humanitarian relief has increased by almost a quarter compared to 2022, to a record 339 million.

Currently, WHO is responding to an unprecedented number of intersecting health emergencies: climate change-related disasters such as flooding in Pakistan and food insecurity across the Sahel and in the greater Horn of Africa; the war in Ukraine; and the health impact of conflict in Yemen, Afghanistan, Syria and northern Ethiopia – all of these emergencies overlapping with the health system disruptions caused by the COVID-19 pandemic and outbreaks of measles, cholera, and other killers.

“This unprecedented convergence of crises demands an unprecedented response,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “More people than ever before face the imminent risk of disease and starvation and need help now. The world cannot look away and hope these crises resolve themselves. I urge donors to be generous and help WHO to save lives, prevent the spread of disease within and across borders, and support communities as they rebuild."

WHO is currently responding to 54 health crises around the world, 11 of which are classified as Grade 3, WHO’s highest level of emergency, requiring a response at all three levels of the organization. As it is often the case, the most vulnerable are the worst hit.

In 2022, WHO provided medicines, other supplies, training for doctors and other health workers, vaccines, enhanced disease surveillance, mobile clinics, mental health support, maternal health consultations and much more. WHO delivers cost-effective, high-impact responses that protect health, lives and livelihoods. Every US$ 1 invested in WHO generates at least US$ 35 in return on investment*.

WHO responds to health emergencies in close collaboration with Member States, other UN agencies, non-governmental organizations, civil society organizations and other partners in the communities and across countries and regions.

The appeal will be launched at an event from WHO’s Headquarters in Geneva, hosted by WHO’s Director-General, Dr Tedros Adhanom Ghebreyesus. It will be webcast from this page, and on WHO’s YouTube channel, Twitter, LinkedIn.

Resources

Note to editors:

WHO is responding to Grade 3 health emergencies in Afghanistan, the Democratic Republic of the Congo, the greater Horn of Africa, Northern Ethiopia, Somalia, South Sudan, the Syrian Arab Republic, Ukraine, and Yemen. The COVID-19 pandemic and mpox (monkeypox) outbreaks are also Grade 3 emergencies. See more about health emergencies.

*A Healthy Return. Investment case for a sustainably financed WHO, May 2022.

Five billion people unprotected from trans fat leading to heart disease

23 Jan

Five billion people globally remain unprotected from harmful trans fat, a new status report from WHO has found, increasing their risk of heart disease and death.

Since WHO first called for the global elimination of industrially produced trans fat in 2018 – with an elimination target set for 2023 – population coverage of best-practice policies has increased almost six-fold. Forty-three countries have now implemented best-practice policies for tackling trans fat in food, with 2.8 billion people protected globally.

Despite substantial progress, however, this still leaves 5 billion worldwide at risk from trans fat’s devastating health impacts with the global goal for its total elimination in 2023 remaining unattainable at this time.

Industrially produced trans fat (also called industrially produced trans-fatty acids) is commonly found in packaged foods, baked goods, cooking oils and spreads. Trans fat intake is responsible for up to 500 000 premature deaths from coronary heart disease each year around the world.

“Trans fat has no known benefit, and huge health risks that incur huge costs for health systems,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “By contrast, eliminating trans fat is cost effective and has enormous benefits for health. Put simply, trans fat is a toxic chemical that kills, and should have no place in food. It’s time to get rid of it once and for all.”

Currently, 9 of the 16 countries with the highest estimated proportion of coronary heart disease deaths caused by trans fat intake do not have a best-practice policy. They are Australia, Azerbaijan, Bhutan, Ecuador, Egypt, Iran (Islamic Republic of), Nepal, Pakistan and Republic of Korea.

Best-practices in trans fat elimination policies follow specific criteria established by WHO and limit industrially produced trans fat in all settings. There are two best-practice policy alternatives: 1) mandatory national limit of 2 grams of industrially produced trans fat per 100 grams of total fat in all foods; and 2) mandatory national ban on the production or use of partially hydrogenated oils (a major source of trans fat) as an ingredient in all foods.

“Progress in eliminating trans fat is at risk of stalling, and trans fat continues to kill people,” said Dr Tom Frieden, President and CEO of Resolve to Save Lives. “Every government can stop these preventable deaths by passing a best-practice policy now. The days of trans fat killing people are numbered – but governments must act to end this preventable tragedy."

While most trans fat elimination policies to date have been implemented in higher-income countries (largely in the Americas and in Europe), an increasing number of middle-income countries are implementing or adopting these policies, including Argentina, Bangladesh, India, Paraguay, Philippines and Ukraine. Best-practice policies are also being considered in Mexico, Nigeria and Sri Lanka in 2023. If passed, Nigeria would be the second and most populous country in Africa to put a best-practice trans fat elimination policy in place. No low-income countries have yet adopted a best-practice policy to eliminate trans fat.

In 2023, WHO recommends that countries focus on these four areas: adopting best-practice policy, monitoring and surveillance, healthy oil replacements and advocacy. WHO guidance has been developed to help countries make rapid advances in these areas.

WHO also encourages food manufacturers to eliminate industrially produced trans fat from their products, aligning to the commitment made by the International Food and Beverage Alliance (IFBA). Major suppliers of oils and fats are asked to remove industrially produced trans fat from the products sold to food manufacturers globally.

The report, called Countdown to 2023 WHO Report on global trans fat elimination 2022, is an annual status report published by WHO in collaboration with Resolve to Save Lives, to track progress towards the goal of trans fat elimination in 2023.

 

For editors:

The World Health Organization has partnered with Resolve to Save Lives, a not-for-profit organization, to support the development and implementation of the REPLACE action package. Launched in 2018, the WHO’s REPLACE action package provides a strategic approach to eliminating industrially produced trans fat from national food supplies.

Since 2017, Bloomberg Philanthropies has supported Resolve to Save Lives’ global efforts to save lives from cardiovascular health disease.   

To find out more, visit: https://www.resolvetosavelives.org or Twitter @ResolveTSL  

 

WHO urges action to protect children from contaminated medicines

21 Jan

WHO is releasing an urgent call to action to countries to prevent, detect and respond to incidents of substandard and falsified medical products.

Over the past four months, countries have reported on several incidents of over-the-counter cough syrups for children with confirmed or suspected contamination with high levels of diethylene glycol (DEG) and ethylene glycol (EG). The cases are from at least seven countries, associated with more than 300 fatalities in three of these countries. Most are young children under the age of five. These contaminants are toxic chemicals used as industrial solvents and antifreeze agents that can be fatal even taken in small amounts, and should never be found in medicines.

Based on country reports, WHO has issued three global medical alerts addressing these incidents. The  Medical Product Alert N°6/2022 on 5 October 2022 focused on the outbreak in the Gambia, Medical Product Alert N°7/2022 on 6 November 2022 focused on Indonesia, and Medical Product Alert No1/2023 on 11 January 2023 focused on Uzbekistan.

WHO’s medical product alerts were rapidly disseminated to the national health authorities of all 194 WHO Member States.  These medical product alerts requested, inter alia: (a) the detection and removal of contaminated medicines from circulation in the markets, (b) increased surveillance and diligence within the supply chains of countries and regions likely to be affected, (c) immediate notification to WHO if these substandard products are discovered in-country; and otherwise inform the public of the dangers and toxic effects of the substandard medicines at issue.

Since these are not isolated incidents WHO calls on various key stakeholders engaged in the medical supply chain to take immediate and coordinated action.

WHO calls on regulators and governments to: 

  • detect and remove from circulation in their respective markets any substandard medical products that have been identified in the WHO medical alerts referred to above as potential causes of deaths and disease;  
  • ensure that all medical products in their respective markets are approved for sale by competent authorities and obtainable from authorized/licensed suppliers;
  • assign appropriate resources to improve and increase risk-based inspections of manufacturing sites within their jurisdiction in accordance with international norms and standards;
  • increase market surveillance including risk-based targeted testing for medical products released in their respective markets including informal markets; and
  • enact and enforce, where relevant and as appropriate, laws and other relevant legal measures to help combat the manufacture, distribution and/or use of substandard and falsified medicines.

WHO calls on manufacturers of medicines to:

  • only purchase pharmaceutical grade excipients from qualified and bona fide suppliers;
  • conduct comprehensive testing upon receipt of supplies and before use in manufacture of finished products;
  • provide assurance of product quality including through certificates of analyses based on appropriate testing results; and
  • keep accurate, complete and proper records of purchase of materials, testing, manufacture, and distribution to facilitate traceability during investigations in case of incidents.

WHO urges all suppliers and distributors of medical products to:

  • always check for signs of falsification and physical condition of medicines and other health products they distribute and/or sell;
  • only distribute and/or sell medicines authorized by, and from sources approved by, competent authorities;
  • keep accurate, complete and proper records relating to the medicines and their distribution and/or sale; and
  • engage competent personnel to handle medicines and provide advice to the public on appropriate use of the medicines.

In addition, WHO will continue to work with the Member State Mechanism on substandard and falsified medical products in implementing its mandate to promote effective collaboration in the prevention, detection and response to substandard and falsified medical products to save lives.

Small Island Developing States accelerate action to tackle biggest killers

18 Jan

The Government of Barbados, the World Health Organization (WHO) and the Pan American Health Organization are holding a high-level technical meeting on noncommunicable diseases (NCDs) and mental health with Small Island Developing States (SIDS). The discussion focusses on progress, challenges, and opportunities to scale up multi-sector actions on NCDs and mental health and to set out recommendations to scale up actions that save and improve lives.

For this occasion, WHO has released a data portal on NCDs in SIDS highlighting some of the highest prevalence rates of NCD and mental health risks in the world. The data shows that over half of people in SIDS are dying prematurely from NCDs and the rate of hypertension is over 30% in almost all of the countries.

Ten of the countries with the highest rates of obesity worldwide are small island states. The highest prevalence of diabetes among adults in the world is also projected to be in SIDS. Rates of mental health conditions reach as high as 15% in the Caribbean and the Pacific.

“Countries are facing multiple overlapping crises. The climate crisis and the COVID-19 pandemic, combined with poverty, unemployment, inequality and the marginalization of minority communities are fuelling an increase in noncommunicable diseases and mental health conditions,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “To address these challenges, we need to hear from affected communities about the challenges they face and the solutions that work in diverse settings. We look forward to working with SIDS to achieve ambitious outcomes on NCDs and mental health.” 

SIDS countries are disproportionately exposed to the impact of the climate crisis on both physical and mental health. The high prevalence of risk factors for NCDs such as tobacco use, low physical activity, unhealthy diet and obesity, coupled with weak integration of NCDs and mental health services in Primary Health Care (PHC) and Universal Health Coverage (UHC), left populations vulnerable to becoming severely ill with COVID-19. This placed further pressure on already strained health systems. Progress and investment in NCD prevention and control, as well as mental health promotion and care, remain inadequate.

“SIDS have a history of dealing with outsized challenges, shaping solutions and influencing the world agenda to advance development,” said the Minister of Health and Wellness of Barbados, the Honourable Dr Jerome Walcott. “We have identified the issues and drivers, while committing to action, mobilizing resources, and collaborating with non-traditional partners. We must critically examine the initiatives that address NCDs and that have the potential to positively impact and improve the health and well-being of our citizens.”

At the high-level meeting, countries have identified key recommendations to scale up action on NCDs and mental health to achieve the SDG target of a one third reduction in premature mortality from NCDs and suicide before 2030.

The recommendations include concrete actions to accelerate collaboration for the early detection, prevention and management of NCDs and mental health conditions across SIDS; strengthening health systems in the face of the climate crisis and the COVID-19 pandemic; promoting health and preventing NCDs with a focus on tackling obesity; providing adequate, sustainable resources (financial and human) for NCDs and mental health; and strengthening information systems for health. These recommendations will also inform the outcome document to the Ministerial Meeting in June 2023. 

The meeting also heard that SIDS are at the forefront of rolling out low-cost, high-impact solutions to reduce the most common risk factors of NCDs and mental health. Examples of successful prevention and treatment interventions in SIDS countries include the use of health taxation; including health into climate change adaptation and mitigation efforts; campaigns on physical and mental health and wellbeing; expanding treatment coverage for NCD and mental health as a part of the national UHC effort; and maintaining NCD and mental health services during health emergencies.

The meeting also provided a platform to address commercial drivers of NCDs. Trade agreements and policies, through their influences on price, availability and promotion of food products, cigarettes, and alcohol, have accelerated the transition away from traditional diets and nutrition. This process has contributed to the alarmingly high levels of obesity, food insecurity and NCDs in SIDS countries.

People living with NCDs and mental health conditions in several SIDS countries shared their experiences. Healthcare professionals, civil society representatives, academics and development partners also joined the meeting.

“Achieving UHC and building climate-resilient societies will be critical in tackling the risk factors of NCDs and mental health, as well as ensuring people living with these conditions can access the treatment and support they need,” said Dr Bente Mikkelsen. “Based on the outcomes of this meeting, the forthcoming Ministerial Meeting in June 2023 will set out an ambitious agenda to accelerate the capacity of SIDS countries to deliver life-saving NCD and mental health outcomes and to provide the global leadership for the NCDs and mental health agenda.”

This agenda will also inform and contribute to preparations for the High-Level Meeting of the UN General Assembly on UHC in 2023, the Fourth High-Level Meeting of the UN General Assembly on NCDs to be held in 2025 and future global health summits on mental health and climate change.

 

 

WHO announces plans to establish a TB Vaccine Accelerator council

16 Jan

The adverse impact of the COVID-19 pandemic on tuberculosis (TB) services has brought the urgency of vaccine development efforts into sharp focus. Speaking earlier today at a high-level panel on TB at the World Economic Forum, Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, announced plans to establish a new TB Vaccine Accelerator Council.

The Council will facilitate the licensing and use of effective novel TB vaccines catalysing high-level alignment between funders, global agencies, governments and end users in identifying and overcoming barriers to TB vaccine development.

“One of the most important lessons from the response to the COVID-19 pandemic is that innovative  health interventions can be delivered fast if they are prioritized politically and financed adequately”, said Dr Tedros Adhanom Ghebreyesus. “The challenges presented by TB and COVID-19 are different, but the ingredients that accelerate science, research and innovation are the same: urgent, up-front public investment; support from philanthropy; and engagement of the private sector and communities. We believe the TB field will benefit from similar high-level coordination.”

Despite countries making bold commitments to end TB by 2030, in the Sustainable Development Goals, the WHO End TB Strategy and the 2018 political declaration on the fight against TB, the epidemic shows no sign of slowing down. In 2021, approximately 10.6 million people fell sick with TB, and 1.6 million died. Drug-resistance continues to be a major problem with close to half a million people developing drug-resistant TB every year.

BCG is currently the only licensed TB vaccine. While it provides moderate efficacy in preventing severe forms of TB in infants and young children, it does not adequately protect adolescents and adults, who account for close to 90% of TB transmissions globally.

A recent WHO commissioned study, An investment case for new tuberculosis (TB) vaccines estimates that, over 25 years, a vaccine that is 50% effective in preventing disease among adolescents and adults could avert up to 76 million new TB cases, 8.5 million deaths, 42 million courses of antibiotic treatment and US$ 6.5 billion in costs faced by TB affected households, especially for the poorest and most vulnerable.

A vaccine that is 75% effective could avert up to 110 million new TB cases and 12.3 million deaths. The study further suggests that every US$ 1 invested in a 50% effective vaccine could generate an economic return of US$ 7 in terms of averted health costs and increased productivity.

Later this year, Heads of States and Governments will meet for a second United Nations High-Level Meeting on TB to review progress against commitments made in the 2018 political declaration. This presents an important opportunity to correct setbacks in the TB response, which includes the urgent development and delivery of new TB vaccines.  

 

WHO welcomes data on COVID-19 in China, meeting with Minister

14 Jan

Earlier today, WHO Director-General Dr Tedros Adhanom Ghebreyesus spoke with Minister Ma Xiaowei, director of China’s National Health Commission, about the COVID-19 situation in the country. WHO appreciates this meeting, as well as the public release of information on the overall situation.  

Chinese officials provided information to WHO and in a press conference on a range of topics, including outpatient clinics, hospitalizations, patients requiring emergency treatment and critical care, and hospital deaths related to COVID-19 infection.   

WHO is analysing this information, which covers early December 2022 to 12 January 2023, and allows for a better understanding of the epidemiological situation and the impact of this wave in China. WHO requested that this type of detailed information continue to be shared with us and the public. WHO notes the efforts by Chinese authorities to scale up clinical care for its population at all levels, including in critical care. 

The overall epidemiology – reflecting a rapid and intense wave of disease caused by known sub-variants of Omicron with higher clinical impact on older people and those with underlying conditions – is similar to waves of infection experienced by other countries, as is the increased pressure on health services. The reported data indicate a decline in case numbers, hospitalizations, and those requiring critical care. WHO has requested a more detailed breakdown of data by province over time.   

While the Chinese Center for Disease Control and Prevention has earlier reported that Omicron sublineages BA.5.2 and BF.7 are currently circulating, WHO continues to ask that further sequences be shared with open access databases such as GISAID for deeper phylogenetic analyses, and for continued collaboration with technical groups working on virus evolution, clinical care, and beyond.    

WHO will continue to work with China, providing technical advice and support, and engaging on analysing the situation. On the call today, Dr Tedros also reiterated the importance of China’s deeper cooperation and transparency on understanding the origins of the COVID-19 pandemic, and in carrying out the recommendations detailed in the report of the Strategic Advisory Group for the Origins of Novel Pathogens. 

 

 

WHO updates COVID-19 guidelines on masks, treatments and patient care

13 Jan

WHO has updated its guidelines on mask wearing in community settings, COVID-19 treatments, and clinical management. This is part of a continuous process of reviewing such materials, working with guideline development groups composed of independent, international experts who consider the latest available evidence and the changing epidemiology.

Masks continue to be a key tool against COVID-19

WHO continues to recommend the use of masks by the public in specific situations, and this update recommends their use irrespective of the local epidemiological situation, given the current spread of the COVID-19 globally. Masks are recommended following a recent exposure to COVID-19, when someone has or suspects they have COVID-19, when someone is at high-risk of severe COVID-19, and for anyone in a crowded, enclosed, or poorly ventilated space. Previously, WHO recommendations were based on the epidemiological situation.

Similar to previous recommendations, WHO advises that there are other instances when a mask may be suggested, based on a risk assessment. Factors to consider include the local epidemiological trends or rising hospitalization levels, levels of vaccination coverage and immunity in the community, and the setting people find themselves in.

Reduced isolation period for COVID-19 patients

For patients with symptoms, the new guidelines suggest 10 days of isolation from the date of symptom onset. Previously, WHO advised that patients be discharged 10 days after symptom onset, plus at least three additional days since their symptoms had resolved.

For those who test positive for COVID-19 but do not have any signs or symptoms, WHO now suggests 5 days of isolation compared to 10 days previously.

The patient can be discharged from isolation early if they test negative on an antigen-based rapid test.

Isolation of people with COVID-19 is an important step in preventing others from being infected. This can be done at home or at a dedicated facility, such as a hospital or clinic.

The evidence considered by the guideline development group showed that people without symptoms are much less likely to transmit the virus than those with symptoms. Although of very low certainty, evidence also showed that people discharged at day 5 following symptom onset risked infecting three times more people than those discharged at day 10.

Review of COVID-19 treatments

WHO has extended its strong recommendation for the use of nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’).

Pregnant or breastfeeding women with non-severe COVID-19 should consult with their doctor to determine whether they should take this drug, due to ‘likely benefits’ and a lack of adverse events having been reported.

Nirmatrelvir-ritonavir was first recommended by WHO in April 2022. WHO strongly recommends its use in mild or moderate COVID-19 patients who are at high-risk of hospitalization. In December 2022, the first generic producer of the drug was prequalified by WHO.

WHO also reviewed the evidence on two other medicines, sotrovimab and casirivimab-imdevimab, and maintains strong recommendations against their use for treating COVID-19. These monoclonal antibody medicines lack or have diminished activity against the current circulating virus variants.

There are currently 6 proven treatment options for patients with COVID-19, three that prevent hospitalization in high-risk persons and three that save lives in those with severe or critical disease. Except for corticosteroids, access to other drugs remains unsatisfactory globally.

Note: The section on the isolation period was updated on 17 January 2023 for clarity.

Urgent action needed as acute malnutrition threatens the lives of millions of vulnerable children

12 Jan

United Nations agencies are calling for urgent action to protect the most vulnerable children in the 15 countries hardest hit by an unprecedented food and nutrition crisis.

Conflict, climate shocks, the ongoing impacts of COVID-19, and rising costs of living are leaving increasing numbers of children acutely malnourished while key health, nutrition and other life-saving services are becoming less accessible. Currently, more than 30 million children in the 15 worst-affected countries suffer from wasting – or acute malnutrition – and 8 million of these children are severely wasted, the deadliest form of undernutrition. This is a major threat to children’s lives and to their long-term health and development, the impacts of which are felt by individuals, their communities and their countries.     

In response, five UN agencies - the Food and Agriculture Organization (FAO), the UN Refugee Agency (UNHCR), the United Nations Children’s Fund (UNICEF), the World Food Programme (WFP) and the World Health Organization (WHO) - are calling for accelerated progress on the Global Action Plan on Child Wasting. It aims to prevent, detect and treat acute malnutrition among children in the worst-affected countries, which are Afghanistan, Burkina Faso, Chad, Democratic Republic of the Congo, Ethiopia, Haiti, Kenya, Madagascar, Mali, the Niger, Nigeria, Somalia, South Sudan, the Sudan and Yemen.

The Global Action Plan addresses the need for a multi-sectoral approach and highlights priority actions across maternal and child nutrition through the food, health, water and sanitation, and social protection systems. In response to increasing needs, the UN agencies identified five priority actions that will be effective in addressing acute malnutrition in countries affected by conflict and natural disasters and in humanitarian emergencies. Scaling up these actions as a coordinated package will be critical for preventing and treating acute malnutrition in children, and averting a tragic loss of life.

The UN agencies call for decisive and timely action to prevent this crisis from becoming a tragedy for the world’s most vulnerable children. All agencies urge for greater investment in support of a coordinated UN response that will meet the unprecedented needs of this growing crisis, before it is too late.


“This situation is likely to deteriorate even further in 2023,” said QU Dongyu, Director-General of the Food and Agriculture Organization of the United Nations. “We must en sure availability, affordability and access ibility of healthy diets for young children, girls, and pregnant and lactating women. We need urgent action now to save lives , and to tackle the root causes of acute malnutrition, working together across all sectors.” Qu said.

“The UN system is responding as one to this crisis and the UN Global Action Plan on Child Wasting is our joint effort to prevent, detect and treat wasting globally. At UNHCR we are working hard to improve analysis and targeting to ensure that we reach children who are most at risk, including internally displaced and refugees populations.” Filippo Grandi, High Commissioner, United Nations High Commissioner for Refugees (UNHCR)   

“Today’s cascading crises are leaving millions of children wasted and have made it harder for them to access key services. Wasting is painful for the child, and in severe cases, can lead to death or permanent damage to children’s growth and development. We can and must turn this nutrition crisis around through proven solutions to prevent, detect, and treat child wasting early. ”Catherine Russell, Executive Director, United Nations Children’s Fund (UNICEF) 

“More than 30 million children are acutely malnourished across the 15 worst-affected countries, so we must act now and we must act together. It is critical that we collaborate to strengthen social safety nets and food assistance to ensure Specialized Nutritious Foods are available to women and children who need them the most.” David Beasley, Executive Director, World Food Programme (WFP) 

“The global food crisis is also a health crisis, and a vicious cycle: malnutrition leads to disease, and disease leads to malnutrition ,” said Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization (WHO).”Urgent support is needed now in the hardest hit countries to protect children’s lives and health, including ensuring critical access to healthy foods and nutrition services, especially for women and children


Note to the editor: 

Wasting or acute malnutrition is a form of undernutrition caused by a decrease in food consumption and/or illness that results in sudden weight loss or oedema. Children with acute malnutrition have low weight for height. They may also have nutritional oedema and other related pathological clinical signs.

Children with acute malnutrition have weakened immune systems and are at higher risk of dying from common childhood diseases. Those that survive could face lifelong growth and development challenges. They risk facing a future marked by illness, poor school results, and poverty with ripple effects across generations.

Child wasting - defined as low weight for height - is the most dangerous form of undernutrition. Severe wasting is the deadliest form, as severely wasted children are 12 times more likely to die than a well-nourished child.

 

 

 

 

A child or youth died once every 4.4 seconds in 2021 – UN report

9 Jan

NEW YORK/GENEVA/WASHINGTON D.C., 10 January 2023 – An estimated 5 million children died before their fifth birthday and another 2.1 million children and youth aged between 5–24 years lost their lives in 2021, according to the latest estimates released by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME).

In a separate report also released today, the group found that 1.9 million babies were stillborn during the same period. Tragically, many of these deaths could have been prevented with equitable access and high-quality maternal, newborn, child and adolescent health care.

“Every day, far too many parents are facing the trauma of losing their children, sometimes even before their first breath,” said Vidhya Ganesh, UNICEF Director of the Division of Data Analytics, Planning and Monitoring. “Such widespread, preventable tragedy should never be accepted as inevitable. Progress is possible with stronger political will and targeted investment in equitable access to primary health care for every woman and child.”

The reports show some positive outcomes with a lower risk of death across all ages globally since 2000. The global under-5 mortality rate fell by 50% since the start of the century, while mortality rates in older children and youth dropped by 36%, and the stillbirth rate decreased by 35%. This can be attributed to more investments in strengthening primary health systems to benefit women, children and young people.

However, gains have reduced significantly since 2010, and 54 countries will fall short of meeting the Sustainable Development Goals target for under-5 mortality. If swift action is not taken to improve health services, warn the agencies, almost 59 million children and youth will die before 2030, and nearly 16 million babies will be lost to stillbirth.

“It is grossly unjust that a child’s chances of survival can be shaped just by their place of birth, and that there are such vast inequities in their access to lifesaving health services,” said Dr Anshu Banerjee, Director for Maternal, Newborn, Child and Adolescent Health and Ageing at the World Health Organization (WHO). “Children everywhere need strong primary health care systems that meet their needs and those of their families, so that – no matter where they are born – they have the best start and hope for the future.”

Children continue to face wildly differentiating chances of survival based on where they are born, with sub-Saharan Africa and southern Asia shouldering the heaviest burden, the reports show. Though sub-Saharan Africa had just 29% of global live births, the region accounted for 56% of all under-5 deaths in 2021, and southern Asia for 26% of the total. Children born in sub-Saharan Africa are subject to the highest risk of childhood death in the world – 15 times higher than the risk for children in Europe and northern America.

Mothers in these 2 regions also endure the painful loss of babies to stillbirth at an exceptional rate, with 77% of all stillbirths in 2021 occurring in sub-Saharan Africa and south Asia. Nearly half of all stillbirths happened in sub-Saharan Africa. The risk of a woman having a stillborn baby in sub-Saharan Africa is 7 times more likely than in Europe and North America.

“Behind these numbers are millions of children and families who are denied their basic rights to health,” said Juan Pablo Uribe, Global Director for Health, Nutrition and Population, World Bank and Director of the Global Financing Facility. “We need political will and leadership for sustained financing for primary health care which is one of the best investments countries and development partners can make.”

Access to and availability of quality health care continues to be a matter of life or death for children globally. Most child deaths occur in the first five years, of which half are within the first month of life. For these youngest babies, premature birth and complications during labour are the leading causes of death. Similarly, more than 40% of stillbirths occur during labour – most of which are preventable when women have access to quality care throughout pregnancy and birth. For children that survive past their first 28 days, infectious diseases like pneumonia, diarrhoea and malaria pose the biggest threat.

While COVID-19 has not directly increased childhood mortality – with children facing a lower likelihood of dying from the disease than adults – the pandemic may have increased future risks to their survival. In particular, the reports highlight concerns around disruptions to vaccination campaigns, nutrition services, and access to primary health care, which could jeopardize their health and well-being for many years to come. In addition, the pandemic has fuelled the largest continued backslide in vaccinations in three decades, putting the most vulnerable newborns and children at greater risk of dying from preventable diseases.

The reports also note gaps in data, which could critically undermine the impact of policies and programmes designed to improve childhood survival and well-being.

“The new estimates highlight the remarkable global progress since 2000 in reducing mortality among children under age 5,” said John Wilmoth, Director, UN DESA Population Division. “Despite this success, more work is needed to address persistent large differences in child survival across countries and regions, especially in sub-Saharan Africa. Only by improving access to quality health care, especially around the time of childbirth, will we be able to reduce these inequities and end preventable deaths of newborns and children worldwide.”

 

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Notes to editors:

The two reports – Levels & Trends in Child Mortality and Never Forgotten – are the first of a series of important data sets released in 2023, with UN maternal mortality figures to be published later this year.

Download multimedia content here.

Access the report and data here and stillbirth report here

About UN IGME

The United Nations Inter-agency Group for Child Mortality Estimation or UN IGME was formed in 2004 to share data on child mortality, improve methods for child mortality estimation, report on progress towards child survival goals and enhance country capacity to produce timely and properly assessed estimates of child mortality. UN IGME is led by UNICEF and includes the World Health Organization, the World Bank Group and the United Nations Department of Economic and Social Affairs, Population Division.

For more information visit: Child Mortality