HEALTH NEWS

Sep. 29, 2022

WHO launches new initiative to stop the spread of invasive malaria vector in Africa

In a 2019 vector alert, WHO identified the spread of Anopheles stephensi as a significant threat to malaria control and elimination – particularly in Africa, where the disease hits hardest. A new WHO initiative, launched today, aims to stop the further spread of this invasive mosquito species in the region.

Originally native to parts of South Asia and the Arabian Peninsula, An. stephensi has been expanding its range over the last decade, with detections reported in Djibouti (2012), Ethiopia and Sudan (2016), Somalia (2019) and Nigeria (2020). Unlike the other main mosquito vectors of malaria in Africa, it thrives in urban settings.

With more than 40% of the population in Africa living in urban environments, the invasion and spread of An. stephensi could pose a significant threat to the control and elimination of malaria in the region. But large-scale surveillance of the vector is still in its infancy, and more research and data are urgently needed.

“We are still learning about the presence of Anopheles stephensi and its role in malaria transmission in Africa,” said Dr Jan Kolaczinski, who leads the Vector Control and Insecticide Resistance unit with the WHO Global Malaria Programme. “It is important to underscore that we still don’t know how far the mosquito species has already spread, and how much of a problem it is or could be.”

WHO’s new initiative aims to support an effective regional response to An. stephensi on the African continent through a five-pronged approach:

  • increasing collaboration across sectors and border;
  • strengthening surveillance to determine the extent of the spread of An. stephensi and its role in transmission;
  • improving information exchange on the presence of An. stephensi and on efforts to control it;
  • developing guidance for national malaria control programmes on appropriate ways to respond to An. stephensi
  • prioritizing research to evaluate the impact of interventions and tools against An. stephensi

Integrated action is “key to success”

Where feasible, national responses to An. stephensi should be integrated with efforts to control malaria and other vector-borne diseases, such as dengue fever, yellow fever and chikungunya. The WHO Global vector control response 2017–2030 provides a framework for investigating and implementing such integration.

“Integrated action will be key to success against Anopheles stephensi and other vector-borne diseases,” noted Dr Ebenezer Baba, malaria advisor for the WHO African Region. “Shifting our focus to integrated and locally adapted vector control can save both money and lives,” he added.

Tracking the spread of Anopheles stephensi

The WHO Malaria Threats Map features a dedicated section on invasive vectors, including An. stephensi. All confirmed reports of the presence of  An. stephensi should be reported to WHO to allow an open sharing of data and an up-to-date understanding of its distribution and spread. This knowledge will ultimately provide a basis to assess the effectiveness of any efforts to control or eliminate An. stephensi.

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For more information:

 

Sep. 23, 2022

 

Geneva, 23 September 2022| The World Health Organization has announced the recommended viral composition of influenza vaccines for the 2023 southern hemisphere influenza season.  

The recommendations issued today will be used by national vaccine regulatory agencies and pharmaceutical companies to develop, produce, and license influenza vaccines for the following influenza season. The periodic update of viruses contained in influenza vaccines is necessary for the vaccines to be effective due to the constantly evolving nature of influenza viruses. 

The recommendation is based on the advice of a group of experts from WHO Collaborating Centres and WHO Essential Regulatory Laboratories that analyze virus surveillance data generated by the WHO Global Influenza Surveillance and Response System (or GISRS).

Around a billion people get seasonal influenza every year and the threat of an influenza pandemic is ever-present. For this reason, the need to monitor circulating respiratory viruses, including influenza, continues to be critical. This monitoring informs the  vaccine composition recommendations that WHO issues twice a year.

The year-round surveillance is conducted by GISRS, a global network of over 150 laboratories in 127 countries, areas or territories set up in 1952.  This year we celebrate its 70th anniversary.

Going forward, GISRS will continue to use its unique position as a global respiratory surveillance network to add value to other respiratory virus threats, including COVID-19, where it has already played a significant role. It will also make use of emerging technologies, for example by expanding genomic surveillance, to continue to protect people from the threat of influenza.

Recommendations

WHO recommends that quadrivalent vaccines for use in the 2023 southern hemisphere influenza season contain the following: 

Egg-based vaccines

  • an A/Sydney/5/2021 (H1N1)pdm09-like virus;
  • an A/Darwin/9/2021 (H3N2)-like virus;
  • a B/Austria/1359417/2021 (B/Victoria lineage)-like virus; and
  • a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

Cell culture- or recombinant-based vaccines

  • an A/Sydney/5/2021 (H1N1)pdm09-like virus;
  • an A/Darwin/6/2021 (H3N2)-like virus;
  • a B/Austria/1359417/2021 (B/Victoria lineage)-like virus; and
  • a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

WHO recommends that trivalent vaccines for use in the 2023 southern hemisphere influenza season contain the following:

Egg-based vaccines

  • an A/Sydney/5/2021 (H1N1)pdm09-like virus;
  • an A/Darwin/9/2021 (H3N2)-like virus; and
  • a B/Austria/1359417/2021 (B/Victoria lineage)-like virus.

Cell culture- or recombinant-based vaccines

  • an A/Sydney/5/2021 (H1N1)pdm09-like virus;
  • an A/Darwin/6/2021 (H3N2)-like virus; and
  • a B/Austria/1359417/2021 (B/Victoria lineage)-like virus

More:

Sep. 20, 2022

Noncommunicable diseases - heart disease and stroke, cancer, diabetes and respiratory disease – now outnumber infectious
diseases as the top killers globally

On 21 September, the World Health Organization will release a new report and data portal on noncommunicable (NCDs) diseases and their risk factors at an event co-organized with Bloomberg Philanthropies during the UN General Assembly.

NCDs are one of the greatest health and development challenges of this century.  Chief among them - cardiovascular diseases (heart disease and stroke), cancer, diabetes and chronic respiratory diseases, along with mental health, cause nearly three-quarters of deaths in the world and kill 41 million people every year. 

The report, Invisible numbers: The true extent of noncommunicable diseases and what to do about them makes the NCDs numbers visible and reminds of the true scale of the threat of NCDs and their risk factors.  It also shows cost-effective and globally applicable interventions that can change those numbers and save lives and money.

The NCD data portal with the latest country-specific data, risk factors and policy implementation for 194 countries brings the numbers in the report to life.  It allows the exploration of the data for the four NCDs (cardiovascular diseases, cancer, diabetes and chronic respiratory diseases) and their main drivers and risk factors (tobacco use, unhealthy diet, harmful use of alcohol and lack of physical activity).  The portal makes the patterns and trends in countries visible and allows comparison across countries or within geographical regions.

The report and its key findings, the data portal and the recording from a press conference held on 15 September for the UN Geneva correspondents are available under embargo.  WHO experts and the report’s authors are available for interviews.

Further information

  • Every two seconds, one person under the age of 70 dies of an NCD, and 86 per cent of those deaths are taking place in low- and middle-income countries (LMICs).  This major shift in public health over the last decades has gone largely unnoticed.
  • Major risk factors that lead to NCDs are tobacco use, unhealthy diet, harmful use of alcohol, physical inactivity and air pollution.  Eliminating these factors could prevent or delay significant ill health and many premature deaths from NCDs.
  • The report and data portal come at a critical juncture for public health: in 2022, only a handful of countries were on track to meet the Sustainable Development Goal (SDG) target on reducing early deaths from NCDs by a third by 2030.  This is despite the fact that the NCDs are truly at the heart of sustainable development and their prevention and treatment is a prime opportunity for investment that will have myriad impacts on economic growth, far outweighing the money spent.

Background reading

Sep. 17, 2022

17 September 2022 

I am deeply concerned about the potential for a second disaster in Pakistan: a wave of disease and death following this catastrophe, linked to climate change, that has severely impacted vital health systems leaving millions vulnerable. The water supply is disrupted, forcing people to drink unsafe water, which can spread cholera and other diarrhoeal diseases. Standing water enables mosquitoes to breed and spread vector- borne diseases such as malaria and dengue. Health centres have been flooded, their supplies damaged, and people have moved away from home which makes it harder for them to access their normal health services. All this means more unsafe births, more untreated diabetes or heart disease, and more children missing vaccination, to name but a few of the impacts on health.  

But if we act quickly to protect health and deliver essential health services, we can significantly reduce the impact of this impending crisis. Health workers in Pakistan are stretched to the limit as they do all they can to deliver critical services amid the destruction. Nearly 2,000 health facilities have been fully or partially damaged. Together with the government of Pakistan, UN and NGO partners, WHO is setting up temporary health facilities and medical camps and helping to re-supply medicines to other health centres. We are increasing disease surveillance so outbreaks can be detected early and people can get the treatment they need. 

Government and partners are providing safe drinking water and access to toilets to lower the risks of disease from dirty water. WHO has provided water purification kits and oral rehydration salts to manage diarrhoeal diseases.  Partners are also helping ensure safer housing and bed nets to protect against mosquitoes and the diseases they carry. 

WHO immediately released $10 million from the WHO Contingency Fund for Emergencies which enabled us to deliver essential medicines and other supplies.

I thank the donors for their prompt response to the flash appeal.  We continue to assess the scale of the crisis and will issue a revised appeal shortly. I urge donors to continue to respond generously so that, together, we can save lives and prevent more suffering.

 

Sep. 15, 2022

 

https://www.who.int/news/item/15-09-2022-who-responds-to-the-lancet-covid-19-commission

15 September 2022 

WHO welcomes the overarching recommendations of The Lancet COVID-19 Commission’s report on “Lessons for the future from the COVID-19 pandemic,” which align with our commitment to stronger global, regional and national pandemic preparedness, prevention, readiness and response. At the same time, there are several key omissions and misinterpretations in the report, not least regarding the public health emergency of international concern (PHEIC) and the speed and scope of WHO’s actions.   

WHO welcomes the Commission’s endorsement of a pandemic agreement, strengthening the International Health Regulations (IHR), and enhancing financing. These issues are core to the vision of WHO Director-General, Dr Tedros Adhanom Ghebreyesus, as distilled in the five priorities for his second term. WHO and its Member States are already enacting these recommendations. The World Health Assembly agreed a historic decision in May 2022 to sustainably finance WHO.This year will see two rounds of public hearings for a pandemic accord take place.

The Commission strongly endorses WHO’s central role in global health, arguing that “WHO should be strengthened” and that reforms “should include a substantial increase of its core budget.”

WHO echoes the Commission’s conclusions that COVID-19 exposed major global challenges, such as chronic under financing of the UN, rigid intellectual property regimes, a lack of sustainable financing for low- and middle-income countries, and “excessive nationalism,” which drove vaccine inequity.

The Organization also agrees with the focus on biosafety, as shown by the formalization of our Technical Advisory Group on biosafety, the publication of our Laboratory biosafety manual – now in its 4th edition – and the publication on 13 September this year of a life sciences framework to help mitigate bio risks and safely govern dual-use research.

WHO places similar emphasis on the importance of multilateralism, solidarity and cooperation when facing pandemics. We also welcome the recognition of the key role that countries themselves play.  

Many of the Commission’s recommendations align with those received over the past two years from review bodies set up by WHO itself, such as the Independent Panel for Pandemic Preparedness and Response (IPPPR), the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme (IOAC) and the IHR Review Committee, as well as assessments from other entities. As we are a learning organization, we established a dashboard of recommendations from these initiatives and others to track their implementation by WHO and others.

WHO’s rapid response

The Commission does not, however, convey the full arc of WHO’s immediate, multi-year, life-saving response, detailed below:  

  • On 30 December 2019, WHO received the first alerts of cases of pneumonia of unknown cause in Wuhan, China, and notified the IHR focal point, seeking further information from Chinese health authorities the next day.
  • On 1 January 2020, WHO activated its Incident Management System to manage daily action. The team, which includes focal points on clinical care, infection prevention and control, diagnostics, logistics, communications and more, met daily throughout 2020, into 2021 and continues to meet this year.  
  • On 5 January 2020, WHO issued a global alert to all Member States through a formal IHR system – the Event Information System – based on our initial risk assessment of the situation in China. This alerted Member States and advised them to take measures to identify cases, care for patients, and prevent infection and onward human-to-human transmission for acute respiratory pathogens with epidemic and pandemic potential. This was WHO’s first global warning to take concrete measures for an unknown respiratory disease. WHO has consistently driven knowledge-sharing through dedicated briefings for countries, during which the critical experiences of early-affected countries were shared and the elements of WHO’s comprehensive response were outlined.
  • On 9 January 2020, WHO convened the first of many teleconferences with established global expert networks, to discuss all available information on the cluster reported from China. These networks enabled the real-time exchange of direct knowledge, experience and early study findings, which fed directly into WHO’s early advice and recommendations.
  • Between 10 and 12 January 2020, WHO published a comprehensive package of technical guidance for countries. This package covered how to test for a high threat respiratory coronavirus, treat patients for severe acute respiratory infection, inform the public to prevent infection and human- to-human transmission, and to prepare health systems to deal with more cases.
  • On 13 January 2020, WHO published the first protocol to develop PCR tests to identify cases based on the release of the full genome sequence two days earlier. By 2 February 2020, WHO began shipping validated PCR assays to countries around the world.
  • On 22 and 23 January 2020, when there were nine cases and no deaths reported outside China, the Director-General convened the Emergency Committee (EC) under the IHR to meet, and advise whether the event constituted a public health emergency of international concern (PHEIC). The Committee advised that it did not. The Director-General said publicly: “Make no mistake. This is an emergency in China, but it has not yet become a global health emergency. It may yet become one”.
  • From 27 to 28 January, following the EC, the Director-General and senior staff travelled to China to meet with top government officials, gather information about the outbreak and seek cooperation.
  • On 30 January 2020, when there were 98 reported cases (and no deaths) in 18 countries outside China, the Director-General reconvened the Emergency Committee. It advised that the outbreak constituted a PHEIC. The DG took their advice and declared a PHEIC, issuing temporary recommendations for how countries could further prepare and respond.
  • On 4 February 2020, WHO’s Strategic Preparedness and Response Plan (SPRP) was published. It outlined comprehensive measures all countries needed to take to suppress transmission and save lives, using a package of interventions including early identification and isolation and care of cases, contact tracing and supported quarantine, use of medical masks, distancing, ventilation, infection prevention and control in health facilities, taking a risk-based approach to small and large gatherings, and for travel.
  • Following regular media briefings held in January, daily briefings began on 5 February 2020. Media briefings continue on a weekly basis, alongside regular live social media conversations with senior WHO experts, demonstrating the priority placed on communicating with leaders and the public.
  • From 11 to 12 February 2020, WHO led a Global Research and Innovation Forum on the new virus, convening nearly 900 experts and funders from more than 40 countries, to take stock of what was known about the novel coronavirus and to set the agenda going forward. A follow-up achievement was WHO’s Solidarity trial, which became one of the largest clinical trials for COVID-19 therapeutics, involving more than 30 countries, over 14 000 patients and nearly 500 hospitals at its peak.

 

A comprehensive and detailed list of actions taken by WHO during the COVID-19 response can be viewed in our interactive timeline.

From day one and to this day, WHO, together with our global expert networks and guideline development groups, regularly updates our guidance and strategies with the latest knowledge about the virus, including updates to the SPRP and the COVID-19 global vaccination strategy, and to the 11th version of WHO’s living guideline on COVID-19 therapeutics, which was published in July 2022.

WHO played, and continues to play, a vital role in getting COVID-19 tools to countries in need, not least through joint endeavours such as the ACT-AcceleratorPandemic Supply Chain Network (PSCN) and UN COVID-19 Supply Chain Task Force. Lab testing capability in African nations rose dramatically over six months, thanks to support from WHO. Only two countries on the African continent had COVID-19 testing capacities at the start of 2020; by mid-year, all 54 countries had them. WHO has supported 18 countries globally to set up plants for medical oxygen.

Throughout the pandemic, the Director-General has repeatedly called for leaders to take actions to protect people and share tools equitably when addressing the world’s most important fora, such as the February Munich Security Conference; the extraordinary G20 Leaders Summit of March 2020; the G7 Summit of June 2021, where the 70% vaccination target was announced; and Global COVID-19 Summits co-hosted by the Biden Administration in September 2021 and May 2022.

Regarding the areas of WHO’s response focused on by the Commission, WHO would like also to highlight the many day-to-day steps, including the following:   

  • WHO repeatedly warned of the potential of asymptomatic human-to-human transmission, particularly pre-symptomatic transmission, including in late January in updated surveillance guidance, in protocols for enhanced surveillance on 29 January (defining a contact as someone with exposure 1 day before symptom onset of a case) and 4 February (changing a contact to someone with exposure up to 4 days before symptom onset of a case), at its Executive Board on 4 February, in guidance documents from 23 and 28 February 2020, in its China mission report and media briefings. WHO issued guidance and enhanced surveillance protocols early in the pandemic to identify contacts among people prior to the development of symptoms.
  • The IHR recognize the sovereign rights of State Parties to introduce restrictions on travel. From the very beginning of the COVID-19 response, WHO recommended many measures countries should take, including screening at entry points.
  • At the beginning of the pandemic, dramatic global supply constraints saw health workers around the world scrambling to find basic supplies to protect themselves. WHO’s early priority was getting access to masks for those most at-risk around the world; we initially recommended the use of medical masks for anyone with symptoms, anyone caring for someone sick, and frontline health workers. Our logisticians and other UN partners were central in activating the pandemic supply chain and increasing global supplies.
  • WHO guidance published on 10 January 2020, outlined respiratory precautions – including airborne precautions – in health-care settings. WHO guidance addressing many forms of transmission including zoonotic, droplet, airborne, short- and long-range aerosol, fomite, and vertical transmission, along with specific recommendations to prevent such transmission in different settings (such as health facilities, schools, workplaces), was updated and expanded regularly throughout the pandemic based on emerging evidence. WHO is leading and coordinating a multi-agency, multidisciplinary, international technical consultation process to discuss and reach a consensus on pathogens that transmit through the air, with a wide range of global experts and international and national agencies. 

 

Looking ahead

The pandemic is not over, though the end is in sight, and WHO continues its response, while laying a stronger foundation for the future:

  • Daily meetings of experts continue in order to update and streamline strategies and guidance. WHO-supported research continues. Helping countries access vaccines continues. Setting up oxygen plants continues.
  • At the World Health Assembly in May 2022, the Director-General presented WHO's proposals, developed in consultation with Member States and other stakeholders – taking into consideration the over 300 recommendations from review bodies and panels – to strengthen the architecture for Health Emergency Preparedness, Response and Resilience.
  • In early September 2022, the financial intermediary fund for pandemic prevention, preparedness, and response was officially launched. This will provide long-term financing to strengthen these capabilities in low- and middle-income countries and address critical gaps.
  • Through the Intergovernmental Negotiating Body to draft and negotiate a WHO international instrument on pandemic preparedness and response, WHO is hosting public hearings, the first since those that fed into the WHO Framework Convention on Tobacco Control (which entered into force in 2005).
  • WHO continues to actively pursue the search for the origins of SARS-CoV-2, with July 2021 marking the establishment of a permanent international Scientific Advisory Group for Origins of Novel Pathogens, or SAGO, which covers both SARS-CoV-2 and future new pathogens.