WHO rolls out plan to rid world of cervical cancer, saving millions of lives

“Eliminating any cancer would have once seemed an impossible dream, but we now have the cost-effective, evidence-based tools to make that dream a reality”, WHO Director-General Tedros Adhanom Ghebreyesus said in a statement.

The strategy, backed by WHO Member States at the World Health Assembly last week, involves vaccinating 90 per cent of girls by the age of 15, screening 70 per cent of women by the age of 35 and again by the age of 45, and treating 90 per cent of women identified with cervical disease.

‘Big milestone’

“This is a big milestone in global health, because for the first time the world has agreed to eliminate the only cancer we can prevent with a vaccine and the only cancer which is curable if detected early”, WHO Assistant Director-General Dr. Princess Nothemba Simelela told a news conference. “We have an opportunity, as the global health community, to end the suffering from this cancer.”

In latest figures, from 2018, 570,000 women acquired cervical cancer and 311,000 died. Without action to stop it, annual case numbers are projected to reach 700,000, with 400,000 associated deaths, by 2030.

Tackling the disease is expected to bring huge economic dividends because of the improved prospects for women’s participation in the workforce, with $3.20 returned to the economy for every dollar invested – or $26 once the benefits for families, communities and societies are factored in.

Cervical cancer is the fourth most common cancer among women globally. Death rates are three times higher in in low- and middle-income countries than in high-income countries.

The disease is caused by two types of human papilloma virus (HPV), a sexually-transmitted infection that exists in more than 100 different forms, with symptoms that can be painful and stigmatising.

There are already three vaccines available to combat HPV and several more in the pipeline, but currently their availability is skewed towards richer countries, and the world needs to come together to help poorer countries get access to vaccines, said Dr. Simelela.

Diagnoses using AI, within minutes

“There is also new technology that is based on artificial intelligence, which can be used to screen women for cervical cancer. And if these technologies are used, we would be able to get a diagnosis of cervical cancer within 15 to 20 minutes”, she said.

That would be a huge advance from the current timeframes which can be a month or longer, especially if women live far from their nearest health facilities, she said.

No time for complacency as COVID-19 cases surge: WHO chief

WHO chief Tedros Adhanom Ghebreyesus said the UN agency is “extremely concerned” by the surge in cases in some countries, particularly in Europe and the Americas, which is pushing health workers and health systems to breaking point. 

“In this moment when some governments have put all of society restrictions in place, there is once again a narrow window of time to strengthen key systems”, he told journalists. 

‘Playing with fire’ 

WHO and its partners are working with national authorities, to ensure health workers who fall ill will receive proper coverage and that health systems will be ready when safe and effective vaccines are rolled out. 

Tedros again highlighted the actions that have helped to prevent COVID-19 spread, such as contact tracing and cluster investigations, noting that countries which have invested in these areas are facing much less disruption.  

“Those countries that are letting the virus run unchecked are playing with fire”, he stated 

The WHO chief stressed the need for greater action to support health workers but also to keep schools open, protect the vulnerable and safeguard the economy.  

“From calling up students, volunteers and even national guards to support the health response in times of crisis, to putting strict measures in place that allow pressure to be removed from the health system.  There is no excuse for inaction. My message is very clear: act fast, act now, act decisively”, he said 

Encouraging but cautious 

Although welcoming the latest news on COVID-19 vaccines, WHO is awaiting further data on these potential treatments. 

Biotech company Moderna announced on Monday that its experimental vaccine has shown a nearly 95 per cent efficacy rate, according to interim results. 

This follows a recent similar announcement by pharmaceutical companies Pfizer and BioNTech. 

Responding to a journalist’s question, WHO Chief Scientist Dr Soumya Swaminathan called the development “quite encouraging”, while also expressing caution. 

“Of course we need to wait and see what the final efficacy and the safety profile of this vaccine will be when the whole data is analyzed after they reach their primary endpoint, and also have enough follow-up of at least two months of half the trial participants for the side effects.  And that will then be submitted to the regulatory agencies”, she said. 

Ensuring equitable access 

The Moderna vaccine is among nine candidates in the COVAX Facility: a global initiative for equitable vaccine access led by Gavi, the Vaccine Alliance; the Coalition for Epidemic Preparedness Innovations (CEPI), and WHO. 

More than 170 countries have joined the Facility, including some 92 low and middle income nations. 

Discussions with several vaccine manufacturers from across the world is ongoing, said Dr. Swaminathan, who explained other considerations for procurement besides efficacy and safety. 

 “There is an independent prioritization group that is being set up that will look at the dossiers, that will look at the data, that manufacturers are submitting,” she told the briefing.  

“Then there are the cost considerations as well. There is the affordability, and then there are practical considerations like the need for cold storage, the number of doses of vaccine that will be required, the number of doses that may be available early in 2021.” 

Limited supplies 

Dr. Swaminathan expressed hope that results from other vaccine trials currently underway will be released in the coming weeks. 

She underscored the need for the COVAX Facility to have the widest possible selection of vaccine candidates as some will be more applicable in certain situations, or among sub-groups such as the elderly, for example. 

“I think we’re looking at at least the first half of next year, as being a period of very, very limited doses”, she said.   

“Supplies are going to be limited.  There are bilateral deals that many of the companies have done, so many of the doses have already been booked by some countries.” 

She stressed the overall goal of ensuring that health workers and others at high risk of COVID-19 are protected wherever they are located, underscoring the need for global solidarity.

Diabetes increasing COVID risks, showing need to strengthen health systems 

“Many efforts have been made to prevent and treat diabetes”, but the disease continues to rise rapidly in low and middle income countries, those “least well-equipped with the diagnostics, medicines, and knowledge to provide life-saving treatment”, said Secretary-General António Guterres. 

A gloomy picture 

Globally, some 422 million adults are living with diabetes (latest figures from 2014), according to the World Health Organization (WHO), compared to around 108 million in 1980 – rising from 4.7 to 8.5 per cent in the adult population. 

This reflects an increase in associated risk factors, such as being overweight or obese.  

Diabetes is a major cause of blindness, kidney failure, heart attack, stroke and lower limb amputation, and the COVID-19 pandemic has brought additional pain to those requiring regular care and treatment who struggle to access therapies for their condition. 

Hope ahead 

A healthy diet, physical activity and not smoking can prevent or delay Type 2 diabetes, formerly called non-insulin-dependent or adult-onset diabetes, the UN said.  

Moreover, the disease can be treated and its consequences avoided or delayed with medication, regular screening and treatment for complications. 

Next year, WHO is launching the Global Diabetes Compact, “a new initiative that will bring structure and coherence to our complementary efforts to reduce the burden of diabetes”, informed Mr. Guterres. 

“Let us work together to make sure that, through this ambitious and much-needed collaboration, we will soon be talking about the decline in diabetes as a public health problem”.   

Hailing nurses 

The theme for World Diabetes Day 2020 is “The Nurse and Diabetes”, which aims to raise awareness around the crucial role of these health care professionals in supporting people living with diabetes. 

Nurses, who currently account for over half of the global health workforce, also help people living with a wide range of health concerns.  

People living with diabetes face a number of challenges, and education is vital to equip nurses with the skills to support them. 

“As we strive to overcome the pandemic, let us do our utmost to ensure Universal Health Coverage, strengthen health systems and advance good health and resilience for all”, the UN chief said.

COVID-19: Consequences of ‘chronic under-investment in public health’ laid bare: Tedros

Tedros Adhanom Ghebreyesus was making closing remarks at the closing of WHO’s governing body, the World Health Assembly, which finalized its annual session this week after its regular May meeting was cut short by COVID-19 safety requirements.

Historic vaccine advances

The WHO chief highlighted the Pfizer/BioNTech vaccine breakthrough announced this week, which results indicate could be around 90 per cent effective, saying he had “no doubt” that vaccines were a vital tool for controlling the on-going pandemic.

“Never in history has vaccine research progressed so quickly. We must apply the same urgency and innovation to ensuring that all countries benefit from this scientific achievement.

“But we have a long way to go. The world cannot put all its eggs in one basket and neglect the many other tools at our disposal, that countries like Thailand have shown are effective, for bringing this virus under control.”

What works against the virus before inoculation, are isolation, testing and treatment programmes, where the contacts of those infected are traced and then quarantine.

Chronic weakness

The COVID-19 pandemic has “demonstrated the consequences of chronic under-investment in public health”, said Tedros, and the health crisis, “has ignited a socio-economic crisis that has impacted billions of lives and livelihoods and undermined global stability and solidarity. Returning to the status quo is not an option.”

The WHO chief said it wasn’t just more investment that was needed in public health infrastructure, “we must also rethink how we value health.”

New brains trust on health economics

Tedros told the Assembly that that time has now come to think of healthcare as an investment, not a cost, “that is the foundation of productive, resilient and stable economies.”

“To start building that narrative, today I am proud to announce that we are establishing a new Council on the Economics of Health for All, to focus on the links between health and sustainable, inclusive and innovation-led economic growth.”

He said the first virtual session of the Council, which will bring together leading economists and health experts, will likely hold its first virtual session in the coming weeks, to set out its work plan and best way of working.

“The pandemic has also shown that there is an urgent need for a globally agreed system for sharing pathogen materials and clinical samples”, he added, “to facilitate the rapid development of medical countermeasures as global public goods.”

Productive session

Among the Assembly’s achievements through the week were a new roadmap to defeat meningitis by 2030; a new roadmap for neglected tropical diseases; a resolution on scaled-up action on epilepsy and other neurological disorders; the adoption of the Immunization Agenda 2030; the Global Strategy to Accelerate the Elimination of Cervical Cancer as a public health problem; and the Global Strategy for TB Research and Innovation.

“Each of these represents an urgent health priority that affects the lives of millions of people, and which increases the demands on, and expectations of, WHO”, said Tedros.

South Sudan: ‘No child anywhere should suffer from polio’ – UN health agency

To stem the outbreak, the Ministry of Health has formed an emergency task force comprised of the World Health Organization (WHO), the UN Children’s Fund (UNICEF) and other partners, for a quick response and to increase surveillance. 

“No child anywhere should suffer from polio, a completely preventable disease”, said Olushayo Olu, WHO Representative for South Sudan. 

While rare, vaccine-derived poliovirus cases can occur when the weakened live virus in the oral polio vaccine, passes through under-immunized populations. If a population is adequately immunized with polio vaccines, it will be protected from both wild polio and circulating vaccine-derived polioviruses. 

Inoculation campaign 

Because immunization is the only way to stop the potentially deadly virus from spreading, South Sudan launched a campaign on Wednesday, aimed at vaccinating 1.5 million children against polio, according to WHO. 

“There is a lot of love in every needle prick, that is how we are protecting the next generation”, said UNICEF South Sudan Representative, Mohamed Ayoya. 

The first round will target children in 45 counties across seven states, including Northern Bahr El Ghazal, Western Bahr El Ghazal, Warrap, Lakes and Eastern Equatoria, where the 15 cases were confirmed. 

Follow-up campaigns covering more states and counties are planned, beginning in December.  

Ahead of and during the campaigns, social mobilizers will increase immunization awareness and participation by engaging communities and community leaders. 

“I urge all parents to take their children for polio vaccination including those who have already been vaccinated”, encouraged the country’s Minister of Health, Elizabeth Achue. “It is safe to receive an additional dose and we want to make sure every child is protected”. 

Preventable polio 

WHO pointed out that less than 50 per cent of the children in South Sudan are immunized against polio and other life-threatening diseases, putting them at risk of lifelong disability and death.  

Moreover, widespread displacement and continual population movements compounded with COVID-19 restrictions, have further aggravated the country’s immunization coverage and have exacerbated children’s vulnerability to polio, especially those in hard-to-reach areas. 

“Despite the ongoing COVID-19 pandemic and flooding [that is] sweeping much of the country, the campaign provides greater opportunity for vulnerable population to receive critical interventions that could avert life threatening disease such as disability from poliomyelitis”, said Dr. Olu. 

On 25 August, South Sudan along with other African countries was declared polio free because there had not been any outbreaks of wild polio virus in the country for more than ten years.  

Stay vigilant 

To keep every child protected, effective and safe vaccines – along with the commitment of parents, other caregivers and health workers – that led to the virus’ eradication in 47 African countries must continue. 

“Immunization is a must and complacency can kill”, the UNICEF representative underscored. “We must ensure all children in South Sudan are taken for routine immunization, which includes the polio vaccine, so this doesn’t happen again when the outbreak is curbed”.

Neglected tropical diseases: Countries endorse new targets to eradicate 20 killers

“We now have the consensus and the commitment of every country to work in an integrated, cross-cutting manner in tackling all the neglected tropical diseases”, said Dr Ren Minghui, WHO Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases.

2030 targets

The freshly-inked roadmap sets global targets and milestones to prevent, control, eliminate and eradicate 20 neglected tropical diseases and disease groups, which affect hundreds of millions of people.

It replaces the first blueprint published in 2012, whose targets will not be achieved, despite significant progress, WHO explained.

In addition to a focus on improved coordination and collaboration among health partners in the next decade in all countries, another distinct feature is a drive for greater ownership by governments and communities.

The 2030 targets include a 90 per cent reduction in the number of people requiring treatment for neglected tropical diseases and a call to eradicate dracunculiasis – also known as Guinea-worm disease – and the chronic skin disease yaws, that affects mainly children below 15 years of age.

“The new road map addresses critical gaps across multiple diseases, integrates and mainstreams approaches within national health systems and coordinates action across sectors,” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical Diseases. “It also provides us with opportunities to evaluate, assess and adjust programmatic actions as needed over the next decade.”

Vertical v horizontal

The emphasis of the new approach is on sustainability and follows a decades-old discussion about the relative merits of so-called “vertically” funded programmes that target specific illnesses, compared with the longer-term “horizontal” approach that involves comprehensive primary health care services offering greater overall protection.

“To do so effectively…countries must change their operating models and culture to facilitate greater ownership of (disease eradication) programmes”, Dr Minghui added, in a call for “smarter investments and high-level political commitment” to reduce the social and economic consequences of neglected tropical diseases.

Drugs arsenal needed

While most neglected tropical disease-control programmes rely on medicines to treat sufferers, WHO has also warned that emerging drug resistance threatens decades of advances.

It remains crucial to monitor drug efficacy closely and develop “an appropriate arsenal of second-line drugs” to ensure that populations continue to be protected against neglected tropical diseases, it said.

In a related development, COVID-19 had played its part in making communities more vulnerable, the UN agency noted, as some people have taken antibiotics in the mistaken belief that they would protect them from the virus.

Antibiotics alarm

While some countries have seen their antibiotic use dramatically decline during pandemic lockdowns, physical distancing and improved hand and respiratory hygiene, “in other situations, antibiotic use has risen alarmingly”, WHO said.

These challenges are on the agenda at the annual World Antimicrobial Awareness Week (WAAW) from 18-24 November.

Its aims are to increase awareness and understanding of global antimicrobial resistance and encourage best practices among members of the public, health workers and policy-makers, to avoid the further emergence and spread of drug-resistant infections.

‘Bring life to those fighting for breath’, UNICEF urges on World Pneumonia Day 

Marking World Pneumonia Day, on 12 November, UNICEF chief Henrietta Fore, highlighted the coronavirus factor, noting that “while the world grapples with the pandemic and the severe consequences it poses for the most vulnerable, we must not lose sight of the fact that pneumonia continues to claim more than 2,000 young lives every day.” 

Every breath counts  

UNICEF pointed out that medical oxygen, coupled with antibiotics, could save the lives of many children suffering with severe pneumonia.  

However, cost can be prohibitive for the poorest families, as can access to health facilities with functioning oxygen supplies, and trained health workers – all of which are scarce in poorer countries. 

Moreover, the pandemic has seen a surge in demand, making the shortages even more prominent.  

Fortunately, oxygen can be produced locally in even remote parts of the world, at affordable cost. A key part of UNICEF COVID-19 response has been delivering oxygen concentrators, devices that take in air from the environment, remove nitrogen, and produce a continuous source of oxygen.  

As of Wednesday, UNICEF had delivered 15,188 oxygen concentrators to 93 countries.  

“Medical oxygen can help save some of these lives”, stressed Ms. Fore. 

One size does not fit all 

The response, however, is not a one-size-fits-all solution.  

Some settings may have available oxygen plants, cylinder-delivery networks and reliable electricity sources to use a concentrator, while others may not.  

And some areas face import restrictions for certain health supplies, or dwindling health budgets and rising prices set by oxygen suppliers.  

To address this, UNICEF is working with governmentsand partners for unique country solutions, mostly involve a mix of oxygen sources from cylinders, concentrators, plants and liquid oxygen. 

The UN agency’s response has been global, rapid, and multi-faceted as it has supplied medical oxygen to over 90 countries to help fight COVID-19 and keep children and newborns with pneumonia alive.  

Oxygen is the answer   

Although this complex commodity can be challenging to provide, especially in rural settings where electricity, infrastructure and essential health equipment may be in short supply, UNICEF has noted a shift in policy worldwide. 

Over the past year, governments, donors, UN agencies and partners have begun to recognize the importance of this essential medicine in helping people recover from pneumonia, whether COVID-19-induced or not. UNICEF is calling on everyone, to “amplify efforts to bring life to those fighting for breath”.   

UN deputy chief conducts solidarity visit to West Africa and the Sahel

Amina Mohammed began her mission in Nigeria on Monday, where she met with President Muhammadu Buhari in the capital, Abuja. 

Ms. Mohammed later joined the Vice-President, Finance Minister and UN colleagues to launch the UN Plus Offer, which will support Government efforts to address the socio-economic impact of the pandemic. 

The offer seeks to mobilize close to $250 million which will be used to strengthen health systems and responses, and to build a stronger poor-focused social protection system in the country.   

While in Nigeria, Ms. Mohammed also launched the UN Women Global Generation Equality Campaign, along with the Minister of Women’s Affairs.

Promoting recovery and resilience 

Throughout her visit to the region, Ms. Mohammed will highlight how the UN has adapted its operations to support national plans for pandemic response and recovery, while continuing to focus on the root causes of inequalities, said UN Spokesperson Stéphane Dujarric, speaking later that day in New York.   

“She will emphasize the sustainable development programmes that promote socio-economic recovery, gender equality, intergenerational leadership, resilience, climate action—as well as the delivery of lifesaving humanitarian assistance to the most vulnerable”, he told journalists at the daily press briefing from UN Headquarters. 

Ms. Mohammed, who is from Nigeria, is the fifth person, and third woman, to be appointed UN Deputy Secretary-General, a post which was established in 1997. 

She also chairs the UN Sustainable Development Group (UNSDG), comprised of the heads of more than 30 UN agencies, funds and programmes. 

The UNSDG supports countries and territories to achieve the 2030 Agenda, aimed at bringing about a more just and equitable world for all people and the planet.

World can save lives and ‘end this pandemic, together’ – WHO chief

“Many countries heard our call back in January when we rang our highest alarm by calling a public health emergency of international concern”, Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO) told a regular press briefing in Geneva. 

Since then, he explained that they have been working closely with the UN agency, following parameters set out in its strategic response plan, outlined on 4 February.

“They’ve conducted reviews, shared data and experience and honed their response to their national experience and unique situation on the ground”, Tedros continued, adding that they have also been strengthening their responses by using Intra-Action Reviews, which harness “a whole-of-society, multi-sectoral approach” at national and sub-national levels. 

“Intra-Action Reviews not only help countries improve their COVID-19 response but also contribute towards their long-term health security”, the WHO chief upheld. “To date, 21 countries have completed them, and others are in pipeline”.

‘Never too late’

The best time to look at country’s emergency response capacity is during an emergency, “when you can clearly see what works, what doesn’t and what you need to improve”, he said.

And wherever a country is, he maintained that they can “turn it around with a whole-of-government and whole-of-society response”.

“There’s hope, and now is the time to double down on efforts to tackle this virus” Tedros stressed. “We can save lives and livelihoods and end this pandemic, together”.

Health ministers speak  

Having conducted reviews in real-time, the Ministers of Health from Thailand, South Africa and Indonesia, shared their experiences with the WHO chief.

Anutin Charnvirakul explained how Thailand drew on lessons learned from SARS back in 2003 and responded to COVID with a strong public health response led by identifying, isolating, treating cases and tracing and quarantining contacts of those infected.

“We commit to improving our response to COVID-19 by working closely with relevant stakeholders”, he stated.

Meanwhile, Zweli Mkhize gave an overview of the pandemic in South Africa, and how the country utilized the Intra-Action Review, the lessons it had learned and its path forward, which includes new committees at both national and provincial levels to ensure that recommendations being “incorporated into strategic plans” are implemented.

“COVID-19 is still with us and we must remain vigilant and continue to fight together”, he warned. 

And Terawan Agus Putranto, Indonesia’s health minister, said their successful response to the pandemic had been built around “coordination, risk communication and community empowerment.”

He also acknowledged that the country needs to improve on its enforcement of “lockdown restrictions and empowering the community, as agents for change”. 

‘Emergency action’ needed to prevent major polio, measles epidemics

According to the two UN agencies, immunization rates in some countries have fallen by as much as 50 per cent, with people unable to access health services because of lockdown and transport disruptions, or unwillingness due to fear of contracting COVID-19. 

Polio and measles vaccination campaigns, designed to fill gaps in essential services, also had to be paused to prevent possible infection of health workers and communities, while protection measures were put in place. 

“COVID-19 has had a devastating effect on health services and in particular immunization services, worldwide,” said Tedros Adhanom Ghebreyesus, Director-General of WHO. 

 “But unlike with COVID, we have the tools and knowledge to stop diseases such as polio and measles. What we need are the resources and commitments to put these tools and knowledge into action,” he added. 

“If we do that, children’s lives will be saved.” 

‘Urgent call to action’ 

UNICEF and WHO estimate that about $655 million are needed to address dangerous immunity gaps in middle-income countries, which are not eligible for Gavi assistance. Of that figure, $400 million are needed to support polio outbreak response over 2020-2021, and $255 million to prepare for, prevent and respond to measles outbreaks over the next three years. 

Issuing an urgent call to action, the two UN agencies warned that if left unchecked, the situation posed an “increasingly high risk of explosive outbreaks and potentially further international spread of both polio and measles.” 

Henrietta Fore, Executive Director of UNICEF, said that the world “cannot allow” the fight against one deadly disease – COVID-19 – to impact the fight against other diseases. 

“Addressing the global COVID-19 pandemic is critical. However, other deadly diseases also threaten the lives of millions of children in some of the poorest areas of the world. That is why today we are urgently calling for global action from country leaders, donors and partners,” she said. 

“We need additional financial resources to safely resume vaccination campaigns and prioritize immunization systems that are critical to protect children and avert other epidemics besides COVID-19.” 

Respond to emerging outbreaks 

WHO and UNICEF also called on countries to respond urgently to emerging disease outbreaks, prioritize immunization in national budgets and strengthen collaboration with partners for increased synergies. 

They also noted that new tools, including a next-generation novel oral polio vaccine and a forthcoming Measles Outbreak Strategic Response Plan are expected to be deployed over the coming months to help tackle these growing threats in a more effective and sustainable manner, and ultimately save lives. 

FROM THE FIELD: coping with COVID in refugee camps

 One hundred thousand households in Somaliland in northwest Somalia have better access to water, protecting them not just from the ravages of climate change but also against the spread of COVID-19, thanks to a project supported by the UN Development Programme.  

Ahead of global health assembly, WHO stresses need for solidarity, preparation

The reminder comes ahead of next week’s World Health Assembly, the annual meeting of the UN agency’s decision-making body, which normally takes place in May but had to be cut short this year due to the pandemic. 

There are more than 47 million COVID-19 cases, and over 1.2 million deaths, according to latest figures.  The Assembly will chart the course for response and global health priorities. 

Crisis unites the world 

“Although this is a global crisis, many countries and cities have successfully prevented or controlled transmission with a comprehensive, evidence-based approach”, said WHO. 

“For the first time, the world has rallied behind a plan to accelerate the development of the vaccines, diagnostics and therapeutics we need, and to ensure they are available to all countries on the basis of equity. The Access to COVID-19 Tools (ACT) Accelerator is delivering real results.” 

A second message WHO is highlighting now is the importance of not backsliding on critical health goals, including achieving the “triple billion” targets by 2023. 

Don’t neglect health goals 

The goal is to see one billion more people worldwide benefiting from universal health coverage, a further billion more better protected from health emergencies, and around a billion citizens enjoying better health and well-being. 

The World Health Assembly is attended by representatives from more than 190 countries.  Since May, nations have adopted several decisions, including on immunization, healthy ageing, cervical cancer, tuberculosis, eye care and food safety. 

The resumed session will discuss a 10-year plan to address neglected tropical diseases, and other concerns such as meningitis, epilepsy and other neurological disorders, maternal infant and young child nutrition, as well as digital health. 

Prepare for future pandemics 

For its third message ahead of the virtual meeting, WHO stressed the need to prepare now for the next pandemic. 

“We’ve seen this past year that countries with robust health emergency preparedness infrastructure have been able to act quickly to contain and control the spread of the SARS-CoV-2 virus”, said the agency, referring to the virus that causes COVID-19. 

The Assembly will consider a draft resolution that aims to strengthen countries’ preparedness, and to ensure they are better equipped to detect and respond to COVID-19 and other infectious diseases. 

UN boosts efforts 

Relatedly, UN leaders working on sustainable development met virtually on Thursday to assess preliminary results and challenges of joint work supporting more than 160 countries and territories during the pandemic. 

So far, UN teams have repurposed around $3 billion of existing funding, while also mobilizing nearly $2 billion for these efforts, aimed at helping countries to both overcome the crisis and recover better. 

The UN Sustainable Development Group (UNSDG) also outlined some of its actions over recent months. 

‘A development emergency of global proportions’ 

These included supporting authorities with delivering nutrition programmes to nearly five million people, with seven million women receiving maternal health services. 

“For the first time, we all recognize this is a development emergency of global proportions. Governments, communities, and citizens have mobilized accordingly – and our UN teams too have stepped up, together, from the onset of the pandemic to address the health, humanitarian and socioeconomic needs.  In many ways this is an expression of global solidarity and response to the most vulnerable. But much more needs to be done, even faster,” said Amina J. Mohammed, the UN Deputy Secretary-General and the UNSDG Chair. 

UN chiefs have pledged to do more, including to boost data collection as a means to address those most in need

Protecting citizens from COVID while granting refugee access, can be done: UNHCR

Opening a virtual session of UNHCR’s annual Dialogue on Protection challenges, Assistant High Commissioner for Protection, Gillian Triggs, warned that “measures restricting access to asylum must not be allowed to become entrenched under the guise of public health”, 

Instead, she urged States to maintain access for asylum seekers and to safeguard the rights of refugees, together with displaced and Stateless people. 

Ms. Triggs also spoke of the deep and hard-hitting impact on refugees of the coronavirus, including restrictions impeding access to asylum, spiraling gender-based violence, risks of unsafe returns, and the loss of livelihoods.

Speaking out

Participants – consisting of displaced people, non-governmental organizations and Government speakers from Asia, Africa, the Middle East and Europe – discussed how compassion and initiative could help ensure that asylum claims were considered during the pandemic, and protection services adapted to reach people in need during lockdowns.They also pointed to how the pandemic presented greater challenges for the protection of refugees, internally displaced and Stateless people, maintaining the need for solidarity and greater support.

“The pandemic has threatened the social and economic rights of the most vulnerable in society – among them refugees and those forcibly displaced who, all too often, depend on the informal economy”, said the UN official. “They are among the first to suffer the economic impacts of a lockdown”.

Moreover, UNHCR operations also report increasing incidents of discrimination, stigmatization and xenophobia against refugees and displaced people, “exacerbating tensions with local communities”, he added.

Stepping up

UNHCR has been advocating for the urgent inclusion of refugees, displaced and Stateless people in the full range of responses to the pandemic, from public health to national social safety nets.

“The virus does not distinguish between legal status or nationality”, Ms. Triggs reminded. “Access to health services should not depend on citizenship or restrictive visa conditions”. 

She upheld that “a realistic and practical opportunity for protection” lies in social inclusion and in non-discriminatory access to education, health and employment. 

To illustrate the difficulties that refugees and internally displaced people face in the context of the pandemic, UNHCR also launched an interactive report called Space, shelter and scarce resources – coping with COVID-19, which highlights how acutely vulnerable displaced populations must contend with the pandemic.

Backdrop

The High Commissioner’s Dialogue was established more than a decade ago for refugees, Governments, the private sector and international organizations to exchange views on global protection matters.

This year, discussions are being held through five virtual sessions spread over the last quarter of the year, with the closing session to take place on 9 December.

Deputy UN chief pushes Security Council on global ceasefire, to fight ‘common enemy’

“I count on your commitment to this appeal”, Amina Mohammed told the meeting via videoconference, on factors driving civil strife worldwide. “And I count on your renewed political and financial investments in prevention and solutions, to stave off security and conflict risks, at a time when the world needs peace and calm more than ever before”.  

She informed that the pandemic continues to exacerbate the risks and drivers of conflict, “from cross-border insecurity and climate-related threats, to social unrest and democratic deficits”.

“Grievances and inequalities are deepening, eroding trust in authorities and institutions of all kinds, and increasing vulnerabilities”, she said.

Millions of women at risk

The deputy UN chief cited the diverse impacts of the pandemic on economic and social inequalities, as well as on the promotion and protection of human rights, especially for women.

“Parties to conflict are taking advantage of the pandemic to create or aggravate insecurity and impede medical care and other life-saving assistance and services”, she attested.  

At the same time women are disproportionately employed in the sectors most affected by lockdowns – where there is “an alarming spike” in gender-based and domestic violence – and are more likely than men to lack savings, social security and health coverage. 

“How can we talk about peace and security when millions of women are at greatest risk in their own homes? And we know there is a straight line between violence against women and girls, civic oppression and conflict”, stated Ms. Mohammed.

Climate driver

Turning to linkages between climate change and security challenges, she dubbed the climate emergency “a major driver of inequality, insecurity and conflict”. 

She recounted her own fact-finding missions in the Sahel, Lake Chad region and Middle East, noting connections between the large-scale displacement of people and “extreme weather events like droughts and floods that destroy homes, livelihoods and communities”. 

“In some cases, the climate crisis threatens the very existence of nations”, Ms. Mohammed spelled out.

‘Stalled’ development 

The UN official also pointed to “stalled” progress on development that is continually being addressed in a “fragmented” manner.

While noting, “the drivers of conflict are not static: they change and evolve”, so too are the opportunities, including new means for learning and growing, she continued.

“The pandemic has already shown that rapid change is possible, as millions of people adopt new ways of working, learning and socializing”, the deputy chief said, urging everyone to “build forward better”.   

She also maintained that recovering from COVID has “reinforced the need for the 2030 Agenda for Sustainable Development – our ultimate prevention tool”, including on gender equality, and upholding the rule of law and good governance.

She called for a “whole-of-UN approach” to the contemporary challenges and drivers of conflict, which must include all Member States.

‘Unequal world order’

Munir Akram, President of the Economic and Social Council (ECOSOC), attributed the UN’s failure in living up to “the ideals of collective and cooperative security” to an “unequal world order”.

The root causes of conflicts “range from the internal struggles for scarce resources; external contests for precious natural resources, and interventions designed to suppress the struggle of peoples to reclaim their own political and economic destinies”, he said.

COVID factor

And due to the COVID-19 pandemic, the world economy is projected to contract by 5-10 per cent, depending on when the virus can be brought under control, according to the ECOSOC chief. 

Noting that over a 100 million people will likely be pushed back into poverty, he flagged that “as usual”, the poorest countries and people “will suffer the most”. 

Unless they receive financial assistance, Mr. Akram said “many developing economies – with lost revenues and laden with unplayable debt – are likely to face economic collapse”, which “would spread chaos and further inflame regional conflicts and global tensions”. 

A toxic brew

Ibrahim Mayaki, head of the New Partnership for Africa’s Development (NEPAD), painted a picture of African populations migrating to cities, including in largely rural countries, warning that conflict only adds to the difficulties States face in providing services for rural dwellers.

He noted that some African border areas, are virtual magnets for violence perpetrated by armed groups and warned that global warming in the Sahel is bringing about “extreme climate events”.

Chairing the meeting – his Caribbean island nation holding the Council presidency for November – Prime Minister of Saint Vincent and the Grenadines, Ralph Gonsalves, reminded that most of the region’s problems do not have military solutions and rejected any solutions that bypass the needs and aspirations of local populations.

He underscored the Government’s urgent responsibility to “end suffering” especially in conflict settings, adding that current chasms cannot be overcome with “baby steps.” 

Protect children and relief workers caught up in conflict, urges UN rights envoy

Special Representative Virginia Gamba stated that “once again children paying the highest price and the COVID-19 pandemic has put an additional burden on them, their families and communities all over the world”.

“Now more than ever we must all act to protect children and support all international efforts to prevent the spread of COVID-19, particularly in situations of armed conflict”, she asserted.

“I join the UN Secretary-General in his appeal for an immediate global ceasefire in all corners of the world — UN envoy

Needing cover

Ms. Gamba pointed to several incidents, including in Libya, where “the few functional health facilities engaged in the COVID-19 response in Tripoli and Benghazi were repeatedly hit and damaged by shelling”.

And last week in Cameroon, she recalled that “several children were reportedly killed, and several others wounded when a school was attacked in the South-West Region”.

Meanwhile in Somalia, attacks against schools and hospitals by Al-Shabaab continue at “an alarming rate, often in conjunction with other grave violations, such as the abduction and recruitment of children”, added the Special Representative.

“In Afghanistan, indiscriminate attacks on schools, universities and other educational facilities are taking place despite the beginning of historic peace talks”, she continued.

Just today, gunmen disguised as police officers stormed Kabul University, taking hostages, and killing and wounding people. 

Keep schools safe

Parties to conflict, whether Governmental forces or non-State armed groups, must keep schools and hospitals safe and not use them for military purposes, urged the UN envoy. 

“I join the UN Secretary-General in his appeal for an immediate global ceasefire in all corners of the world and, once again, call upon all parties to conflict to abide by their obligations under international law and prevent attacks against education and health facilities, as wellas other civilian infrastructure and protected personnel”, she concluded.
 

‘If we invest in health systems, we can bring this virus under control’ – WHO chief

“Public health is more than medicine and science and it is bigger than any individual and there is hope that if we invest in health systems…we can bring this virus under control and go forward together to tackle other challenges of our times”, UN World Health Organization chief Tedros Adhanom Ghebreyesus told journalists in a regular press briefing.

‘Seize the opportunity’

Speaking via video conference from self-quarantine, having himself been in recent contact with someone who tested positive for COVID-19, the symptom-free WHO chief noted that over the weekend cases spiked in some countries in Europe and North America.   

“This is another critical moment for action…for leaders to step up…for people to come together for a common purpose”, he said. “Seize the opportunity, it’s not too late”.

He also flagged that where cases are going up exponentially and hospitals reaching capacity “patients and health workers alike” are at risk. 

“We need countries to again invest in the basics so that measures can be lifted safely and Governments can hopefully avoid having to take these measures again”, the UN agency chief asserted.

As some countries are putting in place measures to ease the pressure of health systems, he attested that building “stronger systems ensuring quality testing, tracing and treatment measures are all key”.

“WHO will keep working to drive forward science, solutions and solidarity”, the WHO chief concluded.

Battling COVID

To understand more about how hospitals can prepare and cope with COVID-19, three guests spoke about how their countries were coping with the pandemic.

The Republic of Korea went from the second highest caseload of coronavirus patients globally to one of the lowest – without having to lock down the country – by drawing on lessons it learned from the 2015 MERS COVID outbreak, according to Yae-Jean Kim, Professor in the Division of Infectious Diseases and Immunodeficiency Department of Pediatrics, Sungkyunkwan University School of Medicine.

In addition to rapid PCR swab testing and rapid isolation, she explained that physicians for the Republic of Korea, among other things, developed “drive-through testing facilities”; had a community treatment centre for milder cases; prepared public hospitals for high-risk communicable diseases; and had private hospitals pick up overload cases.   

From South Africa, Mervyn Mer, Principal Specialist at Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, said they worked within their capacity to reach the greatest number of people.

Since the pandemic struck South Africa months after other countries, they used their time to draw up a protocol to maximize “everything we feasibly could”, including expanding the capacity of existing hospitals as opposed to putting up field hospitals, he said. 

Meanwhile, new WHO staff member Marta Lado, an infectious disease specialist and chief medical officer of Partners In Health in Sierra Leone, underscored that the 2014-2016 Ebola outbreak had that country how to manage infectious diseases through contact tracing, surveillance, critical care and PPE use.

“One of the most important lessons learned is how we were able to develop a critical care training” that covered monitoring patients vital signs and for shock as well as ventilation and oxygen, she detailed. 

First Person: supporting migrants on the COVID-19 frontline in Myanmar

Myanmar has been preparing for the return of hundreds of thousands of workers – some 650,000 are in Thailand alone – and one of the key tasks was to set up quarantine facilities for those returning migrants. Sandi Swe, who has been working in a quarantine facility since March 2020, shared her experience with UN News. 

April should have been a month of festivities, celebrating Thingyan – the Burmese New Year – but this year has been unlike any other, because of the measures Myanmar has taken to curb COVID-19. As the news of the global pandemic spread, Myanmar’s migrant workers began to return home, and the country has prepared for mass returns by providing safe quarantine facilities. 

Many were established in the border town of Myawaddy, in Kayin State; men and women sheltered in different facilities, and I volunteered to support women migrant returnees. 

I work for a local Myawaddy-based organization, Migrant Monitoring Group (MMG) and, before the pandemic, I had provided awareness-raising training to migrants. I decided to volunteer, even though I was worried, because it didn’t feel right to let fear get in the way. It was simple: everyone needed help, and I could provide that help. 

I started working in the quarantine facility in March and at the beginning, I admit, I took this pandemic very lighly. But day by day, month by month, it is still here. The protective measures are becoming part of our daily routine and we can’t even guess when it will be over.

The number of migrants decreased significantly in the last few months, so aside from cleaning the facilities, we were not that busy and I thought this pandemic was almost over: until now, that is. The rate of return is increasing again, and 100 to 200 migrants are arriving every day. 

In the minds of many people, the issue of migration and returning migrants has  been linked to COVID-19. This job has allowed me to understand the migrants at a deeper level, the challenges they face currently, their anxieties about the present and the future. I believe I understand their situation more clearly and I certainly feel empathy for them. I want to support these people.

It feels good when they ask me for my help, when people need me, especially since I know I can be of assistance and make a difference.

Empowered by helping others

Before the pandemic, I didn’t have any experience of this type of work, but the fact remains that nothing could have prepared me or anyone else for this global emergency. 

I have found time to contemplate how the job empowered me and enriched my life, emotionally, physically and mentally. I have more energy now, and I have to learn to take care of myself and my health, especially if I am to provide more help to others. Before COVID-19, I stayed home most of the time, but working in this environment has shown me that I like to work with other people. 

I pray every day for the pandemic to end quickly. I know I am okay, and it has not affected me too much, but there are others who have lost income and opportunities. I pray for them as well.
 

Long-term symptoms of COVID-19 ‘really concerning’, says WHO chief

“Although we’re still learning about the virus, what’s clear is that this is not just a virus that kills people.  To a significant number of people, this virus poses a range of serious long-term effects,” said WHO chief Tedros Adhanom Ghebreyesus, speaking in Geneva on Friday during the UN agency’s latest virtual press conference. 

The situation also underscores how herd immunity is “morally unconscionable and unfeasible”, he added. 

Vast spectrum of fluctuating symptoms 

The WHO Director-General described the vast spectrum of COVID-19 symptoms that fluctuate over time as “really concerning.” 

They range from fatigue, a cough and shortness of breath, to inflammation and injury of major organs – including the lungs and heart, and also neurological and psychologic effects. 

Symptoms often overlap and can affect any system in the body. 

“It is imperative that Governments recognize the long-term effects of COVID-19 and also ensure access to health services to all of these patients,” he said. 

“This includes primary health care and when needed specialty care and rehabilitation.”  

Seven months ‘evaporated’ 

Three patients – an epidemiologist, a nurse and a 26-year-old software engineer – shared their experiences with COVID-19 and its long-term consequences. 

Professor Paul Garner, an infectious disease epidemiologist at the Liverpool School of Tropical Medicine in England, was “fit and well” when he fell ill with the disease in March.  

For four months, he battled cyclical bouts of fatigue, headaches, mood swings and other symptoms, followed by three months of complete exhaustion. 

“When I overdid things, the illness would echo back, it would come back. And it was completely unpredictable,” he said, speaking via videolink. 

Professor Garner reported that his health has only begun to improve within the past two weeks. 

“I never thought I would have seven months of my life wiped out by this virus,” he said. “It has just gone, evaporated.”

Against herd immunity 

Stories like this underline how people facing the long-term effects of COVID-19 must be given the time and care they need to recover fully, according to the WHO chief. 

“It also reinforces to me just how morally unconscionable and unfeasible the so-called ‘natural herd immunity’ strategy is,” he said, adding, “not only would it lead to millions more unnecessary deaths, it would also lead to a significant number of people facing a long road to full recovery.”

He explained that herd immunity is only possible when a safe and effective COVID-19 vaccine has been distributed globally, and equitably. 

“And until we have a vaccine, Governments and people must do all that they can to suppress transmission, which is the best way to prevent these post-COVID long-term consequences,” he stated. 

Kenya relief bid begins to avert ‘hunger crisis’ among poor workers hit by COVID 

“COVID-19 has caused untold suffering especially to families living in the poor urban areas who normally rely on informal day-to-day employment; many families in the coastal region are struggling just to feed themselves”, said Lauren Landis, WFP’s Kenya Country Director. 

With the help of local and national authorities in Kenya, the World Food Programme (WFP) has begun rolling out aid for more than 400,000 urban poor in COVID-19 hotspots. 

In addition to the 300,000 people in Nairobi receiving aid for the next four months, around 100,000 more in Mombasa will receive three months’ assistance in the coastal city.

“WFP’s support complements other social protection programmes run by the national and county governments”, Ms. Landis explained. “Together, we can avert a hunger and nutrition crisis among poor communities living in urban areas”. 

Monthly support 

Throughout Kenya, some 1.7 million people living in informal settlements have been affected by the COVID crisis amidst surging infection numbers, according to WFP. 

The unemployment rate has doubled to 10.4 per cent, from 5.2 per cent in March when the first cases of COVID-19 were reported, according to the national statistics office. 
 
Once a month, each selected family in need will receive around $40 in local currency, enough to cover half of the monthly food and nutrition needs for a household of four.

Coastal crash 

Travel restrictions and partial lockdowns have devastated Mombasa’s coastal economy, which relies heavily on tourism. 

Mombasa County, which is Kenya’s second largest urban area, accounts for 12 per cent of the number of coronavirus infections in Kenya, the second highest number after the capital, Nairobi, WFP spokesperson Tomson Phiri said. 

“As a result of rising infections, most of the tourism sector was forced to cut its workforce and many businesses either closed entirely or are struggling to stay afloat”, he told journalists via an online briefing in Geneva.  

The UN agency is also partnering with the national and local government to support malnutrition treatment for some 6,000 children and women in Mombasa. This involves providing a nutritious peanut-based paste for children and fortified flour for malnourished mothers.   

Tough neighbourhood 

Outside Kenya, which is Africa’s third-largest economy, WFP warned that countries with large numbers of urban poor living in crowded slums were also vulnerable. 

These included Nigeria, Africa’s wealthiest nation, where the agency only recently announced measures to help struggling families to cope with the economic fallout of the pandemic in the three urban pandemic hotspots of Abuja, Kano and Lagos.  

In Somalia, where WFP already supports 125,000 in urban areas, the agency plans to assist up to 450,000 internally displaced people who are likely to be impacted by COVID-19. 

WFP has also increased its overall relief plan in response to the triple shock of COVID-19, the desert locust invasion and flooding. 

In South Sudan, on top of regular assistance provided to five million people a month, WFP intends to assist an additional 1.6 million individuals in mainly urban settings who face rising food needs linked to COVID-19.