Countries failing to prevent violence against children, agencies warn

18 Jun

Half of the world’s children, or approximately 1 billion children each year are affected by physical, sexual or psychological violence, suffering injuries, disabilities and death, because countries have failed to follow established strategies to protect them.

This is according to a new report published today by the World Health Organization (WHO), UNICEF, UNESCO, the Special Representative of the United Nations Secretary-General on Violence against Children and the End Violence Partnership.

“There is never any excuse for violence against children," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We have evidence-based tools to prevent it, which we urge all countries to implement. Protecting the health and well-being of children is central to protecting our collective health and well-being, now and for the future.”

The report – Global Status Report on Preventing Violence Against Children 2020 – is the first of its kind, charting progress in 155 countries against the “INSPIRE” framework, a set of seven strategies for preventing and responding to violence against children. The report signals a clear need in all countries to scale up efforts to implement them. While nearly all countries (88%) have key laws in place to protect children against violence, less than half of countries (47%) said these were being strongly enforced.

The report includes the first ever global homicide estimates specifically for children under 18 years of age – previous estimates were based on data that included 18 to 19-year olds. It finds that, in 2017, around 40,000 children were victims of homicide.

“Violence against children has always been pervasive, and now things could be getting much worse,” said UNICEF Executive Director Henrietta Fore. “Lockdowns, school closures and movement restrictions have left far too many children stuck with their abusers, without the safe space that school would normally offer. It is urgent to scale up efforts to protect children during these times and beyond, including by designating social service workers as essential and strengthening child helplines.”

Progress is generally uneven

Of the INSPIRE strategies, only access to schools through enrollment showed the most progress with 54% of countries reporting that a sufficient number of children in need were being reached in this way. Between 32% to 37% of countries considered that victims of violence could access support services, while 26% of countries provided programmes on parent and caregiver support; 21% of countries had programmes to change harmful norms; and 15% of countries had modifications to provide safe physical environments for children.

Although a majority of countries (83%) have national data on violence against children, only 21% used these to set baselines and national targets to prevent and respond to violence against children.

About 80% of countries have national plans of action and policies but only one-fifth have plans that are fully funded or have measurable targets. A lack of funding combined with inadequate professional capacity are likely contributing factors and a reason why implementation has been slow.

The COVID-19 response and its impact on children

“During the COVID-19 pandemic, and the related school closures, we have seen a rise in violence and hate online – and this includes bullying. Now, as schools begin to re-open, children are expressing their fears about going back to school,” said Audrey Azoulay, UNESCO Director-General. “It is our collective responsibility to ensure that schools are safe environments for all children. We need to think and act collectively to stop violence at school and in our societies at large.”

Stay-at-home measures including school closures have limited the usual sources of support for families and individuals such as friends, extended family or professionals. This further erodes victims’ ability to successfully cope with crises and the new routines of daily life. Spikes in calls to helplines for child abuse and intimate partner violence have been observed.

And while online communities have become central to maintain many children’s learning, support and play, an increase in harmful online behaviours including cyberbullying, risky online behavior and sexual exploitation have been identified. 

“Whilst this report was being finalized, confinement measures and the disrupted provision of already limited child protection services exacerbated the vulnerability of children to various forms of violence,” said Najat Maalla M’jid, Special Representative of the United Nations Secretary-General on Violence against Children. “To respond to this crisis a unified, child rights and multisectoral framework for action for children is critical requiring a strong mobilization of governments, bilateral/multilateral donors, civil society, private sector and children, whose views must be heard and truly taken into account to ensure duly protection and the possibility for all to thrive and reach their full potential.”

Accelerating action to protect children

WHO and its partners will continue to work with countries to fully implement the INSPIRE strategies by enhancing coordination, developing and implementing national action plans, prioritizing data collection, and strengthening legislative frameworks.  Global action is needed to ensure that the necessary financial and technical support is available to all countries. Monitoring and evaluation are crucial to determine the extent to which these prevention efforts are effectively delivered to all who need them.

“Ending violence against children is the right thing to do, a smart investment to make, and it’s possible.  It is time to fully fund comprehensive national action plans that will keep children safe at home, at school, online and in their communities,” said Dr Howard Taylor, End Violence Partnership. “We can and must create a world where every child can thrive free from violence and become a new generation of adults to experience healthy and prosperous lives.”

Editors note:

The data for the report was compiled through a survey administered between 2018 and 2019 with responses from over 1000 decision-makers from 155 countries. The INSPIRE strategies launched in 2016 call for the implementation and enforcement of laws; changing norms and values to make violence unacceptable; creating safe physical environments for children; providing support to parent and caregivers; strengthening income and economic security and stability; improving response and support services for victims; and providing children with education and life skills.

Related links

To download the report (in English only) and executive summary (in English, French, Russian and Spanish), go to: https://who.canto.global/b/SSHOR and use password: 490759.

To watch the launch event taking place on Thursday, 18 June from 15:00 to 16:30 CEST, please register at https://bit.ly/2ApZXKa. After registering, you will receive a confirmation email with details on how to access the event. Interpretation will be provided in the 6 UN languages.

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For more information about WHO, visit www.who.int. Follow WHO on Twitter and Facebook.

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across more than 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. Follow UNICEF on Twitter and Facebook.

The Special Representative of the United Nations Secretary-General on Violence against Children is a global independent advocate promoting the prevention and elimination of all forms of violence against children. The Special Representative acts as a bridge builder and a catalyst of actions in all regions, across sectors and settings where violence against children may occur. She mobilizes political support to generate renewed concern at the harmful effects of violence on children working with Governments, national institutions, civil society organizations and children promoting behavioral and social change to end violence against children by 2030. For more Information, visit: https://violenceagainstchildren.un.org/. Follow on Twitter Facebook and Instagram

The End Violence Partnership is a public-private partnership established by the UN Secretary-General in 2016. End Violence is made up of over 420 partners and act as a global platform for advocacy, evidence-based action and investments to end all forms of violence against children. The End Violence Partnership focus on three main areas: keeping children safe at home, online and in and through schools.

UNESCO is the United Nations Educational, Scientific and Cultural Organisation. It seeks to build peace through international co-operation in Education, the Sciences and Culture. UNESCO's programmes contribute to the Sustainable Development defined in Agenda 2030, adopted by the UN General Assembly in 2015.

WHO welcomes FDA approval of new formulation of dolutegravir for young children living with HIV

18 Jun

WHO welcomes the recent decision by the U.S. Food and Drug Administration (FDA) to approve a dispersible 5 mg formulation of dolutegravir (DTG) for use in infants and children living with human immunodeficiency virus type 1 (HIV-1). The tablet, taken orally, has been approved for use in paediatric patients from four weeks of age weighing at least 3 kg in combination with other antiretroviral treatments. 

This approval was supported by a trial that included 75 infants and children infected with HIV-1 with an average age of 27 months. According to the FDA press release, 62% of pediatric patients taking the 5 mg formulation had an undetectable HIV viral load at 24 weeks and, at 48 weeks, 69% had an undetectable viral load. On average, the patients had higher levels of CD4 cells that help the body fight off infection.

The FDA has also extended the use of the already approved DTG 50 mg film-coated tablet to include paediatric HIV patients weighing 20 kg and above. Previously, the 50 mg tablet was only approved in the US for children from six years of age with a weight of more than 30 kg.

Submission of the dispersible 5 mg formulation of dolutegravir to the European Medicines Agency took place in December 2019 and is under evaluation, with a decision expected by the end of the year. Two generic versions of the paediatric DTG 10 mg dispersible scored tablet are currently under review by the U.S. FDA, and a decision on these formulations is anticipated by the end of the year. These generic versions will expand access to paediatric dolutegravir and help to reduce pill burden while maintaining dosage flexibility to deliver FDA approved dose.

In 2018, WHO published up-to-date recommendations for the use of antiretroviral (ARV) drug regimens to treat and prevent HIV infection. These guidelines recommended a dolutegravir-based regimen as the preferred first-line and second-line regimen for children for whom approved DTG dosing is available. To date, implementation of WHO guidance has only been possible for children weighing at least 20 kg, for whom 50 mg adult tablets could be used based on WHO dosing recommendations

This FDA approval marks a significant step in making available optimized, paediatric formulations of dolutegravir for children, allowing full implementation of WHO’s most recent recommendations. Many countries have already adopted the latest WHO guidelines on DTG for all children. WHO encourages all remaining countries to do so and to develop plans for a rapid introduction of paediatric DTG (see policy brief on Considerations for introducing new antiretroviral drugs formulations for children).

”Children are among the most vulnerable and disproportionately affected populations in the HIV epidemic. The lack of optimal antiretroviral medicines with suitable paediatric formulations has been a longstanding barrier to improving health outcomes for children living with HIV, contributing towards low treatment coverage, and poor virological suppression,” said Dr Meg Doherty, Director of Global HIV, Hepatitis and STI Programmes. “This approval will greatly expand the use of dolutegravir among children and adolescents, providing them relatively rapid access to an optimal drug that has so far – like many paediatric ARVs – only been available to adults,” she added. 

As the majority of AIDS-related deaths among children occur during the first five years of life, the availability of an optimal ARV formulation for children above 3 kg and 4 weeks of age is a significant milestone with the potential to save many lives. The expedited development and introduction of optimal paediatric formulations is the central goal of global partnerships such as the WHO-led Global Accelerator for Paediatric Formulations (GAP-f).

Globally, an estimated 770 000 people died from HIV-related causes in 2018 and there were 1.7 million new infections. Children under the age of five represented approximately 14% of the total deaths due to HIV infection. 

Compulsory drug detention and rehabilitation centres

18 Jun

UNAIDS, WHO Regional Office for South-East Asia (WHO SEARO), WHO Regional Office for Western Pacific (WHO WPRO), and other United Nations entities in the region urgently call on Member States to close compulsory drug detention and rehabilitation centres and implement voluntary, evidence-informed and rights-based health and social services in the community.

Key Messages

There is no evidence that compulsory drug detention and rehabilitation centres are beneficial in terms of a favourable or effective environment for the treatment of drug dependence; or for the “rehabilitation” of individuals who have engaged in sex work; or for children who have been victims of sexual exploitation, abuse or the lack of adequate care and protection. Instead, inmates face higher vulnerabilities, including HIV, TB as well as COVID-19, as a result of sub-standard living conditions, including massive overcrowding and other challenges in maintaining physical distancing. 

Compulsory drug detention and rehabilitation centres need to be closed. Instead, voluntary, evidence-informed and rights-based health and social services must be implemented in the community. This is as an important measure to curb the spread of COVID-19 and to facilitate the recovery and reintegration of those in the centres back into their families and communities.

UN entities at the global level have urged political leaders to ensure that COVID-19 preparedness and responses in prisons and any closed settings are identified and implemented in line with fundamental human rights; are guided by WHO guidance and recommendations; and never amount to torture and other cruel, inhuman or degrading treatment or punishment.

WHO SEARO stand committed to work with Member States as they take steps to permanently close compulsory drug detention and rehabilitation centres. WHO will support transition to evidence-informed system of voluntary community-based treatment and services that are aligned with international guidelines and principles of drug dependence treatment, drug use and human rights.

Call for expression of interest: Electricity access in healthcare facilities

18 Jun
The purpose of this full-time consultancy is to take stock and analyse existing data with regards to electricity access in healthcare facilities in low-income countries, and through this activity also contribute to the preparation of a ‘Global Assessment of Electricity in Healthcare Facilities’ report.  

The consultant will support the health and energy team within the Air Quality and Health (AQH) Unit of the WHO’s Department of Environment, Climate Change, and Health. The activity is part of WHO's work as Secretariat of the Global Health and Energy Platform of Action.

Background

Achieving universal health coverage, a key element of the Sustainable Development Goals (SDG), means ensuring that everyone has access to quality healthcare yet not enough attention is given to energy’s role in healthcare. Energy is critical for the delivery of health services. When health facilities have sufficient and reliable electricity, women can more safely give birth at night and during emergencies such as COVID- 19, medical equipment can be powered and better sterilized and clinics can preserve life-saving vaccines for new-borns, children and adults.

Yet, despite energy’s importance to delivering health services, it is estimated that tens of thousands of health centers across low- and middle-income countries are not connected to the grid and lack electricity. A similar number of hospitals suffer from frequent and debilitating blackouts. In parts of Sub-Saharan Africa, for example, only 28% of health facilities are estimated to have access to reliable electricity.  This puts patients at risk and makes the jobs of healthcare workers all the more challenging. This acute shortage of electricity access can be particularly detrimental in emergencies such as COVID-19 when reliable electricity is the need of the hour to save lives.

The task of increasing access to reliable and modern energy in health facilities faces a number of barriers. For example, in many parts of Sub-Saharan Africa and South Asia, grid extension cannot keep up with population growth and the power demands that come with it. Additionally, many health facilities and the communities they serve are often very remote and characterized by poor surrounding infrastructure and low energy demand, making them unattractive to traditional energy service providers (e.g. utilities). Indeed, the business-as-usual approach to electrification is proving costly, unreliable and too slow.  As a result, these facilities sometimes resort to the use of diesel systems, which not only are polluting, but also not affordable, while diesel supply is often unreliable, especially in rural areas, resulting in a sporadic service.

 

 

 

Call for expression of interest: Global assessment of electricity in healthcare facilities

18 Jun

The purpose of this consultancy is to support WHO and partners on the development of the 'Global Assessment of Electricity in Healthcare Facilities’ report.

The consultancy entity will support the health and energy team within the Air Quality and Health (AQH) Unit of the WHO’s Department of Environment, Climate Change, and Health.

Background

Achieving universal health coverage, a key element of the Sustainable Development Goals (SDG), means ensuring that everyone has access to quality healthcare yet not enough attention is given to energy’s role in healthcare. Energy is critical for the delivery of health services. When health facilities have sufficient and reliable electricity, women can more safely give birth at night and during emergencies such as COVID- 19, medical equipment can be powered and better sterilized and clinics can preserve life-saving vaccines for new-borns, children and adults.

Yet, despite energy’s importance to delivering health services, it is estimated that tens of thousands of health centers across low- and middle-income countries are not connected to the grid and lack electricity. A similar number of hospitals suffer from frequent and debilitating blackouts. In parts of Sub-Saharan Africa, for example, only 28% of health facilities are estimated to have access to reliable electricity.  This puts patients at risk and makes the jobs of healthcare workers all the more challenging. This acute shortage of electricity access can be particularly detrimental in emergencies such as COVID-19 when reliable electricity is the need of the hour to save lives.

The task of increasing access to reliable and modern energy in health facilities faces a number of barriers. For example, in many parts of Sub-Saharan Africa and South Asia, grid extension cannot keep up with population growth and the power demands that come with it. Additionally, many health facilities and the communities they serve are often very remote and characterized by poor surrounding infrastructure and low energy demand, making them unattractive to traditional energy service providers (e.g. utilities). Indeed, the business-as-usual approach to electrification is proving costly, unreliable and too slow.  As a result, these facilities sometimes resort to the use of diesel systems, which not only are polluting, but also not affordable, while diesel supply is often unreliable, especially in rural areas, resulting in a sporadic service.

Luxembourg and WHO sign new Memorandum of Understanding, committing flexible funding to support WHO Triple billion targets

18 Jun

Today Luxembourg’s Minister for Development Cooperation and Humanitarian Affairs and Minister of the Economy, Mr Franz Fayot, and WHO Director General Dr Tedros  Adhanom Ghebreyesus signed a new Memorandum of Understanding (MoU) for the period 2020-2023 in support of the Organization’s Thirteenth General Programme of work 2019-2023. The signature of the new MOU underscores the longstanding commitment of the Government of the Grand Duchy of Luxembourg – an important partner in global health – to help WHO to achieve its ambitious triple billion targets by 2023: 1 billion more people will benefit from universal health coverage; 1 billion more will be better protected in health emergencies, and 1 billion more will enjoy improved health and wellbeing.

“The partnership with Luxembourg is very special to WHO and we are extremely grateful for the multi-annual, flexible funding Luxembourg provides,” said Dr Tedros.

The overall objective of the MoU is to support the achievement of the Sustainable Development Goals through WHO’s work in countries, focussing on three broad areas:

  • Achieving universal health coverage
  • Addressing health emergencies
  • Promoting healthier populations

By providing flexible and predictable funding to WHO, Luxembourg is effectively helping WHO to be agile and strategic in achieving its triple billion goals.

The new MoU also addresses gender equality in line with the UN System-wide Action Plan on Gender Equality and the Empowerment of Women, that enables gender issues to be mainstreamed systematically and measurably into all UN functions and entities,  and highlights the importance of the Junior Professional Officer programme.

The signature of the new MoU follows Luxembourg’s support to WHO in March 2020 for the COVID-19 response, to the WHO Contingency Fund for Emergencies and the COVID-19 Technology Access Pool (C-TAP), an initiative aimed at making vaccines, tests, treatments and other health technologies to fight COVID-19 accessible to all.

WHO welcomes preliminary results about dexamethasone use in treating critically ill COVID-19 patients

18 Jun

The World Health Organization (WHO) welcomes the initial clinical trial results from the United Kingdom (UK) that show dexamethasone, a corticosteroid, can be lifesaving for patients who are critically ill with COVID-19. For patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth, according to preliminary findings shared with WHO.

The benefit was only seen in patients seriously ill with COVID-19, and was not observed in patients with milder disease. 

“This is the first treatment to be shown to reduce mortality in patients with COVID-19 requiring oxygen or ventilator support,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This is great news and I congratulate the Government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this lifesaving scientific breakthrough.”

Dexamethasone is a steroid that has been used since the 1960s to reduce inflammation in a range of conditions, including inflammatory disorders and certain cancers. It has been listed on the WHO Model List of Essential Medicines since 1977 in multiple formulations, and is currently off-patent and affordably available in most countries.

The researchers shared initial insights about the results of the trial with WHO, and we are looking forward to the full data analysis in the coming days. WHO will coordinate a meta-analysis to increase our overall understanding of this intervention. WHO clinical guidance will be updated to reflect how and when the drug should be used in COVID-19.

Today’s news builds off the WHO Research & Development Blueprint meeting, which took place in Geneva in mid-February to accelerate health technologies for COVID-19, where further research into the use of steroids was highlighted as a priority. The findings reinforce the importance of large randomized control trials that produce actionable evidence. WHO will continue to work together with all partners to further develop lifesaving therapeutics and vaccines to tackle COVID-19 including under the umbrella of the Access to COVID-19 Tools Accelerator. 

EU-UK talks: MEPs display unwavering support for the EU position

18 Jun
Parliament regrets that differences remain substantial, with little time left to reach an agreement on the future EU-UK relationship. In a resolution adopted by a large majority, Parliament takes stock of the EU-UK negotiations on a new partnership so far and acknowledges the negotiating parties’ call to intensify talks in July.