News (English) - World Health Organization

WHO prequalifies diagnostic test to support safer administration of P. vivax malaria treatments

Wed, 08 Jan 2025 11:56:44 Z

On 18 December 2024, the World Health Organization (WHO) prequalified the first diagnostic test for glucose-6-phosphate dehydrogenase (G6PD) deficiency which can help to safely deliver WHO-recommended treatments to prevent relapse of Plasmodium vivax (P. vivax) infection.

The prequalification of this G6PD diagnostic test marks a significant milestone in facilitating safe and effective P. vivax malaria treatment, reaffirming WHO’s dedication to ensuring equitable access to life-saving health solutions globally. Some 500 000 people die each year from malaria, most of them children.

The prequalification of this test immediately followed the prequalification, in early December, of two new tafenoquine products for anti-relapse treatment of P. vivax malaria, and these therapeutics were recommended in updated WHO malaria guidelines released a few days earlier, in late November.

This package of actions by WHO reflects the organization’s recent adoption of synchronized and parallel processes for two key functions: developing recommendations for essential health products and overseeing their prequalification.

While these processes remain entirely independent, their alignment aims to significantly reduce the time required to bring vital health products to low- and lower-middle-income countries. This streamlined approach underscores WHO’s commitment to improving global health equity by expediting access to life-saving products.

P. vivax malaria is endemic in all WHO Regions except the European Region, with an estimated 9.2 million clinical cases occurring in 2023. P. vivax is the dominant malaria parasite in most countries outside of sub-Saharan Africa.

G6PD deficiency, a genetic condition, affects more than 500 million people. While most people are unaware of their G6PD deficiency and go through life without suffering ill effects, certain drugs administered to prevent malaria relapse caused by P. vivax can result in acute haemolysis (destruction of red blood cells). Without accessible and reliable G6PD testing, it has been challenging to safely provide anti-relapse treatments, limiting the widespread use of this effective therapy.

“The prequalification of this G6PD enzyme test for patients with P. vivax malaria can help countries in enhancing access to much-needed quality-assured tests, enabling safe and effective treatment and prevention of this type of relapsing malaria,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. “Currently, no other prequalification applications are received for this type of tests. We encourage the submission of additional products to expand the range of effective diagnostic tools available to countries in need.”

“Wider availability of the test can help strengthen the global malaria response by reducing the number of P. vivax infections due to relapse and in turn reduce onward transmission,” said Dr Daniel Ngamije Madandi, Director of WHO’s Global Malaria Programme.

Testing devices that can accurately distinguish patients with G6PD activity levels above and below the normal levels provide critical information to clinicians to decide which of P. vivax anti-relapse treatment regimens is most appropriate, including low- and high-dose primaquine and single-dose tafenoquine.

The STANDARD G6PD System diagnostic tool manufactured by SD Biosensor, Inc., is a semi-quantitative, near-patient solution designed for the measurement of G6PD enzyme activity in capillary or venous whole blood. The device is intended for use in both laboratory and non-laboratory settings and operates with the STANDARD G6PD Analyzer, a hand-held device, delivering results in a few minutes.

Milestone: COVID-19 five years ago

Mon, 30 Dec 2024 16:15:51 Z

Five years ago on 31 December 2019, WHO’s Country Office in China picked up a media statement by the Wuhan Municipal Health Commission from their website on cases of ‘viral pneumonia’ in Wuhan, China. In the weeks, months and years that unfolded after that, COVID-19 came to shape our lives and our world.

At WHO, we went to work immediately as the new year dawned. WHO employees activated emergency systems on 1 January 2020, and informed the world on 4 January. By 9-12 January, WHO had published its first set of comprehensive guidance for countries, and on 13 January, we brought together partners to publish the blueprint of the first SARS-CoV-2 laboratory test.

All along, we convened experts and ministries of health from around the world, gathered and analysed data, and shared what was reported, what we learned and what it meant for people. Read about WHO’s actions in this interactive timeline.

As we mark this milestone, let’s take a moment to honour the lives changed and lost, recognize those who are suffering from COVID-19 and long COVID, express gratitude to the health workers who sacrificed so much to care for us, and commit to learning from COVID-19 to build a healthier tomorrow.

We continue to call on China to share data and access so we can understand the origins of COVID-19. This is a moral and scientific imperative. Without transparency, sharing, and cooperation among countries, the world cannot adequately prevent and prepare for future epidemics and pandemics.

As we pose the question, “Is the world better prepared for the next pandemic than we were for COVID-19?” see WHO Director-General Dr Tedros Adhanom Ghebreyesus’s response at a recent press conference: https://who.canto.global/b/SHEJL

Kamal Adwan Hospital out of service following a raid yesterday and repeated attacks since October

Fri, 27 Dec 2024 20:04:46 Z

WHO is appalled by yesterday’s raid on Kamal Adwan Hospital, which put the last major health facility in North Gaza out of service. The systematic dismantling of the health system and a siege for over 80 days on North Gaza puts the lives of the 75,000 Palestinians remaining in the area at risk.

Initial reports indicate that some areas of the hospital were burnt and severely damaged during the raid, including the laboratory, surgical unit, engineering and maintenance department, operations theatre, and the medical store. Earlier in the day, twelve patients and a female health staff were reportedly forced to evacuate to destroyed and non-functional Indonesian Hospital where it is not possible to provide any care, while the majority of the staff, stable patients and companions were moved to a nearby location. Additionally, some people were reportedly stripped and forced to walk toward southern Gaza. Over the last two months, the area around the hospital has remained highly volatile and attacks on the hospitals and on health workers have occurred almost daily. This week, bombardments in its vicinity reportedly killed 50 people, including five health workers from Kamal Adwan Hospital.

Kamal Adwan is now empty. Yesterday evening, the remaining 15 critical patients, 50 caregivers and 20 health workers were transferred to Indonesian Hospital, which lacks the necessary equipment and supplies to provide adequate care. The movement and treatment of these critical patients under such conditions pose grave risks to their survival. WHO is deeply concerned for their wellbeing, as well as for the Kamal Adwan Hospital director who has been reportedly detained during the raid. WHO lost contact with him since the raid began.

An urgent WHO mission to Indonesian Hospital is being planned for tomorrow to assess the situation at the facility, provide basic medical supplies, food and water, and safely move critical patients to Gaza City for continued care.

The raid on the Kamal Adwan hospital follows escalating restrictions on access and repeated attacks. Since early October 2024, WHO has verified at least 50 attacks on health on or near the hospital. Despite the increasingly dire needs for emergency and trauma services and supplies, only 10 out of 21 WHO missions to Kamal Adwan have been partially facilitated between early October and December. During these missions, 45 000 liters of fuel, medical supplies, blood, and food were delivered, and 114 patients along with 123 companions were transferred to Al-Shifa Hospital. But the deployment of international emergency medical teams has been repeatedly denied.

WHO and partners' efforts to sustain the hospitals’ operations have been undone. With Kamal Adwan and Indonesian hospitals entirely out of service, and Al-Awda Hospital barely able to function, and severely damaged due to recent airstrikes, the healthcare lifeline for those in North Gaza is reaching a breaking point.

WHO calls for urgently ensuring that hospitals in North Gaza can be supported to become functional again.

Hospitals have once again become battlegrounds, reminiscent of the destruction of the health system in Gaza City earlier this year.

Since October 2023, WHO has repeatedly issued urgent calls to protect health workers and hospitals as per international humanitarian law —yet these calls remain unheard. Health facilities, workers and patients are always off limits. They must be actively protected and never be attacked, nor used for military purposes. The principles of precaution, distinction and proportionality under International Humanitarian Law are absolute and always apply.

Statement by Dr Tedros Adhanom Ghebreyesus, WHO Director-General on the attack on the Sana'a airport, Yemen

Thu, 26 Dec 2024 18:01:57 Z

Our mission to negotiate the release of the United Nations staff detainees and to assess the health and humanitarian situation in Yemen concluded today.

We continue to call for the detainees' immediate release.

As we were about to board our flight from Sana’a, about three hours ago (around 5 pm local time), the airport came under aerial bombardment. One of our plane’s crew members was injured. At least two people were reported killed at the airport.

The air traffic control tower, the departure lounge — just a few meters from where we were — and the runway were damaged. We will need to wait for the damage to the airport to be repaired before we can leave.

My UN and WHO colleagues and I are safe.

Our heartfelt condolences to the families whose loved ones lost their lives in the attack.

Luxembourg and WHO sign two strategic agreements

Mon, 23 Dec 2024 16:44:44 Z

A Strategic Partnership Framework (SPF) with the Ministry of Development Cooperation and Humanitarian Affairs and multiyear agreement with the Ministry of Health and Social Safety was signed on 20 December 2024. By signing two new partnership agreements, Luxembourg reaffirmed its continued support for WHO to fulfill a shared mission to promote, provide and protect health.

Statement on the antigen composition of COVID-19 vaccines

Mon, 23 Dec 2024 10:00:11 Z

Key points:

Vaccination remains an important public health countermeasure against COVID-19. As per the WHO Director General’s standing recommendations for COVID-19, Member States are recommended to continue to offer COVID-19 vaccination based on the recommendations of the WHO Strategic Advisory Group of Experts on Immunization (SAGE).
SARS-CoV-2 continues to circulate and evolve with important genetic and antigenic evolution of the spike protein since the beginning of the COVID-19 pandemic.
The objective of an update to COVID-19 vaccine antigen composition is to enhance vaccine-induced immune responses to circulating SARS-CoV-2 variants.
The WHO TAG-CO-VAC advises retaining the use of a monovalent JN.1 lineage variant as the antigen in future formulations of COVID-19 vaccines.
In accordance with WHO SAGE policy, vaccination should not be delayed in anticipation of access to vaccines with an updated composition; vaccination programmes can continue to use any available WHO emergency-use listed or prequalified COVID-19 vaccines.

The WHO Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC) continues to closely monitor the genetic and antigenic evolution of SARS-CoV-2 variants, immune responses to SARS-CoV-2 infection and COVID-19 vaccination, and the performance of COVID-19 vaccines against circulating variants. Based on these evaluations, WHO advises vaccine manufacturers and regulatory authorities on the implications for future updates to COVID-19 vaccine antigen composition. In April 2024, the TAG-CO-VAC recommended the use of a monovalent JN.1 lineage vaccine antigen as one approach to induce enhanced neutralizing antibody responses to JN.1 and its descendent lineages. Several manufacturers (using mRNA and recombinant protein-based vaccine platforms) have updated COVID-19 vaccine antigen composition to monovalent JN.1 lineage formulations (JN.1 or KP.2) and some of these have been approved for use by regulatory authorities. Previous statements from the TAG-CO-VAC can be found on the WHO website.

The TAG-CO-VAC reconvened on 10-12 December 2024 to review the genetic and antigenic evolution of SARS-CoV-2; immune responses to SARS-CoV-2 infection and/or COVID-19 vaccination; the performance of currently approved vaccines against circulating SARS-CoV-2 variants; and the implications for COVID-19 vaccine antigen composition.

Evidence reviewed

The published and unpublished evidence reviewed by the TAG-CO-VAC included: (1) SARS-CoV-2 genetic evolution with additional support from the WHO Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE); (2) Antigenic characterization of previous and emerging SARS-CoV-2 variants using virus neutralization tests with animal antisera and further analysis of antigenic relationships using antigenic cartography; (3) Immunogenicity data on the breadth of neutralizing antibody responses elicited by currently approved vaccine antigens against circulating SARS-CoV-2 variants using animal and human sera; (4) Preliminary immunogenicity data on immune responses following infection with circulating SARS-CoV-2 variants; (5) Available vaccine effectiveness (VE) estimates of currently approved vaccines during periods of circulation of XBB.1 and JN.1 lineages; and (6) Preliminary preclinical and clinical immunogenicity data on the performance of candidate vaccines with updated antigens shared confidentially by vaccine manufacturers with TAG-CO-VAC. Further details on the publicly available data reviewed by the TAG-CO-VAC can be found in the accompanying data annex. Unpublished and/or confidential data reviewed by the TAG-CO-VAC are not shown.

Summary of available evidence

In 2024, SARS-CoV-2 continues to circulate globally and cause severe disease, post COVID-19 condition and death. The majority of COVID-19 deaths continue to occur in individuals aged 65 years and older and those with coexisting conditions. There are persistent and increasing gaps in the reporting of cases, hospitalizations and deaths, from WHO Member States, making epidemiological trends difficult to infer.
Currently circulating SARS-CoV-2 variants are all derived from JN.1. The weekly proportion of XEC sequences among all SARS-CoV-2 sequences submitted to GISAID continues to increase, while the weekly proportions of all other Variants of Interest (JN.1) or Variants Under Monitoring (KP.2, KP.3, KP.3.1.1, JN.1.18 and LB.1) are now declining. There are other JN.1-derived variants that are currently in low proportions, but which have mutations that may give them an advantage over XEC: currently LP.8.1, NP.1, LF.7.2 are variants being monitored and/or characterized.
In published and unpublished data using antisera from naïve animal models, circulating JN.1-derived variants (JN.1, JN.1.16.1, KP.2, KP.2.3, KP.3, KP.3.1.1, LB.1 and XEC) are antigenically closely related.
- Analysis of naïve mice immunized with mRNA vaccine antigens (KP.3, KP.3.1.1, XEC) showed that JN.1, KP.3.1.1, XEC are antigenically closely related to each other (approximately 1 antigenic unit in cartographic analysis, which corresponds to a two-fold-reduction in neutralization). Antisera to KP.3.1.1 and XEC generate cross-reactive neutralizing antibody titers to each other and to other emerging variants.
- Antisera from naïve hamsters infected with JN.1 descendent lineages showed that circulating JN.1-derived variants such as KP.3.1.1 are antigenically closely related to JN.1 and to each other (approximately 1 antigenic unit in cartographic analysis). JN.1 antisera showed greater cross-reactivity to KP.2 and KP.3.1.1, as compared to KP.2 antisera.
In published and unpublished data from humans, vaccination with monovalent JN.1 or KP.2 antigens significantly increased neutralizing antibody titers that cross-reacted with all JN.1 descendent lineages tested.
- Analysis of pre- and post-vaccination sera from JN.1 or KP.2 immunized individuals demonstrated that vaccination results in strong rises in neutralizing antibody titers against JN.1 and descendent variants, including KP.2, KP.2.3, KP.3, KP.3.1.1 and XEC.
- Post-monovalent JN.1 or KP.2 vaccination neutralizing antibody titers against KP.3.1.1 and XEC were modestly lower (consistent 2-fold reductions in titers) than those against the homologous JN.1 or KP.2 antigens.
- There were greater reductions in cross-neutralization of emerging JN.1 lineage variants using post-monovalent XBB.1.5 vaccination sera, as compared to post-monovalent JN.1 or post-monovalent KP.2 vaccination sera.
In a context of infection- and vaccine-derived immunity in the majority of the population, contemporary vaccine effectiveness (VE) estimates are relative (rVE) rather than absolute (comparing vaccinated to unvaccinated individuals). rVE, sometimes referred to as “up-to-date VE”, demonstrates the added protection of most recent vaccination over and above pre-existing immunity derived from previous infections and/or vaccinations. There are currently studies reporting VE or rVE estimates using monovalent JN.1 lineage (JN.1 or KP.2) vaccines.
Approved monovalent XBB.1.5 mRNA COVID-19 vaccines continued to provide additional protection against severe disease and death during periods of XBB descendent lineage circulation in the first three months after vaccination; rVE point estimates against symptomatic disease were typically lower. During periods of JN.1 descendent lineage circulation, monovalent XBB.1.5 mRNA vaccines continued to show additional protection in the first three months after vaccination, however, available evidence points towards a reduction in rVE estimates against JN.1-derived variants, as compared to XBB.1 lineage variants, for protection against death, severe disease, symptomatic disease and infection.
The VE estimates for monovalent XBB.1.5 vaccines against JN.1-derived variants are consistent with reductions in neutralizing antibody titers observed in preclinical and clinical immunogenicity studies of post-monovalent XBB.1.5 vaccination sera against JN.1 descendent variants, as compared to XBB.1 lineage variants.
Preclinical data shared confidentially with the TAG-CO-VAC by vaccine manufacturers show that immunization of naïve mice, as well as of mice previously immunized with SARS-CoV-2 variants with monovalent JN.1-containing or monovalent KP.2-containing vaccine candidates resulted in good neutralization of JN.1 and descendent variants, including KP.3.1.1, XEC and MC.1. However, neutralizing antibody titers against KP.3.1.1, XEC and MC.1 were approximately 2-fold lower than those against the homologous immunizing antigen. A single preclinical immunogenicity study in mice using an XEC vaccine candidate showed comparable neutralizing antibody titers against JN.1, KP.3.1.1 and XEC as compared to a JN.1 vaccine candidate.
Clinical data shared confidentially with the TAG-CO-VAC by vaccine manufacturers show that post-monovalent JN.1 sera neutralized JN.1 and its derivatives including KP.3.1.1 and XEC well.

The TAG-CO-VAC acknowledges several limitations of the available data:

There are persistent and increasing gaps in the reporting of cases, hospitalizations and deaths, from WHO Member States, as well as in genetic/genomic surveillance of SARS-CoV-2 globally, including low numbers of samples sequenced and limited geographic diversity. The TAG-CO-VAC strongly supports the ongoing work of the WHO Coronavirus Network (CoViNet) to address this information gap.

The timing, specific mutations and antigenic characteristics of emerging and future variants are difficult to predict, and the potential public health impact of these variants remain unknown. There are JN.1-derived variants such as LP.8.1, NP.1 and LF.7.2 that are currently in low proportions, but which have mutations that may give them more immune escape than XEC. These will continue to be monitored and/or characterized. The TAG-CO-VAC strongly supports the ongoing work of the TAG-VE.
Although neutralizing antibody titers have been shown to be important correlates of protection from SARS-CoV-2 infection and of estimates of vaccine effectiveness, there are multiple components of immune protection elicited by infection and/or vaccination. Data on the immune responses following JN.1 descendent lineage infection or monovalent JN.1, KP.2 or XBB.1.5 vaccination are largely restricted to neutralizing antibodies. Data and interpretation of other aspects of the immune response, including cellular immunity, are limited.
Immunogenicity data against currently circulating SARS-CoV-2 variants are not available for all COVID-19 vaccines. Further, there are very limited data on immune responses following infection in humans with recent SARS-CoV-2 variants (e.g., KP.3.1.1, XEC).
Estimates of VE against recently circulating SARS-CoV-2 variants, including XBB or JN.1 descendent lineages, are limited in terms of the number and geographic diversity of studies, vaccine platforms evaluated, populations assessed, and duration of follow-up. Furthermore, the referent population for VE estimates varies substantially with respect to prior history of vaccination. There are currently no direct comparative estimates for monovalent JN.1, KP.2 or XBB.1.5 vaccines versus other antigen composition(s) delivered during the same time period. Finally, VE estimates may be confounded by differences in undocumented infection-derived immunity between groups, leading to potential underestimation of VE.

Recommendations for COVID-19 vaccine antigen composition

Given the breadth in immune responses demonstrated by monovalent JN.1 lineage vaccines against circulating variants, the TAG-CO-VAC advises retaining the current COVID-19 vaccine antigen composition, i.e. a monovalent JN.1 lineage variant (NextStrain: 24A, GenBank: PP298019, GISAID: EPI_ISL_18872762) as one approach to induce enhanced neutralizing antibody responses to JN.1 and its descendent variants (e.g., KP.3.1.1 and XEC).

Other approaches that demonstrate broad and robust neutralizing antibody responses against currently circulating JN.1 descendent lineage variants, such as vaccine antigens derived from more recent variants or alternative formulations, could also be considered.

As per the WHO Director General’s standing recommendations for COVID-19, Member States are recommended to continue to offer COVID-19 vaccination based on the recommendations of the WHO SAGE. Vaccination should not be delayed in anticipation of access to vaccines with an updated composition; vaccination programmes can continue to use any available WHO emergency-use listed or prequalified COVID-19 vaccines.

Further data requested

Given the limitations of the evidence upon which the recommendations above are derived and the anticipated continued evolution of the virus, the TAG-CO-VAC strongly encourages generation of the following data (in addition to the types of data outlined in October 2024):

Immune responses and clinical endpoints (i.e. VE and/or comparator rates of infection and severe disease) in varied human populations who receive COVID-19 vaccines with a monovalent JN.1 or KP.2 vaccine antigen composition, across different vaccine platforms, as well as further clinical and laboratory data on the performance of all currently approved COVID-19 vaccines against emerging SARS-CoV-2 variants.
Strengthened epidemiological and virological surveillance, as per the Standing Recommendations for COVID-19 in accordance with the International Health Regulations (2005), to determine if emerging variants are antigenically distinct and able to displace circulating variants.
Clinical evaluation of relevant new vaccine antigens derived from more recent variants.

As previously stated, the TAG-CO-VAC continues to encourage the further development of vaccines that may improve protection against infection and reduce transmission of SARS-CoV-2.

The TAG-CO-VAC will continue to closely monitor the genetic and antigenic evolution of SARS-CoV-2 variants, immune responses to SARS-CoV-2 infection and COVID-19 vaccination, and the performance of COVID-19 vaccines against circulating variants. The TAG-CO-VAC will also continue to reconvene every six months to evaluate the implications for COVID-19 vaccine antigen composition. At each meeting, recommendations to either maintain current vaccine composition or to consider updates will be issued.

Lebanon: soaring needs for trauma treatment and rehabilitation

Thu, 19 Dec 2024 14:49:14 Z

The ceasefire and the cessation of hostilities took effect on 27 November, offering temporary relief for the millions of civilians caught in the conflict in Lebanon. But Lebanon’s suffering did not end amid staggering unmet health needs. Bordering Syria and Israel, Lebanon’s overburdened health system is reeling from the impacts of an economic crisis, political deadlock, refugee crisis and now war.

The country is host to 1.5 million Syrian refugees: inevitably, events in Syria impact Lebanon and WHO operations. Syrian nationals are entering Lebanon at the same time as Syrian refugees are returning to Syria from Lebanon.

"An already decimated health system remarkably withstood this latest storm, but it has been further weakened. The challenges are complex and call for specialized, sustained support," said WHO Representative to Lebanon Dr Abdinasir Abubakar.

A rocky road ahead

The road ahead for Lebanon‘s health system is rocky and the future uncertain.

Lebanon’s cumulative real GDP has shrunk by 38% since 2019, according to the World Bank, with the war being the latest of many blows. As of today, more than 1 million people displaced by hostilities have returned to southern Lebanon where the physical and health infrastructure is in tatters. Several health facilities remain closed and most hospitals are running below capacity due to financial restraints and shortages of staff, long-standing challenges in Lebanon.

More than 530 health workers and patients have been killed or injured in attacks on health care and thousands of health workers have been displaced or have emigrated leaving the hospitals and the health centres grappling to meet the health needs of the populations. In order to keep hospitals running, the need for health workers is dire.

Water and sanitation systems have been severely disrupted, compounding the risk of disease outbreaks. With nearly 7% of buildings in ruins in the two southern governorates that were hardest hit, thousands remain on the move and won’t be able to return home anytime soon. Those who have returned face the risks posed by explosive remnants of war, as well as greater overall health risks.

Growing need for specialized trauma care

Since 8 October 2023, more than 4000 people were killed and 17 000 injured in Lebanon alone. Since the ceasefire took hold and conflict-impacted areas have become more accessible, the death toll continued climbing as more bodies are found in the 16 000 buildings that have been partially or completely destroyed, leaving an estimated 8 million tonnes of debris.

"The physical destruction is similar to what you see after an earthquake – and that has resulted in complex injuries, open wounds and fractures. And since the treatment provided during the war was often not optimal, the injured end up needing multiple surgeries to prevent complications and disabilities, " said Dr Ahmad Alchaikh Hassan, WHO Trauma Technical Officer.

One in 4 people with life-changing injuries will need long-term rehabilitation and, in some cases, assistive technologies and prosthetics. Specialized support will be required as the technical capacities in Lebanon cannot cope with the increasing numbers of people in need for these services and commodities.

"This need for specialized health care will persist for months and years to come. Lebanon needs reconstructive surgeons to treat the severely injured, eye doctors to treat the thousands of people injured in the pager attack, physiotherapists to start rehabilitating amputees and prosthetists to assist users of assistive devices," said WHO Representative Dr Abubakar.

WHO’s response

Ensuring a sufficient number of trained health workers with expertise in war-related trauma and plastic reconstructive surgery is a priority.

Three weeks into an 8-week ceasefire, WHO and the Ministry of Public Health are working on replenishing medical supplies and restoring health services country-wide.

"WHO and national health authorities have carried out several mass casualty management trainings across Lebanon – resulting in stronger, more life-saving assertive responses. Without these timely interventions, the outcomes would be unconscionable," said Dr Hassan, WHO's Trauma Technical Officer.

The ongoing WHO operations include scaling up trauma care capacity, training surgeons on specialized trauma care in conflict areas, providing mental health trainings to health workers, capacity building for rehabilitation in post-conflict settings, replacing damaged equipment, identifying gaps in health coverage, and preparing for future scenarios and the subsequent health impact.

WHO also provided 5000 contingency blood bags and reagents to blood banks and developed awareness material on unexploded ordinances and other health risks for first responders and civilians. WHO and the Ministry of Public Health run strong country-wide surveillance for disease outbreaks which pose a heightened risk in post-conflict settings.

"The road to recovery will be long and windy. Our aim is to assist the health system to bounce back, and be resilient and prepared. We are grateful to our many partners who have supported this response but this is not the end of it. This is the start and the need for technical and financial support has never been greater," concluded WHO Representative Dr Abubakar.

President Macron, WHO Director-General, and global health leaders inaugurate WHO Academy in Lyon

Tue, 17 Dec 2024 12:44:09 Z

The WHO Academy in Lyon, France, officially opened its doors today with a high-profile inauguration ceremony. The Academy aims to tackle the growing global shortage of health and care workers, projected to reach 10 million by 2030, by training thousands of health professionals each year.

New WHO report reveals governments deprioritizing health spending

Wed, 11 Dec 2024 22:08:01 Z

The 2024 Global Heath Expenditure Report by the World Health Organization (WHO) shows that the average per capita government spending on health in all country income groups fell in 2022 from 2021 after a surge in the early pandemic years. The report entitled, “Global spending on health Emerging from the pandemic” has been published in alignment with the Universal Health Coverage (UHC) Day campaign marked annually on 12 December. The campaign’s focus for 2024 is on improving financial protection for people everywhere to access health services they need.

Government spending on health is crucial to delivering UHC. Its deprioritization can have dire consequences in a context where 4.5 billion people worldwide lack access to basic health services and 2 billion people face financial hardship due to health costs.

“While access to health services has been improving globally, using those services is driving more and more people into financial hardship or poverty. Universal Health Coverage Day is a reminder that health for all means everyone can access the health services they need, without financial hardship,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

Who’s paying for healthcare?

Protecting people from financial hardship due to out-of-pocket health costs is fundamental to achieving health for all. Yet, WHO’s report shows that out-of-pocket spending remained the main source of health financing in 30 low- and lower middle-income countries. In 20 of these countries, more than half of total health spending in the country was paid for by patients out of their pocket, which contributes to the cycle of poverty and vulnerability.

The challenges posed by the lack of financial protection for health are not limited to lower-income countries. Even in high-income countries, out-of-pocket payments lead to financial hardship and unmet need, particularly among the poorest households. Most recent health accounts data show that in over a third of high-income countries, more than 20% of total health spending was paid out-of-pocket.

On the occasion of UHC Day, WHO is calling on leaders to make UHC a national priority and eliminate impoverishment due to health-related expenses by 2030. Effective strategies to strengthen financial protection include minimizing or removing user charges for those most in need, including people with low incomes or chronic conditions, adopting legislation to protect people from impoverishing health costs and establishing health financing mechanisms through public funding to cover the full population.

Public funding needs to budget for an affordable package of essential health services – from health promotion to prevention, treatment, rehabilitation and palliative care – using a primary health care approach.

Lessons from the pandemic

During the COVID-19 pandemic in 2020–2022, public spending on health – mainly via government health budgets –enabled health systems to respond quickly to the emergency. This reflects the advantage of government budgets in financing public health functions, in particular population-based public health interventions, versus other health financing schemes, during times of health emergencies. Government funding ensured that more people were protected and more lives were saved.

Emerging from the pandemic, countries are at a crossroads. Governments face difficult decisions as they work to strengthen the resilience of health systems against future health threats while addressing their populations' healthcare needs in a challenging economic environment.

Twenty-five years of WHO tracking global health spending

The key to making better choices on future health investments is timely and reliable evidence on the level and pattern of health spending. For 25 years the WHO Health Expenditure Tracking programme has had a major influence on how critical information on health spending is compiled and reported at the country level and globally.

Among its most notable achievements are the establishment of the Global Health Expenditure Database – the world’s richest source of health expenditure data covering more than 190 countries since 2000--and the Global Health Expenditure Report, which has been published annually since 2017. These global public goods drive informed policymaking, transparency and accountability worldwide.

WHO and partners advance efforts for UHC impact

This year’s UHC Day also provides a platform for a milestone discussion in WHO’s efforts to advance support and collaboration with countries in reorienting their health systems to advance UHC and achieve health security in countries, regions and globally. From 11–13 December, national health representatives, heads of WHO country offices, and health policy advisers from over 125 countries are meeting in Lyon, France to take stock of progress and challenges, agree on priority areas and working methods, and set the agenda for the next phase of the UHC Partnership from 2025-2027.

The UHC Partnership is WHO’s flagship initiative on international cooperation for UHC, which brings WHO and partners together to support concrete actions to achieve UHC. It is funded by the European Union, Belgium, Canada, the French Ministry for Europe and Foreign Affairs, Germany, Irish Aid, the Government of Japan, and the United Kingdom - Foreign, Commonwealth & Development Office.

Over 1 in 5 adults worldwide has a genital herpes infection – WHO

Mon, 09 Dec 2024 16:27:03 Z

Around 846 million people aged between 15 and 49 are living with genital herpes infections – more than 1 in 5 of this age-group globally – according to new estimates released today. At least 1 person each second – 42 million people annually – is estimated to acquire a new genital herpes infection.

Most of the time, these infections cause no or few symptoms. However, for some people they lead to painful genital sores and blisters that can recur throughout life, causing significant discomfort and often requiring multiple healthcare visits. According to the estimates, more than 200 million people aged 15 to 49 suffered at least one such symptomatic episode in 2020.

The authors of the study, published in the journal Sexually Transmitted Infections, say that new treatments and vaccines are needed to reduce adverse health effects of the herpes virus and control its spread.

“While most people with a genital herpes infection experience few symptoms, with so many infections genital herpes still causes pain and distress for millions globally and strains already overburdened health systems,” said Dr Meg Doherty, Director of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes at WHO. “Better prevention and treatment options are urgently needed to reduce herpes transmission and will also contribute to reducing the transmission of HIV.”

Currently, there is no cure for herpes, although treatments can relieve symptoms. In addition to sores, genital herpes can also on occasion lead to serious complications, including neonatal herpes – a rare condition most likely to occur when a mother acquires the infection for the first time in late pregnancy and then transmits the virus to her baby during childbirth.

There are two types of the herpes simplex virus (HSV), known as HSV-1 and HSV-2, both of which can lead to genital herpes. According to the estimates, 520 million people in 2020 had genital HSV-2, which is transmitted during sexual activity. From a public health perspective, genital HSV-2 is more serious since it is substantially more likely to cause recurrent outbreaks, accounts for around 90% of symptomatic episodes, and is linked to a three-fold increased risk of getting HIV.

Unlike HSV-2, HSV-1 primarily spreads during childhood through saliva or skin to skin contact around the mouth to cause oral herpes, with cold sores or mouth ulcers the most common symptoms. In those without previous infection, however, HSV-1 can be acquired through sexual contact to cause genital infection in adolescence or adulthood. Some 376 million people are estimated to have had genital HSV-1 infections in 2020. Of these, 50 million are estimated also to have HSV-2 as it is possible to have both types at the same time.

While the 2020 estimates show virtually no difference in the prevalence of genital HSV-2 compared to 2016, estimated genital HSV-1 infections are higher. Over recent years, several countries have observed changing patterns of transmission in HSV-1, with adult genital infections increasing as childhood oral infections decline. Reduced oral spread during childhood may be linked to factors like less crowded living conditions and improved hygiene, which then increases susceptibility to the virus at older ages. The authors note that these increases may also partially reflect changes in methods and additional data sources.

“Stigma around genital herpes means it has been discussed too little, despite affecting millions of people globally. Not enough has been done to address this common infection,” said Dr Sami Gottlieb, an author of the report and Medical Officer within WHO’s Department of Sexual and Reproductive Health and Research including the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP). “Expanded research and investment in developing new herpes vaccines and therapies, and their equitable use, could play a critical role in improving quality of life for people around the world.”

While they are not fully effective at stopping its spread, correct and consistent use of condoms reduces risks of herpes transmission. People with active symptoms should avoid sexual contact with other people, since herpes is most contagious when sores are present. WHO recommends that people with symptoms of genital herpes should be offered HIV testing and if needed, pre-exposure prophylaxis for HIV prevention.

In line with its Global Health Sector Strategy on HIV, viral hepatitis and sexually transmitted infections for 2022-2030, WHO works to increase awareness about genital herpes infections and related symptoms, improve access to antiviral medications, and promote related HIV prevention efforts. It is also working to advance research and development of new tools for the prevention and control of herpes infections, such as vaccines, treatments and topical microbicides.

Earlier this year, a new study showed that genital herpes infections not only cause significant health impacts but also major economic costs – amounting to an estimated US $35 billion a year worldwide – through health care expenditures and productivity loss.

Editor’s note

The study, Estimated global and regional incidence and prevalence of herpes simplex virus infections and genital ulcer disease in 2020: Mathematical modeling analyses, updates the 2012 and 2016 WHO estimates. It was authored by experts from WHO, HRP, the WHO Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections and Viral Hepatitis at Weill Cornell Medicine-Qatar as well as the University of Bristol.

Based on comprehensive regional systematic reviews and meta-analyses of HSV-1 and HSV-2 prevalence for all WHO regions, the study estimates the prevalence and incidence of genital HSV infection and HSV related genital ulcer disease in 2020 globally and by region.

Reinvigorated global efforts needed to curb rising malaria threat

Fri, 06 Dec 2024 14:02:01 Z

New data from the World Health Organization (WHO) reveal that an estimated 2.2 billion cases of malaria and 12.7 million deaths have been averted since 2000, but the disease remains a serious global health threat, particularly in the WHO African Region.

Drowning deaths decline globally but the most vulnerable remain at risk

Fri, 06 Dec 2024 13:27:14 Z

WHO publishes its first-ever report on drowning prevention, which reveals a 38% drop in the global drowning death rate since 2000—a major global health achievement. However, the report notes that drowning remains a major public health issue.

WHO announces first prequalification of a tuberculosis diagnostic test

Wed, 04 Dec 2024 21:20:12 Z

The World Health Organization (WHO) has granted prequalification to the molecular diagnostic test for tuberculosis (TB) called Xpert® MTB/RIF Ultra. It is the first test for TB diagnosis and antibiotic susceptibility testing that meets WHO's prequalification standards.

Tuberculosis is one of the world’s leading infectious disease killers, causing over a million deaths annually and imposing immense socioeconomic burdens, especially in low- and middle-income countries. Accurate and early detection of TB, especially drug-resistant strains, remains a critical and challenging global health priority.

“This first prequalification of a diagnostic test for tuberculosis marks a critical milestone in WHO’s efforts to support countries in scaling up and accelerating access to high-quality TB assays that meet both WHO recommendations and its stringent quality, safety and performance standards,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. “It underscores the importance of such groundbreaking diagnostic tools in addressing one of the world's deadliest infectious diseases.”

WHO prequalification of this test is expected to assure quality of diagnostic tests used to improve access to early diagnosis and treatment. It complements WHO’s endorsement approach, which is grounded in emerging evidence, diagnostic accuracy, and patient outcomes alongside considerations for accessibility and equity, with prequalification requirements on quality, safety, and performance.

WHO’s assessment for prequalification is based on information submitted by the manufacturer, Cepheid Inc., and the review by Singapore’s Health Sciences Authority (HSA), the regulatory agency of record for this product.

Designed for use on the GeneXpert® Instrument System, this nucleic acid amplification test (NAAT) Xpert® MTB/RIF Ultra detects the genetic material of Mycobacterium tuberculosis, the bacterium that causes TB, in sputum samples, and provides accurate results within hours. Simultaneously, the test identifies mutations associated with rifampicin resistance, a key indicator of multidrug-resistant TB.
It is intended for patients who screen positive for pulmonary TB and who have either not started anti-tuberculosis treatment or received less than three days of therapy in the past six months.

“High-quality diagnostic tests are the cornerstone of effective TB care and prevention,” said Dr Rogerio Gaspar, WHO Director for Regulation and Prequalification. “Prequalification paves the way for equitable access to cutting-edge technologies, empowering countries to address the dual burden of TB and drug-resistant TB.”

In a joint effort by WHO Global TB Programme and the Department of Regulation and Prequalification to improve access to quality-assured TB tests and expand diagnostic options for countries, WHO is currently assessing seven additional TB tests.

New report highlights need for sustained investment in infection prevention and control programmes

Fri, 29 Nov 2024 08:40:50 Z

A large proportion of healthcare-associated infections can be prevented with improved IPC practices and basic water, sanitation and hygiene (WASH) services. This report provides a baseline assessment for policymakers, IPC professionals, health-care workers and stakeholders to guide action.

Second meeting of the International Health Regulations (2005) Emergency Committee regarding the upsurge of mpox 2024

Thu, 28 Nov 2024 15:15:42 Z

The Director-General of the World Health Organization (WHO) is hereby transmitting the report of the second meeting of the International Health Regulations (2005) (IHR) Emergency Committee (Committee) regarding the upsurge of mpox 2024, held on Friday 22 November 2024, from 12:00 to 17:00 CET.

Notwithstanding some progress towards controlling the spread of mpox resulting from national and international response efforts, the Committee noted the rising number and continuing geographic spread of mpox cases, especially those due to monkeypox virus clade Ib infection; the operational challenges in the field in need of stronger national commitments; as well as the need to mount and sustain a cohesive response across countries and partners. The Committee advised that the event continues to meet the criteria of a public health emergency of international concern (PHEIC) and provided its views regarding the proposed temporary recommendations.

The WHO Director-General expresses his most sincere gratitude to the Chair, Members, and Advisors of the Committee. The WHO Director-General concurs with the advice of the Committee that the event continues to constitute a PHEIC for the reasons detailed in the proceedings of the meeting below, and issues revised temporary recommendations in relation to this PHEIC, which are presented at the end of this document.

Proceedings of the meeting

Sixteen (16) Members of, and two Advisors to, the International Health Regulations (2005) (IHR) Emergency Committee (Committee) were convened by teleconference, via Zoom, on Friday, 22 November 2024, from 12:00 to 17:00 CET. Thirteen (13) of the 16 Committee Members, and one of the two Advisors to the Committee participated in the meeting.

The Director-General of the World Health Organization (WHO) delegated the WHO Deputy Director-General to welcome the Committee Members and Advisors, and invited Government Officials designated to present to the Committee on behalf of the five invited States Parties – Burundi, the Democratic Republic of the Congo (DRC), Kenya, Rwanda and Uganda.

The WHO Deputy Director-General recalled that the determination of the public health emergency of international concern (PHEIC), on 14 August 2024, was a call for national authorities to invest energetically to prevent and control the transmission of monkeypox virus (MPXV) with particular focus on clade Ib, to reduce the risk of international spread of mpox, and for the international community to act cohesively and intensely with all the tools and resources available for the prevention and control of mpox.

Highlighting the evolution of mpox globally (see details under the heading “Session open to representatives of States Parties invited to present their views), the WHO Deputy Director-General stressed that, since the Committee last met in August 2024, the situation has become more complex and continues to require a coordinated international response, including in all countries and especially in those with limited number of mpox cases before wider spread of disease may occur. He outlined the constructive collaborations and efforts of WHO and numerous partners, including the Africa Centres for Disease Control and Prevention (Africa CDC), to scale up the response at regional, national and sub-national levels; and the establishment, by WHO and partners, of the Access and Allocation Mechanism (AAM) as part of the interim Medical Countermeasures Network endorsed by WHO Member States, to support the equitable allocation and distribution of vaccines, therapeutics and diagnostics. The WHO Deputy Director-General outlined a number of challenges States Parties are facing to interrupt the transmission of mpox, including a number of concurrent health emergencies and competing health priorities, hence requiring political commitment and resources to further scale up targeted and integrated interventions at local levels.

The Representative of the Office of Legal Counsel briefed the Members and Advisors on their roles and responsibilities and identified the mandate of the Committee under the relevant articles of the IHR. The Ethics Officer from the Department of Compliance, Risk Management, and Ethics provided the Members and Advisors with an overview of the WHO Declaration of Interests process. The Members and Advisors were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or actual conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the Committee. Each Member and Advisor was surveyed, with no conflicts of interest identified.

The meeting was handed over to the Chair who introduced the objectives of the meeting, which were to provide views to the WHO Director-General on whether the event continues to constitute a PHEIC, and if so, to provide views on the potential proposed temporary recommendations.

Session open to representatives of States Parties invited to present their views

The WHO Secretariat presented an overview of the global epidemiological situation of mpox, all MPXV clades included, highlighting that, since the Committee last met in August 2024, MPXV transmission has been reported in all six WHO Regions. While the WHO African Region represents the largest contributor to the global increase of mpox cases due to clades Ia, Ib and IIa, mpox in the WHO Western Pacific Region has been increasing due to an MPXV clade IIb outbreak among men who have sex with men reported from Australia.

With regards to the spread of MPXV clade Ib in the WHO African Region, since the Committee last met, the WHO Secretariat presented that the foci of transmission are in the DRC, with clade Ib now detected in six provinces, including in the urban area of the capital Kinshasa. MPXV clade Ib has also spread in neighbouring countries, including in Burundi (2,083 mpox cases, growing in the urban areas of Bujumbura and Gitega) and Uganda (582 mpox cases, growing in the capital Kampala) with established sustained community transmission; and Kenya (17 mpox cases) and Rwanda (37 mpox cases) with clusters of mpox cases (data reported as of 19 November 2024).

Additionally, travel-related cases of MPXV clade Ib infection, mostly epidemiologically linked to the above-mentioned countries, have been detected in eight countries in the following WHO Regions – African Region (Zambia and Zimbabwe); Americas Region (United States of America); European Region (Germany, Sweden, and the United Kingdom. In the United Kingdom, transmission within the household of the case occurred); and South-East Asian Region (India and Thailand).

Available data from the sub-national level in the DRC shows that the observed dynamics of transmission of MPXV clade Ib are changing over time and are diverse across affected health zones. Since MPXV clade Ib was first detected in September 2023 in South Kivu province in the health zone of Kamituga, the most affected age group has shifted from adults, where transmission was first observed and appears to have been sustained by contact within commercial sexual networks, to younger age groups, including children, and sustained by household and likely broader community transmission through close physical contact.

The same epidemiological characteristics are being observed in the capital Kinshasa, where the outbreak is largely driven by transmission between adults, but where steadily more children are being reported as a result of close physical contact within households and/or the community. It is worth noting that, regardless of the circulating MPXV clades, adults of 50 years of age or older are less affected, likely due to the immunity conferred by prior vaccination against smallpox.

The WHO Secretariat indicated that information about mortality in confirmed cases of mpox, regardless of the MPXV clade, is limited. In the DRC, based on routine syndromic surveillance data, deaths attributed to mpox are predominant in rural areas known to be endemic for MPXV clade Ia – with variable case fatality rates observed across those areas, but being consistently higher in children under 5 years of age.

Outside the DRC, deaths associated with MPXV clade Ib infection have been reported in Burundi (1), Uganda (2) and Kenya (1).

The WHO Secretariat presented the assessed risk by MPXV clades and further expressed in terms of overall public health risk where any given clade/s is/are circulating, and risk of national and international spread, as: Clade Ib – high public health risk and high risk of national/international spread; Clade Ia – high public health risk and moderate risk of national/international spread; Clade II – moderate public health risk and moderate risk of national/international spread.

The WHO Secretariat subsequently provided an update on actions WHO has taken, with States Parties and partners, following the issuance of the temporary recommendations on 19 August 2024, the extension of the standing recommendations for mpox, and the WHO appeal: mpox public health emergency 2024, and based on the WHO Mpox global strategic preparedness and response plan, September 2024-February 2025; the Africa CDC-WHO Mpox Continental Preparedness and Response Plan for Africa, September 2024-February 2025; A coordinated research roadmap – Mpox virus - Immediate research next steps to contribute to control the outbreak (2024).

In addition to the overview provided by the WHO Deputy Director-General, the WHO Secretariat provided detailed updates on progress and challenges related to the following areas of the response, including: collaborative surveillance, safe and scalable clinical care, community protection, access to countermeasures, including diagnostics and vaccines (over 1.1 million doses of MVA-BN vaccine allocated to date), operations (deployment of human resources, dispatch of personal protective equipment, diagnostic tests, etc. to the field), funding (of the 87.4 million USD needed as per WHO appeal, 40.6 million USD were received or pledged; 3.5 million USD were released from the WHO's Contingency Funds for Emergencies), and coordination with partners.

Representatives of Burundi, the DRC, Kenya, Rwanda and Uganda updated the Committee on the mpox epidemiological situation in their countries and their current response efforts, needs and challenges. Mpox vaccine is currently being used in the DRC and Rwanda, and there are plans to use it in Kenya and Uganda, whereas vaccination against mpox is currently not encompassed by the response strategy of Burundi.

Members of, and the Advisor to, the Committee then engaged in questions and answers with the WHO Secretariat and invited Government Officials, on the issues and challenges presented.

The determination that the upsurge of mpox constitutes a PHEIC in August 2024 was regarded by States Parties attending the meeting as having boosted domestic response efforts and the mobilization of international resource to support those efforts.

However, the lack of information at national and local levels, including the suboptimal implementation of response interventions, was regarded as an obstacle to progress in controlling and interrupting MPXV transmission. Examples to that effect related to the proportion of suspected mpox cases tested; the time from diagnosis to subsequent isolation of mpox cases; the trend of mpox test positivity rate; the proportion of contacts that have completed the follow-up period; the proportion of mpox cases with an unknown epidemiological link, and trend thereof; and challenges with mpox vaccination implementation. Challenges with vaccination implementation include: the current vaccination coverage in countries with mpox vaccines, including in targeted at risk groups; the proportion of contacts that have received mpox vaccine; the time elapsed between the last exposure of an unvaccinated contact; and the administration of mpox vaccine.

The observed multifaceted dynamics of the spread of MPXV was discussed at length in terms of (a) the expansion of transmission from within known commercial sexual networks, and subsequently within households, and to the wider community with sustained transmission; (b) opportunities to refine the risk assessment approach, considering lower geographical levels and vulnerable subsets of population; and (c) the potential for predictive mathematical modeling approaches to anticipate MPXV spread both within countries and internationally.

Aspects related to the use of mpox vaccines as part of the response were discussed, including, but not limited to, (a) progress with global and domestic regulatory issues; (b) challenges for use of mpox vaccines in infants, children, adolescents, and immunocompromised persons (as per WHO vaccine position paper, August 2024); (c) need to implement vaccination as part of an integrated targeted response to interrupt MPXV transmission in hotspots at the local level, as opposed to a broader geographical use of the vaccine; (d) uncertainties related to the effectiveness of post-exposure use of the vaccine; (e) possible inclusion of studies to assess vaccine effectiveness in vaccine deployment plans; and (f) approaches to overcome vaccine hesitancy.

The coordination between Africa CDC and WHO in supporting States Parties’ response efforts in implementing the Africa CDC-WHO Mpox Continental Preparedness and Response Plan for Africa, September 2024-February 2025 was reported as collaborative, constructive and progressive. WHO and Africa CDC have a joint continental incident management team based in Kinshasa, DRC. A significant achievement of this coordination is the alignment of the vaccine allocation process and the AAM with the Technical Review Committee and the vaccination group within the Continental IMST.

Deliberative session

Following the session open to invited States Parties, the Committee reconvened in a closed session to examine the questions in relation to whether the event constitutes a PHEIC or not, and if so, to consider the temporary recommendations drafted by the WHO Secretariat in accordance with IHR provisions.

The Chair reminded the Committee Members of their mandate and recalled that a PHEIC is defined in the IHR as an “extraordinary event, which constitutes a public health risk to other States through the international spread of disease, and potentially requires a coordinated international response”.

The Committee was unanimous in expressing the views that the ongoing upsurge of mpox still meets the criteria of a PHEIC and that the Director-General be advised accordingly.

The overarching consideration underpinning the advice of the Committee is the limited effectiveness and efficiency of the response implemented at local level, particularly in Burundi and the DRC, to interrupt MPXV transmission – specifically in terms of surveillance, laboratory diagnostics, contact tracing, and community education and engagement. If duly and systematically implemented early on, such interventions could substantially contribute to the interruption of transmission both locally and globally, especially considering that access to mpox vaccine is often challenging, and the strategic use of vaccine has yet to be fully implemented.

On that basis, and further elaborating upon issues addressed during the question and answers session, the Committee considered that:

The event is “extraordinary” because of (a) the increased number of mpox cases and geographical expansion of foci of MPXV clade Ib transmission within States Parties; (b) the evolving dynamics of MPXV clade Ib transmission – from within known commercial sexual networks, to within households, to the wider community – resulting in the infection of broader age-groups, and/or vulnerable population groups, and/or co-infection and co-circulation with other MPXV clades and/or pathogens, and, hence, generating uncertainties and unknowns in terms of morbidity and mortality, and, consequently, leading to new response challenges, including regarding clinical care; (c) the risk of MPVX clade Ib mutations in the context of sustained community transmission, resulting in new dynamics of transmission and/or associated with new morbidity and mortality patterns (e.g. changes of transmissibility and/or virulence); (d) the ongoing prevalence of MPXV clade Ia infections in DRC with new foci of sexual network disease transmission in the capital Kinshasa.

The event “constitutes a public health risk to other States through the international spread of disease” because of (a) the documented recent exportation of MPVX clade Ib cases from States Parties where that clade is circulating to others within the WHO African Region and at least three additional WHO Regions; (b) the epidemiological link of exported MPVX clade Ib cases in the areas where exposure occurred is not known; (c) the risk that MPXV, and clade Ib in particular, is introduced in States Parties that may not comply with reporting requirement to WHO under IHR provisions, and/or may not have the capacities to implement response interventions.

The event “requires a coordinated international response” through (a) intensified engagement of international partners with national authorities to (i) raise the profile of mpox as public health priority, and (ii) strengthen prevention and response operations at the local level through the deployment of dedicated human resources and supplies; (b) mobilization of financial resources and their effective and efficient use; (c) the facilitation of equitable access to mpox including vaccines and diagnostics, including with the view to build capacity for the local and/or regional production of vaccine in the mid- to longer term.

The Committee indicated the need to start elaborating on the considerations that would inform their future advice to terminate the PHEIC while assessing the three criteria defining a PHEIC.

The Committee subsequently considered the draft of the temporary recommendations proposed by the WHO Secretariat.

Notwithstanding that temporary recommendations constitute non-binding advice to States Parties, and noting that it was the first time that a set of temporary recommendations included one related to reporting on the implementation thereof, the WHO Secretariat presented the structure and outcome of the survey to that effect administered to, and completed online by the five States Parties to which the temporary recommendations issued on 19 August 2024 were directed to (Burundi, the DRC, Kenya, Rwanda and Uganda). Provided that the Director-General would determine that the event still constitutes a PHEIC, and issue temporary recommendations accordingly, the Committee formulated suggestions to the WHO Secretariat to improve the survey by encompassing the local dimension of the response, and to use the outcome of the survey for shaping the proposed temporary recommendations.

The Committee then considered the revised set of temporary recommendations proposed by the WHO Secretariat, should the Director-Generals determine that the event still constitutes a PHEIC. The Committee had received the proposed set ahead of the meeting and, noting the proposal to extend most of the temporary recommendations issued on 19 August 2024, the Committee formulated suggestions regarding the definition of “hotspot”, referred to in some of the recommendations.

The Committee indicated that it would be giving further consideration to the proposed temporary recommendations while finalizing the report of the meeting.

Conclusion

The Committee reiterated its concern regarding the continuing spread of MPXV and uncertainties ensuing, and the effectiveness and efficiency of the response at the local level. The Committee underscored the need for the sustained commitment by national authorities in focusing efforts and resources at the local level to interrupt MPXV transmission, as well as the role of coordinated international cooperation in supporting and complementing such efforts in a synergistic manner. Therefore, the Committee considers that the determination by the WHO Director-General that the upsurge of mpox still constitutes a PHEIC would be warranted.

The WHO Deputy Director-General expressed his gratitude to the Committee’s Officers, its Members and Advisor and closed the meeting.

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Temporary recommendations

These temporary recommendations are issued to States Parties experiencing the transmission of monkeypox virus (MPXV), including, but not limited to, those where there is sustained community transmission, and where there are clusters of cases or sporadic travel-related cases of MPXV clade Ib^.^[1]

They are intended to be implemented by those States Parties in addition to the current standing recommendations for mpox, which will be extended until 20 August 2025.

In the context of the global efforts to prevent and control the spread of mpox disease outlined in the WHO Strategic framework for enhancing prevention and control of mpox- 2024-2027, the aforementioned standing recommendations apply to all States Parties.

All current WHO interim technical guidance can be accessed on this page of the WHO website. WHO evidence-based guidance has been and will continue to be updated in line with the evolving situation, updated scientific evidence, and WHO risk assessment to support States Parties in the implementation of the WHO Strategic Framework for enhancing mpox prevention and control.

Pursuant to Article 3 Principle of the International Health Regulations (2005) (IHR), the implementation of these temporary recommendations, as well as the standing recommendations for mpox, by States Parties shall be with full respect for the dignity, human rights and fundamental freedoms of persons, in line with the principles set out in Article 3 of the IHR.

===

^[1]Note: The text in backets next to each temporary recommendation indicates the status with respect to the set of temporary recommendations issued on 19 August 2024. The following temporary recommendation issued on that occasion was terminated – “Prepare for the introduction of mpox vaccine for emergency response through convening of national immunization technical advisory groups, briefing of national regulatory authorities, preparing national policy mechanisms to apply for vaccines through available mechanisms”.

Emergency coordination

Secure political commitment and engagement to intensify prevention and response efforts, including resource allocation, in hotspots - defined as the lowest operational level reporting mpox cases in the prior 4 weeks (NEW);
Establish or enhance national and local emergency prevention and response coordination arrangements (EXTENDED, with re-phrasing);
Establish or enhance the coordination of all partners and stakeholders engaged in or supporting prevention and response activities through cooperation, including by introducing accountability mechanisms (EXTENDED, with re-phrasing);
Establish a mechanism to constantly monitor the effectiveness of prevention and response measures implemented in the hotspots, so that such measures can be adjusted as needed (NEW);
Engage and strengthen partner organizations for collaboration and support, including humanitarian actors in contexts with insecurity or areas with internal or refugee population displacements and in hosting communities in insecure areas (EXTENDED, with rephrasing);

Collaborative surveillance and laboratory diagnostics

Enhance surveillance, by increasing the sensitivity of the approaches adopted and ensuring comprehensive geographical coverage (EXTENDED);
Expand access to accurate, affordable and available diagnostics to test for mpox, including through strengthening arrangements for the transport of samples, the decentralization of testing and arrangements to differentiate MPXV clades and conduct genomic sequencing (EXTENDED, with re-phrasing);
Identify, monitor and support contacts of people with mpox to prevent onward transmission (EXTENDED);
Scale up efforts to thoroughly investigate cases and outbreaks of mpox to understand the modes of transmission, and prevent its onward transmission to contacts and communities (EXTENDED, with re-phrasing);
Report to WHO suspected, probable and confirmed cases of mpox in a timely manner and on a weekly basis (EXTENDED);

Safe and scalable clinical care

Provide clinical, nutritional and psychosocial support for patients with mpox, including, where appropriate and possible, isolation in care centres and materials and guidance for home-based care (EXTENDED, with re-phrasing);
Develop and implement a plan to expand access to optimised supportive clinical care for all patients with mpox, including children, patients living with HIV, and pregnant women. This includes offering HIV tests to adult patients who do not know their HIV status and to children as appropriate, with linkages to HIV treatment and care services when indicated; and the prompt identification and effective management of endemic co-infections, such as malaria, varicella zoster and measles viruses, and other sexually transmitted infections (STIs) among cases linked to sexual contact (EXTENDED, with re-phrasing);
Strengthen health and care workers’ capacity, knowledge and skills in the clinical and infection and prevention and control pathways – screening, diagnosis, isolation, to discharge of patients, including post discharge follow up for suspected and confirmed mpox –, and provide health and care workers with personal protective equipment (MODIFIED);
Enhance infection prevention and control (IPC) measures and availability of water sanitation, hygiene (WASH) and waste management services and infrastructure in healthcare facilities and treatment centers to ensure quality healthcare service delivery and protection of health and care workers and patients (NEW);

International traffic

Establish or strengthen cross-border collaboration arrangements for surveillance, management and support of suspected cases and contacts of mpox, the provision of information to travellers and conveyance operators, without resorting to general travel and trade restrictions unnecessarily impacting local, regional or national economies (EXTENDED, with re-phrasing);

Vaccination

Prepare for the integrated targeted use of vaccine for “Phase 1-Stop the outbreak” (as defined in the WHO “Mpox global strategic preparedness and response plan” (2024)) through identification of hotspots to interrupt sustained community transmission (NEW);
Initiate plans for vaccination in the context of an integrated response in hotspots, targeting people at high risk of infection (e.g., contacts of cases of all ages, including sexual contacts, and health and care workers, etc.). This entails a targeted integrated response, including active surveillance and contact tracing, the agile adaptation of immunization strategies and plans to the local context of hotspots; the availability of vaccines and supplies; the proactive community engagement, to generate and sustain demand for and trust in vaccination; and the collection of data during vaccination according to implementable research protocols (MODIFIED);

Community protection (MODIFIED)

Strengthen, particularly in hotspots, risk communication and community engagement systems with affected communities and local workforces for outbreak prevention, response and vaccination strategies, including through training, mapping high risk and vulnerable populations, social listening and community feedback, while managing misinformation. This entails, inter alia, communicating effectively the uncertainties regarding the natural history of mpox, updated information about mpox including information from ongoing clinical trials, about the efficacy of vaccines against mpox, and the uncertainties regarding duration of protection following vaccination (MODIFIED);
Address stigma and discrimination of any kind via meaningful community engagement, particularly in health services and during risk communication activities (EXTENDED);
Promote and implement IPC measures and basic WASH and waste management services in household settings, congregate settings (e.g. prisons, internally displaced persons and refugee camps, etc.), schools, points of entry and cross border transit areas (MODIFIED, and previously under “Safe and Scalable Clinical Care”);

Governance and financing

Galvanize and scale up national funding and explore external opportunities for targeted funding of prevention, readiness and response activities (EXTENDED);
Integrate mpox prevention and response measures in existing programmes aimed at prevention, control and treatment of other endemic diseases – especially HIV, as well as other STIs, malaria, tuberculosis, and COVID-19, as well as non-communicable diseases –, striving, to the extent possible, not to negatively impact their delivery (EXTENDED);

Addressing research gaps

Invest in addressing outstanding knowledge gaps and in generating evidence, during and after outbreaks, as defined in “A coordinated research roadmap – Mpox virus - Immediate research next steps to contribute to control the outbreak” (2024) (MODIFIED);
Invest in field studies to better understand animal hosts and zoonotic spillover in the areas where MPXV is circulating (NEW);
Strengthen and expand use of genomic sequencing to characterize the epidemiology and chains of transmission of MPXV to better inform control measures (NEW);

Reporting on the implementation of temporary recommendations

Report quarterly to WHO on the status of, and challenges related to the implementation of these temporary recommendations, using a standardized tool and channels that will be made available by WHO (EXTENDED).

International Pathogen Surveillance Network announces first recipients of grants to better understand disease threats

Tue, 26 Nov 2024 10:10:30 Z

The World Health Organization (WHO) and partners announced 10 projects that will receive almost US$ 2 million in grants to improve capacities in pathogen genomic surveillance.

The catalytic grant fund was established by the International Pathogen Surveillance Network (IPSN) to support partners from low- and middle-income countries to build their capacities in pathogen genomic analysis. This technology analyses the genetic code of viruses, bacteria and other disease-causing organisms to understand, in conjunction with other data, how easily they spread, and how sick they can make people. This data allows scientists and public health teams to track and respond to infectious disease threats, supports the development of vaccines and treatments and empowers countries to take faster decisions.

The fund is hosted by the United Nations Foundation and supported by the Bill & Melinda Gates Foundation, The Rockefeller Foundation and Wellcome.

“The IPSN catalytic grant fund has incredible potential to expand pathogen genomic surveillance for all, which we are already seeing through the first round of grantmaking,” said Sara Hersey, Director of Collaborative Intelligence at the WHO Hub for Pandemic and Epidemic Intelligence. “We are eager to support this work, which plays a key role in pandemic and epidemic prevention worldwide.”

“The IPSN catalytic grant fund recipients will accelerate the benefits of pathogen genomic surveillance in low- and middle-income settings, as well as explore new applications for genomic surveillance, such as wastewater surveillance,” said Manisha Bhinge, Vice President of the Health Initiative at The Rockefeller Foundation. “Pandemics and epidemics continue to be a global threat, further amplified by climate change. There is urgent need for equitable access to these tools and capabilities to protect lives in vulnerable communities.”

One of the recipients, the American University of Beirut, will use wastewater surveillance to study how diseases spread in refugee populations, helping to ensure that people can quickly receive the care and support they need in migration settings. Another grantee, the Pasteur Institute of Laos, will use the funding to develop new methods to track avian flu in live-bird markets, a setting that is often overlooked but vital to millions of people worldwide.

“If we are to protect vulnerable populations from the devastating impacts of disease, we first need to better understand how these pathogens spread, evolve and cause illness. These projects, developed in-country and tailored to local priorities, will generate new insights, knowledge and evidence that will help track global pathogen trends and inform evidence-based decisions to implement effective interventions” said Titus Divala, Interim Head of Epidemics and Epidemiology at Wellcome.

The Federal University of Rio de Janeiro in Brazil will use the funding to develop an open-source bioinformatics tool that can be used to conduct offline analyses. The tool will be piloted in Latin America with potential for global use, especially in low-resource settings.

"SARS-CoV-2 and subsequent regional disease outbreaks have underscored the importance of access to genomic surveillance tools in all countries. The IPSN's catalytic investments will generate data and innovative methods to support the much-needed scale-up in LMICs," said Simon Harris of the Gates Foundation.

The grantees were announced at the IPSN Global Partners Forum held in Bangkok, Thailand, from 21–22 November. The event was co-hosted by the WHO Regional Offices for South-East Asia and the Western Pacific and the Centre for Pathogen Genomics at the Doherty Institute in Australia.

A second round of catalytic grant funds will be made available to IPSN members in 2025.

Note to editors:

Background on the IPSN

The IPSN is a new global network of pathogen genomic actors, brought together by the WHO Pandemic Hub, to accelerate progress on the deployment of pathogen genomics, and improve public health decision-making. The IPSN envisions a world where every country has equitable access to sustained capacity for genomic sequencing and analytics as part of its public health surveillance system. It sets out to create a mutually supportive global network of genomic surveillance actors that amplifies and accelerates the work of its members to improve access and equity.

More information about the network can be found here: www.who.int/initiatives/international-pathogen-surveillance-network.

Background on the WHO Hub for Pandemic and Epidemic Intelligence

Forming part of the WHO Health Emergencies Programme, the WHO Hub for Pandemic and Epidemic Intelligence (the WHO Pandemic Hub), facilitates a global collaboration of partners from multiple sectors that supports countries and stakeholders to address future pandemic and epidemic risks with better access to data, better analytical capacities, and better tools and insights for decision-making. With support from the Government of the Federal Republic of Germany, the WHO Pandemic Hub was established in September 2021 in Berlin, in response to the COVID-19 pandemic, which demonstrated weaknesses around the world in how countries detect, monitor and manage public health threats.

More information about the WHO Pandemic Hub can be found here: https://pandemichub.who.int

Background on the Centre for Pathogen Genomics

The Centre for Pathogen Genomics at the Doherty Institute, University of Melbourne is an academic and training hub that supports new collaboration for translational research, genomics-informed infectious disease surveillance, and capacity building and training across the Asia-Pacific region. The Centre is underpinned by a portfolio of world-leading experts across pathogen genomics, public health, surveillance, bioinformatics, research, and capacity building and training, with years of experience in using cutting-edge technologies to address infectious diseases of national and global importance.

Full list of the first IPSN catalytic grantees:

National Institute for Health Research (Angola) - “Metagenomic surveillance for epidemic prevention in the DRC-Angola cross-border (FEEVIR Project)”
Federal University of Rio de Janeiro (Brazil) - “Development of an offline-capable computational framework for decentralised real-time untargeted pathogen genomic surveillance”
National Public Health Laboratory (Cameroon) - “Integrating surveillance of malaria parasites into the National Public Health Laboratory genomics platform in Cameroon”
Evangelical University of Africa (Democratic Republic of Congo) - “Generating genomic surveillance data of pathogens in Democratic Republic of Congo by extending the Mini-Lab with a Nanopore MinION sequencer”
Noguchi Memorial Institute for Medical Research, University of Ghana (Ghana) - “Air Sampling Surveillance for Antimicrobial Resistance Monitoring and Pathogens of Public Health Interest”
Ashoka University, International Foundation for Research and Education, Council of Scientific and Industrial Research (India) - “Quantitative mapping of environmental to clinical AMR via DNA barcoding”
Pasteur Institute of Laos (Laos) - “Environmental genomic surveillance of avian Influenza A viruses in high-risk live-bird markets in Laos: an innovative sequencing approach”
American University of Beirut (Lebanon) - “Wastewater Genomic Surveillance of Underestimated Viral Diarrheal Diseases among Vulnerable and Refugee Populations in Lebanon”
Rwanda Biomedical Centre (Rwanda) - “Establishing a Rwandan One Health genomic surveillance network for endemic and emerging viral hemorrhagic fevers”
Medical Research Institute Colombo (Sri Lanka) - “Piloting the application of pathogen genomics for public health and surveillance of foodborne disease”

The first-ever global oral health conference highlights universal health coverage by 2030

Mon, 25 Nov 2024 23:02:12 Z

Delegations from over 110 countries are coming together to produce national roadmaps and negotiate a joint declaration on oral health at the first-ever global oral health meeting organized by the World Health Organization (WHO). The declaration is expected to outline collective commitments from Member States to accelerate the implementation of the Global strategy and action plan on oral health 2023–2030.

Oral diseases are the most common noncommunicable diseases (NCDs) worldwide, affecting an estimated 3.5 billion people. Oral health is often misunderstood as just dental health, overlooking its broader importance. Oral diseases include dental caries or cavities, gum disease, tooth loss, oral cancer, noma and birth defects, affecting the mouth, teeth and facial structures that are essential for eating, breathing and speaking.

"Oral health is an important part of well-being, yet millions of people lack access to the services they need to protect and promote their oral health,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO calls on all countries to prioritize prevention and expand access to affordable oral health services as part of their journey towards universal health coverage.”

This groundbreaking event, hosted by the Government of the Kingdom of Thailand, is part of the preparatory process for the fourth UN High-Level Meeting on NCDs (4^th UN HLM on NCDs) in 2025. It aims to accelerate progress towards UHC, reaffirm political commitments made by Member States, and promote the implementation of the Global strategy and action plan on oral health 2023–2030.

“Oral health is a crucial aspect of overall health, and Thailand is proud to host this landmark global meeting,” said H.E. Mr Somsak Thepsutin, Minister of Public Health in Thailand. “Our commitment to universal health coverage includes ensuring that all citizens have access to quality oral health services and promoting prevention through our communities, reinforcing our dedication to improving health outcomes for everyone."

Key outcomes of the meeting – the Bangkok declaration on oral health – will inform the WHO Director-General’s report for the 4^th UN HLM on NCDs in 2025, ensuring better recognition and integration of oral diseases in the future global NCD agenda.

The Declaration seeks to guarantee oral health as a fundamental human right. It recognizes that improving access to affordable oral health care cannot be achieved without integrating it into primary health care and UHC packages.

During the meeting, it is expected a new global coalition on oral health will be announced, aiming to foster partnerships to enhance the reach and effectiveness of oral health initiatives worldwide.

The WHO first global oral health meeting is being attended by delegations from Member States, UN agencies, international organizations, philanthropic foundations, civil society organizations and other stakeholders dedicated to advancing oral health, NCDs and UHC programmes.

Note to editors:

The Global strategy and action plan on oral health 2023–2030 provides a framework to address challenges in preventing and controlling oral diseases, promoting oral health within the NCD agenda and ensuring that essential services are accessible without financial strain as part of UHC initiative. It outlines six strategic objectives, 100 actions and 11 global targets aimed at reducing the burden of oral diseases, which contribute significantly to the global NCD crisis.

For more information and to watch the meeting, please visit WHO global oral health meeting event webpage.

Lebanon: a conflict particularly destructive to health care

Thu, 21 Nov 2024 15:22:48 Z

Since 7 October 2023, 47% of attacks on health care – 65 out of 137 – have proven fatal to at least one health worker or patient in Lebanon, as of 21 November 2024.

This is a higher percentage than in any active conflict today across the globe – with nearly half of all attacks on health causing the death of a health worker.

In comparison, the global average is 13.3%, based on the SSA’s figures from 13 countries or territories that reported attacks in the same period, 7 October 2023–18 November 2024 – among them Ukraine, Sudan and the occupied Palestinian territory (oPt). In the case of oPt, 9.6% of the total number of incidents has resulted in the death of at least one medical professional or patient.

According to the SSA, 226 health workers and patients were killed in Lebanon and 199 injured between 7 October 2023 and 18 November 2024.

In the same period, the SSA registered a combined total of 1401 attacks on health in oPt, Lebanon and Israel – 1196 in oPt, 137 in Lebanon and 68 in Israel.

Civilian health care has special protection

“These figures reveal yet again an extremely worrying pattern. It’s unequivocal – depriving civilians of access to lifesaving care and targeting health providers is a breach of international humanitarian law. The law prohibits the use of health facilities for military purposes – and even if that is the case, stringent conditions to taking action against them apply, including a duty to warn and to wait after warning,” said WHO Representative in Lebanon Dr Abdinasir Abubakar.

International humanitarian law states that health workers and facilities should always be protected in armed conflicts and never attacked. Health facilities must not be used for military purposes, and there should be accountability for the misuse of health facilities.

“There need to be consequences for not abiding by international law, and the principles of precaution, distinction and proportionality should always be adhered to. It’s been said before, indiscriminate attacks on health care are a violation of human rights and international law that cannot become the new normal, not in Gaza, not in Lebanon, nowhere,” said WHO Regional Director for the Eastern Mediterranean Dr Hanan Balkhy.

The majority of incidents in Lebanon impact health workers

The majority (68%) of incidents in Lebanon registered by the SSA impacted health personnel, a pattern seen repeatedly in the last few years, including in Gaza in the past year. In Lebanon, roughly 63% affected health transport and 26% affected health facilities.

Attacks on health care hit twice. First, when health workers lose their lives or when a health centre is obliterated, and again in the following weeks and months when the injured can’t be treated, those who are dependent on regular care don’t receive it and when children can’t be immunized.

“Casualty numbers among health workers of this scope would debilitate any country, not just Lebanon. But what the numbers alone cannot convey is the long-term impact, the treatments for health conditions missed, women and girls prevented from accessing maternal, sexual and reproductive health services, undiagnosed treatable diseases and, ultimately, the lives lost because of the absence of health care. That is the impact that’s hard to quantify,” said Dr Abubakar.

1 in 10 hospitals in Lebanon directly impacted

The greater the blow to the health workforce, the weaker the longer-term ability of a country to recover from a crisis and deliver health care in a post-conflict setting

Lebanon is a lower middle-income country with a fairly advanced health system that’s been hit hard by multiple crises in recent years. After hostilities in Lebanon escalated in September 2024, the growing number of attacks on health have caused further strain on an already over-burdened system.

Today, the country’s health system is under extreme duress, with 15 out of 153 hospitals having ceased to operate, or only partially functioning. Nabatieh, as an example, one of Lebanon’s 8 governorates, has lost 40% of its hospital bed capacity.

“Attacks on health care of this scale cripple a health system when those whose lives depend on it need it the most. Beyond the loss of life, the death of health workers is a loss of years of investment and a crucial resource to a fragile country going forward,” Dr Balkhy concluded.

So far this year, between 1 January 2024 and 18 November 2024, a total of 1246 attacks on health care were registered globally, in 13 countries or territories, killing 730 health workers and patients and injuring 1255.

Note to editors

The Surveillance System for Attacks on Health Care (SSA), established in 2017 by the World Health Organization, is an independent global monitoring mechanism whose goal is to collect reliable data on attacks on health care and to then identify patterns of violence that inform risk reduction and resilience measures so that health care is protected. The SSA also provides an evidence base for advocacy against attacks on health care.

WHO Investment Round: culminating moment at G20 Summit as leaders pledge

Tue, 19 Nov 2024 21:11:47 Z

The first-ever Investment Round of the World Health Organization (WHO) reached a culminating moment during the G20 Leaders' Summit today in Rio de Janeiro, chaired by the President of Brazil, H.E. Luiz Inácio Lula da Silva. Heads of state and government at the G20 voiced strong support for a sustainably funded WHO, additional financial pledges were announced, and incoming G20 Chair South Africa pledged to maintain a focus in 2025 on sustainably financing the Organization.

The support was reflected in the G20 Rio de Janeiro Leaders’ Declaration which said: “We reiterate the central coordinating role of the World Health Organization (WHO) in the global health architecture, supported by adequate, predictable, transparent, flexible and sustainable financing. We support the conducting of the WHO Investment Round as an additional measure for financing the WHO activities.”

The Investment Round is raising funds for WHO’s strategy for global health, the Fourteenth General Programme of Work, which can save an additional 40 million lives over the next four years. The Investment Round has succeeded in shifting WHO’s funding model so that it is more predictable, flexible and resilient.

With the pledges received from Australia, Indonesia and Spain at the Leaders’ Summit, and the United Kingdom of Great Britain and Northern Ireland shortly afterwards, WHO has now received pledges of US$ 1.7 billion. Including other signed funding agreements and expected funding from partnerships, WHO has funding of US$ 3.8 billion for the next four years. This means that WHO has raised 53% of the US$ 7.1 billion funding needed, successfully increasing predictability as compared to previous periods. WHO, Member States and partners will continue efforts to cover the remaining gap so the Organization can deliver on the strategy for 2025–2028.

The Investment Round has also successfully broadened WHO’s donor base, improving its funding resilience. Since its launch in May, there have been 70 new pledges from Member States, and philanthropic and private sector donors, 39 of which are contributing voluntary funds for the first time. This is making WHO’s funding more diversified and thus marks a milestone in the Organization’s evolution.

Seven of these new donors are low-income countries and 21 are middle-income countries, representing a shift in WHO’s funding base. This shift also demonstrates broad-based recognition of the need to invest in health and in WHO.

Forty-six donors have so far pledged more flexible funding, compared to 35 in the last four years, increasing the ability of WHO to use the funds where they are most needed.

Overall, the Investment Round means that WHO can work more efficiently, better plan the implementation of its Strategy and respond even better to crises.

It is expected that a number of other governments and donors will pledge to the Investment Round in the coming months. 

Quotes:

President of Brazil, H.E. Luiz Inácio Lula da Silva, said: “The World Health Organization represents humanity’s greatest ideals. Investment over the next four years will be repaid many times over in well-being gained. It will set the foundation for future generations.”

The Chancellor of the Federal Republic of Germany, Olaf Scholz, said: “The work of the WHO benefits all of us. It needs reliable financing from a broad base. Every contribution counts."

President of France, Emmanuel Macron, said: “The World Health Organization deserves our support, as our unique common, universal, compass to global health. It is the only organization technically and politically able to coordinate our global action, and edict universal norms and advice in the field of health. As part of this Investment Round, WHO is bringing to life a new Academy, open to all health practitioners around the world, to tackle one of the key investment priorities identified during the COVID crisis, which is human capacity in the health sector. In a nutshell, investing in WHO is investing in the strengthening of our response capacity to health crises and in particular to pandemics.”

President of South Africa H.E. Cyril Ramaphosa, who will Chair the G20 Presidency in 2025, said: “We are proud to carry the baton on from Brazil and continue to spotlight the importance of WHO and the need for sustainable financing towards the goal of health for all.”

President of Indonesia, H.E Mr Prabowo Subianto, said: “I would like to announce that Indonesia is pleased to support international efforts. In this case, we are willing to commit US$ 30 million to bridge the funding gap on WHO activities.”

“The WHO Investment Round is about mobilizing the predictable, flexible funding WHO needs to save lives, prevent disease and make the world a healthier and safer place,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “I thank President Lula for his strong support for WHO and for hosting the culmination of the Investment Round during the G20 Leaders’ Summit, and I thank all donors for their contributions. I am grateful to President Ramaphosa for carrying the baton for sustainable financing for WHO into South Africa’s G20 Presidency next year.”

Editor’s note:

On 26 November 2024, a correction was made to the news release as noted below:

The sentence in the original news release read:

With the pledges received from Australia, Indonesia and Spain at the Leaders’ Summit, WHO has now received pledges of US$ 1.7 billion. Including other signed funding agreements and expected funding from partnerships, WHO has funding of US$ 3.8 billion for the next four years. This means that WHO has raised 53% of the US$ 7.1 billion funding needed, successfully increasing predictability as compared to 2020, when WHO had only 17% of funding secured for its previous strategy. WHO, Member States and partners will continue efforts to cover the remaining gap so the Organization can deliver on the strategy for 2025–2028.

This was changed to:

With the pledges received from Australia, Indonesia and Spain at the Leaders’ Summit, and the United Kingdom of Great Britain and Northern Ireland shortly afterwards, WHO has now received pledges of US$ 1.7 billion. Including other signed funding agreements and expected funding from partnerships, WHO has funding of US$ 3.8 billion for the next four years. This means that WHO has raised 53% of the US$ 7.1 billion funding needed, successfully increasing predictability as compared to previous periods. WHO, Member States and partners will continue efforts to cover the remaining gap so the Organization can deliver on the strategy for 2025–2028.

An additional quote was added:

President of Indonesia, H.E Mr Prabowo Subianto, said: “I would like to announce that Indonesia is pleased to support international efforts. In this case, we are willing to commit US$ 30 million to bridge the funding gap on WHO activities.”

WHO adds LC16m8 mpox vaccine to Emergency Use Listing

Tue, 19 Nov 2024 20:07:50 Z

The World Health Organization (WHO) has granted Emergency Use Listing (EUL) for the LC16m8 mpox vaccine, making it the second mpox vaccine to be supported by WHO following the Director-General’s declaration of an mpox public health emergency of international concern (PHEIC) on 14 August 2024.

This decision is expected to facilitate increased and timely access to vaccines in communities where mpox outbreaks are surging. In 2024, cases have been reported across 80 countries, including 19 countries in Africa, based on data as of 31 October 2024. The Democratic Republic of the Congo, the hardest-hit country, recorded a large majority of suspected cases – over 39 000 – as well as more than 1000 deaths.

Today’s move is particularly relevant as the Government of Japan has announced that it will donate 3.05 million doses of the LC16m8 vaccine, along with specialized inoculation needles, to the Democratic Republic of the Congo. This is the largest donation package announced to date in response to the current mpox emergency.

LC16m8 is a vaccine developed and manufactured by KM Biologics in Japan. The Technical Advisory Group (TAG) for EUL of vaccines convened to discuss the outcome of the LC16m8 vaccine review, including the product and programmatic suitability assessments. The TAG recommended the vaccine for use in individuals over one year of age as a single dose vaccine, via a multiple puncture technique using a bifurcated needle.

“WHO emergency use listing of the LC16m8 vaccine against mpox marks a significant step in our response to the current emergency, providing a new option to protect all populations, including children,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. “Vaccines are one of the important tools to help contain the outbreak as part of a comprehensive response strategy that also includes improved testing and diagnosis, treatment and care, infection prevention control, and engagement and education within affected communities.”

WHO’s assessment for EUL is based on information submitted by the manufacturer and review by the Pharmaceuticals and Medical Devices Agency (PMDA), the Japanese regulatory agency of record for this vaccine. The LC16m8 vaccine has been used in Japan during previous mpox outbreaks and was shown to be safe and effective, including in people with well-controlled HIV.

The WHO Strategic Advisory Group of Experts (SAGE) on Immunization reviewed available evidence and recommended the use of LC16m8 vaccine in outbreak settings in children and others with a documented high-risk of exposure to mpox.

However, minimally replicating vaccines, such as LC16m8, should not be used during pregnancy and in people who are immunocompromised. Immunocompromised persons include those with active cancer, transplant recipients, immunodeficiency, and active treatment with immunosuppressive agents. They also include people living with HIV with a current CD4 cell count of <200 cells µl.

The Global Advisory Committee on Vaccine Safety reviewed the updated safety data on LC16m8 on 20 September 2024 and recommended that healthcare workers are provided with training on the use of bifurcated needles to prevent injuries and adverse effects. In light of the changing epidemiology and emergence of new virus strains, it remains important to collect as much data as possible on vaccine safety and effectiveness in different contexts.

WHO continues to work closely with manufacturers, global partners and countries to ensure the availability and administration of safe and effective life-saving products.

On 13 September 2024, WHO prequalified the Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) vaccine and expanded its indication to include use in individuals aged 12 years and older on 8 October 2024.

Note to editors:

WHO Prequalification (PQ) and Emergency Use Listing (EUL) are mechanisms used to evaluate quality, safety and efficacy of medical products, such as vaccines, diagnostics and medicines, and product suitability for use in the contexts of low- and middle-income countries. Products receiving PQ or EUL support decision-making for international, regional and country procurement by UN and partner procurement agencies and Member States. PQ is based on the review of full set of quality, safety and efficacy data on medical products, including risk management plan and programmatic suitability. EUL is a risk benefit assessment to address urgent demands during public health emergencies based on available limited data where the benefits outweigh the risks.

WHO and partners rally cervical cancer elimination efforts

Sat, 16 Nov 2024 16:35:08 Z

As world leaders arrive in Rio de Janeiro, Brazil, for the G20 Summit this weekend, the city’s iconic Christ the Redeemer statue will be illuminated in the colour teal. The Brazilian advocates behind this effort are among many around the globe joining the World Health Organization (WHO) to mobilize efforts on a worldwide “Day of Action for Cervical Cancer Elimination.” Other countries are marking the day with campaigns to provide human papillomavirus (HPV) vaccination and screening, launching new health policies to align with the world’s first-ever effort to eliminate a cancer, and raising awareness in communities.

Four years ago to the day, 194 countries resolved to eliminate cervical cancer and WHO launched a global strategy. Since then, significant progress has been made. At least 144 countries have introduced the HPV vaccine, over 60 countries now include HPV testing in their cervical screening programmes and 83 countries include surgical-care services for cervical cancer in health-benefit packages.

“I thank all the health workers who are playing a critical role in this global effort,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “While we are making progress, we still face huge inequities, with women in low-income countries bearing most of the burden. Only with strong leadership and sustained investment can we achieve our shared goal of equitable access for communities most in need.”

Marking this campaign for the fourthyear, governments, partners and civil society are organizing various activities and commitments. These include:

Chile will announce a pilot for self-collection with HPV testing, which will be incorporated as part of its health care reform and universal primary health care.
China: Medical schools and hospitals will host a series of academic lectures, health runs, and illuminations to raise awareness across 31 cities.
Democratic Republic of the Congo will host a 3-day forum to launch a national strategy for cervical cancer elimination, concluding with a march through Kinshasa for cervical cancer awareness.
Ethiopia, with support from Gavi, will launch an HPV vaccination campaign aiming to reach over 7 million girls.
India: Civil society groups in different states will host a series of activities that include awareness campaigns and trainings for health-care professionals.
Ireland will launch its Action Plan to achieve cervical cancer elimination, one year after announcing its goal to achieve this milestone by 2040 on the Day of Action in 2023.
Japan’s Ministry of Health, local municipalities, and hospitals will illuminate over 70 landmarks across the country during their annual Teal Blue Campaign.
Nigeria will raise awareness through advocacy led by the Nigerian First Ladies Against Cancer.
Rwanda will announce its goal to reach the 90-70-90 targets by the year 2027, three years ahead of the WHO goal.
South Africa’s Department of Health will roll out health provider trainings in 3 provinces.

Push for better tests

WHO is launching new guidance on Target Product Profiles (TPPs) for HPV screening tests. This technical product outlines preferred standards for new HPV tests. The tests should be able to function even in remote areas in low- and middle-income country settings where disease burden is highest. The TPPs highlight the importance of tests that give women the option to collect their own samples for testing; and the value of tools that enable HPV testing in settings closer to where women receive care.

The new publication aims to support innovation in the HPV testing market, emphasizing high-performance, low-cost, and accessible solutions, particularly transformative in resource-limited settings.

Editor’s note

In 2020, 194 countries resolved to eliminate a cancer for the first time and WHO launched the Global strategy to eliminate cervical cancer as a public health problem. This historic response to the W HO Director-General’s call to action in 2018 catalyzed a social movement and sparked an annual tradition, bringing communities across the world together for a Day of Action for Cervical Cancer Elimination.

Measles cases surge worldwide, infecting 10.3 million people in 2023

Thu, 14 Nov 2024 10:48:03 Z

Worldwide, there were an estimated 10.3 million cases of measles in 2023, a 20% increase from 2022, according to new estimates from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). Inadequate immunization coverage globally is driving the surge in cases.

Measles is preventable with two doses of measles vaccine; yet more than 22 million children missed their first dose of measles vaccine in 2023. Globally, an estimated 83% of children received their first dose of measles vaccine last year, while only 74% received the recommended second dose.

Coverage of 95% or greater of two doses of measles vaccine is needed in each country and community to prevent outbreaks and protect populations from one of the world’s most contagious human viruses.

“Measles vaccine has saved more lives than any other vaccine in the past 50 years,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “To save even more lives and stop this deadly virus from harming the most vulnerable, we must invest in immunization for every person, no matter where they live.”

“The number of measles infections are rising around the globe, endangering lives and health,” CDC Director Mandy Cohen said. “The measles vaccine is our best protection against the virus, and we must continue to invest in efforts to increase access.”

As a result of global gaps in vaccination coverage, 57 countries experienced large or disruptive measles outbreaks in 2023, affecting all regions except the Americas, and representing a nearly 60% increase from 36 countries in the previous year. The WHO African, Eastern Mediterranean, European, South-East Asia and Western Pacific regions experienced a substantial upsurge in cases. Nearly half of all large or disruptive outbreaks occurred in the African region.

An unacceptable death toll due to rising measles cases

The new data show that an estimated 107 500 people, mostly children younger than 5 years of age, died due to measles in 2023. Although this is an 8% decrease from the previous year, far too many children are still dying from this preventable disease. This slight reduction in deaths was mainly because the surge in cases occurred in countries and regions where children with measles are less likely to die, due to better nutritional status and access to health services.

Even when people survive measles, serious health effects can occur, some of which are lifelong. Infants and young children are at greatest risk of serious complications from the disease, which include blindness, pneumonia, and encephalitis (an infection causing brain swelling and potentially brain damage).

As measles cases surge and outbreaks increase, the world’s elimination goal, as laid out in Immunization Agenda 2030, is under threat. Worldwide, 82 countries had achieved or maintained measles elimination at the end of 2023. Just this week, Brazil was reverified as having eliminated measles, making the WHO Americas Region once again free of endemic measles. With the exception of the African Region, at least 1 country in all WHO regions has eliminated the disease.

Urgent and targeted efforts by countries and partners, particularly in the African and Eastern Mediterranean regions, and in fragile, conflict-affected and vulnerable settings, are needed to vaccinate all children fully with two doses of measles vaccine. This requires achieving and maintaining high-performing routine immunization programmes and delivering high-quality, high-coverage campaigns when those programmes are not yet sufficient to protect every child.

Countries and global immunization partners must also strengthen disease surveillance, including the Global Measles Rubella Laboratory Network (GMRLN). Strong disease surveillance is critical to optimizing immunization programmes and detecting and responding rapidly to measles outbreaks in order to mitigate their size and impact.

Note to editors

Progress Toward Regional Measles Elimination — Worldwide, 2000–2023 is a joint publication of WHO and CDC. It is published within the WHO Weekly Epidemiological Record and in CDC’s Morbidity and Mortality Weekly Report. CDC and WHO use statistical modelling to estimate measles cases and deaths each year, based on cases reported by countries, and revise previous year's estimates to assess disease trends over time.

CDC and WHO are founding members of the Measles & Rubella Partnership (M&RP), a global initiative to stop measles and rubella. Under the umbrella of Immunization Agenda 2030 and guided by the Measles and Rubella Strategic Framework 2030, M&RP’s mission includes addressing the decline in national vaccination coverage, hastening the recovery of the measles backsliding resulting from COVID-19 pandemic, and accelerating progress towards creating a world free of measles and rubella. The partnership also includes American Red Cross, Bill & Melinda Gates Foundation, Gavi, the Vaccine Alliance, United Nations Foundation, and UNICEF.

Measles elimination is defined as the absence of endemic measles virus transmission in a region or other defined geographical area for more than 12 months. Conversely, a country is no longer considered to be measles free if the virus returns and transmission is sustained continuously for more than a year.

For more information on CDC’s global measles vaccination efforts, visit https://www.cdc.gov/global-measles-vaccination.

For more information on WHO’s measles response and support, visit https://www.who.int/news-room/fact-sheets/detail/measles.

Urgent action needed as global diabetes cases increase four-fold over past decades

Wed, 13 Nov 2024 23:30:51 Z

The number of adults living with diabetes worldwide has surpassed 800 million, more than quadrupling since 1990, according to new data released in The Lancet on World Diabetes Day. The analysis, conducted by the NCD Risk Factor Collaboration (NCD-RisC) with support from the World Health Organization (WHO), highlights the scale of the diabetes epidemic and an urgent need for stronger global action to address both rising disease rates and widening treatment gaps, particularly in low- and middle-income countries (LMICs).

“We have seen an alarming rise in diabetes over the past three decades, which reflects the increase in obesity, compounded by the impacts of the marketing of unhealthy food, a lack of physical activity and economic hardship," said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “To bring the global diabetes epidemic under control, countries must urgently take action. This starts with enacting policies that support healthy diets and physical activity, and, most importantly, health systems that provide prevention, early detection and treatment.”

The study reports that global diabetes prevalence in adults rose from 7% to 14% between 1990 and 2022. LMICs experienced the largest increases, where diabetes rates have soared while treatment access remains persistently low. This trend has led to stark global inequalities: in 2022, almost 450 million adults aged 30 and older – about 59% of all adults with diabetes – remained untreated, marking a 3.5-fold increase in untreated people since 1990. Ninety per cent of these untreated adults are living in LMICs.

The study further reveals substantial global differences in diabetes rates, with the prevalence of diabetes among adults aged 18 and older around 20% in the WHO South-East Asia and the Eastern Mediterranean Regions. These two regions, together with the African Region, have the lowest rates of diabetes treatment coverage, with fewer than 4 in 10 adults with diabetes taking glucose-lowering medication for their diabetes.

WHO’s commitment to global diabetes response

Addressing the soaring diabetes burden, WHO is also launching a new global monitoring framework on diabetes today. This product represents a crucial step in the global response, providing comprehensive guidance to countries in measuring and evaluating diabetes prevention, care, outcomes and impacts. By tracking key indicators such as glycaemic control, hypertension and access to essential medicines, countries can improve targeted interventions and policy initiatives. This standardized approach empowers countries to prioritize resources effectively, driving significant improvements in diabetes prevention and care.

WHO’s Global Diabetes Compact, launched in 2021, includes the vision of reducing the risk of diabetes, and ensuring that all people who are diagnosed with diabetes have access to equitable, comprehensive, affordable and quality treatment and care. The work undertaken as part of the Compact will also support the prevention of type 2 diabetes from obesity, unhealthy diet and physical inactivity. In addition, the same year, a diabetes resolution was endorsed at the World Health Assembly urging Member States to raise the priority given to the prevention, diagnosis and control of diabetes as well as prevention and management of risk factors such as obesity.

In 2022, WHO established five global diabetes coverage targets to be achieved by 2030. One of these targets is to ensure that 80% of people with diagnosed diabetes achieve good glycemic control. Today’s release underlines the scale and urgency of action needed to advance efforts to close the gap.

The upcoming year 2025 presents a significant opportunity to catalyse action against the alarming rise in diabetes worldwide with the Fourth High-level Meeting of the United Nations General Assembly on the prevention and control of noncommunicable diseases (NCDs) to take place in September. This meeting brings heads of states and governments together to set a powerful vision for preventing and controlling NCDs, including diabetes, through a collective commitment to address root causes and improve access to detection and treatment. By aligning efforts towards the 2030 and 2050 goals, this high-level meeting is a pivotal moment for strengthening global health systems, including primary health care and halting the rise in the diabetes epidemic.

Notes for editors

The study released today was conducted by the NCD Risk Factor Collaboration (NCD-RisC), a worldwide network of over 1500 researchers and practitioners, in collaboration with WHO. It is the first global analysis of trends in both diabetes rates and treatment coverage that is based on data from over 140 million people aged 18 years or older that were included in more than 1000 studies covering populations in all countries. The study used an updated methodology of measuring diabetes prevalence in populations from previous studies to provide a more accurate overview of the global diabetes epidemic.

IsDB joins efforts with WHO and development partners to promote health impact investment

Tue, 12 Nov 2024 09:44:46 Z

The Islamic Development Bank (IsDB) announced today an important grant allocation of US$ 10 million to WHO to implement the Health Impact Investment Platform (HIIP).

WHO demands urgent integration of health in climate negotiations ahead of COP29

Thu, 07 Nov 2024 09:32:52 Z

Ahead of the 2024 UN Climate Change Conference in Baku (COP29), the World Health Organization (WHO) calls for an end to reliance on fossil fuels and advocates for people-centred adaptation and resilience.

Launching the COP29 special report on climate and health and a technical guidance on Healthy Nationally Determined Contributions, WHO urges world leaders at COP29 to abandon the siloed approach to addressing climate change and health. It stresses the importance of positioning health at the core of all climate negotiations, strategies, policies and action plans, to save lives and secure healthier futures for present and future generations.

“The climate crisis is a health crisis, which makes prioritizing health and well-being in climate action not only a moral and legal imperative, but a strategic opportunity to unlock transformative health benefits for a more just and equitable future,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “COP29 is a crucial opportunity for global leaders to integrate health considerations into strategies for adapting to and mitigating climate change. WHO is supporting this work with practical guidelines and support for countries.”

Bold health argument for climate action

Developed by WHO in collaboration with over 100 organizations and 300 experts, the COP29 special report on climate change and health identifies critical policies across three integrated dimensions – people, place and planet. The report outlines key actions aiming to protect all people, particularly the estimated 3.6 billion people who live in areas which are most susceptible to climate change.

The report underlines the importance of the governance that integrates health in climate policy-making – and climate in health policy-making – being essential for progress. The report’s top recommendations include:

make human health and well-being the top measure of climate success to catalyse progress and ensure people-centred adaptation and resilience;

end fossil fuel subsidies and reliance by realigning economic and financial systems to protect both people's health and the environment, through investment in clean, sustainable alternatives that reduce pollution-related diseases and cut carbon emissions;

mobilize financing for climate-health initiatives, particularly to strengthen responsive health systems and support the health workforce, creating resilient, climate-proof health systems to protect health and save lives;

invest in proven solutions; just 5 interventions – from heat-health warning systems, to clean household energy, to efficient pricing of fossil fuels – would save almost 2 million lives a year, and bring US$ 4 in benefits for each dollar invested;

build greater focus on the role of cities in health outcomes, through more sustainable urban design, clean energy, resilient housing, and improved sanitation; and

increase protections for and restoration of nature and biodiversity, recognizing the synergistic health benefits of clean air, water and food security.

“Health is the lived experience of climate change,” said Dr Maria Neira, Director, Environment, Climate Change and Health, WHO. “By prioritizing health in every aspect of climate action, we can unlock significant benefits for public health, climate resilience, security, and economic stability. Health is the argument we need to catalyze urgent and large-scale action in this critical moment.”

Enhanced WHO action on health and climate

Climate NDCs or Nationally Determined Contributions are national plans and commitments made by countries under the Paris Agreement. While health is identified as a priority in 91% of the NDCs, few outline specific actions to leverage the health benefits of climate mitigation and adaptation or to protect health from climate-related risks.

To support countries to better integrate health into their climate policies, WHO has released today WHO quality criteria for integrating health into Nationally Determined Contributions: Healthy NDCs. The guidance outlines practical actions for ministries of health, ministries of environment, and other health-determining sectors (e.g. transport, energy, urban planning, water and sanitation) to incorporate health considerations within their adaptation and mitigation policies and actions.

This technical guidance serves as a concrete framework to implement the recommendations included in the WHO’s COP29 special report, addressing key areas such as leadership and enabling environment; national circumstances and policy priorities; mitigation; adaptation; loss and damage; finance; and implementation. Integrating health within climate plans will support:

addressing health impacts: tackling the diverse health effects of climate change;
strengthening health systems: enhancing climate resilience and decarbonization in health systems; and
promoting co-benefits: focusing on key sectors that have a strong influence both on health and climate change mitigation and adaptation, such as transportation and energy.

In addition to its own initiatives, WHO convenes 90 countries and 75 partners through the Alliance for Transformative Action on Climate and Health (ATACH). This platform was established to advance the commitments made at COP26 for building climate-resilient and sustainable health systems. ATACH promotes the integration of climate change and health nexus into respective national, regional, and global plans using the collective power of WHO Member States and other stakeholders to drive this agenda forward with urgency and scale.

Quotes of support

António Guterres, Secretary-General of the United Nations:

“The climate crisis is also a health crisis. Human health and planetary health are intertwined. Countries must take meaningful action to protect their people, boost resources, cut emissions, phase out fossil fuels, and make peace with nature. COP29 must drive progress towards those vital goals for the planet’s health and for people’s health.”

Dr Rajiv J. Shah, President of The Rockefeller Foundation:

“The impact of climate change has to be measured in more than degrees: we have to account for lives saved, lost, and improved. The Rockefeller Foundation is working closely with the World Health Organization and many other partners to center health considerations in all climate action, including efforts to enable just energy transitions and to increase economic opportunities for people living in frontline communities.”

Dr Vanessa Kerry, WHO Director-General Special Envoy for Climate Change Health:

"This report exposes how the accelerating climate and health crisis impacts more than just our health – it undermines economies, deepens inequities, and fuels political instability. As leaders gather for COP29, we urge them to fast-track a just transition and increase funding for health systems and frontline health workers to protect the most vulnerable. Health must be central in climate discussions, metrics, and Nationally Determined Contributions. To safeguard people, economies, and global security, health must be at the heart of climate action. We can’t afford to wait."

Dr Alan Dangour, Director of Climate & Health at Wellcome:

“In every single country, climate change is costing lives, causing pain and suffering. It is a common crisis that must unite us to act, and act quickly. At COP29, countries must grasp the opportunity to commit to ambitious cross-government climate actions that both protect the planet and improves health for all. By working together, we can still change our current course and save lives.”

Dr Micaela Serafini, President, Médecins Sans Frontières (MSF), Switzerland:

“Today, we are in an unacceptable situation where the world’s most vulnerable people are paying the highest price for a problem they did not cause. Solutions to safeguard their health must be prioritized, with the well-being of people placed at the heart of climate action. Failing to do so will take a toll on the very vitals of humanity.”

Jagan Chapagain, Secretary General, The International Federation of Red Cross and Red Crescent Societies (IFRC):

“From the impacts of extreme heat to the spread of illnesses through floodwaters, from malnutrition as crops fail to mosquito-borne diseases where they haven’t been seen before, the climate crisis is the ultimate health crisis. This report is vital – highlighting how climate change makes us sick and what we need to do about it.”

Jeni Miller, PhD, Executive Director, Global Climate and Health Alliance

“Health workers are seeing the impacts of climate change firsthand, in the suffering of patients and communities they serve. During COP29, it is time for all governments to demonstrate readiness to protect people’s lives by getting serious about bold climate action. Wealthy governments must deliver the funding needed to help the most impacted countries to build their resilience and response to climate shocks. And together, governments must spell out how and when they will achieve the fossil fuel phase out promised at COP28, to deliver a full, healthy, and just clean energy transition.”

Jaber Oufkir, Liaison Officer for Public Health Issues, The International Federation of Medical Students’ Association (IFMSA):

The IFMSA envisions a world where climate change is fundamentally recognized as a health-care emergency. We foresee a future where the health sector leads the charge toward a net-zero economy, prioritizing sustainable practices and advocating for systemic changes. The climate crisis is not just an environmental issue; it’s a health crisis that impacts young people profoundly. Yet, youth voices are often absent from the conversations that could make a real difference. We strongly believe that young perspectives must be front and centre in the fight against climate change and highlight the importance of transparent intergenerational collaboration, creating a space where climate, health, and youth empowerment intersect for change. Our vision calls for actionable commitments from decision-makers to integrate health into Nationally Determined Contributions (NDCs), prioritize health equity, and integrate climate adaptation strategies into public health frameworks. We ultimately envision diligent efforts towards phasing out fossil fuels and taking necessary steps to ensure a sustainable future for all.