Joy in South Sudan, as schools reopen after 14-month COVID lockdown

Describing the “joy” felt by children and aid workers as classrooms reopened on Monday after more than 14 months of COVID-19 restrictions, Mads Oyen, UNICEF’s chief of field operations, explained that going back to school was about more than just learning.

“Especially in a country like South Sudan, where we’re also faced with humanitarian emergencies in many parts of the country”, he explained. “Schools are places for children to be safe and to be protected and also to access basic services, school feeding and so on.”

Despite the welcome development, the UNICEF official noted that many children had not been able to return to class, their future development held up by a chronic humanitarian emergency, fuelled by ongoing violence and climate shocks.

Malaria one threat among many

The warning comes ahead of the upcoming rainy season, which brings with it a higher risk of cholera, malaria and respiratory infections.

There has already been a near-doubling of outpatient admissions in the last weeks, likely from malaria infections or reinfections, Mr Oyens said.

“(It’s) about controlling malaria, it’s about controlling any measles outbreaks, it’s about providing clean water to kids”, he explained, before highlighting the “multiple risks” that children face.

These include “violence, exploitation and abuse (and) recruitment by armed groups, still going on, psychosocial distress and family separation”.

Fewer that one in 10 children has access to child protection services, the veteran UNICEF worker said, noting that between January and March this year, the agency scaled up treatment to more than 50,000 children who were suffering from severe acute malnutrition.

The recovery rate was more than 95 per cent “in some of the most difficult-to-operate areas of the world”, he added.

Health threat to 800,000

In a related development, the International Organization for Migration (IOM) warned on Tuesday that life-saving healthcare for more than 800,000 South Sudanese, may have to be cut if funding is not found urgently.

“Internally displaced persons, returnees and conflict-affected populations already living in dire conditions may soon face even greater danger to their lives and health due to the COVID-19 pandemic and the onset of the rainy season and floods”, the UN agency said.

Come June, primary healthcare services may no longer be available for women and children, the elderly and those living with disabilities.

These services range from maternal and child health, including the screening of under-fives to detect malnutrition, sexual and reproductive health services and testing and treatment for HIV/AIDS and tuberculosis.

‘A right and necessity’

“Health is not a luxury, it’s a right and a necessity. We must mobilize to ensure no one is left behind,” said Jacqueline Weekers, Director of Migration Health for IOM. 

“In the past year, we have learned the hard way that when some people don’t have access to health services, everyone can be at risk.”

Before COVID-19, South Sudan’s health system was already heavily dependent on humanitarian actors who now face worrying funding shortfalls, IOM said, in an appeal for $744,175 per month to continue providing life-saving care. 

Essential health services are provided in former UN Protection of Civilian sites, host communities as well as remote and hard-to-reach locations serviced by the IOM’s mobile rapid response teams

UN envoy Gordon Brown urges G7 countries to fund global COVID vaccination push

Speaking during the regular briefing by the World Health Organization (WHO), and ahead of next month’s G7 summit, Mr. Brown, who is the UN’s Special Envoy for Global Education, said inaction will only lead to greater global division. 

A life or death choice 

“By our failure to extend vaccination more rapidly to every country, we are choosing who lives and who dies”, he warned. 

“And I say the world is already too deeply divided between rich and poor to allow a new unbridgeable divide to become entrenched between the world’s vaccinated who live, and the under-vaccinated who are at risk of dying.” 

As Prime Minister, Mr. Brown hosted the G20 summit in 2009, where the world’s major economies committed an additional $1.1 trillion to address the fallout from the global financial crisis,  He is now on a campaign to galvanize support to demand that the G7 “deploy its wealth to end the disease.”  

More COVID-19 cases were reported in the past two weeks than in the first six months of the pandemic, with India and Brazil accounting for half, WHO chief Tedros Adhanom Ghebreyesus told journalists. 

“The G7 countries are the world’s economic and political leaders. They’re also home to many of the world’s vaccine producers. We will only solve the vaccine crisis with the leaders of these countries”, he said. 

Shared threat, shared solutions 

Tedros reported that the landmark global collaboration developing and delivering COVID-19 vaccines to countries worldwide, known as the ACT Accelerator, remains $19 billion underfunded. Up to $45 billion will be needed next year to inoculate most adults. 

“We face a shared threat that we can only overcome with shared solutions”, he said. “Sharing financial resources, sharing vaccine doses and production capacity, and sharing technology, know-how and waiving intellectual property.” 

Formula for ‘burden-sharing’ 

For Mr. Brown, mass global vaccination is not an act of charity, but “the best insurance policy for the world”.  Though costing billions now, the result will be “trillions of additional economic output, made possible when trade resumes in a COVID-free world.” 

The $60 billion in funding is required not only for vaccines, but also for vital medical supplies, diagnostics and medical oxygen “currently and shamefully in short supply in India and elsewhere”. 

He provided a formula for rich countries to shoulder the cost, based on national income, current wealth and benefits from the resumption of trade. 

The breakdown would see the United States covering 27 per cent, Europe 23 per cent, Japan six per cent and the UK five per cent. Australia, Canada and South Korea would pay two per cent each.   

“I say to the G7…you have the power and the ability to pay for nearly two-thirds of the cost and secure a historic breakthrough by agreeing an equitable burden sharing formula that could cover global health provision”, he said. 

Mr. Brown added that the world’s major economies, the G20, could cover more than 80 per cent of the cost and donate urgently needed vaccine doses, while the world’s 30 richest countries could pay for more than 90 per cent. 

“And the same burden-sharing formula could also be applied so that instead of the familiar pandemic cycle of panic now and neglect later, the world invests now when there is a cash shortfall, and for the future in pandemic preparedness …to ensure that even if future outbreaks happen, pandemics become preventable.”

Latest deadly Ebola virus outbreak in DR Congo declared over

The virus – an often-fatal illness spread through contact with bodily fluids, which kills, on average, around half of those infected – re-emerged in February, nine months after another outbreak in the same province was declared over.

In a press release, WHO congratulated the health authorities in DRC, and the health workers “on the ground for their swift response which built on the country’s previous experience in tackling Ebola outbreaks.”

Eleven confirmed cases and one probable case resulting in six deaths and six recoveries were recorded in four health zones in North Kivu, from 7 February, when the Ministry of Health announced the resurgence of Ebola in Butembo.

Results from genome sequencing conducted by the country’s National Institute of Biomedical Research, found that the first Ebola case detected in the outbreak was linked to the previous outbreak, but the source of infection is yet to be determined.

‘Huge credit’ to local workers

“Huge credit must be given to the local health workers and the national authorities for their prompt response, tenacity, experience and hard work that brought this outbreak under control”, said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Although the outbreak has ended, we must stay alert for possible resurgence and at the same time use the growing expertise on emergency response to address other health threats the country faces.”

The response was coordinated by the Provincial Department of Health in collaboration with WHO and partners.

With nearly 60 experts on the ground, WHO helped local workers to trace contacts as soon as the outbreak was declared, providing treatment, engaging communities and vaccinating nearly 2,000 people at high risk, including over 500 frontline workers.

“Today’s declaration of an end to the latest Ebola outbreak in the Democratic Republic of the Congo is a testament to the professionalism, sacrifices, and collaboration by hundreds of true health heroes, in particular the Congolese responders,” said WHO chief Tedros Adhanom Ghebreyesus, in a statement released later on Monday. “The World Health Organization is committed to helping national and local authorities, and the people of North Kivu, prevent the return of this deadly virus and to promote the overall health and well-being of all at-risk communities.”

Insecurity factor

The response was often hampered by insecurity due to armed groups in the restive region, close to the border with Uganda, and social unrest, according to WHO, “which at times limited the movement of responders”.

There were concerns too, over the potential cross-border spread of the outbreak. However, due to the effective response the outbreak was contained within North Kivu province.

“While the 12th outbreak is over, there is a need for continued vigilance and maintaining a strong surveillance system as potential flare-ups are possible in the months to come”, said WHO.

It is important to continue with sustained disease surveillance, monitoring of alerts and working with communities to detect and respond rapidly to any new cases and WHO will continue to assist health authorities with their efforts to contain quickly a sudden re-emergence of Ebola, the UN health agency added.

COVID, measles, cholera

WHO continues to work with the Government of DRC to fight other public health problems such as outbreaks of measles and cholera, and of course, the COVID-19 pandemic.

Latest figures from WHO show more than 22,000 cases and 144 deaths attributable to the coronavirus.

The 2018–2020 outbreak was the 10th in the DRC and the country’s deadliest, with 3,481 cases, 2,299 deaths and 1,162 survivors.

An ongoing Ebola outbreak also erupted in Guinea, West Africa, beginning in February.

Address inequalities to end AIDS by 2030, UN chief says in new report

Despite action and progress against HIV in some places and population groups, HIV epidemics continue to expand in others, the report revealed. It was launched just weeks ahead of a major UN General Assembly meeting on AIDS. 

“It is imperative to break out of an increasingly costly and unsustainable cycle of achieving some progress against HIV but ultimately not enough to bring about an end to the pandemic”, the Secretary-General said in the report. 

“Inequalities are the key reason why the 2020 global targets were missed. By ending inequalities, transformative outcomes can be achieved for people living with HIV, communities and countries.” 

New infections triple 

In 2016, the UN General Assembly set the target of having fewer than 500,000 new HIV infections by 2020.  Last year, the figure was 1.7 million, or three times the target.  Similarly, the 690,000 AIDS-related deaths in 2019 far exceed the goal of less than 500,000 deaths a year. 

“Ending AIDS as a public health threat by 2030 is still within reach—many countries are showing that rapid progress against HIV is possible when evidence-informed strategies and human rights-based approaches are adopted”, said Winnie Byanyima, Executive Director of UNAIDS, which is leading the global fight against the disease.  

“But it requires bold political leadership to challenge and address the social injustices and inequalities that continue to make certain groups of people and entire communities highly vulnerable to HIV infection.” 

Address inequalities, prioritize prevention 

The report underscores that addressing social and structural factors that perpetuate inequalities is key.  

For example, gender inequality, anchored by harmful gender norms, restricts women’s use of HIV services, and sexual and reproductive health services. This can impact decision-making, including the ability to refuse unwanted sex or to negotiate safer sex. 

Vulnerable, marginalized and criminalized communities also remain at higher risk of HIV infection because they are not receiving essential information and HIV services, whether for prevention or care.  These groups include gay men and other men who have sex with men, people who use drugs, sex workers, transgender people, prisoners and migrants. 

Get back on track 

The 10 recommendations for putting the world back on the path to ending AIDS cover issues such as addressing inequalities and reaching all people at risk of HIV infection.   

The goal is to keep new infections to under 370,000, and AIDS-related deaths to under 250,000, by 2025. 

They call for closing gaps in HIV testing and treatment, and putting “gender equality and the human rights of women and girls in all their diversity” at the centre of efforts to mitigate risk. 

Other steps call for prioritizing HIV prevention to ensure that 95 per cent of people at risk have prevention options by 2025, and eliminating new infections among children. 

Lessons in preparedness 

The report also outlined how the COVID-19 pandemic has exposed social inequalities and health system weaknesses.  

The Secretary-General said the world should leverage experience from responding to the AIDS crisis to strengthen health systems and improve pandemic preparedness.  

He also appealed for more global solidarity, including to increase annual HIV investments in low and middle-income countries to $29 billion by 2025.

Vaccinated Europeans now outnumber those infected by COVID, but ‘threat remains present’

Based on confirmed cases, 5.5 per cent of the entire European population has now had COVID-19, while 7 per cent has completed a full vaccination series.

But WHO Regional Director for Europe, Hans Kluge said in a video message, “the virus still carries the potential to inflict devastating effects”.

“As a matter of fact, close to half of all COVID-19 infections in the Region since January last year were reported to WHO during the first 4 months of this year”, he added.

Shaping the pandemic’s course

Although new cases fell significantly last week, for the first time in two months, infection rates across the region remain “extremely high”, according to Dr. Kluge, who noted that individual and collective public health and social measures in most countries, remain “dominant factors in shaping the pandemic’s course”.

Crucially, national governments in the region are slowly but surely vaccinating those most at risk.

“To date, some 215 million doses of vaccine have been administered”, said the WHO official.

Approximately 16 per cent of the region’s population has had a first vaccine dose, as well as 81 per cent of health workers in 28 countries throughout the region.

Hospital admissions are decreasing and death rates are falling in high-risk groups with the highest vaccination rates.

“Vaccines are saving lives, and they will change the course of this pandemic and eventually help end it”, said Dr. Kluge.

‘Clearest path to normal’

The WHO Regional Director maintained that vaccines alone will not end the pandemic but along with strong public health measures, they offer “the clearest path back to normal”.

He underscored the importance of continuing to share information, engage communities and maintain surveillance, saying otherwise “we can’t identify new variants”.

“And without contact tracing, governments may need to reimpose restrictive measures”, Dr. Kluge warned.

Vital immunizations

Every year during European Immunization Week, WHO highlights that for over 200 years, vaccines have protected against life-threatening diseases.

“Today they help protect against more than 20 diseases, from pneumonia to cervical cancer and now also COVID-19”, said Dr. Kluge.

Vaccines are bringing us closer to ending this pandemic, eradicating polio and eliminating measles, cervical cancer and other vaccine-preventable diseases.

And they are helping to edge populations into a world without the threat of antibiotic resistance.

“The fact that the countries of the European Region on average reached 96% of children scheduled to receive their first dose of measles vaccine in 2019, is testament to the commitment of governments in the Region to eliminate measles”, he said.

“We now need that commitment to vaccinating against the SARS-CoV-2 virus”.

Beyond COVID

To keep an upper hand on vaccine-preventable diseases, health systems must provide essential primary health care, including routine inoculations while controlling the pandemic.

Dr. Kluge recalled that faltering immunization rates in 2019 led to more than 100,000 measles cases, warning that that when routine immunization services are temporarily interrupted – as also witnessed a year ago in European countries hardest hit by the first wave of COVID – infectious disease outbreaks may flare up further down the line.

“Hard-earned success can slip away fast”, he said urging “high immunization coverage with routine vaccines”.

For vaccines to again change the course of history, they must be injected into people’s arms, he added.

“Ultimately, it is us, the people who receive them, who make them work for the good of all”.

Madagascar edges toward famine, UN food agency appeals for assistance

And with acute malnutrition rates continuing to rise, urgent action is required to address this unfolding humanitarian crisis, the World Food Programme (WFP) warned. 

“If we don’t reverse this crisis, if we don’t get food to the people in the south of Madagascar, families will starve and lives will be lost”, Amer Daoudi, WFP’s Senior Director of Operations, said, after visiting one of the worst affected areas, Sihanamaro. 

Evolving catastrophe 

Most districts in the South are in the throes of a nutrition emergency with Global Acute Malnutrition (GAM) levels in children under five, nearly doubling over the last four months – touching an alarming 16.5 per cent – the Ministry of Health reported.  

Children with acute malnutrition are four times more likely to die than healthy youngsters. 

And in the worst affected district of Ambovombe, GAM has risen above 27 per cent, putting the lives of many children at risk.  

Meeting needs, saving lives 

Over the next six months, WFP needs $74 million to save lives in the world’s second-largest island State.  

“We have witnessed heart-breaking scenes of severely malnourished children and starving families”, said Mr. Daoudi, appealing for “money and resources…to help the people of Madagascar”. 

After the alarm was raised across Amboasary district, the UN agency has been progressively assisting up to 750,000 people through food and cash distributions each month. 

State of peril 

Consecutive years of drought in the South have left at least 1.35 million people in need of emergency food and nutrition assistance, according to WFP.  

Since last September, the start of the lean season, the situation had turned critical as families had already depleted their food supplies and gone through vital seed stocks, leaving nothing for the November/December 2020 planting season.  

Currently, up to 80 per cent of the population in certain areas in the south are resorting to desperate survival measures, such as eating locusts, raw red cactus fruits or wild leaves. 

Moreover, with a lack of rain during the last planting season, prospects for the 2021 harvest are poor, indicating another longer tougher lean season from October to March 2022.  

WFP said that food production this year is expected to be “less than 40 per cent of the last five-year average”, which only adds to the difficulties faced by communities already on the brink of survival to feed themselves. 

At the same time, semi-arid conditions in southern Madagascar, combined with high levels of soil erosion, deforestation and unprecedented sandstorms, have transformed arable land into wasteland across the region.

Increased cancer risk for petroleum industry workers and people living near plants: New UN study

The findings add to increasing evidence of the health consequences of air pollution from petroleum extraction and refining.

Types of cancer risk

The review identified an increased risk of mesothelioma, skin melanoma, multiple myeloma, and cancers of the prostate and urinary bladder, and conversely, decreased risk of cancers of the oesophagus, stomach, colon, rectum, and pancreas.

Offshore petroleum work was associated with an increased risk of lung cancer and leukaemia.

Living close to petroleum facilities was also associated with an increased risk of childhood leukaemia.

Scientists in the Environment and Lifestyle Epidemiology Branch of the agency carried out 41 cohort studies, 14 case–control studies, and two cross-sectional studies to compile their review.

Their findings have been published in the International Journal of Environmental Research and Public Health.

More research needed

The authors point out that further studies on the effect of exposure to petroleum and its closest derivatives (e.g. benzene) are needed in order to identify how they modify cancer risk.

In particular, there is a need for targeted studies in under-researched areas of high petroleum production with presumably higher exposures.

The scientists argue that the best way forward may be an international consortium to guide new studies in Africa, the Middle East, and Asia, in order to harmonize how studies are carried out and how exposure is assessed.

UN providing equipment and supplies to help India fight rapid COVID-19 surge

“In India’s time of need, the UN is doing everything it can to rapidly provide critical equipment and supplies to central and state governments”, said Resident Coordinator Renata Lok Dessallien. 

WHO and sister agency the UN Children’s Fund, UNICEF, are procuring equipment and supplies, including 7,000 oxygen concentrators and 500 nasal devices for oxygen supply, in addition to oxygen generating plants, COVID-19 testing machines, and personal protective kits. 

“The current rapid surge of COVID-19 cases has put immense pressure on the health systems, already overburdened since the start of the pandemic. We need to act with speed, expand hospital capacities and equip them with medical supplies, most needed to save lives”, said Dr Poonam Khetrapal Singh, Regional Director for WHO in South-East Asia. 

The region has led the world in COVID-19 infections for a third straight week, mainly due to the situation in India, which has recorded 2.17 million new cases, or a 52 per cent increase. 

Mobile field hospitals 

WHO is helping India to scale-up additional hospital beds by procuring mobile field hospitals which could be set up in the most affected areas.  The field hospitals have a capacity of 20 to 30 beds but can be increased to a maximum of 50, if needed. 

The agency is also providing for laboratories to meet the huge demand for testing, and over 2,600 staff have been redeployed from programmes for polio and neglected tropical diseases to support pandemic response. 

Meanwhile, in the western state of Maharashtra, the second most populous in the country, UNICEF has engaged experts to work on risk governance.  

In it together 

India this week completed a 100-day COVID-19 vaccination drive, with 145 million doses administered. Dr Khetrapal Singh said efforts to ramp up vaccination coverage are needed. 

She also stressed the need to continue key public health measures, such as testing and contact tracing, along with physical distancing, proper hand washing and use of masks, to curtail virus transmission. 

Dr Khetrapal Singh underlined WHO’s commitment to continue working with health authorities at all levels, saying “Together we must do all we can to halt the current COVID-19 surge”.

COVID-19 cases rise for ninth consecutive week, variants continue spreading 

Nearly 5.7 million new cases were reported in the last seven-day period, above previous highs, the World Health Organization (WHO) said in its latest coronavirus update published late Tuesday. 

The number of deaths from the virus also increased – now for the sixth consecutive week – with more than 87,000 confirmed victims. 

Southeast Asia spike 

All parts of the world reported falling numbers of infections, apart from Southeast Asia and Western Pacific regions. 

And although Southeast Asia reported the highest increases in infections and deaths for the third week in a row, it was India that accounted for the vast majority of cases, with 2.17 million new cases – a 52 per cent increase. 

This is the equivalent of nearly four in 10 global cases reported in the past week, followed by the United States (with 406,001 new cases, representing a 15 per cent decrease), Brazil (404,623 new cases, a 12 per cent decrease), Turkey (378,771 cases, a nine per cent decrease) and France (211,674 new cases, a nine per cent decrease). 

Mutations 

On the three known coronavirus variants of concern, WHO said that the so-called UK strain has been detected and verified in three more countries since last week, bringing the total to 139; that’s effectively most of the world, except Greenland and several central and southern African nations. 

The South African origin variant is in 87 countries and the mutations first found in Brazil and Japan, has been reported in 54. 

Monitoring is ongoing into seven other so-called “variants of interest”, the UN health agency said. 

Globally, there have been more than 148 million confirmed cases of COVID-19, including 3.1 million deaths, according to WHO.  

As of 27 April 2021, a total of 961,231,417 vaccine doses have been administered. 

Risky business: COVID-19 and safety at work

The world of work has been upended by COVID-19, and the effects are likely to be long-lasting. Before the pandemic, there were some 260 million home-based workers (not including domestic or care workers). The International Labour Organisation (ILO) estimates that figure could have doubled, with as many as one in three workers remote working in North America and Europe, and one in six in sub-Saharan Africa.

The rollout of vaccines, mainly in the developed world,  has increased the possibilities of a return to the workplace, but many companies and workers have signalled a wish to retain a degree of home working, after seeing some of the benefits. For employers, these include minimising the risk of contagion and  potentially spending less on expensive office space whilst staff no longer have to spend commuting to and from the workplace.

‘If you’re losing your mind, I’m right there with you’

However, whilst some are enjoying baking bread or taking a stroll during a conference call, and using the commuting time to indulge in new pursuits, others have been craving a return to a more structured work-life routine.

“I tell myself daily that I am grateful to have a job with understanding supervisors and colleagues. But all of it is hard. If you’re also a working mum losing her mind daily, know that I’m right there with you,” says Paulina, a New York-based teleworker.

“I have chaired meetings with a laptop and headphones on one side of a tiny, New York City kitchen while cooking lunch and having a screaming toddler wrapped around my ankles. While all of this is cute once or maybe twice, regular screams of children in the background can only be tolerated for so long. I should know, because I passed that line sometime in July.”

Stories such as this explain why a recent study by the International Labour Organisation (ILO) found that 41 per cent of people who worked from home considered themselves highly stressed, compared to 25 per cent of those who worked on-site.

“The most effective way to eliminate the risk of contagion in a work context is, for those who can do it, teleworking, says Joaquim Nunes, head of occupational health and safety at the ILO, “But we still need to pay attention to the physical and mental well-being of workers”.

As teleworking is likely to remain an important factor in many people’s jobs, Mr. Nunes says that work-related policies will have to be updated to reflect the new reality.

“There’s a good chance that the rise of teleworking during the COVID-19 pandemic will permanently change how we live and work. Many governments have realised this, and are taking a fresh look at the rights of employees working from home. For example, companies should ensure that workers do not feel isolated, whilst giving them the right to disconnect, rather than being online 24 hours a day”.

In Chile, a law adopted early in March 2020 goes some way to addressing some of these concerns. The legislation recognizes the right of remote workers to disconnect for at least 12 continuous hours in a 24-hour period. In addition, employers cannot require workers to respond to communications on rest days or holidays.

A healthy home?

Beyond the question of comfort and mental health, is one of physical safety. It is often said that most accidents happen at home, so, if this is where much of the working week is spent, should employers be responsible for making sure apartments aren’t death traps?

“For now, there are no easy answers when it comes to ensuring a suitable home office environment”, says Mr. Nunes. “However, we can say that the same principles that apply to other workplaces apply to teleworkers, in that employers have a general duty of care, as reasonably practicable. Employers can’t control the workplace when staff are working from home, but they can provide ergonomic equipment to workers, such as suitable chairs, and help them to assess their own risks and to learn about how to maintain healthy lifestyles.”

Teleworking is also challenging for enforcement agencies, as usually inspectors do not have free access to the private spaces. One solution to ensure compliance with legislation could be virtual inspections, which are already taking place in Nordic countries on a voluntary basis. “These involve labour inspectors video calling a worker at home, and being shown their work chair, desk, and lighting setup”, explains Mr. Nunes. “These inspections can serve as a way to monitor the home workplace and provide advice, but also raise understandable privacy concerns”.

Frontline fears

Whilst the new teleworkers and their employers grappled with their new reality, a large part of the global workforce had no choice but to go to a physical place of work. The difficulties faced by health care workers were widely reported, but employees in several other industries had to brave the trip to the workplace – sometimes on crowded trains and buses – and, often, interact with other people, at considerable risk to their health.

In the US, these fears led to collective action by workers at Whole Foods, a grocery subsidiary of Amazon. On March 31, 2020, in response to seeing their colleagues testing positive with COVID-19, workers decided to call in sick, and demand sick leave, free coronavirus testing and hazard pay. This was followed in April by work stoppages at some of America’s biggest companies, including Walmart, Target and FedEx.

Whilst early advice on protection and prevention focused on measures such as hand washing, the wearing of masks and gloves, and physical distancing, the ILO quickly realised that more needed to be done to address work-related issues.

“In the workplace, you have to think about more than just the individual worker: the whole environment needs to be protected’, explains Mr. Nunes. “One example that many of us will have come across is in shops and supermarkets, where it is now common to see PVC separators between cashiers and customers. Work surfaces are also being cleaned much more frequently, but this raises other concerns that need to be addressed, such as the potential for skin complaints or respiratory problems caused by the chemicals in cleaning products.”

Whilst areas such as healthcare and retail have been grappling with these issues for several months, other parts of the economy could soon be opening up. In several countries, plans are being made to allow gatherings of large numbers of people to take place, in venues such as concert halls and cinemas, and, heading into summer in the northern hemisphere, the range of permitted tourist activities looks set to expand.

However, for this to take place, and for economies to safely open, governments and employers, in collaboration with workers, will need to make sure that workers in these, and all other industries, are safe at their workplaces, and confident they will not be exposed to unnecessary risks, particularly those related to COVID-19.

Key workers need greater protections amidst COVID fight, new ILO report warns

A new report by the ILO, released to mark World Day for Safety and Health at Work, found that 7,000 health workers have died since the outbreak of the crisis, while 136 million health and social care workers are at risk of contracting COVID-19 through work.

The document, Anticipate, prepare and respond to crises. Invest now in resilient OSH (Occupation Safety and Health) systems, looks at how countries can minimize the risks for everyone in the workplace, in the event of future health emergencies.

It also highlights the mental health pressures associated with the pandemic: one in five healthcare workers globally, has reported depression and anxiety symptoms.

Strong, resilient safety systems

The report outlines the critical roles played during the pandemic by strong workplace guidance backed by enforcement, and calls for them to be dovetailed with national crisis emergency plans.

“There could be no clearer demonstration of the importance of a strong, resilient, occupational safety and health environment. Recovery and prevention will require better national policies, institutional and regulatory frameworks, properly integrated into crisis response frameworks”, said ILO Director-General Guy Ryder.

Pros and cons of teleworking

It’s not only health and care sectors that have proven to be sources of COVID-19 outbreaks.

Many workplaces where staff are in closed environments or spend time in close proximity with each other – including in shared accommodation or transport – are affected.

And while teleworking has been essential in limiting the spread of the virus, it has also blurred the lines between work and private life, adding to people’s mental stress.

Sixty-five per cent of enterprises surveyed by the ILO and the G20 OSH Network, focused on occupational safety, reported that worker morale has been difficult to sustain while teleworking.

The report stated that small and micro-sized enterprises have often found it hard to meet official safety-at-work requirements because many have lacked the resources to adapt to the threats posed by the pandemic.

In the informal economy, the UN agency warned that many of the world’s 1.6 billion workers in the sector, especially in developing countries, have continued working despite lockdowns, restrictions on movement and social interaction.

This has put them at high risk of catching the virus, yet most do not have access to basic social protection, such as sick leave or sick pay.

Social dialogue is key

International labour standards (ILS) offer specific guidance on how to respond to these challenges and reduce the risk of virus transmission in the workplace, the report says.

They provide tools to implement safety-first measures and to ensure that workers, employers and Governments, can maintain decent work, while adjusting to the socio-economic consequences of the pandemic.

ILS also encourage social dialogue as the best way to ensure that procedures and protocols are effectively implemented and accepted, the report concludes.

‘Disasters know no borders’ says Guterres, 35 years on from Chernobyl nuclear accident

A 20-second shut down of the Chernobyl nuclear power plant on 26 April 1986, created a surge that led to a chemical explosion, which released nearly 520 dangerous radionuclides into the atmosphere. As a result, large parts of the former Soviet Union were contaminated; territory which now lies within the borders of Belarus, Ukraine and Russia, according to the UN. 

Marking the 35th anniversary of the accident, Secretary-General António Guterres said that together, “we can work to prevent and contain [disasters]… support all those in need, and build a strong recovery”. 

Never forget 

As one of the most serious nuclear accidents in history, nearly 8.4 million people in the three countries were exposed to radiation, according to the UN. 

Some 350,000 were forced to leave their homes in severely contaminated areas, which left a deeply traumatic and lasting impact on their lives: “Their suffering must not be forgotten”, said the top UN official. 

He also pointed to the anniversary as an occasion to recognize the recovery efforts led by the three governments as well as the work of “scientists who sifted through the evidence” to provide important analysis that has informed emergency planning and reduced risks. 

A legacy of assistance 

While the Organization had helped the people in the areas surrounding Chernobyl at the onset, four years after the accident the Soviet Government acknowledged the need for international assistance.  

That same year, 1990, the General Assembly adopted a resolution calling for “international cooperation to address and mitigate the consequences at the Chernobyl nuclear power plant”. This began the UN’s participation in the recovery effort. 

In 2002, the world body announced a shift in the Chernobyl strategy, with a new focus on a long-term developmental approach. 

And in 2019, a new safety casing over the old shelter was completed and given to the Government of Ukraine. It was achieved with €2.2 billion in donations from over 45 nations.  

The UN said the milestone one of the largest ever seen projects in terms of international cooperation in the field of nuclear safety. 

Working for ‘the common good’ 

UN country teams – working with civil society, international partners and donors – first supported emergency and humanitarian aid, then recovery and finally social and economic development, Mr. Guterres noted, adding that “our joint efforts have enjoyed some success”. 

He cited that the number of small and medium-sized businesses operating in areas directly affected by the disaster has risen from 2,000 in 2002 to 37,000 today.  

And thousands of residents, community leaders and doctors have been trained on health risks and promoting healthy lifestyles. 

The Chernobyl disaster was contained by governments working with academics, civil society and others, “for the common good”, the UN chief said.  

“It holds important lessons for today’s efforts to respond to the COVID-19 pandemic”, he concluded.

A ‘malaria-free future’ is possible, UN chief says on international day

“We commend all countries that have reached the ambitious target of zero malaria”, said Secretary-General António Guterres.  

“Together, they are showing the world that a malaria-free future is possible”. 

‘Key to success’ 

Countries with zero malaria have reached the people at risk with the necessary services, from prevention to detection and treatment, regardless of citizenship or financial status,  said the top UN official.   

“Sustained funding, surveillance systems and community engagement have been the key to success”, he added.  

Yet, while these achievements deserve celebrating, it is important to remember the millions around the world who continue to suffer and die from this deadly illness.   

Each year, malaria claims the lives of more than 400,000 people, mainly young children in Africa.  And, every year, there are more than 200 million new cases of this fatal parasitic disease.   

With robust political commitment, adequate investment and the right mix of strategies, “malaria can be defeated”, upheld the UN Secretary-General.   

Stamping out malaria 

Between 2000 and 2019, the number of countries with fewer than 100 indigenous malaria cases increased from six to 27, according to the World Health Organization (WHO), calling it “a strong indicator” that malaria elimination is within reach.

The UN health agency lauded those countries that have already done so saying: “They provide inspiration for all nations that are working to stamp out this deadly disease and improve the health and livelihoods of their populations”.

Country breakdown 

In 2019, Africa shouldered 94 per cent of all malaria cases and deaths worldwide, with more than half of all cases occurring in the five countries of Nigeria, 27 per cent; Democratic Republic of the Congo, 12 per cent; Uganda and Niger, five per cent each; and Mozambique, four per cent, according to WHO.

During that same period, about three per cent per cent of malaria cases were reported in South-East Asia and two per cent in the Eastern Mediterranean region.  

The Americas and Western Pacific region each accounted for fewer than one per cent of all cases. 

Certifying zero malaria 

Certification of malaria elimination is WHO’s official recognition of a country’s malaria-free status, which it grants when a State has proven, beyond reasonable doubt, that the chain of indigenous malaria transmission has been interrupted nationwide for at least the past three consecutive years. 

Following 50 years of solid commitment by the Government and people of El Salvador to end the disease, in February it became the first country in Central America to receive the distinction. 

Meanwhile China, which  registered zero indigenous cases in 2016 and has stayed malaria-free to date, applied last year for the WHO malaria-free certification. 

Japan: UN experts ‘deeply disappointed’ by decision to discharge Fukushima water

“The release of one million tonnes of contaminated water into the marine environment imposes considerable risks to the full enjoyment of human rights of concerned populations in and beyond the borders of Japan”, said Marcos Orellana, Special Rapporteur on toxics and human rights, Michael Fakhri,  Special Rapporteur on Right to Food, and David Boyd, Special Rapporteur on human rights and the environment in a joint statement. 

‘Very concerning’ 

Given the warnings from environmentalists and some governments that the discharge would affect many people as well as the environment at large, the experts called the Government’s decision “very concerning”.  

It comes after years of discussions with communities – including the fishing sector, which was already severely hit by the 2011 disaster – environmental NGOs, neighbouring countries and civil society.  

“The decision is particularly disappointing as experts believe alternative solutions to the problem are available”, they said. 

Fallout 

Noting that the water may contain quantities of radioactive carbon-14, as well as other radioactive isotopes, the independent experts raised their concerns with the Japanese Government that discharging radioactive water to the Pacific Ocean threatens the health of people and planet.  

Meanwhile, in reply to expert concerns, the Japanese Government has suggested that the treated water stored in the tanks was not contaminated.   

However, the experts upheld that the ALPS water processing technology had failed to completely remove radioactive concentrations in most of the contaminated water stored in tanks at the Fukushima Daiichi plant.  

“A first application ALPS failed to clean the water below regulatory levels and there are no guarantees that a second treatment will succeed”, they said, adding that the technology did not remove radioactive tritium or carbon-14.  

Isotope concerns 

While Japan said that the tritium levels are very low and do not pose a threat to human health, scientists warn that in the water, the isotope organically binds to other molecules, moving up the food chain affecting plants and fish and humans. 

Moreover, they say the radioactive hazards of tritium have been underestimated and could pose risks to humans and the environment for over 100 years.    

“We remind Japan of its international obligations to prevent exposure to hazardous substances, to conduct environmental impact assessments of the risks that the discharge of water may have, to prevent transboundary environmental harms, and to protect the marine environment”, the experts concluded. 

Special Rapporteurs and independent experts are appointed by the Geneva-based UN Human Rights Council to examine and report back on a specific human rights theme or a country situation. The positions are honorary and the experts are not paid for their work.

Alert over shortage of new drugs for ‘world’s most dangerous bacteria’  

The alert from the World Health Organization (WHO) is delivered in a report showing that none of the 43 antibiotics in development today sufficiently addresses the growing threat posed by 13 priority drug-resistant bacteria. 

“The persistent failure to develop, manufacture, and distribute effective new antibiotics is further fuelling the impact of antimicrobial resistance and threatens our ability to successfully treat bacterial infections,” said Dr. Hanan Balkhy, WHO Assistant Director General on antimicrobial resistance. 

Those most at risk are young children and those living in poverty, but antibiotic-resistant infections can affect anyone, said WHO partner AMR. 

Youngsters at risk 

According to WHO, three in 10 newborns who develop blood infections die, because the antibiotics that are used to treat sepsis are no longer effective. 

Bacterial pneumonia – another preventable illness which has developed resistance to available drugs – is also a major cause of childhood mortality among under-fives. 

WHO’s annual Antibacterial Pipeline Report, notes that almost all antibiotics available today are variations of those discovered by the 1980s.  

We rely hugely on them in all areas of our lives, from having a tooth out at the dentist, to organ transplants and cancer chemotherapy. 

Unproductive pipeline  

But after reviewing antibiotics that are in the clinical stages of testing, as well as those in development, the report highlighted a “near static pipeline” of production, which WHO’s Haileyesus Getahun likened to the “Achilles heel” of global health security.  

“Opportunities emerging from the COVID-19 pandemic must be seized to bring to the forefront the needs for sustainable investments in research and development of new and effective antibiotics,” said Mr. Getahun, WHO Director of Antimicrobial Resistance Global Coordination.   

“We need a global sustained effort including mechanisms for pooled funding and new and additional investments to meet the magnitude of the antimicrobial threat.”  

Only a few drugs have been given early-stage approval by regulators in recent years “and most of these agents…offer limited clinical benefit over existing treatments, WHO said, with the warning that the “rapid emergence of drug-resistance to these new agents” was a certainty. 

The clinical pipeline and recently approved antibiotics are insufficient to tackle the challenge — WHO

Fractional gains 

This was despite the fact that “some promising products” were in different stages of development, as only a fraction of these will make it to market in a sector hampered by the small return on investment from successful antibiotic products, which has limited the interest of most large pharmaceutical companies.  

“Overall, the clinical pipeline and recently approved antibiotics are insufficient to tackle the challenge of increasing emergence and spread of antimicrobial resistance,” the UN agency concluded. 

Driving research 

To promote investment in antibiotics development, WHO and partner Drugs for Neglected Diseases initiative (DNDi) have set up the Global Antibiotic R&D Partnership (GARDP) to develop innovative treatments.  

The UN health agency has also been working closely with other non-profit funding partners such as the CARB-X to accelerate antibacterial research. 

Another important new WHO-partnered initiative is the AMR Action Fund, that was set up by pharmaceutical companies, philanthropists and the European Investment Bank; its aim is to strengthen and accelerate antibiotic development through pooled funding.  

New global compact aims to drive down diabetes deaths, boost insulin access

The development comes as risk of early death from diabetes is increasing, underscoring why countries must tackle the disease and bring treatment to all who need it. 

The COVID-19 connection 

“The need to take urgent action on diabetes is clearer than ever”, said Tedros Adhanom Ghebreyesus, the WHO Director-General.  

“The number of people with diabetes has quadrupled in the last 40 years.  It is the only major noncommunicable disease for which the risk of dying early is going up, rather than down. And a high proportion of people who are severely ill in hospital with COVID-19 have diabetes.” 

More than 420 million people worldwide live with diabetes, a group of chronic diseases characterized by elevated blood sugar, which can cause damage to the heart, blood vessels, eyes, kidneys and nerves.  

The most common is type 2 diabetes, which occurs when the body becomes resistant to insulin, the hormone that regulates blood sugar. 

Action on insulin 

The global compact focuses on several priorities.  Among the most urgent is increasing access to diabetes diagnostic tools and medicines, particularly insulin, in low and middle-income countries. 

Roughly half of all adults with type 2 diabetes remain undiagnosed, according to WHO.  Additionally, half of all people with the condition do not get the insulin they need, putting them at risk of irreversible complications such as early death, amputation and sight loss. 

The insulin market is currently dominated by three companies, but a pilot programme for WHO prequalification of the medication, introduced two years ago, could change the situation.  The prequalification process ensures medicines meet global standards for quality, safety and efficacy.   

“Prequalification of insulin produced by more manufacturers could help increase the availability of quality-assured insulin to countries that are currently not meeting demand”, WHO said in a press release.

Meanwhile, discussions are underway with manufacturers of insulin, and other diabetes medicines and diagnostic tools, which could help meet demand at prices that countries can afford. 

Quantifying costs, meeting targets 

Another key aim of the compact is to set a “global price tag” that quantifies the costs and benefits of meeting new targets for diabetes care.  Governments also will be encouraged to meet their commitments to include diabetes prevention and treatment in primary healthcare and universal health coverage packages. 

Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO, added that the compact seeks to rally key stakeholders, as well as people who live with diabetes, around a common agenda to generate new momentum and create solutions. 

“The ‘all hands on deck’ approach to the COVID-19 response is showing us what can be achieved when different sectors work together to find solutions to an urgent public health problem,” he said. 

Share knowledge, foster collaboration 

The new compact was launched at the Global Diabetes Summit, co-hosted by WHO and the Government of Canada, with the support of the University of Toronto. 

“Canada has a proud history of diabetes research and innovation. From the discovery of insulin in 1921 to one hundred years later, we continue working to support people living with diabetes,” said Patty Hajdu, the country’s Minister of Health.  

“But we cannot take on diabetes alone. We must each share knowledge and foster international collaboration to help people with diabetes live longer, healthier lives — in Canada and around the world.”

WHO and partners urge countries to halt sales of wild mammals at food markets

The interim guidance, published on Tuesday, is aimed at reducing public health risks associated with these transactions as most emerging infectious diseases have wildlife origins. 

“Globally, traditional markets play a central role in providing food and livelihoods for large populations. Banning the sale of these animals can protect people’s health – both those working there and those shopping there”, they said in a press release. 

No way to check for viruses 

The temporary guidelines were issued by WHO alongside the World Organization for Animal Health (OIE) and the UN Environment Programme (UNEP).   

They said animals, particularly wild animals, are the source of more than 70 per cent of all emerging infectious diseases in humans, many of which are caused by novel viruses. Wild mammals sold in markets pose particular risk as there is no way to check if they carry dangerous viruses. 

“Traditional markets, where live animals are held, slaughtered and dressed, pose a particular risk for pathogen transmission to workers and customers alike,” the guidance stated.

The partners noted that some of the earliest known cases of COVID-19, which is caused by the novel coronavirus SARS-CoV-2, were linked to a traditional food market in Wuhan, China.  Many of the first people to have the disease were stall owners, market employees or regular visitors. 

“It is likely that the virus that causes COVID-19 originated in wild animals, as it belongs to a group of coronaviruses normally found in bats”, they said.    

“One hypothesis is that the virus was initially transmitted to humans through an intermediary animal host that is, as yet, unknown. Another possibility is that the virus was transmitted directly from a host species of animal to humans.” 

Additional hygiene guidance 

In addition to halting sales of wild animals, the guidelines also call for governments to close markets, or sections of markets, and to re-open them “only on condition that they meet required food safety, hygiene and environmental standards and comply with regulations.” 

Authorities are also urged to improve hygiene and sanitation at traditional food markets to reduce transmission of zoonotic diseases. 

“During this pandemic, additional measures for crowd control and physical distancing, hand washing and sanitizing stations as well as education on respiratory hygiene including on use of face masks should be introduced in market settings to limit the possibility of person-to-person transmission of disease,” they added.

COVID ‘long way from over’ as cases and deaths surge – WHO

Although January and February saw six consecutive weeks of plummeting COVID-19 cases, the World Health Organization (WHO) chief said that had gone into reverse, with last week yielding “the fourth-highest number of cases in a single week so far”. 

“We have now seen seven consecutive weeks of increasing cases, and four weeks of increasing deaths”, Tedros Adhanom Ghebreyesus told journalists at a regular media briefing. 

Keep physical distancing 

More than 780 million doses of vaccine have now been administered globally, but several Asian and Middle Eastern countries have seen large increases in infections, he said. 

While acknowledging that vaccines are “vital and powerful” instruments, the WHO chief reiterated that they are not the only tools needed to defeat the coronavirus.  

“Physical distancing works. Masks work. Hand hygiene works. Ventilation works. Surveillance, testing, contact tracing, isolation, supportive quarantine and compassionate care – they all work to stop infections and save lives”, Tedros underscored. 

‘Complacency and inconsistency’ 

While stressing the need for “a consistent, coordinated and comprehensive approach” in battling the virus, he said that “confusion, complacency and inconsistency in public health measures and their application, are driving transmission and costing lives”. 

WHO wants to see societies and economies reopening, and travel and trade resuming, instead it is witnessing intensive care units overflowing and people dying, which Tedros maintained “is totally avoidable”. 

He said proven public health measures and strong systems that have enabled countries to respond rapidly and consistently, illustrate that COVID “can be stopped and contained”, adding that those nations are now able to enjoy sporting events, concerts, restaurants and seeing their family and friends safely. 

Increase vaccine output 

Currently, global manufacturing is insufficient to deliver quick, equitable vaccines and other essential health products, according to the WHO official. 

Early in the pandemic, African countries agreed on a coordinated continental approach, “and now they’re coming together for a coordinated approach to scaling up manufacturing”, he said. 

Tedros stressed the importance of investing in “sustainable and secure domestic manufacturing capacity and national regulatory authorities”, asserted that “what can be done today, should be done today”. 

Noting that WHO and its partners have established a COVAX manufacturing taskforce, to increase supply and build a sustainable vaccine manufacturing platform, he offered the UN agency’s technical assistance in assessing the feasibility of local production and to access technology and know-how. 

Bad choices 

Despite continuing transmissions, some countries are re-opening restaurants, night clubs and indoor markets, with too few people taking precautions. 

Moreover, the UN health chief observed that some young people appear to feel that it doesn’t matter if they get COVID-19. 

“Young, healthy people have died. And we still don’t fully understand the long-term consequences of infection for those who survive”, he reminded, echoing reports of some mild cases that have left long-term symptoms, including fatigue, weakness and anxiety. 

While the pandemic is “a long way from over”, Tedros said there were numerous reasons to be optimistic. 

He pointed to the decline in cases and deaths during the first two months of the year as evidence that the virus and its variants can be stopped. 

“With a concerted effort to apply public health measures alongside equitable vaccination, we could bring this pandemic under control in a matter of months”, he attested. 

However, the WHO chief added that this hinges on the decisions and actions that governments and individuals make every day, spelling out: “The choice is ours”.

FROM THE FIELD: providing hope for those living with HIV in Yemen

War, a humanitarian crisis, a looming famine, a health system close to collapse and the deepening impact of the COVID-19 pandemic have led to a “catastrophic situation” in which a woman dies in childbirth every two hours in Yemen, according to the UN Population Fund (UNFPA).

Low-income countries have received just 0.2 per cent of all COVID-19 shots given

Although more than 700 million vaccine doses have been administered globally, richer countries have received more than 87 per cent, and low-income countries just 0.2 per cent. 

“There remains a shocking imbalance in the global distribution of vaccines”, said WHO chief Tedros Adhanonom Ghebreyesus, speaking during the agency’s regular briefing from Geneva.   

“On average in high-income countries, almost one in four people has received a vaccine. In low-income countries, it’s one in more than 500.  Let me repeat that: one in four versus one in 500.” 

Bilateral deals hurt COVAX 

The global solidarity initiative, COVAX, has also experienced a shortage of vaccines.  While the mechanism has distributed some 38 million doses so far, it was expected to deliver nearly 100 million by the end of March. 

“The problem is not getting vaccines out of COVAX; the problem is getting them in”, he said. 

“We understand that some countries and companies plan to do their own bilateral vaccine donations, bypassing COVAX for their own political or commercial reasons. These bilateral arrangements run the risk of fanning the flames of vaccine inequity.” 

Scaling up solidarity 

COVAX partners, who include Gavi, the vaccine alliance, are working on several options to scale up production to meet the goal of delivering two billion doses by the end of the year. 

Dr Seth Berkley, the Chief Executive Officer at Gavi, highlighted the need for continued solidarity. 

“What we are now beginning to see are supply constraints, not just of vaccines, but also of the goods that go into making vaccines”, he said. 

COVAX is in discussions with several high-income countries to get them to share surplus vaccine doses, he said. It is also developing cost-sharing mechanisms so that low income countries can buy additional doses through COVAX, funded by multilateral development banks. 

Dr Berkley added that financing is also needed as demand for vaccines has risen with the emergence of new COVID-19 variants. 

Concern over the ‘raging inferno’ in Brazil 

WHO remains deeply concerned about what one of its experts labelled the “raging inferno of an outbreak” in Brazil, in response to a journalist’s question about scaling up vaccines to address the emergency there. 

South America’s largest country has recorded more than 340,000 deaths since the pandemic began, making it second only to the United States. 

Tedros said he has spoken with the newly appointed health minister, and officials at the federal level, which he hoped will “help with moving forward in our partnership.” 

Continue prevention measures

Dr. Bruce Aylward, a WHO Senior Adviser, described the situation in Brazil as “very, very concerning”.  Delivering more vaccines would have minimal impact, he said, emphasizing the need to continue measures that have proved to slow virus spread. 

“Even by the time you get vaccines into a country, by the time you get them into people – and you’re getting them to a relatively small proportion of the population – that will have a small effect in limiting the risk to some people”, he said. 

“But what you’re dealing with here is a raging inferno of an outbreak, and that requires population-level action in the rapid identification, isolation, quarantining, because you have to approach this at that scale to slow this thing down.” 

Dr. Maria Van Kerkhove, WHO Technical Lead on COVID-19, added that while vaccines are a powerful tool, they alone will not end the pandemic.   

“The trajectory of this pandemic around the world is going in the wrong direction”, she said, referring to six consecutive weeks of increased cases and rising deaths.  

“We have tools right now that can prevent infections and can save lives, so we need to find reasons why measures aren’t in place…and find solutions to actually get these in place.”