World Health Organization Corporate news releases, statements, and notes for media issued by the World Health Organization.
- Investing in midwife-led interventions could save 4.3 million lives per year, new study findson Dec 3 2020 at 08:01
About two-thirds of maternal deaths, newborn deaths and stillbirths could be prevented by 2035 if the current level of care by professional midwives educated and regulated to international standards was scaled up to provide universal access, finds a new study led by the United Nations Population Fund (UNFPA), WHO, and the International Confederation of Midwives published today in the Lancet Global Health. The study’s modelled estimates indicate that where midwife-delivered interventions such as family planning, diabetes management, assisted delivery and breastfeeding support take place, 4.3 million lives could be saved per year by 2035.“These findings should leave no doubt in the minds of ministers of health, education and finance that midwife-led interventions have the potential to save the lives of women and their newborns at a vast scale,” says Elizabeth Iro, WHO Chief Nursing Officer. “Now it is time to act. We must take urgent action to invest in midwives.”Greater investment in professional midwives, a profession categorised by the International Labour Organization as distinct from nursing, could improve the survival of mothers and babies, particularly in low- and middle-income countries. To realise this potential, midwives need education and training to international standards, to be part of a supportive and skilled team, and work in an environment with adequate water, sanitation and medical supplies.The study is based on modelled estimates of deaths averted in 88 low- and middle-income countries that account for more than 95% of global maternal and newborn deaths and stillbirths. These countries have severe health workforce shortages: they are home to 74% of the world’s population but just 46% of the world’s doctors, nurses and midwives. The new study follows a 2014 publication in The Lancet Series in Midwifery and uses the Lives Saved Tool (LiST) which models variations in deaths based on the uptake, effectiveness and impact of about 30 midwife delivered interventions. Using an updated version of LiST, the current study provides three scenarios on the impact of increasing the provision of midwife healthcare around the world. The three scenarios include: achieving universal coverage by 2035; increasing coverage of midwife-delivered interventions by 25% every 5 years; or increasing coverage by 10% every 5 years.Improving the health of mothers and newborns remains an important priority on the international agenda and there has been an increasing awareness around the role of midwives in addressing this need, including through WHO's campaign on the year of the nurse and wife.Key Findings
- Global equitable access to COVID-19 vaccines estimated to generate economic benefits of at least US$ 153 billion in 2020–21, and US$ 466 billion by 2025, in 10 major economies, according to new report by the Eurasia Groupon Dec 2 2020 at 21:53
As world leaders gather virtually at the Special Session of the General Assembly in response to the COVID-19 pandemic, new data published today finds that leaving low- and lower-middle-income countries (LLMICs) without access to vaccines amid the COVID-19 pandemic will cause significant economic damage that puts decades of economic progress at risk – for both LLMICs and advanced economies alike. The report by the Eurasia Group analyses ten major economies – Canada, France, Germany, Japan, Qatar, South Korea, Sweden, United Arab Emirates, United Kingdom and the United States – to assess the economic benefits to advanced economies of contributing to the work of the Access to COVID-19 Tools (ACT) Accelerator.The ACT Accelerator, led by WHO and partnering with the world’s leading international health organizations, is a unique global collaboration which supports the development and equitable distribution of the tests, treatments and vaccines the world needs to fight COVID-19. However, the programme still has a significant funding gap of US$ 28.2 billion – with US$ 4.3 billion needed urgently to fast-track critical areas of work. If that shortfall isn’t met, low- and low-middle income countries will have delayed access to these vital tools in 2021, which will result in a protracted pandemic, with severe economic consequences, not just for these countries by also for the wider global economy. The report, which was commissioned by the Bill & Melinda Gates Foundation, finds that the economic benefits of a global equitable vaccine solution alone for the 10 countries included in the analysis would be at least US$ 153 billion in 2020-21, rising to US$ 466 billion by 2025. This is more than 12 times the US$ 38 billion estimated total cost of the ACT Accelerator. This figure was compiled using the expected negative effects of sustained coronavirus outbreaks in LLMICs, based on the downside and baseline scenarios of the IMF’s October 2020 World Economic Outlook forecasts.So far, the 10 countries featured in the report have contributed $2.4 billion to the work of the ACT Accelerator, with the United Kingdom committing just over US$ 1 billion, and Germany, Canada, Japan and France committing US$ 618 million, US$ 290 million, US$ 229 million and US$ 147 million respectively.In just seven months, the ACT Accelerator’s progress has been significant: over 50 diagnostic tests have been evaluated and new rapid antigen diagnostics have been developed and being made available for LMICs; life-saving Dexamethasone treatments are being rolled out, research into monoclonal antibody treatments is advancing; and through the Health Systems Connector, the health system requirements for delivery of COVID-19 tools have been mapped in 4 out of 6 world regions.COVAX, the Vaccines Pillar of the ACT Accelerator, has the world’s largest and most diverse portfolio of vaccines. It aims to accelerate the development and manufacture of COVID-19 vaccines, and to guarantee fair and equitable access for every participating country. Working with 189 countries, COVAX is supporting the development of 9 vaccine candidates through CEPI, 8 of which are in clinical trials. COVAX has secured hundreds of millions of doses of three promising candidates, including at least 200 million doses for LICs, with the support of the Bill & Melinda Gates Foundation.This new report emphasizes the funding urgency and the return on investment for donor countries of the work of the ACT Accelerator, which published its Urgent Priorities and Financing Requirements on 10 November.Dr Tedros Adhanom Ghebreyesus, WHO Director-General, called on countries to commit to the work of the ACT Accelerator, stating that, “The ACT Accelerator is the global solution to ending the acute phase of the pandemic as quickly as possible by ensuring equitable access to COVID-19 tools. Contributing to the ACT Accelerator it is not just the right thing to do – it’s the smart thing for all countries – socially, economically and politically.”Alexander Kazan, Managing Director for Global Strategy at Eurasia Group and one of the authors of the report said, “There is a clear humanitarian and ethical case for supporting the ACT Accelerator and the Covax facility, along with the obvious economic gains it would bring to developing countries; doing nothing risks reversing years if not decades of economic progress. But our analysis shows that the program is likely to yield economic and other returns for major donor countries as well. The ACT Accelerator is a unique opportunity to save lives, repair the global economy, and build diplomatic capital that will last a generation.”Hassan Damluji, Deputy Director at the Bill & Melinda Gates Foundation, commenting on the report’s findings said, “The moral case for an equitable global solution to the COVID-19 crisis has always been clear, but with high-income countries reeling from a huge shock, their governments are increasingly focusing on investments that can help their own economies to rebound. This report adds to the body of evidence that shows that the ACT Accelerator is precisely one of those investments. It is both the right thing to do, and an investment that will pay dividends by bringing the global economy back from the brink, benefiting all nations.”Notes to EditorsEurasia GroupEurasia Group is the world's leading global political risk research and consulting firm. By providing information and insight on how political developments move markets, we help clients anticipate and respond to instability and opportunities everywhere they invest or do business. Our expertise includes developed and developing countries in every region of the world, specific economic sectors, and the business and investment playing fields of the future. With our best-in-class advisory and consulting offerings and GZERO Media, the Eurasia Group umbrella provides the marketplace with a complete political risk solution. Headquartered in New York, we have offices in Washington DC, London, San Francisco, Brasilia, Sao Paulo, Singapore, and Tokyo, as well as on-the-ground experts and resources in more than a hundred countries. "Politics first” grounds our work: Politics is the lens through which we view the world, and we are committed to analysis that is free of political bias and the influence of private interests. The ACT AcceleratorThe Access to COVID-19 Tools Accelerator (ACT Accelerator), is the proven, up-and-running global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. It was set up in response to a call from G20 leaders in March and launched by the WHO, European Commission, France and The Bill & Melinda Gates Foundation in April 2020.The ACT Accelerator is not a decision-making body or a new organization, but works to speed up collaborative efforts among existing organizations to end the pandemic. It is a framework for collaboration that has been designed to bring key players around the table with the goal of ending the pandemic as quickly as possible through the accelerated development, equitable allocation, and scaled up delivery of tests, treatments and vaccines, thereby protecting health systems and restoring societies and economies in the near term. It draws on the experience of leading global health organizations which are tackling the world’s toughest health challenges, and who, by working together, are able to unlock new and more ambitious results against COVID-19. Its members share a commitment to ensure all people have access to all the tools needed to defeat COVID-19 and to work with unprecedented levels of partnership to achieve it. The ACT Accelerator comprises four pillars: diagnostics, therapeutics, vaccines and health system strengtheningThe diagnostics pillar, co-convened by the Global Fund and FIND is focused on bringing to market 2–3 high-quality rapid tests, training 10,000 healthcare professionals across 50 countries and establishing testing for 500 million people in Low and Middle-Income countries by mid-2021.The therapeutics pillar is led by Unitaid and Wellcome. Therapeutics can play a role in all stages of COVID-19 disease: to prevent infection; suppress symptoms and spread of infection to others; treat or prevent symptoms; as a life-saving treatment for severe symptoms; and as a treatment that can speed up recovery. The aim in the next 12 months is to develop, manufacture and distribute 245 million treatments, helping COVID-19 sufferers to recover from the disease.The COVAX vaccines pillar, convened by CEPI, Gavi and WHO, is speeding up the search for an effective vaccine for all countries. At the same time, it is supporting the building of manufacturing capabilities, and buying supply, ahead of time so that 2 billion doses can be fairly distributed by the end of 2021.The health systems connector, led by the WHO, World Bank and the Global Fund, is working to ensure that these tools can reach the people who need them.Cross-cutting all of these is the workstream on Access & Allocation, hosted by the World Health Organization (WHO).
- Global Solidarity to End TB and HIVon Dec 2 2020 at 16:23
The theme of this year’s World AIDS Day is “Global solidarity, resilient services”. At the 2016 UN High-level Meeting on ending AIDS, member states committed to a 75% reduction of TB deaths among people living with HIV by 2020, compared with 2010. Estimates for 2019 suggest that there has been some notable progress with a 63% reduction; however, the target for 2020 is unlikely to be reached, particularly in the context of the current COVID-19 pandemic.
- Profile: Dr Collins Tabu, Head of Immunization Programme, Ministry of Health, Kenyaon Dec 2 2020 at 12:18
In this Q&A, Dr Collins Tabu, head of Kenya’s National Vaccines and Immunization Program, reflects on the country’s malaria vaccine pilot experience on the recent 1st anniversary of RTS,S/AS01 introduction, particularly in the context of COVID-19.
- New toolkit aims to improve global birth defects surveillanceon Dec 1 2020 at 19:54
Birth defects or congenital anomalies are an invisible tragedy around the world. Every year an estimated 295 000 newborns die due to congenital anomalies during the first 28 days of life. The most common, severe congenital anomalies are heart defects, neural tube defects and Down’s syndrome. Congenital anomalies can cause miscarriage, stillbirth, and for those who survive, lifelong physical and psychological difficulties. The lack of medical, surgical and support services to care for children affected, especially in low-resource settings, can take a toll on families and children.In an effort to build up better prevention and care services to decrease the number of congenital anomalies worldwide and to better care for those who are born with birth defects, WHO, the Centers for Disease Control and Prevention, the International Clearinghouse for Birth Defects Surveillance and Research, and the March of Dimes today launched a new toolkit – Birth defects surveillance: a manual for programme managers and Birth defects surveillance: quick reference handbook of selected congenital anomalies. “Many birth defects go unreported worldwide, and surveillance systems, particularly in low- and middle-income countries, are weak or do not exist,” says Dr Anshu Banerjee, Director, WHO Department of Maternal, Newborn, Child, and Adolescent Health and Ageing. “By investing in birth defects surveillance to collect better quality data, countries can adequately provide the high-quality services for prevention, care and support these children and families need.”With the growing recognition of the impact of birth defects due to infectious diseases like Zika virus, nutrition deficiencies and other conditions in pregnancy, the updated manual is intended to serve as a tool for the development, implementation and ongoing improvement of national congenital anomalies surveillance programmes. The manual is also accompanied by a newly created quick reference handbook for front-line health care professionals who are diagnosing and collecting data on congenital infections and birth defects. It includes illustrations and photos of different birth defects, as well as summaries of the guidance for diagnosis and data collection. Through the development of a population-based surveillance programmes that accurately capture congenital anomalies, countries can better understand the burden of these conditions, become more aware of the risks involved, refer identified infants to services in a timely manner, and use prevalence estimates to evaluate and strengthen any current prevention or clinical management programmes. Countries can also use the information gathered to inform stakeholders and policy-makers about the importance of investing in programmes aimed at reducing the occurrence of congenital anomalies, and to help them plan for appropriate services.Congenital anomalies are largely preventable through improved nutrition in women of reproductive age, prenatal counselling and folic acid supplementation, adequate antenatal care, including vaccination, and screening, prevention and treatment for infectious diseases during pregnancy, like syphilis and rubella.In 2010, Member States adopted a resolution to promote primary prevention and improve the health of children with congenital anomalies through developing and strengthening registration and surveillance systems, developing expertise and building capacity, and strengthening research and studies on etiology, diagnosis and prevention.“Today, WHO is committed as ever to increasing awareness, reducing stigma and expanding access to services for prevention and care of birth defects as part of every country’s journey towards universal health coverage,” says Zsuzsanna Jakab, WHO Deputy Director-General.
- One Health and integrated vector management: communication, collaboration and complementarity to address real-life problemson Dec 1 2020 at 09:11
Many neglected tropical diseases (NTDs) result from diverse types of interactions and often complex cycles of transmission between humans and animals, both vertebrates and invertebrates, and changing social and environmental conditions. Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030 was endorsed by the Seventy-third World Health Assembly last week. The road map supports a cross-sectoral strategy that encompasses One Health and the measures articulated in the Global Vector Control Response (GVCR) 2017–2030.
- TDR and WHO launch a new digital health research toolkit for TB careon Nov 30 2020 at 12:45
TDR, in partnership with the WHO Global Tuberculosis Programme, has developed an interactive web-based toolkit that supports national TB programmes and other partners to conduct implementation research designed to evaluate digital technologies for TB care. This will be launched today at a workshop taking place in Beijing, China.
- Overcoming the drug-resistant TB crisis in children and adolescentson Nov 30 2020 at 11:06
World Children’s Day marks the day, over three decades ago, on which world leaders adopted the historic Convention of the Rights of the Child, promising to every child to promote and protect their rights, including the right to life and the right to health.
- World AIDS Day 2020 – WHO calls for global solidarity to maintain HIV serviceson Nov 30 2020 at 09:57
On 1 December WHO is calling on global leaders and citizens to rally for “global solidarity” to maintain essential HIV services during COVID 19 and beyond - and to ensure continued provision of HIV services for children, adolescents and populations most at risk for the disease. The Organization also calls on countries to provide healthworkers with greater protection and support so they can continue their work safely during the pandemic.
- WHO calls for reinvigorated action to fight malariaon Nov 29 2020 at 21:43
The World Health Organization (WHO) is calling on countries and global health partners to step up the fight against malaria, a preventable and treatable disease that continues to claim hundreds of thousands of lives each year. A better targeting of interventions, new tools and increased funding are needed to change the global trajectory of the disease and reach internationally-agreed targets. According to WHO‘s latest World malaria report, progress against malaria continues to plateau, particularly in high burden countries in Africa. Gaps in access to life-saving tools are undermining global efforts to curb the disease, and the COVID-19 pandemic is expected to set back the fight even further. “It is time for leaders across Africa – and the world – to rise once again to the challenge of malaria, just as they did when they laid the foundation for the progress made since the beginning of this century,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Through joint action, and a commitment to leaving no one behind, we can achieve our shared vision of a world free of malaria.” In 2000, African leaders signed the landmark Abuja Declaration pledging to reduce malaria deaths on the continent by 50% over a 10-year period. Robust political commitment, together with innovations in new tools and a steep increase in funding, catalyzed an unprecedented period of success in global malaria control. According to the report, 1.5 billion malaria cases and 7.6 million deaths have been averted since 2000. A plateau in progressIn 2019, the global tally of malaria cases was 229 million, an annual estimate that has remained virtually unchanged over the last 4 years. The disease claimed some 409 000 lives in 2019 compared to 411 000 in 2018. As in past years, the African Region shouldered more than 90% of the overall disease burden. Since 2000, the region has reduced its malaria death toll by 44%, from an estimated 680 000 to 384 000 annually. However, progress has slowed in recent years, particularly in countries with a high burden of the disease. A funding shortfall at both the international and domestic levels poses a significant threat to future gains. In 2019, total funding reached US $3 billion against a global target of $5.6 billion. Funding shortages have led to critical gaps in access to proven malaria control tools. COVID-19 an added challenge In 2020, COVID-19 emerged as an additional challenge to the provision of essential health services worldwide. According to the report, most malaria prevention campaigns were able to move forward this year without major delays. Ensuring access to malaria prevention – such as insecticide-treated nets and preventive medicines for children – has supported the COVID-19 response strategy by reducing the number of malaria infections and, in turn, easing the strain on health systems. WHO worked swiftly to provide countries with guidance to adapt their responses and ensure the safe delivery of malaria services during the pandemic. However, WHO is concerned that even moderate disruptions in access to treatment could lead to a considerable loss of life. The report finds, for example, that a 10% disruption in access to effective antimalarial treatment in sub-Saharan Africa could lead to 19 000 additional deaths. Disruptions of 25% and 50% in the region could result in an additional 46 000 and 100 000 deaths, respectively. “While Africa has shown the world what can be achieved if we stand together to end malaria as a public health threat, progress has stalled,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “COVID-19 threatens to further derail our efforts to overcome malaria, particularly treating people with the disease. Despite the devastating impact COVID-19 has had on African economies, international partners and countries need to do more to ensure that the resources are there to expand malaria programmes which are making such a difference in people’s lives.” WHO responseA key strategy to reignite progress is the “High burden to high impact” (HBHI) response, catalyzed in 2018 by WHO and the RBM Partnership to End Malaria. The response is led by 11 countries – including 10 in sub-Saharan Africa – that account for approximately 70% of the world’s malaria burden. Over the last 2 years, HBHI countries have been moving away from a “one-size-fits all” approach to malaria control – opting, instead, for tailored responses based on local data and intelligence. A recent analysis from Nigeria, for example, found that through an optimized mix of interventions, the country could avert tens of millions of additional cases and thousands of additional deaths by the year 2023, compared to a business-as-usual approach.While it is too early to measure the impact of the HBHI approach, the report finds that deaths in the 11 countries were reduced from 263 000 to 226 000 between 2018 and 2019. India continued to make impressive gains, with reductions in cases and deaths of 18% and 20%, respectively, over the last 2 years. There was, however, a slight increase in the total number of cases among HBHI countries, from an estimated 155 million in 2018 to 156 million in 2019. Meeting global malaria targetsThis year’s report highlights key milestones and events that helped shape the global response to the disease in recent decades. Beginning in the 1990s, leaders of malaria-affected countries, scientists and other partners laid the groundwork for a renewed malaria response that contributed to one of the biggest returns on investment in global health. According to the report, 21 countries eliminated malaria over the last 2 decades; of these, 10 countries were officially certified as malaria-free by WHO. In the face of the ongoing threat of antimalarial drug resistance, the 6 countries of the Greater Mekong subregion continue to make major gains towards their goal of malaria elimination by 2030. But many countries with a high burden of malaria have been losing ground. According to WHO global projections, the 2020 target for reductions in malaria case incidence will be missed by 37% and the mortality reduction target will be missed by 22%.Note to editorsWHO’s work on malaria is guided by the Global technical strategy for malaria 2016-2030 (GTS), approved by the World Health Assembly in May 2015. The strategy includes four global targets for 2030, with milestones along the way to track progress. The 2030 targets are: 1) reducing malaria case incidence by at least 90%; 2) reducing malaria mortality rates by at least 90%; 3) eliminating malaria in at least 35 countries; and4) preventing a resurgence of malaria in all countries that are malaria-free. Near-term GTS milestones for 2020 include global reductions in malaria case incidence and death rates of at least 40% and the elimination of malaria in at least 10 countries. According to the report, the 2020 milestones for malaria case incidence and mortality rates will be missed:- Case incidence: WHO projects that, in 2020, there were an estimated 56 malaria cases for every 1000 people at risk of the disease against a GTS target of 35 cases. The GTS milestone will be missed by an estimated 37%.- Mortality rate: The estimate for globally projected malaria deaths per 100 000 population at risk was 9.8 in 2020 against a GTS target of 7.2 deaths. The milestone will be missed by an estimated 22%. WHO African Region – Since 2014, the rate of progress in both cases and deaths in the region has slowed, attributed mainly to the stalling of progress in several countries with moderate or high transmission. In 2019, six African countries accounted for 50% of all malaria cases globally: Nigeria (23%), the Democratic Republic of the Congo (11%), United Republic of Tanzania (5%), Niger (4%), Mozambique (4%) and Burkina Faso (4%). In view of recent trends, the African Region will miss the GTS 2020 milestones for case incidence and mortality by 37% and 25%, respectively. “High burden to high impact” (HBHI) – Launched in November 2018, HBHI builds on the principle that no one should die from a disease that is preventable and treatable. It is led by 11 countries that, together, accounted for approximately 70% of the world’s malaria burden in 2017: Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, India, Mali, Mozambique, Niger, Nigeria, Uganda and United Republic of Tanzania. Over the last two years, all 11 HBHI countries have implemented activities across four response elements: 1) political will to reduce the toll of malaria; 2) strategic information to drive impact; 3) better guidance, policies and strategies; and 4) a coordinated national malaria response Malaria elimination – Between 2000 and 2019, 10 countries received the official WHO certification of malaria elimination: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Kyrgyzstan (2016), Sri Lanka (2016), Uzbekistan (2018), Paraguay (2018), Argentina (2019) and Algeria (2019). In 2019, China reported zero indigenous cases of malaria for the third consecutive year; the country recently applied for the official WHO certification of malaria elimination. In 2020, El Salvador became the first country in Central America to apply for the WHO malaria-free certification In the six countries of the Greater Mekong subregion – Cambodia, China (Yunnan Province), Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam – the reported number of malaria cases fell by 90% from 2000 to 2019, while P. falciparum (Pf) cases fell by 97% in the same time period. This accelerated decrease in Pf malaria is notable in view of the threat posed by antimalarial drug resistance in the subregion. A call for innovation – Eliminating malaria in all countries, especially those with a high disease burden, will likely require tools that are not available today. In September 2019, the WHO Director-General issued a “malaria challenge,” calling on the global health community to ramp up investment in the research and development of new malaria-fighting tools and approaches. This message was further reinforced in the April 2020 report of the WHO Strategic advisory group on malaria eradication.
- Existing HIV and TB laboratory systems facilitating COVID-19 testing in Africaon Nov 27 2020 at 17:51
Many countries in resource-limited settings have high HIV, malaria, tuberculosis, hepatitis, and/or sexually transmitted infection (STI) burdens. ince the start of the COVID-19 pandemic, scaling up testing has been a critical component to identify, isolate, and trace suspected cases as efforts to reduce transmission and care for patients early. Through conducting over 10 million tests, countries in Africa have identified nearly 2 000 000 COVID-19 cases. In many countries, there has been heavy reliance on the laboratory systems built and developed by HIV and TB programs.
- Successful continuation of antiretroviral therapy delivery during COVID 19 – best practices from the South East Asia Regionon Nov 26 2020 at 17:41
The COVID-19 pandemic was predicted to and has had a major impact on the essential HIV health services in the Southeast Asia region (SEAR), putting at risk the benefits accrued over the last two decades – best practices from the Southeast Asia Region.
- Continuing PrEP services for adolescents in Brazil despite COVID-19 disruptionson Nov 26 2020 at 15:58
PrEP1519 is the first demonstration study in Latin America exploring acceptability, use, and persistence of pre-exposure prophylaxis (PrEP) amongst adolescent men who have sex with men (MSM) and transgender women (TGW) aged 15-19 years. The study is ongoing in three cities in Brazil: Salvador, São Paulo, and Belo Horizonte. During the COVID-19 pandemic, the PrEP1519 study team ensured a contingency plan to minimize effects of the pandemic disruptions on people participating in the study, to initiate and continue accessing PrEP and other sexual health services. They use telehealth platforms such as text messages, online social media (Instagram and Facebook), and an artificial intelligence chatbot called Amanda Selfie to recruit participants, provide peer support and care. The team also provides discreet home delivery of condoms, lubricants, douches, HIV self-tests and medicines for PrEP. In addition, in-person appointments remain possible, when necessary.Importance of maintaining HIV prevention services during the COVID-19 pandemicThe story of Miguel (*) a young person who joined the study in July 2019 highlights the importance of maintaining HIV prevention services during the COVID-19 pandemic. While Miguel was enrolled in the PrEP programme, he reported poor adherence to his PrEP medication. During the lockdown, he contacted the PrEP1519 team for an HIV test due to an acute viral infection. The test was facilitated under safe conditions at a PrEP1519 clinic. He tested negative for HIV, but positive for syphilis and was treated on the same day. His partner, however, tested positive for HIV, after which Miguel was tested again for HIV. The second test confirmed that he was HIV-negative. Following his experience, Pedro is motivated to continuing his PrEP regimen to prevent HIV. (*Name changed for anonimity)A PrEP1519 participant receives a home-based HIV prevention kit during COVID-19 lockdown A member of the clinical team conducting a PrEP1519 telehealth consultationRapid test for syphilis at the PrEP1519 clinic. The clinical team also advised that the participant’s partner undergo STI and HIV testing.PrEP1519 client with the physician prescribing PrEP
- Pre-exposure prophylaxis services in Thailand during COVID-19on Nov 26 2020 at 15:49
Thailand’s key population-led health services (KPLHS) are a hallmark of the success of the country’s HIV response. In Thailand, KPLHS refer to a defined set of HIV-related health services for key populations designed and delivered by trained and qualified lay providers, who are often members of key populations. These services are needs-based, demand driven and client-centered, and include HIV testing, pre-exposure prophylaxis (PrEP) services, and linkage to HIV care. KPLHS augments the national program in Thailand by bridging the gap between government services and key populations, especially for the most marginalized communities. Currently, more than half of all Thai PrEP users access PrEP through KPLHS. In the first half of 2019, COVID-19 impacted the delivery of and access to KPLHS and other HIV services in Thailand. For example, numbers of HIV and STI testing clients in major HIV/STI centers declined by 50-75%, there were reductions in numbers of new HIV diagnoses and treatment initiations, there was uncertainty around the supply of PrEP, travel restrictions prevented some clients from visiting their usual providers, and there were personal protective equipment shortages. PrEP Xpress delivery service The Institute of HIV Research and Innovation (IHRI) supported KPLHS to adapt PrEP services and implement a range of innovations at the community level. These included: extending PrEP-prescriptions from 3 to 6 months for many clients continuing PrEPtelehealth consultations to minimize clinic visits and allow those under movement or travel restrictions to continue to access PrEP care Xpress delivery services for medicationSTI self-sampling, and PrEP effective use counseling was introduced, allowing MSM clients to choose to stop, re-start and tailor daily or event-driven use to their HIV risk.Self-samplingAs KP-lay providers in community-based clinics were not prioritized during personal protective equipment shortages, KPLHS made improvised plastic shields and other protective equipment to help protect themselves and their clients. Improvised PPE to protect clients and their providers at the MPLUS clinicOutside the ‘clinic’, KPLHS also helped ensure that client’s essential life needs were met during the pandemic, including food packages, daily necessities, temporary housing/shelter, emergency funds, and live-saving guides and toolkits for those practicing sex work. Food deliveries to vulnerable clients These service adaptations have helped overcome some of the barriers to PrEP services for key populations during the COVID-19 pandemic. The adaptations are largely sustainable, have helped expand the differentiated service delivery model for PrEP and are becoming popular options for clients. Indeed, STI self-sampling has increased in popularity with rates of acceptance increasing from 48% in May 2020 to 78% in July 2020.KPLHS and other HIV services should embed adaptations that improve accessibility, availability, quality and acceptability, including those introduced in response to the COVID-19 pandemic, to improve PrEP services post-COVID-19. The adaptations introduced by KPLHS in Thailand and their successes provide important lessons for other countries and HIV services.
- WHO releases new guidance on integrating mental health in radiological and nuclear emergency responseon Nov 26 2020 at 11:17
The Framework for mental health and psychosocial support in radiological and nuclear emergencies, released today, brings together, for the first time, existing knowledge from the fields of mental health and protection from radiation in an integrated guide for preparedness for and response to nuclear and radiological emergencies.
- Every move counts towards better health – says WHOon Nov 25 2020 at 22:59
Up to 5 million deaths a year could be averted if the global population was more active. At a time when many people are home bound due to COVID-19, new WHO Guidelines on physical activity and sedentary behaviour, launched today, emphasize that everyone, of all ages and abilities, can be physically active and that every type of movement counts. The new guidelines recommend at least 150 to 300 minutes of moderate to vigorous aerobic activity per week for all adults, including people living with chronic conditions or disability, and an average of 60 minutes per day for children and adolescents. WHO statistics show that one in four adults, and four out of five adolescents, do not get enough physical activity. Globally this is estimated to cost US$54 billion in direct health care and another US$14 billion to lost productivity. The guidelines encourage women to maintain regular physical activity throughout pregnancy and post-delivery. They also highlight the valuable health benefits of physical activity for people living with disabilities. Older adults (aged 65 years or older) are advised to add activities which emphasize balance and coordination, as well as muscle strengthening, to help prevent falls and improve health. Regular physical activity is key to preventing and helping to manage heart disease, type-2 diabetes, and cancer, as well as reducing symptoms of depression and anxiety, reducing cognitive decline, improving memory and boosting brain health. “Being physically active is critical for health and well-being – it can help to add years to life and life to years,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Every move counts, especially now as we manage the constraints of the COVID-19 pandemic. We must all move every day – safely and creatively.” All physical activity is beneficial and can be done as part of work, sport and leisure or transport (walking, wheeling and cycling), but also through dance, play and everyday household tasks, like gardening and cleaning. “Physical activity of any type, and any duration can improve health and wellbeing, but more is always better,” said Dr Ruediger Krech, Director of Health Promotion, World Health Organization, “and if you must spend a lot of time sitting still, whether at work or school, you should do more physical activity to counter the harmful effects of sedentary behaviour.” “These new guidelines highlight how important being active is for our hearts, bodies and minds, and how the favourable outcomes benefit everyone, of all ages and abilities”, said Dr Fiona Bull, Head of the Physical Activity Unit which led the development of the new WHO guidelines. WHO encourages countries to adopt the global guidelines to develop national health policies in support of the WHO Global action plan on physical activity 2018-2030. The plan was agreed by global health leaders at the 71st World Health Assembly in 2018 to reduce physical inactivity by 15% by 2030.
- Update: WHO revision of pain management guidelineson Nov 25 2020 at 12:58
This is an update of the August 2019 information brief on WHO’s revision of the two following guidelines: Ensuring balance in national policies on controlled substances: Guidance for availability and accessibility of controlled medicines (2011)WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses (2012) WHO guideline on ensuring balanced national policies for access and safe use of controlled medicinesGuideline on the management of chronic pain in childrenGuideline Stage Lead WHO technical unit Access to Medicines and Health ProductsControlled.email@example.com Maternal Newborn Child and Adolescent Health and Ageing Planning WHO GRC planning approval received March 2020 January 2020 Scope The proposed scope for this guideline has been developed and is available here. The proposed scope for this guideline was developed following the public hearing in which stakeholders expressed their views. The proposed scope for this guideline has been developed and is available at the following link:WHO Guideline for the management of chronic pain in children Public hearing A public hearing regarding the scope of the guideline took place on 19 February 2020. The written statements submitted on the guideline have been consolidated and can be found here. A public hearing in relation to the scope of the guideline for the management of chronic pain in children was held on 16th January 2020. Views were expressed on the proposed scope by 49 different stakeholders across the different WHO regions. These included academic groups, NGOs, practitioners and patient representatives. Appointment of GDG The list of Guideline Development Group members has been confirmed and is available here. Public comments on the proposed list were accepted until 9th February 2020. The list of Guideline Development Group members for the guideline for the management of chronic pain in children is available here. Public comments on the proposed list were accepted until 14 January 2020. Planning- initial GDG meeting The first GDG meeting was held in June 2020 to finalise the scope of the guideline. A second GDG meeting is scheduled for 15th December 2020 to prioritise outcomes. The first GDG meeting was held on 24th January 2020 to finalise the scope of the guideline and prioritise outcomes. The guideline will answer the following key question: among children with chronic pain (population), would giving pharmacologic, physical, psychological or a combination of these (intervention), compared to standard care or active comparators (comparator), result in change of pain experience, functional disability, health-related quality of life and other critical outcomes (outcomes)? Synthesis of evidence WHO Procurement issued a Request for Proposals (RFP) from specialist technical experts. A systematic review team has been selected. WHO Procurement issued a Request for Proposals (RFP) from specialist technical experts. A systematic review team was selected. Systematic and comprehensive evidence retrieval and synthesis on the effectiveness, safety and sociocultural acceptability of the possible interventions is being done by the Cochrane Pain, Palliative and Supportive Care (PaPas) group, Cochrane Qualitative Implementation methods Group (QIMG) and the Cochrane Response team. Development Development- GDG meeting A GDG meeting is planned for May 2021 to review the outcomes of the systematic review and evidence synthesis A second meeting of the GDG took place on 14-18 September 2020 wherein they formulated recommendations based on the evidence and other explicit considerations. Editing / peer review External Review Group An External Review Group (ERG) has been appointed for consultation and peer review An External Review Group (ERG) has been appointed for consultation and peer review. Finalisation Expected publication date The final guideline will be submitted to the WHO Guideline Review Committee for final approval. The guideline is expected to be published Mid 2021 The final guideline was submitted to the WHO Guideline Review Committee on 15 October 2020 and have been approved. The guideline is expected to be published in December 2020 Interim guidance: Whilst the documents are being updated, countries in need of guidance on pain management can:use the list of resources (https://www.who.int/docs/default-source/documents/pain-guidelines-list-of-resources.pdf) for advice concerning access to appropriate medicines for pain and palliative care, and/orcontact WHO to request technical support at firstname.lastname@example.orgRelated information briefs:January Update here.27 August 2019: WHO revision of pain management guidelines20 June 2019: Web statement on pain management guidance(https://www.who.int/medicines/areas/quality_safety/guide_on_pain/en/) Document updated on 21 January 2020 with further details on the Policy guideline.
- The city of lights glows teal for cervical cancer eliminationon Nov 23 2020 at 14:01
Paris, the City of Lights, celebrated the world’s historic commitment to eliminate cervical cancer by illuminating in teal on November 17th
- Countdown to 2030 launches expanded 2020 country profiles on early childhood developmenton Nov 23 2020 at 13:25
The early childhood period is considered to be the most important developmental phase throughout the lifespan. What happens to the child in the first few years of life is critical for the child’s developmental trajectory and lifecourse influencing their mental and physical health, education and future economic participation. In order to track global progress on early childhood development (ECD), WHO, UNICEF and partners today launched new expanded 2020 ECD Countdown to 2030 country profiles. The updated profiles cover 42 ECD indicators and 197 countries, including 60 high-income countries, encompassing 99.8% of the world’s children younger than 5 years. The 2020 profiles reveal substantial threats to the world’s youngest inhabitants:Fewer than half of infants younger than 6 months are exclusively breastfed in most countries with dataAt least 25% of children younger than 5 years are stunted in about a third of the countriesFewer than half of young children in a third of the countries receive the benefits of early stimulation and responsive care by adults in their homeMore than three-quarters of children aged 1–4 years experience violent discipline by their caregivers in almost half of the countries.The Countdown to 2030 country profiles on ECD are an important step in establishing a global monitoring and accountability system for early childhood development, and prompting further advocacy and action to advance ECD. However, data in a number of critical areas still remains a challenge. Among countries with available data on ECD indicators fewer than half have data on crucial indicators such as child poverty, or whether young children receive a minimally acceptable diet or attend early education. Rights-based advocacy has helped to raise the availability of data on duration of paid maternity leave and birth registration to above 90% in countries included in the country profiles, but few have data on important indicators, such as early education or home stimulation. Under the COVID-19 pandemic restrictions, many families have become the sole providers of the nurturing care required for young children’s development. While much is unknown about the pandemic’s impact on children’s development, ECD data collected before the start of pandemic will provide countries with useful baselines to assess the potential effects of health and societal disruptions on young children and their families in the years to come.Today, urgent action and investment in ECD by governments and national and international organizations are needed, as well as a global definition on responsive caregiving that can be standardized and compared across cultures and contexts.WHO, UNICEF, the World Bank, and multidisciplinary experts are moving forward with defining measures of responsive caregiving, and working to strengthen questions on children’s health, learning, nutrition, and family environment in standardized household surveys.
- World leaders join forces to fight the accelerating crisis of antimicrobial resistanceon Nov 20 2020 at 14:51
The heads of the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), and the World Health Organization (WHO) today launched the new One Health Global Leaders Group on Antimicrobial Resistance. Group members include heads of government, government ministers, leaders from private sector and civil society. The group is co-chaired by their Excellencies Mia Mottley, Prime Minister of Barbados, and Sheikh Hasina Wazed, Prime Minister of Bangladesh. The full list of the members of the One Health Global Leaders Group is available here. The group will harness the leadership and influence of these world-renowned figures to catalyze global attention and action to preserve antimicrobial medicines and avert the disastrous consequences of antimicrobial resistance.The Tripartite organizations launched the group during World Antimicrobial Awareness Week 2020 (18-24 November), as part of their shared call for united action to preserve and protect antimicrobial medicines. The group was created in response to a recommendation from the Interagency Coordination Group on Antimicrobial Resistance and supported by the Secretary-General of the United Nations.The Directors General described the rapid rise of antimicrobial resistance as one of the world’s most urgent threats to human, animal, plant and environmental health – endangering food security, international trade, economic development and undermining progress towards the Sustainable Development Goals (SDGs). Antimicrobial resistance also leads to increased health care costs, hospital admissions, treatment failure, severe illness and death. Preventing the most severe outcomes of antimicrobial resistance Antimicrobial resistance is making many infections harder to treat worldwide. WHO’s latest reporting shows that the world is running out of effective treatments for several common infections. “Antimicrobial resistance is one of the greatest health challenges of our time, and we cannot leave it for our children to solve,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Now is the time to forge new, cross-sector partnerships that will protect the medicines we have and revitalize the pipeline for new ones.” A common agenda across human, animal and plant health Misuse and overuse of antimicrobials in humans, animals and agriculture are the main drivers of antimicrobial resistance. Resistant micro-organisms can spread between humans, animals or the environment, and the antimicrobial medicines used to treat various infectious diseases in animals and humans can be the same. “No single sector can solve this problem alone,” said QU Dongyu, Director-General of FAO. “Collective action is required to address the threat of antimicrobial resistance – across different economic sectors and country borders.”Elevating political leadership for good governanceThe group will provide political leadership to address this critical global challenge. It will elevate the need to prioritize best practices to address antimicrobial resistance at global, regional, and national levels. And it will advise and advocate for the development and implementation of polices and legislation to govern the importation, manufacture, distribution and use of quality antimicrobial drugs across all sectors.“Antimicrobial resistance is a current problem affecting animal health, human health, and the environment, we need to act today to protect their efficacy,” said Dr Monique Eloit, Director General of OIE. “I am confident that this group will advocate powerfully to implement legislation and mobilize key stakeholders to change antimicrobial use practices to protect our collective health and welfare.”More information on the work of the Tripartite (FAO/OIE/WHO) is available here. For more information on World Antimicrobial Awareness Week, visit WHO’s campaign page. A full calendar of World Antimicrobial Awareness Week events can be found here. Note to Editors:The Interagency Coordination Group (IACG) on Antimicrobial Resistance was convened by the Secretary-General of the United Nations after the UN High-Level Meeting on Antimicrobial Resistance in 2017 following the request of the 2016 Political Declaration of the High Level Meeting on Antimicrobial Resistance contained in resolution A/RES/71/3. The IACG brought together partners across the UN, international organizations and individuals with expertise across human, animal and plant health, as well as the food, animal feed, trade, development and environment sectors, to formulate a blueprint for the fight against antimicrobial resistance. The Secretariat for the IACG was provided by WHO, with contributions from FAO and OIE. The IACG completed its mandate on 29 April 2019 upon the handover of its report to the UN Secretary-General.The World Health OrganizationThe World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goals for 2019-2023 are to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and to provide a further billion people with better health and well-being.The Food and Agriculture OrganizationThe Food and Agriculture Organization (FAO) is a specialized agency of the United Nations that leads international efforts to defeat hunger. Our goal is to achieve food security for all and make sure that people have regular access to enough high-quality food to lead active, healthy lives. We believe that everyone can play a part in ending hunger.The World Organisation for Animal HealthThe OIE is the intergovernmental organisation responsible for improving animal health worldwide. Founded in 1924, it is recognised as a reference organisation for international standards relating to animal health and zoonoses by the World Trade Organization (WTO) and has a total of 182 Member Countries. The OIE maintains permanent relations with international and regional organisations and has Regional and Sub-regional Offices on every continent.
- WHO and other stakeholders join forces to accelerate access to effective paediatric HIV and tuberculosis diagnostics and medicineson Nov 20 2020 at 07:50
On World Children’s Day, WHO is pleased to issue a call urging stakeholders to accelerate access to effective paediatric HIV and tuberculosis (TB) diagnostics and medicines.The Action Plan, which is launched today, has been developed by a wide group of stakeholders under the auspices of the Fifth Vatican High-Level Dialogue on Paediatric HIV and TB in Children Living with HIV which was held earlier this month. Children are one of the most disadvantaged populations in the HIV and AIDS and TB response. In 2019, 95 000 AIDS-related deaths occurred in children, two-thirds of those deaths in 21 focus countries. 850 000 children living with HIV were not accessing treatment, 65% of which were aged 5-14 years. These children are also particularly susceptible to co-infection with tuberculosis, a major cause of AIDS-related deaths in this population. In 2019, an estimated 36 000 children who were living with HIV died from TB.There are several challenges that hamper the rapid development of paediatric formulations, including lack of paediatric data for new drugs, delay in completion of clinical studies, challenges with taste, and slow market uptake among others. In addition, high prices of diagnostic products, limited availability and accessibility to novel technical and case-finding interventions as well as fragmented and delayed regulatory approvals are some of the challenges faced in finding appropriate diagnostics for children. All in all these delay and affect uptake of essential services to diagnose and treat children with HIV and TB.The plan agreed upon by participants of the High Level Dialogue includes pledges to accelerate development of new pediatric HIV and TB formulations; improved diagnostic devices and assays for children with TB; and lower prices for early infant HIV diagnosis.Researchers and pharmaceutical companies have committed to continue and expand their collaborations to investigate and develop better medicines for children. Regulators committed to work towards facilitating the regulatory pathways for priority TB and HIV paediatric medicines. Government representatives confirmed their support for advancing widespread availability of new tests and optimal paediatric medicines. Policymakers committed to continue updating their normative work to capture new developments and support prioritization of research and development for medicines and diagnostics. Finally, key donors expressed their commitment by continuing and expanding their investments to support development of better formulations for children.Organizers of the High-Level Dialogue included WHO and the Elizabeth Glaser Paediatric Aids Foundation, in their capacity as co-chairs of the AIDS Free Working Group of the Start Free, Stay Free, AIDS Free framework, as well as The US President's Emergency Plan for AIDS Relief (PEPFAR), UNAIDS, representatives of faith-based organizations, and the Stop TB partnership. Participants included leaders of major diagnostic and pharmaceutical companies, multilateral organizations, governments, regulators, faith-based organizations, and services providers for children and adolescents living with HIV and TB.The 2020 High-Level Dialogue serves as a reminder of the challenges that exist, but also highlights the opportunities we can capitalize on when we work together. WHO remains committed in working with its partners in ensuring progress towards a Start Free, Stay Free and AIDS Free generation and to reaching the targets as included in the political declaration of the UN General Assembly High Level Meeting on TB and the WHO End TB Strategy. "The impact of the COVID-19 pandemic has laid bare the power of collaboration and partnership to accelerate action. The WHO Global HIV programme recognizes this Action Plan as the roadmap to reset the speed at which innovations in drugs and diagnostics can lead to child-centered impact. We are proud to commit to developing the norms and standards, policies and research agendas on this pathway to success" said Dr Meg Doherty, Director the WHO Global HIV, Hepatitis and STI Programmes.Dr Tereza Kasaeva, Director of WHO's Global TB Programme reaffirmed: "We welcome the action plan and the impetus it will bring to scale up access to tuberculosis diagnostics and medicines for children and adolescents. Any child who dies from TB, HIV, COVID-19 or any infectious disease is one too many. We look forward to convening countries, partners and civil society to ensure rapid implementation of this plan to save young lives."
- Joint Statement on Data Protection and Privacy in the COVID-19 Responseon Nov 19 2020 at 16:00
The United Nations, IOM, ITU, OCHA, OHCHR, UNDP, UNEP, UNESCO, UNHCR, UNICEF, UNOPS, UPU, UN Volunteers, UN Women, WFP and WHO support the adoption of the following joint statement, in line with the UN Personal Data Protection and Privacy Principles adopted by the UN System Organizations to support its use of data and technology in the COVID-19 response in a way that respects the right to privacy and other human rights and promotes economic and social development. The COVID-19 pandemic has become a global emergency, with devastating consequences in terms of loss of life and economic decline, and significantly hampering progress toward achieving the United Nations Sustainable Development Goals. Poor and vulnerable communities are particularly imperiled by this deadly disease and its economic ramifications. Mounting evidence demonstrates that the collection, use, sharing and further processing of data can help limit the spread of the virus and aid in accelerating the recovery, especially through digital contact tracing. Mobility data derived from people’s usage of mobile phones, emails, banking, social media, postal services, for instance, can assist in monitoring the spread of the virus and support the implementation of the UN System Organizations’ mandated activities. Such data collection and processing, including for digital contact tracing and general health surveillance, may include the collection of vast amounts of personal and non-personal sensitive data. This could have significant effects beyond the initial crisis response phase, including, if such measures are applied for purposes not directly or specifically related to the COVID-19 response, potentially leading to the infringement of fundamental human rights and freedoms. This concern is especially pressing if some emergency measures introduced to address the pandemic, such as digital contact tracing, are turned into standard practice. The UN Secretary-General highlighted in his policy brief on human rights and COVID-19 that “Human rights are key in shaping the pandemic response, both for the public health emergency and the broader impact on people’s lives and livelihoods. Human rights put people centre-stage. Responses that are shaped by and respect human rights result in better outcomes in beating the pandemic, ensuring healthcare for everyone and preserving human dignity.” Any data collection, use and processing by UN System Organizations in the context of the COVID-19 pandemic should be rooted in human rights and implemented with due regard to applicable international law, data protection and privacy principles, including the UN Personal Data Protection and Privacy Principles. Any measures taken to address the COVID-19 pandemic should also be consistent with the mandates of the respective UN System Organizations and take into account the balancing of relevant rights, including the right to health and life and the right to economic and social development. Taking into account the UN Personal Data Protection and Privacy Principles, the UN Secretary-General’s policy brief on human rights and COVID-19, and relevant health and humanitarian standards, data collection, use and processing by UN System Organizations in their operations should, at a minimum: Be lawful, limited in scope and time, and necessary and proportionate to specified and legitimate purposes in response to the COVID-19 pandemic; Ensure appropriate confidentiality, security, time-bound retention and proper destruction or deletion of data in accordance with the aforementioned purposes; Ensure that any data exchange adheres to applicable international law, data protection and privacy principles, and is evaluated based on proper due diligence and risks assessments; Be subject to any applicable mechanisms and procedures to ensure that measures taken with regard to data use are justified by and in accordance with the aforementioned principles and purposes, and cease as soon as the need for such measures is no longer present; and Be transparent in order to build trust in the deployment of current and future efforts alike. A coordinated and inclusive global UN-wide response rooted in solidarity is necessary to contain the pandemic and minimize its negative impact across the world. Although the statement is aimed to address the challenges of the current COVID-19 pandemic, it may serve as a precedent for using data to respond to any future crises of a similar scale quickly and while respecting data protection and privacy.  WHO issued “Ethical considerations to guide the use of digital proximity tracking technologies for COVID-19 contact tracing”. More information can be found at https://www.who.int/publications/i/item/WHO-2019-nCoV-Ethics_Contact_tracing_apps-2020.1
- Learning from history: Sanitation for prosperityon Nov 19 2020 at 01:00
This story accompanies the UNICEF-WHO State of the World's Sanitaton report launched on 19 November 2020. This report, aims to draw attention to the sanitation crisis, bring together lessons from high-achieving countries, and presenting a vision of what is needed to deliver universal access to safe sanitation.
- Regulating sanitation services as a public goodon Nov 19 2020 at 01:00
Yvonne Magawa (ESAWAS), Batsirai Majuru (WHO), Bisi Agberemi (UNICEF), Jan-Willem Rosenboom & Alyse Schrecongost (BMGF)Faecal sludge transport workers in Kenya - UNICEF/UN0348903/ModolaThis blog is part of a series for World Toilet Day highlighting issues within the WHO-UNICEF State of the World’s Sanitation report. The topic of sanitation regulation is also covered in 'Catalysing Citywide Sanitation For All Through Regulating Service Providers' by IWA's Regulation for Citywide Inclusive Sanitation initiative's advisory and taskforce members - Yvonne Magawa (ESAWAS), Diego Polania (CRA), and Gustavo Saltiel (World Bank).For too long sanitation, specifically on-site sanitation systems such as septic tanks and pit latrines, have been left in the realm of household responsibility.The scant investments available for urban sanitation gravitate towards sewered infrastructure, reaching small proportions of large urban areas, primarily wealthier populations. Urban populations continue to grow rapidly, often in dense settlements with limited basic public services or infrastructure. Particularly for sanitation, households are forced to make do, covering the costs of basic access for themselves. The very nature of safe sanitation, however, means that the decisions and priorities of individuals are largely decoupled from what would be required to protect public health, the environment, and reach the poorest. Services for safely containing, emptying, transporting and treating human waste, and preventing pits and septic tanks from contaminating groundwater and open drains are needed, but without regulation, investments will not prioritize public health outcomes. This situation is both unfair to the households and ineffective in achieving a primary purpose of sanitation: protecting public health. Sanitation is fundamentally a public good. Individuals’ decisions maximize their own best interest – they do not necessarily serve the best interests of society at large. Investments in sanitation need to be planned, regulated and financed to align the priorities of individual households with those of service providers. This alignment is required to address the broader social goals of public health protection, cleaner environments, and stronger economies. Among the countries that have made extraordinary gains in a generation, a common factor among them has been strong political leadership that clarified public goals, gave clear mandates to the responsible authorities to achieve those goals, regulated authorities’ delivery of services, and mobilized the corresponding investments needed.Where utilities manage sewers, generally those utilities have a defined, public service-oriented mandate, performance accountability, and financing strategies. Over two thirds of countries have environmental standards for wastewater treatment. Beyond sewered areas, urban sanitation remains a public good, but it is largely delivered by unorganized and unregulated private or informal actors. Few countries have standards for faecal sludge treatment or safe reuse of wastewater or sludge. Individual providers of emptying and transport services may or may not be subject to a smattering of on-paper regulatory codes or standards. Where standards exist, they are almost universally decoupled from efforts to monitor, incentivize or enforce compliance. As a result, less than a third of mandated oversight agencies are able to carry out the basic functions of monitoring and enforcement. Robust regulatory systems can address the market failures of urban sanitation to protect public health and incentivize delivery of safe, inclusive, and viable services. We highlight three issues critical to pursuit of this outcome that merit case studies, discussion, and sector learning and evolution. First, regulations can help to better link sanitation services to public health protections. Simple statement but not a simple task. Regulation of sanitation services has long lagged behind that of water services: only 1 in 5 countries have any indicators for sanitation service quality. If sanitation services are to protect public health, then public health-aligned guidance and oversight must become the expected norm in all countries, for sewered and non-sewered sanitation systems alike. Health outcomes must be designed into simple, transparent and effective by-laws, codes and standards; actionable and funded monitoring and enforcement systems are required to make those standards meaningful. To achieve this, systems must be designed in collaboration with public health authorities. Public health risk assessment and risk management priorities must underpin product and service standards along the full sanitation service chain. This includes measures to address the specific health risks, stigma and marginalization faced by sanitation workers in unregulated settings. Second, as with public health regulation, the focus of economic and performance regulation of sanitation services must be on safe, inclusive services, irrespective of the infrastructure used. Failure to focus mandates and regulatory frameworks on service outcomes instead of infrastructure inputs exacerbates systemic inequity and exclusion. In most cases, providers of non-sewered products and services remain unregulated and unorganized retail actors. They deliver services with wide variability in price and quality, with little accountability for the quality of their service to households or for public health. Market structuring – particularly economic and performance regulation of services – is required if public or private providers are to be incentivized to protect public health, to reach low income communities, and to mobilize investment and innovation. Economic regulatory tools can help align customer inclusion and affordability goals with providers’ financial interests.Finally, if the public sector is well-structured and regulated, it can increase business opportunity, available finance, and incentivize investment in innovation to meet health and inclusivity goals. Recognizing sanitation as a public good does not imply that the public sector has sole responsibility for delivering public services. Indeed, without structuring sanitation as a public service, opportunities for private sector engagement are more restricted, higher risk, less effective, less profitable, and less aligned with the public good. Tools and business models that align public, customer, and provider interests have not always been clear, but promising innovations are emerging in urban markets in Kenya, Malaysia, Zambia, and other countries. In these areas, regulators are insisting on improved sector outcomes. They are also supporting utilities and the private sector to learn and grow as the sector transforms and more is expected of everyone. Significant challenges remain. In many countries sanitation is entirely managed by municipalities. Municipal service systems tend to be subject to individuals’ short term political interests, missing accountability mechanisms, and with limited flexibility to generate or ringfence revenue effectively. Treatment compliance or the relationship between customer-based revenue mechanisms and service quality can be opaque.We have good reason to believe that well-designed regulatory systems can accelerate global progress toward SDG 6.2 and 6.3, and improve public health. The WHO Guidelines on Sanitation and Health provide a useful point of departure in addressing public health criteria in sanitation regulations, and articulating the role of the health sector in sanitation authorities’ service provision.In addition, a new publication – the WHO-UNICEF State of the World’s Sanitation – launching today draws attention to the role of regulators in solving the sanitation crisis. The report brings together lessons from high-achieving countries, and presents a vision of what is needed to deliver universal access to safe sanitation. It calls for urgent action around five areas: governance; financing; capacity development; data; and innovation, and highlights leadership, effective coordination and regulation as effective pathways for achieving safe sanitation for all. Building on the directions outlined in the report, WHO and other partners working with regulators’ networks such as the East and Southern Africa Water and Sanitation (ESAWAS) Regulators Association and the WHO International Network of Drinking-water and Sanitation Regulators (RegNet), will work to create concrete and contextualized changes in regulation of sanitation services that can inform future updates of the report.
- Your Right To A Better Worldon Nov 18 2020 at 11:00
Health is a human right, and tactics learned from the human rights movement can help ensure every person access to the highest standard of sexual and reproductive health. WHO, HRP and partners present a new documentary series about the power of people to change the world. Every individual on the planet has the right to the highest standard of health and well-being in all aspects of their sexuality, their body and their reproductive choices – but there is no ‘one size fits all’ strategy for making this a reality. Right To A Better World is a documentary video series produced by WHO and HRP, in partnership with UN Human Rights (OHCHR) and the Oxford Human Rights Hub (OxHRH). It explores how tactics developed by the human rights movement can be used to achieve sexual and reproductive health rights, and drive meaningful progress towards the fulfillment of the 2030 Agenda for Sustainable Development. “A human rights-based approach to health is essential to achieving my top priority as DG – universal health coverage,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus, when he signed the 2017 WHO-OHCHR Framework of Cooperation. Right To A Better World builds on this major milestone for health and human rights, affirming that rights holders and their experiences belong at the centre of every discussion and decision affecting them. “The achievement of the 2030 Agenda for Sustainable Development hinges on the realization of human rights, which necessitates action across sectors and disciplines,” said Veronica Birga, Chief of Women's Human Rights and Gender Section of UN Human Rights. “The lessons in this series created through a multi-disciplinary partnership are invaluable and make it clear that securing rights for all, is not only the right way, but the smart way to achieve truly sustainable development.” There are four 20-minute thematic episodes in Right To A Better World, all free to access: contraception , comprehensive sexuality education maternal mortality and morbidity , and violence against women . “This powerful series creates a unique synergy between academic and practical human rights approaches, vividly demonstrating the key role human rights can play when advocating for sexual and reproductive health rights in political, legal, and international forums,” said Professor Sandra Fredman, Director of OxHRH. “The “Right to a Better World” series bridge the communicative divide between health and human rights practitioners, throwing the spotlight on the importance of addressing not only health outcomes but the underlying gender inequalities, stereotypes and structures,” adds Dr Meghan Campbell, Deputy Director at OxHRH. Although health outcomes and the achievement of rights have improved for many across these core components of sexual and reproductive health, progress overall remains fragile and uneven. In each episode across the series, experts in health and human rights share their professional struggles and successes working on the frontline of communities worldwide. As advocates and activists, they represent a broad range of professional fields, ages, levels and backgrounds. The episodes can be watched at home, in groups and in classroom settings. Viewers are encouraged to learn from the experiences shared, and consider how tactics could be adapted to their own contexts. “Human rights are the key to ensuring every person has access to comprehensive sexual and reproductive health care, and WHO and HRP are committed to mainstreaming human rights into health policies and programmes. Our partnership with UN Human Rights and OxHRH affirms that in the changing landscape of sexual and reproductive health, human rights must be heard as loudly as clinical and scientific research,” said Ian Askew, Director of the WHO Department of Sexual and Reproductive Health and Research including HRP. Join the conversation at #RightToABetterWorld. Right To A Better World VIDEOS Comprehensive sexuality education (episode 1 of 4) Building support and understanding of every young person’s right to education, health and well-being, in an inclusive and gender equal society. Contraception (episode 2 of 4) Ensuring each woman's and adolescent’s right to make decisions about their reproductive health and future. Maternal mortality and morbidity (episode 3 of 4) Ensuring every woman's and adolescent’s right to not only survive pregnancy and childbirth, but have a positive experience of this profound life event. Violence against women (episode 4 of 4) Building a world in which women and girls are free from all forms of violence and discrimination.