Do not use weather as a basis to relax COVID-19 control measures, UN agency urges

^{Photo: UNICEF/Habibul HaqueA young girl, accompanied by her mother – both wearing masks – at a park in Dhaka, Bangladesh.}

In a new report, the UN World Meteorological Organization (WMO) highlighted that infections rose in warm seasons in 2020 – the first year of the pandemic – and that “there is no evidence” that this could not happen again in 2021. 

“At this stage, evidence does not support the use of meteorological and air quality factors as a basis for governments to relax their interventions aimed at reducing transmission,” Ben Zaitchik, co-chair of an interdisciplinary and international WMO Task Team that produced the report, said. 

“We saw waves of infection rise in warm seasons and warm regions in the first year of the pandemic, and there is no evidence that this couldn’t happen again in the coming year”, Mr. Zaitchik, from the Department of Earth and Planetary Sciences, Johns Hopkins University, added. 

The report highlighted that COVID-19 transmission dynamics last year appear to have been controlled primarily by government interventions rather than meteorological factors. Other relevant drivers include changes in human behaviour and demographics of affected populations, and more recently, virus mutations. 

Infection seasonality ‘not yet well understood’ 

The report looked at the potential role of seasonality, as respiratory viral infections, like cold or influenza frequently show some form of seasonality, such as the autumn-winter peak for influenza in temperate climates. This led to speculation that, if it persists for many years, COVID-19 could be a strongly seasonal disease. 

“It is premature to draw conclusions for the COVID-19 virus”, WMO said. 

The underlying mechanisms that drive seasonality of respiratory viral infections are not yet well understood, according to the report. 

“A combination of direct impacts on virus survival, impacts on human resistance to infection, and indirect influence of weather and season via changes in human behaviour may be at work”, it said, noting that laboratory studies of COVID-19 causing SARS-CoV-2 virus “yielded some evidence that the virus survives longer under cold, dry, and low ultraviolet radiation conditions”. 

“However, these studies have not yet indicated if direct meteorological influences on the virus have a meaningful influence on transmission rates under real world conditions”, the report added. 

Air quality influence ‘still inconclusive’ 

The Task Team further noted that the evidence on the influence of air quality factors is still inconclusive. 

It said that there is “some preliminary evidence” that poor air quality increases COVID-19 mortality rates, but not that pollution directly impacts airborne transmission of the SARS-CoV-2 virus. 

The report also noted that at present there is no direct, peer reviewed evidence of pollution impacts on the airborne viability of the virus.

Health experts give green light to Janssen COVID jab, allay clotting concerns

In a virtual press conference from Geneva, SAGE hailed the one-dose Janssen shot – produced by a Johnson & Johnson subsidiary – as a safe and lifesaving addition to the three other vaccines it has already approved for use: Pfizer, Moderna and AstraZeneca.

The expert panel also noted that clotting episodes – also known as hypercoagulable events – were a symptom of COVID-19, amid the suspension of the AstraZeneca/Oxford vaccine by several European countries, pending scientific review.

‘These are lifesaving products’

“The world is in a place where there is insufficient supply to meet the requirements of people who need to be vaccinated; clearly, any of these vaccines are lifesaving products”, said Dr. Kate O’Brien, Director, Department of Immunization, Vaccines and Biologicals at the World Health Organization (WHO).

She insisted that the vaccines “need to be used as quickly as we can get them deployed. People can have confidence in their safety and efficacy and in the quality of the manufacture of the products.”

During trials for the Janssen vaccine involving nearly 44,000 people, 10 of the 22,000 people who received the blank dose developed a blood clot – or thrombo-embolic events – while 14 of the remaining 22,000 who were inoculated, developed a clot.

“This is about the same”, for both groups said Dr Annelies Wilder-Smith, SAGE Technical Advisor. “There’s a slight imbalance, but it’s still not statistically significant,”

No evidence clots related to vaccines

“As for the vaccine itself, we have not seen it in a trial, there’s no reason to think and no biological causability as far we understand now, that the vaccine could cause thrombo-embolic events itself. However, we have to be open for new events, and we have to take it seriously.”

Dr Wilder-Smith explained that those recruited for vaccine testing were intentionally chosen because they were people who were “at high risk” of developing blood clots.

“COVID really pre-disposes patients to a hypercoagulable state where indeed many of the deaths that we see in the severe cases are due to thrombo-embolic events”, Dr Wilder-Smith said, ahead of an expected announcement by the European Medical Agency (EMA) on the issue on Thursday.

In a statement released on Wednesday specifically adressing the AstraZenica suspension by some European nations, the agency said it was “good practice” to investigate the possible linkages, that the benefits of the vaccine “outweigh its risks” and WHO “recommends that vaccinations continue.”

Infections heading up

The development comes amid a rise in new cases of coronavirus infection worldwide, increasing by 10 per cent in the past week, to more than three million new reported cases.

WHO reported on Wednesday that after peaking in early January 2021 – when there were just under five million cases a week – new cases then declined to around 2.5 million in the week commencing 15 February 2021.

But the past three weeks have seen cases increasing again.

This week, the Americas and Europe continue to account for more than 80 per cent of new cases and new deaths, with rises in new cases in all regions – apart from Africa, where they remained the same as last week.

As of 17 March 2021, there have been 120,164,106 confirmed cases of COVID-19, including 2,660,422 deaths, reported to WHO.

More than 363,000,000 vaccine doses have been administered globally.

South Asia: Sharp rise in child, maternal deaths due to COVID-19-induced disruptions

Disruptions in health services due to COVID-19 “may have contributed to an additional 239,000 child and maternal deaths in South Asia” – UN report

In a new report, UN Children’s Fund (UNICEF), World Health Organization (WHO) and UN Population Fund (UNFPA) said that the impact also included sharp drops in the number of young children treated for severe acute malnutrition as well as in childhood immunizations.  

According to George Laryea-Adjei, UNICEF Regional Director for South Asia, the fall-off of these critical services has had a devastating impact on the health and nutrition of the poorest and most vulnerable families. 

“It is absolutely vital that these services are fully restored for children and mothers who are in desperate need of them, and that everything possible is done to ensure that people feel safe to use them”, he stressed. 

The region also suffered increased levels of unemployment, poverty and food insecurity due to the pandemic, further undermining public health, the report said 

Millions of girls unlikely to ever return to school 

The report – which covered Afghanistan, Bangladesh, Nepal, India, Pakistan and Sri Lanka – also found that about 420 million children were out of school due to the pandemic and its related control measures.  

It warned that 4.5 million girls are likely to never return to school, and are at particular risk due to deteriorating access to sexual and reproductive health and information services. 

“Given the cultural and social context of South Asia, the suspension of these services is deepening inequalities and is likely to lead to an increase in the number of maternal and neonatal deaths”, Bjorn Andersson, UNFPA Regional Director for Asia and the Pacific said.  

“There are also likely to be an additional 3.5 million unintended pregnancies in this region”, Mr. Andersson warned. 

Wider impact of COVID-19 also included increased risk of child marriage and  stunting – impaired growth and development due to poor nutrition and health. 

Prioritize essential health services 

The UN agencies called for prioritizing essential health services for pregnant women, adolescents and young infants, as well as strengthening supply chains for the delivery of vaccines and other essential childhood medicines. 

Poonam Khetrapal Singh, WHO Regional Director for South-East Asia, underlined that maintaining essential health services is vital for the region’s COVID-19 response strategy “as disruption would only increase the risk of deaths from preventable causes”. 

The report also called for ensuring uninterrupted and improved health services for all, helping vulnerable populations address health needs, and stepping up of key COVID-19 prevention measures. 

It also urged cash transfer programmes to support the poorest families.

Keep mothers and newborns together, new health research says

In many countries, if COVID-19 infections are confirmed or suspected, newborn babies are being routinely separated from their mothers, putting them at higher risk of death and lifelong health complications, according to the agency. 

“Disruptions to essential health services during COVID-19 have severely affected the quality of care provided to some of the most vulnerable babies, and this includes their right to the lifesaving contact they need with their parents”, Anshu Banerjee, WHO Director for Maternal, Newborn, Child and Adolescent Health, said.  

According to WHO, the risk is greatest in the poorest countries where the greatest number of preterm births and infant deaths occur, and disruptions to kangaroo mother care – early, prolonged skin-to-skin contact with a parent, and exclusive breastfeeding – will worsen these risks. 

“Decades of progress in reducing child deaths will be jeopardized unless we act now to protect and improve quality care services for mothers and newborns, and expand coverage of lifesaving interventions like kangaroo mother care”, Dr. Banerjee added.    

The new research, by WHO and partners, was published in the Lancet EclinicalMedicine.  

Kangaroo mother care 

WHO said that up to 125,000 babies’ lives could be saved with full coverage of kangaroo mother care. The model of care is particularly important for babies born preterm (before 37 weeks) or at low birthweight (under 2.5 kilogrammes), where it has shown to reduce infant deaths by as much as 40 per cent, hypothermia by more than 70 per cent, and severe infections by 65 per cent. 

Queen Dube, Director of Health at the Ministry of Health in Malawi, one of the report authors, underscored the benefits. 

“Kangaroo Mother Care is one of our most cost-effective ways to protect small and sick newborns. According to our analysis, these risks by far outweigh the small chance of a newborn baby getting severe disease from COVID-19”, Dr. Dube said. 

WHO advised that mothers should continue to share a room with their babies from birth and be able to breastfeed and practice skin-to-skin contact – even when COVID-19 infections are suspected or confirmed – and should be supported to ensure appropriate infection prevention practices. 

Low COVID risk

It also noted that studies showed mainly no symptoms or mild disease from COVID-19 in infected newborns, with low risk of neonatal death, with the new study estimating the risk of newborns catching COVID-19 would result in fewer than 2,000 deaths. 

However, infection during pregnancy may result in increased risk of preterm birth, which means it is even more important to ensure the right care is given to support preterm babies and their parents during the COVID-19 pandemic, WHO added. 

COVID disrupts contraception services, leads to 1.4 million unintended pregnancies, says UNFPA 

According to new estimates from the UN Population Fund (UNFPA) and Avenir Health, this has led to around 1.4 million unintended pregnancies.  

These latest figures come as many countries, particularly high-income nations, show early signs of steeply declining birth rates.  

Together, the findings demonstrate how the pandemic has severely impacted women’s control over their own reproductive health, and undermined family planning. 

Contraceptives out of stock 

Analysing contraceptive service disruptions last year in 115 lower and middle income countries, data from UNFPA, Google Mobility and other surveys, found that access to family planning was hit by travel restrictions, interrupted supply chains and overwhelmed health facilities, among other factors.  

“The results, for many women, have been life-changing”, according to the UN sexual and reproductive health agency. 

UNFPA profiled a 32-year-old Nepalese woman who married at 17, became a mother of four by age 24, and became pregnant after the nearby health centre ran out of contraceptives. Her fifth baby was born on 25 February. 

Unintended pregnancies put a great strain on families that are already struggling under pandemic-related financial burdens, the UN agency explained. 

And its consequences are not simply economic, they are also linked to increased maternal morbidity, mortality and unsafe abortions.  

UNFPA’s projections showed that family planning services were largely disrupted in April and May of last year for an average of 3.6 months.  

Earlier estimates, produced in April 2020, illustrated that serious family planning disruptions lasting six months could affect 47 million women in low and middle income countries, and result in seven million unintended pregnancies. 

Acting swiftly  

Fortunately, quick action has helped many health systems to maintain or restore essential health services, including contraceptives, said UNFPA.  

The agency pointed out that even amid rising costs and supply chain constraints, it was able to procure and deliver contraceptives and other reproductive health supplies, as well as personal protective equipment for health workers. 

Creative efforts, such as using a ride-hailing app to deliver contraceptives, SMS outreach and targeting family planning counselling to quarantine centres, also helped maintain or restore services.  

UNFPA sad that many women continue to face serious obstacles to receiving family planning and other life-saving reproductive health services.  

A growing price 

Although the total costs of the pandemic are not yet known, the World Health Organization (WHO) estimates that 2.5 million people around the world have died from COVID-19.  

When the full toll is calculated, UNFPA upheld that it will have to include the “extraordinary consequences” borne by women and girls, including those whose futures were rewritten, bodies injured or lives lost due to disruptions in access contraception and health care.

‘Some light at the end of the tunnel’ as pandemic turns one – Guterres

“So many lives have been lost”, said António Guterres, with “economies upended and societies left reeling.  The most vulnerable have suffered the most. Those left behind are being left even further behind.”

He commended the effort across the world to adapt, and live in news ways, honouring health workers “for their dedication and sacrifice and all other essential workers who have kept societies running. I salute all those who have stood up to the deniers and disinformation, and have followed science and safety protocols”, he said. “You have helped save lives.”

The key – vaccines for all

Mr. Guterres said the UN would continue mobilizing the international community to live up to the promise of the COVAX equitable vaccines initiative, and make them “affordable and available for all, to recover better, and to put a special focus on the needs of those who have borne the burden of this crisis on so many levels – women, minorities, older persons, persons with disabilities, refugees, migrants and indigenous peoples.”

 All in all, with the unprecedented vaccine development effort in multiple nations across the world, “there’s some light at the end of the tunnel” he said, lauding the start of last week’s historic rollout which has continued by COVAX, to bring shots to some of the lowest-income nations.

“Yet I am deeply concerned that many low-income countries have not yet received a single dose, while wealthier countries are on track to vaccinating their entire population”, added the UN chief, highlighting what he said were the many examples of “vaccine nationalism” and hoarding in the richer nations taking place, together with side deals involving manufacturers.

‘Greatest moral test’

“The global vaccination campaign represents the greatest moral test of our times”, he said.

“It is also essential to restart the global economy – and help the world move from locking down societies to locking down the virus”, added the Secretary-General. “COVID-19 vaccines must be seen as a global public good.  The world needs to unite to produce and distribute sufficient vaccines for all, which means at least doubling manufacturing capacity around the world.

“That effort must start now. Only together can we end this pandemic and recover.” 

Mr. Guterres said that solidarity was the key, and the creation of a genuine united front: “Only together can we revive our economies. And then, together, we can all get back to the things we love.”

Regression on ‘virtually every indicator’ of progress for children: UNICEF

“The number of children who are hungry, isolated, abused, anxious, living in poverty and forced into marriage has increased. At the same time, their access to education, socialization and essential services including health, nutrition and protection has decreased”, Henrietta Fore, UNICEF Executive Director, said. 

“The signs that children will bear the scars of the pandemic for years to come are unmistakable.” 

Stark findings 

According to the latest data from UNICEF, children in developing countries have been particularly affected, with rates of child poverty there feared to rise by around 15 per cent and an additional 140 million children in these countries also projected to be in households living below the poverty line. 

168 million schoolchildren globally missed out on almost a year of classes, and more than 1 in 3 of the schoolchildren were unable to access remote learning, while schools were closed. 

A sharp rise is also feared in child marriages, with about 10 million additional girls at risk of being married before they turn 18, unravelling years of progress in reducing the horrendous practice, and robbing young girls of their childhood and threatening their lives and health. 

Health indicators, including mental health, for children also suffered major setbacks, and hunger and malnutrition rose sharply. As of March, children accounted for 13 per cent of global COVID-19 infections in 107 countries surveyed (data under 20 years of age). Nearly 100 million children were at risk of missing vaccines due to paused measles campaigns in 26 countries (data as of November 2020). 

Furthermore, over two-thirds of mental health services for children were disrupted globally, and at least 1 in 7 children and young people lived under stay-at-home policies for most the year, leading to feelings of anxiety, depression and isolation. 

Refugees and asylum seekers, in some 59 countries with available data, faced additional challenges, unable to access COVID-19-related social protection support due to border closures and rising xenophobia and exclusion (data as of November 2020). 

Keep children at ‘heart’ of recovery 

UNICEF Executive Director Fore called on all countries and stakeholders to ensure children are “at the heart of recovery efforts”. 

“This means prioritizing schools in reopening plans. It means providing social protection including cash transfers for families. And it means reaching the most vulnerable children with critical services”, she urged. 

“Only then can we protect this generation from becoming a lost generation.” 

‘COVID-19 doesn’t discriminate, but societies do’, say women frontliners

Dr. Roopa Dhatt, Executive Director of Women in Global Health, and two scientists who have developed COVID-19 vaccines – Professor Sarah Gilbert of Oxford University and Dr. Özlem Türeci of German company BioNTech, one of the vaccine pioneers – were guest speakers at the bi-weekly briefing by the World Health Organization (WHO) held on Monday, International Women’s Day. 

WHO chief Tedros Adhanom Ghebreyesus said the pandemic has disproportionately affected women, who have faced challenges ranging from rising violence, to higher levels of unemployment.  And although women make up the majority of health workers globally, or 70 per cent, they only account for a quarter of those in leadership roles. 

Last month, the UN agency launched the Gender Equal Health Initiative whose objectives include boosting the proportion of women health leaders, promoting equal pay, and ensuring safe and decent working conditions for health workers, which includes having access to personal protective equipment (PPE) and vaccines. 

Inequality at the table 

Dr. Dhatt, a physician in the United States, spoke of her “rollercoaster” year treating COVID-19 patients while also working to expand her organization and manage duties at home.   

She warned that the fundamental flaws and inequalities which the pandemic has exposed must be resolved urgently before the next global crisis. 

“The extraordinary work done by women in the health and care workforce in this pandemic has not earned them an equal seat at the decision-making table, and as a result, we have all lost out on their talent and expertise”, she said. 

Although proud of her contributions, Dr. Dhatt said like many health professionals, she felt furious that richer nations were not prepared for the pandemic “even though it was not unexpected”. 

She was also angry that her sickest patients tend to be black or Latina “and this is not new”, she said, adding “COVID-19 does not discriminate, but societies do.” 

Pandemic hits career prospects 

Professor Gilbert from Oxford University in the United Kingdom previously worked on vaccines for influenza, Ebola and MERS, which was also caused by a coronavirus.

She acknowledged women’s “enormous contribution” during COVID-19, including in comprising two-thirds of the team that developed the Oxford/AstraZeneca vaccine.   

“However, of the senior positions in the team, only one-third are women”, she said, emphasizing that more needs to be done so that women can progress in the field and other disciplines. 

“There are concerns that the pandemic has had more of an effect on the careers and livelihood of women than men, and as we begin to make our plans for recovery, we must not neglect this,” she stated.  

Professor Gilbert reported on the Oxford/AstraZeneca vaccine’s effectiveness in protecting older populations, but pointed to the work ahead in assessing its ability against COVID-19 variants.  Preparations are being made to update the vaccine, if necessary. 

Increase vaccine partnerships 

“As vaccinations are rolled out around the world, with the most vulnerable being protected first, we need to continue to monitor virus transmission and apply all available measures to reduce it to protect those not yet vaccinated and reduce the chances of new variants arising”, she recommended.  

“And to increase the amount of vaccine doses that can be delivered across the world, I encourage vaccine manufacturers to form new partnerships in diverse geographical locations to manufacture, fill and distribute vaccines that are already approved.” 

As a self-described “wanderer between three worlds” – medicine, immunology and entrepreneurship, Dr. Türeci has witnessed lack of gender equality “every day”. 

‘Making the seemingly impossible, possible’ 

But things are different at BioNTech, the company she co-founded with her husband, Professor Uğur Şahin, as women make up 54 per cent of employees and nearly half of the top management. 

“We like to think that being a gender-balanced team has been critical for making the seemingly impossible possible: to develop the COVID-19 vaccine within 11 months without shortcuts,” she said. 

The BioNTech vaccine, developed with pharmaceutical giant Pfizer, was the first-ever authorized for use.  Together with the Oxford/AstraZeneca vaccine, it is part of the UN-backed COVAX initiative that is working to make inoculation accessible to all people everywhere. 

As more vaccines come on stream, Dr. Türeci underscored the goal of achieving herd immunity, or widescale population protection, through equitable rollout worldwide. 

 “’Mission Herd Immunity’ means that no one will be safe until everyone is safe: across genders, ethnicities, economies and nations”, she said, outlining the need for collective action in areas such as ramping up vaccine production, improving supply chains and securing funding. 

Woman army officer in forefront of COVID-19 battle in Sierra Leone

“COVID-19 is a dynamic and fluid situation,” says Lieutenant Matilda Mattu Moiwo. “You can’t predict everything that will occur in advance.” 

Lt. Moiwo is a staff officer of the Republic of Sierra Leone Armed Forces. Her military training serves her well in the fight against COVID-19. 

As the National Emergency Medical Services Referral Coordinator in the capital city of Freetown, Lt. Moiwo has to juggle national ambulance services, clinicians at hospitals, treatment centers and isolation units, and psychosocial assistance for patients and their families. She also disseminates test results and updates a national database on COVID-19.

Lt. Moiwo remains level-headed despite the skyrocketing demands for her team since the first case of COVID-19 was detected in the West African country in March 2020. 

She remembers one particular COVID-19 case, where a pregnant woman at full term needed a caesarean section. “For this woman, it was not just a matter of having a safe delivery. This was the very first delivery for a coronavirus patient in Sierra Leone. Health care workers at the isolation unit were worried. So was the patient.” 

It took an hour or more of managing the elements needed for a safe delivery, but in the end, the hard work paid off and the woman delivered a baby girl.  

Cases like these call for creative thinking, says Lt. Moiwo. “It is critical to get the right patients to the right places because we offer different treatment centers with different levels of care, depending on severity,” she says. 

Building women’s leadership is part of government efforts to promote gender equality in all areas of life. Such moves include a new law on sexual offenses, the launch of one-stop centres on sexual and gender-based violence, and the government’s 2019 declaration of rape and sexual violence as a national emergency. 

All these efforts are supported by the UN Country Team in Sierra Leone. And, says UN Resident Coordinator, Babatunde Ahonsi, supporting gender equality also means supporting the fight against COVID-19. 

“COVID-19 is an all-hands-on-deck situation,” says Mr. Ahonsi. “If women are prevented from taking leadership positions, then we’re fighting the pandemic with one hand tied behind our back. When women are subjected to sexual violence, then there’s that much less energy and resources to advance public health.” 

The equation works both ways. Just as gender equality supports public health, public health can support gender equality—if proper attention is paid to it.

That’s why the UN Country Team works on both gender equality and COVID-19—and makes sure that the two go hand in hand. 

For instance, Mr. Ahonsi led an effort to secure the donation of 100,000 face masks from China for the Sierra Leone Ministry of Health and Sanitation.  

UNICEF reached out to 50 health influencers, including women leaders, who advocated for the proper use of masks, handwashing, and physical distancing.

The World Health Organization provided technical support to the government and health facilities, which includes the National COVID-19 Emergency Response Centre, where Lt. Moiwo is a leader. 

“When we make progress in gender equality, we make progress in every area of human endeavor,” says the UN Resident Coordinator. 

Lt. Moiwo puts that notion into practice every day on the job. She believes that, by stepping up as a leader, she is helping dismantle discrimination against women.

‘They all died on the same day’: a Benin doctor on her fight against COVID-19

A doctor in Benin has been telling the UN about the challenging conversations she has had with the relatives of patients who have died from COVID-19, and how she has used her long medical experience to effectively lead a team of health care workers.

“The most painful moment in managing this crisis was in June 2020 when I had three severe cases of COVID-19. They all died on the same day.”

Dr. Rokhiatou Babio is one of the few women in Benin to lead a medical team on the frontline of the coronavirus pandemic, work which is supported by the United Nations in the north-east of the West African country. She recounts the shocking experience on that sombre and cruel day, a month into her new job.

“One of the three patients practically died in my arms”.

She falls into a deep silence and then continues. “You have to deal with the relatives after the deaths. The hardest part for them was not being able to take the mortal remains of their loved ones with them. It is difficult to convince them, even with the support of a psychologist”. 

Dr. Babio is a general practitioner at the emergency department of the University Hospital of Borgou. She also supervises a team of 40 medical staff at the COVID-19 care centre of the Borgou Army Instruction Hospital, which admits coronavirus patients from five of Benin’s 12 departments – Atacora, Borgou, Alibori, Donga and Collines.

As an expert with a long experience of medical emergency and epidemic care, Dr. Babio has managed four health crises in her career. Faced with the COVID-19 pandemic, she says she was quickly able to inspire confidence in other “less experienced” team members.

“As soon as I took on this task, my goal was to save the lives of patients while protecting health care workers, most of whom had never managed an epidemic before. It was, therefore, necessary from the first days to establish a climate of confidence and make them want to manage COVID-19 patients,” she says.

Dr. Babio divided her staff into three multi-disciplinary, teams made up of men and women. To get the best out of each of them, she listened to issues from all staff members, both professional and personal.

“Each colleague has my number and can contact me at any time to voice their concerns. This lowers staff stress levels and ensures good management of the epidemic”, she adds.

In Benin some people are surprised to see a woman at the helm of the emergency department, more so as the COVID-19 case management coordinator. But she says she’s the right person for the job.

“Since 2016, I have been managing epidemics of viral hemorrhagic fevers in Lassa and my competence has been recognized at the international level,” she says.

The doctor stresses that women are good at managing conflicts. “We are first and foremost mothers and, therefore, born to show empathy”.

Her colleague, Dr. Hermès Melvis Amoussouvi, a general practitioner, agrees. He acknowledges that leadership is “genderless”.

“A leader should be able to inspire both women and men. But it is important, and it is increasingly noticeable, that women realize their capacity to do as much or even better than men. Women have their own potential, and we must embrace it,” Dr. Amoussouvi said.

The UN country team in Benin is working closely with the government to facilitate women’s integration in all sectors of society, including in medicine.

“We cannot build the future we want and achieve the Sustainable Development Goals (SDGs) without the full participation of all stakeholders in society, especially women,” says Salvator Niyonzima, who, as Resident Coordinator, is the most senior UN official in Benin.

He emphasizes the significance of the promotion of gender equality and women’s rights in a broader social context. “Gender equality, enshrined in SDG 5, is often measured by the existence of a legal framework to promote, enforce and monitor the application of the principles around non-discrimination based on sex.”

Dr. Babio says she’s determined to do her best for her patients. “What a pleasure to see our patients getting better. I feel re-energized when they are grateful for our support. Yes, we save human lives”.

Her competence is well recognized by her peers and patients. “I take my hat off to this very dynamic team under the leadership of a rigorous and methodical woman,” explains Ms. Hermine Fatoumbi, a patient who has just recovered from COVID-19.

Mental health alert for 332 million children linked to COVID-19 lockdown policies: UNICEF

Based on new research, it said on Thursday that more than 330 million youngsters have been stuck at home for at least nine months, since the virus spread uncontrollably this time last year.

This has left them feeling isolated and anxious about their future, said UNICEF spokesperson James Elder: “Tens and tens of millions of youngsters have been left feeling isolated and afraid and lonely and anxious because of these enforced lockdowns and isolations that have become as a result of this pandemic.”

He said countries needed to emerge from this pandemic “with a better approach, a better approach to child and adolescent mental health, and that probably starts just by giving the issue the attention it deserves.”

Mental vulnerabilities

Half of all mental disorders develop before the age of 15, according to UNICEF and the majority of the 800,000 people who die by suicide annually, are under 18s.

The UN agency also said that the pandemic has disrupted or halted critical mental health services in 93 per cent of countries worldwide.

UNICEF Executive Director, Henrietta Fore, said that when day after day “you are away from your friends and distant loved ones, and perhaps even stuck at home with an abuser, the impact is significant.

“Many children are left feeling afraid, lonely, anxious, and concerned for their future. We must emerge from this pandemic with a better approach to child and adolescent mental health, and that starts by giving the issue the attention it deserves.”

For children experiencing violence, neglect or abuse at home, lockdowns have left many stranded with abusers. Children in vulnerable population groups – like those living and working on the streets, children with disabilities, and children living in conflict settings – risk having their mental health needs overlooked entirely.

According to WHO, the COVID-19 pandemic has disrupted or halted critical mental health services in 93 per cent of countries worldwide, while the demand for mental health support is increasing.

UNICEF responding

To respond to growing needs, the agency has offered support to Governments and partners to prioritize services for children.

In Kazakhstan, this has led to the launch of a UNICEF platform for individual online counselling services, alongside distance training in schools for mental health specialists.

In China, the agency has also worked with social media company Kuaishou, to produce an online challenge to help reduce anxiety in children.

Later this year, UNICEF will dedicate its biennial flagship report on the state of the world’s children, to child and adolescent mental health, in a bid to increase awareness of the global challenge, exacerbated profoundly by the coronavirus.

Boost investment

“If we did not fully appreciate the urgency prior to the COVID-19 pandemic, surely we do now”, said Ms. Fore.

Countries must dramatically invest in expanded mental health services and support for young people and their caregivers in communities and schools. We also need scaled-up parenting programmes to ensure that children from vulnerable families get the support and protection they need at home.”

Untreated hearing loss threatens nearly 2.5 billion people worldwide – WHO 

The World Health Organization’s (WHO) report, launched ahead of World Hearing Day 2021 on Wednesday, says that in less than 30 years, nearly 2.5 billion people globally face the threat of hearing loss – at least 700 million of whom will require ear and hearing care as well as other rehabilitation services, unless action is taken. 

That figure would mark a significant increase from the current 430 million people worldwide who are experiencing “disabling hearing loss”.  

“Our ability to hear is precious. Untreated hearing loss can have a devastating impact on people’s ability to communicate, to study and to earn a living”, said WHO Director-General chief Tedros Adhanom Ghebreyesus. “It can also impact on people’s mental health and their ability to sustain relationships”. 

Hearing investments 

The new report underlines the need to promptly step-up efforts to prevent and address hearing loss by investing and expanding access to ear and hearing care services. 

WHO has calculated that governments can expect a cost-effective return of nearly $16 for every dollar invested. 

The vast majority of those with disabling hearing loss, live in low and middle income countries where policies, trained professionals, infrastructure and basic awareness to address the issue, are commonly lacking. 

“Integrating ear and hearing care interventions within national health plans and delivering these through strengthened health systems, as part of universal health coverage, is essential to meet the needs of those at risk of or living with hearing loss”, said Bente Mikkelsen, Director of the WHO Department of Noncommunicable Diseases.  

Hearing loss 

In children, almost 60 per cent of hearing loss can be prevented through measures such as rubella and meningitis immunizations, improved maternal and neonatal care, and screening for and early management of otitis media – inflammatory diseases of the middle ear.  

In adults, noise control, safe listening and surveillance of medicines that cause a toxic effect on the ear or its nerve supply, together with thorough ear hygiene can help maintain good hearing and reduce the potential for hearing loss. 

Correcting the loss 

Identification is the first step in addressing hearing loss and related ear diseases. 

According to WHO, clinical screening at strategic points in life ensure that any loss of hearing and ear diseases can be identified as early as possible. 

Moreover, recent technological advances, including accurate and easy-to-use tools, can identify ear disease and hearing loss at any age, and screenings can be done during the COVID-19 pandemic and in underserved areas of the world. 

Untreated hearing loss can have a devastating impact on people’s ability to communicate, to study and to earn a living — WHO chief

Once diagnosed, early intervention is key. Medical treatment can cure most ear diseases and where hearing loss is irreversible, rehabilitation can prevent adverse consequences of hearing loss.  

A range of options are available, including technology such as hearing aids and cochlear implants, which, when accompanied by appropriate support services and rehabilitative therapy, are effective and can benefit children and adults alike. 

“To ensure that the benefit of these technological advances and solutions is equitably accessible to all, countries must adopt an integrated people-centered approach”, Dr. Bente Mikkelsen advised. 

The report also highlights that sign language and other sensory substitution, such as speech reading, are important options for many deaf people, as are hearing assistive technology and services, including captioning and sign language interpretation.

‘We sink or we swim together’: 5 things you need to know about COVAX

1) What is COVAX?

COVAX (COVID-19 Vaccines Global Access) is the vaccines element of the ACT-Accelerator programme, led by the WHO and international partners, to develop a set of tools to fight the virus. WHO says that the programme has supported the fastest, most coordinated, and successful global effort in history to fight a disease.

The aim is to distribute two billion doses, mostly to poorer countries, in 2021, and immunise 27 per cent of their citizens.

“No one is safe until everyone is safe”, has been a World Health Organization (WHO) mantra since the beginning of the global COVID-19 health crisis. However, richer countries had the resources to pre-order vast quantities of vaccines, ensuring that their populations were first in the queue when pharmaceutical companies got the green light to deliver doses, prompting UN human rights experts to warn against “vaccine hoarding”, and insist that vaccines must be available for all.

2) How does it work?

Funded by richer countries and private donors, who have raised more than $2 billion, COVAX was launched in the early months of the pandemic, to ensure that people living in poorer countries would not be left out, when successful vaccines came onto the market. The UN Children’s Fund (UNICEF), in collaboration with the UN’s Pan American Health Organization (PAHO), is taking the lead in efforts to procure and supply doses.

Some 92 low and lower-income countries are purchasing vaccines with support from COVAX, and it is expected that the poorest citizens will be vaccinated free of charge. Around 80 higher-income economies have announced that they will finance the vaccines from their own budgets.

3) Which vaccines are being distributed through COVAX?

By the end of 2020, the WHO had lined up almost two billion doses of existing and candidate vaccines for use worldwide. Not all of those vaccines will be effective against the virus, but assembling such a huge vaccine reservoir meant that the UN health agency can say with confidence that COVAX will distribute enough doses to protect health and social care workers in all participating countries by mid-2021.

Some 1.2 million doses of the Pfizer-BioNTech vaccine, which requires ultra-cold chain storage are to be delivered to 18 countries in the first quarter of 2021, out of an agreed total of 40 million. A much larger rollout of around 336 million doses of the AstraZeneca/Oxford jab will be dispatched to nearly all countries that have signed up to the COVAX scheme, from Afghanistan to Zimbabwe.

4) Which countries are receiving the first COVAX doses?

On 24 February around 600,000 doses of the AstraZeneca/Oxford vaccine, produced under licence in India, arrived in Ghana, welcomed by WHO as a historic step towards the goal of ensuring equitable distribution of vaccines worldwide. This shipment was swiftly followed by the arrival of more than half a million AstraZeneca/Oxford doses in Côte d’Ivoire.

These initial shipments are part of an initial 90 million doses due to be sent to Africa from the COVAX facility in the first half of 2021, supporting the inoculation of around three per cent of those most in need of protection, including health workers and other vulnerable groups.

By the end of 2021, it is hoped that, with the availability of more vaccines and increased production capacity, 600 million doses will have been rolled out, and some 20 per cent of the African population will have been vaccinated.

5) Why is it important?

The COVID-19 virus has taken a huge human toll. More than two million people worldwide have succumbed to the virus. Many more have been hospitalized, and suffered ongoing debilitating consequences. COVAX is intended to stem this tragic loss of life and chronic illness.

In addition, billions of lives have been disrupted by the travel restrictions, lockdowns and other measures put in place to slow the spread of the virus. Millions of jobs have been lost as the global economy has slowed down, and health services have been overwhelmed, making it harder for patients with non-COVID-related ailments to receive treatment.

It’s hoped that the vaccines provided by COVAX will contribute to reversing those damaging trends and return the world to normality, whatever that might look like.

WHO chief Tedros Adhanom Ghrebeyesus has pointed out that COVAX is not a charity effort: in a highly inter-connected global economy, effective vaccines, widely available in all countries, are the fastest way to end the pandemic, kick-start the global economy, and ensure a sustainable recovery. In the WHO chief’s words, “we sink or we swim together”.

UN’s nuclear watchdog agency will not be ‘bargaining chip’ in Iran nuclear deal

 After speaking to the International Atomic Energy Agency’s (IAEA) Board of Governors, Director General Rafael Grossi told a press conference that while the agency had opened a window of opportunity for diplomacy in Iran, it should not be put in the middle of negotiations between Iran, the United States and other nations over the deal.  

On 15 February, Iran announced that it would stop implementing “voluntary transparency measures” in the Joint Comprehensive Plan of Action (JCPOA), known commonly as the Iran nuclear deal, along with other arrangements in Iran’s Safeguards Agreement.  

The IAEA chief said to the 35-nation board that a “temporary bilateral technical understanding” had been agreed upon during his visit to the country last month that would enable the UN agency to “resume its full verification and monitoring of Iran’s nuclear-related commitments under the JCPOA if and when Iran resumes its implementation of those commitments”. 

Serious concern 

The IAEA chief also raised the alarm that nuclear activities in the Democratic People’s Republic of Korea (DPRK), commonly known as North Korea, remains “a cause for serious concern”.  

“The continuation of the DPRK’s nuclear programme is a clear violation of relevant UN Security Council resolutions and is deeply regrettable”, Mr. Grossi said, adding that the Vienna-based agency was intensifying its readiness “to play its essential role in verifying North Korea’s nuclear programme”. 

Reviewing nuclear safety 

The IAEA chief also drew attention to the agency’s Nuclear Safety Review 2021, which provides an overview of the agency’s activities and global trends in nuclear, radiation, transport and nuclear waste safety protcols, as well as in emergency preparedness and response.  

“This year, it also identifies the priorities in these areas, and provides an analytical overview of overall trends”, he said. 

Strengthen preparedness  

Moreover, the UN official flagged IAEA’s work in strengthening global preparedness for future pandemics through its Zoonotic Disease Integrated Action (ZODIAC) initiative on diseases, that jump from animals to humans – the common path for viruses such as COVID-19. 

He said the initiative will help to reduce the chance that the next outbreak will wreak “the deadly destruction we are suffering today”. 

And Mr. Grossi informed the members that last week, IAEA signed revised arrangements with the Food and Agriculture Organization (FAO) to “help Member States respond to emerging challenges from climate change to outbreaks of zoonotic diseases”. 

Climate on the table 

As the Agency prepares for the 2021 UN Climate Change Conference, known as COP26, scheduled for November in Glasgow, Scotland, Mr. Grossi said that he would personally deliver the message that “nuclear energy has a seat at the tables when the world’s future energy and climate policies are being discussed”.  

“Almost five years after the signing of the Paris Agreement, governments are becoming increasingly aware that they must shift from fossil fuels to nuclear and other low-carbon technologies, if they are to reach their net zero objectives”, Mr. Grossi said. 

The Director-General concluded by assuring that the agency was continuing its work on advancing gender equality, and invited Member States to join a panel discussion with some of the IAEA’s early women pioneers on 8 March, International Women’s Day.

COVID-19 cases rise for first time in seven weeks: WHO

Four of the agency’s six regions reported a rise in numbers, with Africa and the Western Pacific excluded. 

“This is disappointing, but not surprising”, said WHO chief Tedros Adhanom Ghebreyesus, speaking during his biweekly press briefing from Geneva. 

“Some of it appears to be due to relaxing of public health measures, continued circulation of variants, and people letting down their guard.” 

The jump in cases comes as the rollout of COVID-19 vaccines continues. 

“Vaccines will help to save lives, but if countries rely solely on vaccines, they’re making a mistake”, Tedros warned, underscoring the importance of basic public health measures such as testing, contact tracing, wearing masks and avoiding crowds. 

‘Encouraging’ signs 

Ghana and Côte d’Ivoire began vaccinating health care workers on Monday, becoming the first countries to benefit from a global mechanism for ensuring vaccine equity.   

Through the COVAX Facility, WHO and our partners are working to ensure every country can begin vaccination within the first 100 days of the year.  

COVAX will deliver 11 million doses to countries this week.  By the end of May, some 240 million doses will be allocated to 142 participating countries. 

Dr. Soumya Swaminathan, WHO’s Chief Scientist, pointed to “encouraging” signs as the world continues to gear up for what is the largest vaccine deployment in history. 

“We’ve seen early data from countries where vaccination campaigns started months ago, the impact that this is having on reducing hospitalizations, reducing deaths, particularly in the older age groups, amongst the vulnerable. We’ve even seen very encouraging data in reduction in infections among health care workers who have received the vaccine”, she said. 

“So, these are still early days, but the signs are encouraging; the safety profile is encouraging. About 250 million doses have been given worldwide, and so far, there have been no major safety signals, so that is reassuring as well.” 

Concern for Tigray region 

WHO explained that some countries have received COVAX vaccines early due to several factors such as the level of government preparedness, but logistical challenges in distributing vaccines, which include labelling, packaging and shipping, can also affect deployment. 

Dr. Michael Ryan, WHO Executive Director, spoke about the difficulty in reaching conflict areas such as the Tigray region in Ethiopia, where government and regional forces have been fighting since November. 

He said the situation is of grave concern, as water, sanitation, essential health services and COVID-19 intervention have been disrupted. Many people are living in displacement camps, increasing risk of diarrhoeal disease, malaria and other illneses. 

WHO has worked to provide essential supplies to cover 450,000 people, or roughly 10 per cent of the population, for three months, Dr. Ryan told journalists.  

“Our primary aim as an organization, wherever we work, is to ensure that all people have access to the basic, essential human right of access to basic health care”, he said. 

“We will work with the Ministry of Health; we will work with health cluster partners and anybody else who can help us to provide better access to the population there.”