WHO Publishes Quality Criteria for Health National Adaptation Plans

11 Feb

Climate change is already impacting human health and health systems, and the burden on communities and health systems is expected to further increase as temperatures rise.

To respond to the growing impacts of climate change and build climate-resilient health systems, countries may develop and implement a health national adaptation plan (HNAP) as a part of the national adaptation plan process.

The new WHO Quality Criteria for Health National Adaptation Plans (HNAPs) provides policy makers and ministries of health with good practices and quality criteria for health adaptation planning. The guidance draws on experience gained since 2012 through WHO’s support to countries in developing and implementing health adaptation plans, and assistance to countries for overcoming challenges in HNAP development. 

These quality criteria cover six topic areas that are crucial for health adaptation planning:

  1. Leadership and enabling environment
  2. Cross-sectoral coordination and policy coherence
  3. Comprehensive coverage of climate-sensitive health risks
  4. Comprehensive coverage of adaptation options and actions
  5. Resourcing
  6. Monitoring, evaluation and reporting

Experiences from countries that have begun this process, developed an HNAP, and/or started implementation, are incorporated throughout the document to demonstrate various practical applications of the quality criteria.

WHO provides a range of technical support to Member States for climate change and health, including the development and implementation of HNAPs and accessing finance health and climate change.

The Quality Criteria for HNAPs can be downloaded here and should be used in conjunction with the WHO guidance to protect health from climate change through health adaptation planning.


ILO joins the Global Action Plan for Healthy Lives and Well-being for All

10 Feb

The 12 signatory agencies to the Global Action Plan for Healthy Lives and Well-being for All (SDG3 GAP) warmly welcome the International Labour Organization (ILO) as a new member of the partnership between health, development and humanitarian agencies working to better support countries to accelerate progress towards the health-related Sustainable Development Goals (SDGs). Amid the COVID-19 pandemic, stronger collaboration is essential for the multilateral system to effectively support countries in getting back on track to achieve the SDGs.

“The ILO's expertise and networks are enormous assets that will help the world recover and build back better from COVID-19,”said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “In this International Year of Health and Care Workers, as health systems struggle to cope with increasing COVID-19 cases, it's vital that health and care workers are vaccinated first in all countries so they can continue to work to keep others safe. We're delighted that ILO is joining the Global Action Plan, and we look forward to working together to protect those who protect all of us."

The ILO has staff based in regional and country offices in 135 countries and ongoing collaborations with WHO and other signatories of the Global Action Plan. Key areas of cooperation include health financing and social protection, occupational health and safety, the working conditions of the health workforce and gender equality.

On joining the partnership, Mr Ryder, Director-General of the ILO said: “The COVID-19 crisis has clearly demonstrated the interaction between health, social factors and decent work. It has highlighted the critical need for investments in all three areas. This will foster recovery and will lead to a more sustainable, equitable development path. Equally, investments in the health of workers and the health and care workforce are vital to make progress towards universal health coverage. If we are to achieve SDG3, increased cooperation is needed. By joining this partnership the ILO reaffirms its commitment to support countries during this pandemic and beyond, through a multilateral and coherent approach.”

Although every agency has a specific mandate, by leveraging their respective mandates and resources and by working together, they are each better able to jointly support countries to fast-track progress towards the health-related SDG targets through:

  • Further strengthening country ownership, engagement and impact on health-related SDGs.
  • Accelerating country progress by ensuring that the SDG3 Global Action Plan responds comprehensively in the COVID-19 era by supporting country-level work across the seven programmatic areas of focus (accelerators), with a commitment to gender, equity and human-rights-based approaches.
  • Further aligning operational and financial strategies, policies and approaches where possible.
  • Accounting for progress under the Global Action Plan and learning together to enhance a shared commitment to accountability for collaboration.

For more information, please visit SDG3 GAP website.


SDG3 GAP agencies 

GAVI, the Vaccine Alliance  

Global Financing Facility for Women, Children and Adolescents (GFF)

International Labour Organization (ILO)

The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) 

Joint United Nations Programme on HIV/AIDS(UNAIDS)

Unitaid

United Nations Development Fund (UNDP)

United Nations Population Fund (UNFPA)

United Nations Children’s Fund (UNICEF)

United Nations Entity for Gender Equality and the Empowerment of Women (UN Women)

World Bank Group

World Food Programme (WFP)

World Health Organization (WHO) 

 

In the COVID-19 vaccine race, we either win together or lose together

10 Feb

Of the 128 million vaccine doses administered so far, more than three quarters of those vaccinations are in just 10 countries that account for 60% of global GDP.

As of today, almost 130 countries, with 2.5 billion people, are yet to administer a single dose.

This self-defeating strategy will cost lives and livelihoods, give the virus further opportunity to mutate and evade vaccines and will undermine a global economic recovery.

Today, UNICEF and WHO – partners for more than 70 years – call on leaders to look beyond their borders and employ a vaccine strategy that can actually end the pandemic and limit variants.

Health workers have been on the frontlines of the pandemic in lower- and middle-income settings and should be protected first so they can protect us.

COVAX participating countries are preparing to receive and use vaccines. Health workers have been trained, cold chain systems primed. What’s missing is the equitable supply of vaccines. 

To ensure that vaccine rollouts begin in all countries in the first 100 days of 2021, it is imperative that:  

  • Governments that have vaccinated their own health workers and populations at highest risk of severe disease share vaccines through COVAX so other countries can do the same.
  • The Access to COVID-19 Tools (ACT) Accelerator, and its vaccines pillar COVAX, is fully funded so that financing and technical support is available to lower- and middle-income countries for deploying and administering vaccines. If fully funded, the ACT Accelerator could return up to US$ 166 for every dollar invested.
  • Vaccine manufacturers allocate the limited vaccine supply equitably; share safety, efficacy and manufacturing data as a priority with WHO for regulatory and policy review; step up and maximize production; and transfer technology to other manufacturers who can help scale the global supply.

We need global leadership to scale up vaccine production and achieve vaccine equity.

COVID-19 has shown that our fates are inextricably linked. Whether we win or lose, we will do so together.”

_____________________

Note to Editors

Dr. Tedros will be addressing the UNICEF Executive Board today at 10:00 am EST. Watch it live on http://webtv.un.org/

COVAX Statement on New Variants of SARS-CoV-2

8 Feb

The emergence of variants of SARS-CoV-2, the virus that causes COVID-19,  serve as a powerful reminder that viruses by their very nature mutate, and that the scientific response may need to adapt if they are to remain effective against them.

In light of recent news stories regarding the preliminary data on minimal effectiveness of the AstraZeneca/Oxford vaccine at preventing mild to moderate COVID-19 disease caused by the viral variant B.1.351, it is important to note that primary analysis of data from Phase III trials has so far shown – in the context of viral settings without this variant – that the AstraZeneca/Oxford vaccine offers protection against severe disease, hospitalisation and death. This means it is vitally important now to determine the vaccine’s effectiveness when it comes to preventing more severe illness caused by the B.1.351 variant.

Additional studies will also allow us to confirm the optimal vaccination schedule and its impact on vaccine efficacy. CEPI has announced funding for additional clinical research to optimize and extend the use of existing vaccines, which could include "mix-and-match" studies of different vaccines used in combinations that may improve the quality and strength of the immune response.  Such studies could be useful in optimizing the use of available vaccines, including the AstraZeneca/Oxford vaccine.

The WHO Strategic Advisory Group of Experts on Immunization (SAGE) convened today to review evidence on the AstraZeneca/Oxford vaccine, including emerging evidence on performance against viral variants, and to consider the demonstrated impact of the product and the risk-benefit assessment for use cases with limited data.  These recommendations for use of the AstraZeneca product are being finalised and will be presented to the WHO Director-General on 9 Feb 2021.   

Even though this recent news on effectiveness of the AstraZeneca/Oxford vaccine against the B.1.351 variant is based on a limited study size which focused on low-risk participants and used interval doses that were not optimized for immunogenicity, these results confirm we must do everything possible to reduce the circulation of the virus, prevent infections and reduce the opportunities for the SARS-CoV-2 to evolve resulting in mutations that may reduce the efficacy of existing vaccines. This means that additionally:

  • Manufacturers must be prepared to adjust to the SARS-CoV-2 viral evolution, including potentially providing future booster shots and adapted vaccines, if found to be scientifically necessary.
  • Trials must be designed and maintained to allow any changes in efficacy to be assessed, and to be of sufficient scale and diversity to enable clear interpretation of results.
  • Enhanced genomic surveillance must be backed by rapid sharing of genetic and meta-data to allow for global coordination and response.
  • Priority should be given to vaccinating high-risk groups everywhere in order to ensure maximum global protection against new strains and minimize the risk of transmission.
  • Governments and donors, as well as development banks, should further support COVAX in order to ensure equitable access and delivery, as well as meet ongoing research and development costs for next-generation vaccines.
  • WHO is enhancing an existing mechanism for tracking and evaluating variants that may affect vaccine composition and expanding that mechanism to provide guidance to manufacturers and countries on changes that may be needed for vaccines.

COVAX was set up to ensure global equitable access to safe and effective COVID-19 vaccines. With the world’s largest actively managed portfolio of COVID-19 vaccine candidates, the COVAX Facility offers its self-financing participants and those eligible for support through the Gavi COVAX Advance Market Commitment access to a diverse range of vaccine candidates, suitable for a broad range of contexts and settings. The ability to deploy vaccines globally to address the evolving pandemic is more critical than ever, as is the importance of coordination to ensure we do not put the impact and value of vaccines at risk.  If new vaccines are required, ensuring global access to these is even more essential, as we continue to see that we are all safe only if everyone is safe. 

With regards to the AstraZeneca/Oxford vaccine, COVAX has signed advance purchase agreements with AstraZeneca and Serum Institute of India and has published plans to distribute nearly 350 million doses in the first half of the year. We expect a decision this month from WHO on whether the vaccines will be granted emergency use listing (EUL) as well as a SAGE recommendation on its optimal use. Should EUL be forthcoming, we expect the vaccine to play a key role in our effort to protect high risk persons and to help end the acute phase of the pandemic.

 

France and WHO: a strategic partnership for global health security

8 Feb

Representatives from the Government of France and the Lyon Metropolis, and representatives of WHO gathered for the annual Statutory meeting of partners of the WHO Lyon Office, held virtually this year. The main objectives of the meeting were to take stock of achievements in 2020 and review the vision and strategic directions of the office in the context of the COVID-19 pandemic and beyond, discuss on-going and future collaboration with local and national partners in the local scientific environment; and collaboration with the WHO Academy, the innovative centre for delivering advanced digital and classroom training to health workers and others around the world.

This year the WHO Lyon Office marks 20 years since its opening in February 2001. “The Government of France and the French partners of the WHO Lyon Office recognized the importance of global health security 20 years ago when they played an instrumental role in the establishment of the Lyon Office,” said Dr Michael Ryan, Executive Director of the WHO Health Emergencies Programme. “WHO is extremely grateful to France not only for its longstanding financial and technical support but also for its strategic partnership that is based on a shared vision for better health outcomes for all people around the world,” added Dr Ryan. 

The Lyon office was established in 2001 to support national laboratory and surveillance systems for epidemic preparedness and response, after an agreement between WHO, the French government, the Metropolis of Lyon (“la Metropole”) and the Merieux Foundation. The scope of the office was broadened in 2005 with the revision of the International Health Regulations (IHR) and the creation of a new team in charge of health security at ports, airports and ground crossings. The office is now part of the Emergency Preparedness Division, Country Readiness Strengthening department, with three units in charge of Public Health Laboratory Strengthening, Border Health Risk Dissemination and Learning and Training Solutions. Its expertise is fully mobilized to provide support to COVID-19 preparedness and response. 

Global health security preparedness and IHR implementation are one the French global health priorities and mentioned as one of the five France-WHO areas of collaboration in the 2020-2025 WHO-France framework agreement signed in 2019.

Moreover, in light of the COVID-19 pandemic, France has contributed 10M EUR to support implementation of the strategic preparedness and response plan, and the Access to COVID-19 Tools (ACT) Accelerator, a unique global partnership that brings together health organizations, scientists, businesses, civil society, and philanthropists to accelerate the development, production and equitable access to COVID-19 tests, treatments and vaccines. The ACT-A was set up in response to a call from G20 Leaders in March 2020 and launched by the WHO, European Commission, France and The Bill & Melinda Gates Foundation in April 2020.

WHO launches consolidated guidelines for malaria

8 Feb

The WHO Guidelines for malaria, launched today, bring together the Organization’s most up-to-date recommendations for malaria in one user-friendly and easy-to-navigate online platform. They are designed to support malaria-affected countries in their efforts to reduce and, ultimately, eliminate a disease that continues to claim more than 400 000 lives each year.

Through the new platform, MAGICapp, users will find:

  • All official WHO recommendations for malaria prevention (vector control and preventive chemotherapies) and case management (diagnosis and treatment). Recommendations for elimination settings are in development.

  • Links to other resources, such as guidance on the strategic use of information to drive impact; surveillance, monitoring and evaluation; operational manuals, handbooks, and frameworks; and a glossary of key terms and definitions.

Users can access the evidence that underpins each WHO recommendation through the new web-based platform. There is a feedback tab to help identify recommendations that may need an update or further clarification, and inputs from stakeholders are also welcome by email (gmpfeedback@who.int). 

Delivering timely, evidence-informed guidance

“These consolidated guidelines represent an important step in our efforts to deliver timely, evidence-based guidance to malaria-endemic countries,” said Dr Pedro Alonso, Director of the WHO Global Malaria Programme. “They will soon become a living resource that is updated periodically as new evidence becomes available, and as WHO guideline development groups bring forward proposals for new or revised recommendations,” he added.

The first version of the Guidelines for malaria – available online only – is a compilation of existing WHO recommendations on malaria and supersedes 2 previous WHO publications: the Guidelines for the treatment of malaria, third edition and the  Guidelines for malaria vector control. Four WHO guideline development groups focused on vector control, chemoprevention, treatment and elimination are currently convening to develop new or updated recommendations, and other groups will convene this year to address additional relevant topics.

Recommendations on malaria will continue to be reviewed and, where appropriate, updated based on the latest available evidence through WHO’s transparent and rigorous guidelines review process. Any updated recommendations will always display the date of the most recent revision in the MAGICapp platform. With each update, a new PDF version of the consolidated guidelines will also be available for download on the WHO website.

Clear, evidence-informed WHO recommendations guide managers of national malaria programmes as they develop polices and strategic plans to combat the disease tailored to the local context; they support decisions around “what to do”. WHO also develops implementation guidance – such as operational and field manuals – to advise countries on “how to” deliver the recommended tools and strategies.

The consolidation of WHO’s malaria guidelines is one of a number of actions the Organization has undertaken in recent years to make its guidance more accessible to end users in malaria-endemic countries. The overall aim is to deliver timely, high quality recommendations through processes that are more transparent, consistent, efficient and predictable.

Key definitions

A WHO guideline is defined broadly as any information product developed by WHO that contains recommendations for clinical practice or public health policy. 

A recommendation tells the intended end-user of a guideline what he or she can or should do in specific situations to achieve the best health outcomes possible, individually or collectively. It offers a choice among different interventions or measures having an anticipated positive impact on health and implications for the use of resources.

WHO announces updated critical concentrations for susceptibility testing to rifampicin

5 Feb

The critical concentrations for culture-based phenotypic drug susceptibility testing (DST) to first-line anti-TB drugs have been revised by the the World Health Organization (WHO). Critical concentrations for rifampicin have been lowered while those for isoniazid have been maintained at the present level. This update helps address the discordance observed between phenotypic and molecular methods to detect rifampicin resistance and improves the accuracy of DST. As a result patients with TB will have a more accurate  diagnosis.

The revision was the outcome of a Technical Expert Group meeting convened by WHO in 2020 to assess the results of a systematic review of published literature on critical concentrations for DST of the most important first-line anti-TB drugs, isoniazid and the rifamycins (rifampicin, rifabutin and rifapentine). New evidence showed that critical concentrations used for phenotypic methods to detect rifampicin resistance may incorrectly classify strains with certain mutations. The following media were considered: Löwenstein-Jensen (LJ), Middlebrook 7H10 (7H10), Middlebrook 7H11 (7H11) and BACTEC™ Mycobacterial Growth Indicator Tube™ 960 (MGIT).

Guidance has been provided to resolve discordance between genotypic and phenotypic results for these drugs and areas for further research have been highlighted. The full report is available here.

DST methods continue to have a very important role to identify resistance not detected by molecular assays and to support the interpretation of molecular assays results. However, they require sophisticated laboratory infrastructure, qualified staff and strict quality assurance procedures.

WHO launches free OpenWHO.org training on rehabilitation for COVID-19

5 Feb

The Clinical Management of Patients with COVID-19 course series is developed for healthcare workers during the COVID-19 pandemic. It provides crucial knowledge necessary to provide safe, effective quality patient care. Presentations address all aspects of clinical management, including facility preparation and surge planning; health worker infection prevention and control; interfacility transfer; clinical management of mild, moderate, and severely ill patients with COVID-19; special considerations for geriatric, pregnant, and pediatric patients with COVID-19; rehabilitation; and ethics and palliative care.

The course series consists of 6 courses, which include video lectures and downloadable presentations that have been updated with the latest guidance and evidence. Each course contains 5-8 modules, and each module includes a quiz to evaluate knowledge acquisition.

The sixth course of the Clinical Management of Patients with COVID-19 course series is devoted to the rehabilitation of patients with COVID-19. The seven course modules address the manifold and varied rehabilitation needs of patients recovering from COVID-19, including patients with cognitive impairment, physical deconditioning and weakness, respiratory impairment, swallow impairment, communication impairment and challenges in completing Activities of Daily Living (ADLs). Techniques for rehabilitation also are addressed.

 

WHO receives nearly 1 200 entries for the second edition of Health for All Film Festival

4 Feb

The World Health Organization's second call for entries to its Health for All Film Festival has received 1 175 submissions from 110 countries. More than 40% of the short films feature themes related to COVID-19, revealing the pandemic's pervasive and universal consequences.

Entries came from such countries as Argentina, Australia, Bangladesh, Brazil, Canada, China, France, Germany, India, Indonesia, Iran, Italy, Kenya, Malaysia, Mexico, Nigeria, Philippines, Portugal, United Kingdom, the United States of America, Russia, South Africa, Spain, Switzerland, Turkey and Uganda. 

Launched in 2020, the festival aims to nurture a new generation of film and video innovators focused on health topics. WHO engaged with independent film-makers, production companies, NGOs, communities, students, and film schools, to ensure a diverse range of entries.  

“Telling stories is as old as human civilization. It helps to inspire, motivate, build empathy and share problems so we can find and share solutions together. Everything WHO does is about stories because everything we do is about people. We’re excited about the quantity and quality of entries in this year’s Health for All Film Festival. Ultimately, we hope the festival is not just a way to tell stories, but to change the arc of people’s stories around the world, towards better health,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. 

Three GRAND PRIX will be awarded in May 2021 for each of the following categories, which are aligned with WHO’s global goals for public health:

  • • Universal health coverage (UHC): films about mental health, non-communicable diseases, major communicable diseases, innovative health services and other UHC stories not part of emergencies;
  • • Health emergencies: films about health emergencies, such as COVID-19 and Ebola, as well as health responses in the context of humanitarian crises and conflict-affected settings;
  • • Better health and well-being: films about environmental and social determinants of health, such as nutrition, sanitation, pollution, and/or films about health promotion or health education.

WHO also plans to award three special prizes: a student-produced film, a health educational film aimed at youth, and a short video designed exclusively for social media platforms.

Entries can include short documentaries or fiction films (3 to 8 minutes in length) or animation films (1 to 5 minutes).

The composition of the Festival jury will be announced in the coming weeks and will include a number of critically-acclaimed artists from the film and music industries, along with WHO experts. The jury will recommend winners to WHO’s Director-General, who will make the final decision. Initial short lists for each category, comprising 15 films per category, will be announced in March.

Richard Curtis, film director and writer from the United Kingdom, who was a member of the 2020 jury, said: "Being a Juror for the Health For All Film Festival was a deeply satisfying job -- so many subjects I knew nothing about suddenly coming to life in the work of some remarkable film-makers. And the actual judgement day was gripping -- really varied and passionate points of view from everyone on the panel. It was a real pleasure and a real privilege."

Wagner Moura, an actor and film director from Brazil, who was also among the jurors in the first edition of the Festival, said: "It was truly an honour for me to participate. The films that I have seen educated me a lot about different health issues around the world, and I want to encourage all persons concerned to keep doing these films, to keep talking about your communities, to keep exposing the vulnerabilities of the communities that you filmed. This is the perfect moment to praise the work of volunteers, of doctors, of health sector workers, that have sacrificed their lives for the sake of the most vulnerable ones."

 

Breast cancer now most common form of cancer: WHO taking action

4 Feb

The global cancer landscape  is changing, according to WHO  experts, on the eve of World Cancer Day 2021. 

Breast cancer has now overtaken lung cancer as the world’s mostly commonly-diagnosed cancer, according to statistics released by the International Agency for Research on Cancer (IARC) in December 2020.

So on World Cancer Day, WHO will host the first of a series of consultations in order to establish a new global breast cancer initiative, which will launch later in 2021. This collaborative effort between WHO, IARC, the International Atomic Energy Agency and other multi-sectoral partners, will reduce deaths from breast cancer by promoting breast health, improving timely cancer detection and ensuring access to quality care.

WHO and the cancer community are responding with renewed urgency to address breast cancer and to respond to the growing cancer burden globally that is straining individuals, communities and health systems.

In the past two decades, the overall number of people diagnosed with cancer nearly doubled, from an estimated 10 million in 2000 to 19.3 million in 2020. Today, one in 5 people worldwide will develop cancer during their lifetime. Projections suggest that the number of people being diagnosed with cancer will increase still further in the coming years, and will be nearly 50% higher in 2040 than in 2020.

The number of deaths from cancer has also increased, from 6.2 million in 2000 to 10 million in 2020. More than one out of every six deaths is due to cancer.

While changes in lifestyle, such as unhealthy diets, insufficient physical activity, use of tobacco and harmful use of alcohol, have all contributed to the increasing cancer burden, a significant proportion can also be attributed to increasing longevity, as the risk of developing cancer increases with age. This reinforces the need to invest in both cancer prevention and cancer control, focusing on actionable cancers like breast, cervical and childhood cancers.

Late diagnosis and lack of access to treatment exacerbated by COVID-19 pandemic

The COVID-19 pandemic has exacerbated the problems of late-stage diagnosis and lack of access to treatment. These occur everywhere but particularly in low- and middle-income countries. In addition to having to cope with the disruption of services, people living with cancer are also at higher risk of severe COVID-19 illness and death.

A WHO survey conducted in 2020 indicated that treatment for cancer had been disrupted in more than 40% of countries surveyed during the pandemic. The findings of the survey have been backed up by published studies indicating that delays in diagnosis are common, while interruptions to and abandonment of therapy have increased significantly. Meanwhile, enrolment in clinical trials and research output have declined.

All stakeholders are working to respond. Some governments have been enabling their populations to seek cancer care safely. Health professionals have adapted treatment to meet the needs of their patients, including through the use of telemedicine, and civil society has supported patients by helping them coordinate their appointments and complete their treatment plans.

World Cancer Day

World Cancer Day, with its slogan “I can and I will”, is also an opportunity to show WHO’s commitment to other major global cancer programmes, on cervical cancer and childhood cancer.

The adoption of the Global strategy to accelerate the elimination of cervical cancer as a public health problem and its associated goals and targets by the World Health Assembly in 2020 has provided added momentum to cervical cancer efforts. Three targets have been set for 2030: 90% of girls fully vaccinated with the HPV vaccine; 70% of women screened; and 90% of women identified with cervical cancer receiving treatment.

Cancer is also a leading cause of death for children and adolescents, with an estimated 400 000 children diagnosed with cancer each year. On International Childhood Cancer Day, 15 February, WHO will be releasing a “how-to” guide for policy-makers and programme managers on strengthening childhood cancer programmes; a new assessment tool to facilitate harmonized data collection and to enable expedited, real-time interpretation of collected data on cancer among children; and an online community-of-practice information-sharing hub for childhood cancer. 

Breast, cervical and childhood cancers all have a high chance of cure if diagnosed early and treated appropriately. This World Cancer Day, WHO is moving ahead with our partners around the world in efforts both to prevent and control cancer and also to provide support to all people living with cancer, wherever they live and whatever their circumstances.