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  • World Health Worker Week – April  5 – 11, 2020

    The COVID-19 pandemic and different international emergencies present us as soon as once more the heroic efforts well being staff on the entrance traces make day-after-day to maintain their communities—and the world—protected and wholesome.  The WHO and the Global Health Workforce Network is happy to associate with civil society companions—the Frontline Health Workers Coalition and its members—to honor well being staff throughout World Health Worker Week: April 5-11, 2020. The Eighth Annual World Health Worker Week is yet one more alternative to mobilize communities, companions, and policymakers to extend assist of well being staff worldwide.

    The 2020 theme is Leaders on the Front Line. This theme highlights the want to offer higher management alternatives for frontline well being staff—significantly ladies well being staff, who make up greater than 70% of the worldwide well being workforce. At the identical time, this theme emphasizes how well being staff usually put themselves on the road, usually at nice private danger to themselves and their households, to avoid wasting and enhance lives.

    We invite all well being workforce stakeholders to affix us by elevating public consciousness and fascinating on well being workforce points, and acknowledge the lifesaving contribution of the well being workforce. All actions can be filtered by a World Health Worker Week portal, hosted by the Frontline Health Workers Coalition secretariat at IntraHealth International.

     Some key methods to get entangled:

    • Add your voice to the #WHWWeek dialog on social media! Use the WHWW Social Media Guide with key messages, graphics, and steered tweets.
    • Participate within the WHWW Video Testimonial Series and inform well being policymakers why frontline well being staff are Leaders on the Line and the way we will higher assist them. It’s straightforward to participate—see the guidance and add your video.
    • Celebrate World Health Day on Tuesday, April 7. In this International Year of the Nurse and the Midwife, World Health Day will shine a lightweight on the important function nurses and midwives play in offering well being care world wide, and name for a strengthening of the nursing and midwifery workforce. Share and promote World Health Day belongings here.

     

     

    World Health Worker Week - April  5 - 11, 2020
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    https://www.who.int/news-room/detail/02-04-2020-world-health-worker-week-2020

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  • Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem 1

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem 2


    A lot of legal issues are bound to arise as an aftermath of the outbreak of Coronavirus otherwise referred to as COVID-19.  There is therefore a need to shed light on some of the issues that may arise and how to navigate them. This article will x-ray the rights of patients, the rights of health workers and the basic minimum obligations of the government.

    The Code of Medical Ethics in Nigeria 2008 lists acts that constitute professional negligence. Rule 29.4 of the Code outlines some of these acts as follows:-

    a)      Failure to attend promptly to a patient requiring urgent attention when the practitioner was in a position to do so;

    b)     Manifesting incompetence in the assessment of a patient;

    c)      Making an incorrect diagnosis particularly when the clinical features were so glaring that no reasonable skillful practitioner could have failed to notice them; 

    d)     Failure to advise, or proffering wrong advice to  a patient on the risk involved in a particular operation or course of treatment, especially if such an operation or course of treatment is likely to result in serious side effects like deformity or loss of organ, or function;

    e)      Failure to obtain the informed consent of the patient before proceeding on any surgical procedure or course of treatment when such consent was necessary; 

    f)       Making a mistake in treatment e.g. amputation of the wrong limb, carelessness that results in the termination of a pregnancy, prescribing the wrong drug, or dosage in error for a correctly diagnosed ailment, etc;

    g)     Failure to refer, or transfer a patient in good time, when such a referral or transfer was necessary;

    h)     Failure to do anything that ought reasonably to have been done under any circumstance for the good of the patient;

    i)       Failure to see a patient as often as his medical condition warrants or to make appropriate comments in the case notes of the practitioner’s observations and prescribed treatment during such visits. It also includes failure to communicate with the patient or with his relatives as may be necessary with regards to any developments, progress or prognosis in the patient’s condition.

     

    Rule 11.2 of the 2008 Code of Medical Ethics in Nigeria provides that, “A physician shall preserve absolute confidentiality on all he knows about his patient even after the patient has died.”

                 Rule 44 of the Code of Medical Ethics has extensive provisions on Confidentiality and when disclosure of information can be made. The Rule provides in part that:

    “Disclosure of information on the patient by the doctor can only be made following an informed consent of the patient in writing. It is clear that the ethic covers even such information as induced abortion, venereal disease, attempted suicide, concealed birth and drug dependence but would exclude situations in which a discretionary breach of confidentiality is necessary to protect the patient or the community from danger and this must be made clear to the patient at the time of the confidential disclosure. Where statutory notification of disease is involved, the consent of the patient is not required.”            

                Confidentiality: To Disclose Identity Of Covid-19 Patients Or Not To Disclose?

    COVID-19 is an infectious disease caused by a newly discovered coronavirus. Most people infected with the COVID-19 will experience mild to moderate respiratory illness and recover without requiring special treatment.  Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.[1]

    The Federal Ministry of Health confirmed the first case of COVID-19 in Nigeria on the 27th of February 2020. It is the case of an Italian citizen who works in Nigeria and returned from Milan, Italy to Lagos, Nigeria on the 25th of February 2020. In reaction to the report, the social was divided between those who want the name of the Italian disclosed and those that preferred it remains confidential. The outcry was even more when the Chief of Staff to the President tested positive according to reports from various media houses[2], but the Minister of Health decided to keep mute on the identity of the President’s aide who contacted the virus, citing confidentiality.

    It will ordinarily be wrong to disclose the medical status of someone infected with COVID-19, for instancethe case of the Italian who was the index case. However in view of the proviso to Rule 44 of the Code of Medical Ethics 2008 which provides that a discretionary breach of confidentiality is necessary in order to protect the community from danger, I am of the view that the test results of popular figures who hold strategic offices like the Chief of Staff to the President or a Governor must be disclosed to guaranty public safety. This is necessary in view of the countless number of people from all works of life they come in contact with on a daily basis.  It will be correct to have made their status public in the overriding interest of the public, since it will enable those who have come in contact with them isolate, just like we have seen in the cases of the British Prime Minister, the Bauchi State Govenor, Prince Charles, the First Lady of Canada and many more. We must commend those who announced their status in public themselves-it is the best thing to do in the interest of humanity

    The World Health Organization (WHO) provides additional guidelines for the management of coronavirus patients specifically.[3]

    Health workers should:

    •follow established occupational safety and health procedures, avoid exposing others to health and safety risks and participate in employer-provided occupational safety and health training; 

    •use provided protocols to assess, triage and treat patients; 

    •treat patients with respect, compassion and dignity; 

    •maintain patient confidentiality; 

    •swiftly follow established public health reporting procedures of suspect and confirmed cases; 

    •provide or reinforce accurate infection prevention and control and public health information, including to concerned people who have neither symptoms nor risk;

    •put on, use, take off and dispose of personal protective equipment properly;

    •self-monitor for signs of illness and self-isolate or report illness to managers, if it occurs; 

    •advise management if they are experiencing signs of undue stress or mental health challenges that require support interventions; and 

    •report  to  their  immediate  supervisor  any  situation  which  they  have  reasonable  justification  to  believe presents an imminent and serious danger to life or health.

     

    Doctors and health workers in Nigeria must endeavor to digest the guidelines in the Code of Medical Ethics as well as the WHO Guidelines for management of Coronavirus victims and ensure they work strictly by their provisions. A breach of these duties have dire consequences. 

    Options Available To Covid-19 Patients Who Are Victims Of Medical Negligence

    A Coronavirus patient who has suffered medical negligence has a number of options:

    1. He could file a complaint with the regulatory body (e.g. the Medical and Dental Council of Nigeria, in the cases involving a Doctor). The Doctor will in the first instance be investigated by the Medical and Dental Practitioners Investigation Panel, after which he will be tried by the Medical and Dental Practitioners Disciplinary Tribunal. If found culpable,  the Doctor may be warned, suspended from practicing for a period not exceeding 6 months or in very serious cases, have his name can be removed from the Register of Medical Practitioners. The Medical and Dental Practitioners’ Disciplinary Tribunal does not award monetary damages.

    2. A suit can be filed against the Medical Doctor, the Hospital, Agency or Government in the High Court for Medical Negligence and monetary damages will be awarded if the Defendant(s) are found culpable.

          3.  If there is an element of Crime, a report could be made to the Police who would conduct Criminal Investigation and where the investigation reveals gross negligence, recklessness or wanton disregard for life of the victim, the police can prosecute or forward the case file to the office of the Attorney General of the State for possible prosecution in deserving cases.  

    A Need To Do More For Doctors And Other Professionals In The Health Sector

    Health workers are at the front line of any outbreak response and as such are exposed to hazards that put them at risk of infection with an outbreak pathogen (in this case COVID-19). Hazards include pathogen exposure, long working  hours,  psychological  distress,  fatigue,  occupational  burnout,  stigma,  and  physical  and  psychological violence. 

    During the outbreak of Ebola more than 500 health care workers died in Guinea, Liberia and Sierra-Leone alone. We also lost some of our finest doctors and health workers to the disease in Nigeria, the most prominent being Dr. Stella Adadevoh, who is credited with having curbed a wider spread of the Ebola virus in Nigeria by placing the index patient, Patrick Sawyer, in quarantine despite pressures from the Liberian  government. As we speak, The coronavirus is waging a war of attrition against health care workers throughout the world, but nowhere is it winning more battles at the moment than in Italy and in Spain, where protective equipment and tests have been in severely short supply for weeks. In Spain 13.6% (6500) of those affected with the coronavirus are health workers and in Italy 10% (7400) of those affected with the virus are health workers. [4] In New York dozens of health workers have been affected with the virus, while hundreds are in quarantine.[5] According to reports filtering in as the time of concluding this article, three health workers have been infected with COVID-19 in Abuja, Nigeria.[6]

    Human Rights Watch research into health system collapse in Hungary and Venezuela suggests the nations’ mismanaged, underfunded, and understaffed public healthcare system is poorly equipped to handle a COVID-19 outbreak. Patients and medical experts described a lack of basic hygiene protocol, lack of isolation rooms, and a shortage of health professionals, doctors and nurses, and medical supplies in general.

    The situation is not too different in Nigeria at the moment and except something drastic is done we might be witnessing a devastating effect of the pandemic. Nigeria’s, public health capacity has been diminished by large scale public sector corruption. Medical personnel lack surgical masks and local supplies have been diverted and shipped to other markets partly due to corruption. Many states are ill-prepared to combat the impeding surge in patients. A senior health worker with a government hospital in Abuja, in an interview with Sahara Reporters, lamented the lack of quality Personal Protective Equipment for them, adding that government must invest in the protection of health workers at the frontline of the battle against the virus. He said, “The unfortunate thing is that the government is not providing us with what to work with. It is sad that our PPE are not up to the world standard and can be penetrated by viruses. Some of us (health workers) have to use our personal funds to purchase gloves as we do not trust the ones government supplied. Nigerians should please remember us in their prayers and government should provide us with what we really need to work.” [7]

    There was report that in Bauchi State a Coronavirus patient rejected the isolation centre at the Bauchi Specialist Hospital and went back home while describing it as “too dirty”.[8]  

    It is disappointing to hear that the hazard allowance for doctors and health workers is N5,000 per month in Nigeria. The amount is very paltry compared to the risks and the attendant emotional and psychological stress suffered by the health-care workers (HWCs) particularly during monumental outbreaks like this. Unfortunately, when a patient is mismanaged, these doctors and health workers bear the burden of paying huge compensation and sometimes losing their jobs. More importantly, the brain-drain in the health sector is monumental, almost all my friends who are doctors, work abroad. Unfortunately, there are concerted efforts by the US Government to engage foreign Doctors to further fortify its health work force as COVID-19 ravages. Many young Nigerian doctors are already considering the offers because the Nigerian government has paid little attention to their welfare and the welfare of the general health workforce. To stop the exodus of our doctors, who are already in short supply, the government must act fast by improving their welfare packages in line with acceptable international standards.

    The psychological needs of doctors and health workers are also often ignored. Unsafe working conditions contribute to health worker attrition in many countries due to work-related illness and injury and the resulting fear of health workers of occupational infection, including from HIV and Tuberculosis. The 2006 World Health Report – Working Together for Health reported on a severe health workforce crisis in fifty-seven countries, most of them in Africa and Asia. [9]

    Protecting the occupational health of health workers is critical to having an adequate workforce of trained and healthy health personnel. Governments at the Federal and State levels are urged to do more by complying fully with the World Health Organization’s guidelines regarding the Rights of Health Workers while combating COVID-19. Some of the rights are:

    ·         assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks;

    ·         provide information, instruction and training on occupational safety and health, including; Refresher training on infection prevention and control(IPC); and Use, putting on, taking off and disposal of personal protective equipment(PPE);

    ·         provide adequate IPC and PPE supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity to healthcare or other staff caring for suspected or confirmed COVID-19 patients, such that workers do not incur expenses for occupational safety and health requirements;

    ·         not be required to return to a work situation where there is continuing orserious danger to life or health, until the employer has taken any necessary remedial action;

    ·         allow workers to exercise the right to remove themselves from a work situation that they have reasonable justification to believe presents an imminent and serious danger to their life or health. When a health worker exercises this right, they shall be protected from any undue consequences; 

    ·         honour the right to compensation, rehabilitation and curative services if infected with COVID-19 following exposure in the workplace. This would be considered occupational exposure and resulting illness would be considered an occupational disease,

    ·         provide access to mental health and counselling resources; and 

    ·         enable co-operation between management and workers and/or their representatives. Etc.

    In conclusion, professional care givers for COVID-19 patients should uphold four basic principles formulated by Beauchamp and Childress in their book ‘Principles of Biomedical Ethics’ in order to protect themselves from liability for negligence. The four basic principles are autonomy, beneficence, non-maleficence and justice.

    Autonomy: People have the right to control what happens to their bodies. This principle simply means that an informed, competent adult patient can refuse or accept treatments, drugs, and surgeries according to their wishes. People have the right to control what happens to their bodies because they are free and rational. And these decisions must be respected by everyone, even if those decisions aren’t in the best interest of the patient.

    Beneficence: All healthcare providers must strive to improve their patient’s health, to do the most good for the patient in every situation. But what is good for one patient may not be good for another, so each situation should be considered individually. And other values that might conflict with beneficence may need to be considered.

    Non-maleficence: “First, do no harm” is the bedrock of medical ethics. In every situation, healthcare providers should avoid causing harm to their patients. You should also be aware of the doctrine of double effect, where a treatment intended for good unintentionally causes harm. This doctrine helps you make difficult decisions about whether actions with double effects can be undertaken.

    Justice: The fourth principle demands that you should try to be as fair as possible when offering treatments to patients and allocating scarce medical resources. You should be able to justify your actions in every situation. For instance, it will amount to a professional misconduct for a Health-care Worker to remove a poor man from the ventilator because a Senator was rushed in. 

    Ahmed Adetola-Kazeem is a partner in Adetola-Kazeem Legal Practice and specializes in Medical and Health Law

    Email: aadetolakazeem@gmail.com;aadetolakazeem@gaklp.com

    [1] https://www.who.int/health-topics/coronavirus#tab=tab_1(Accessed on the 28th of March 2020)

    [2] https://businessday.ng/coronavirus/article/abba-kyari-tests-positive-for-coronavirus-buhari-negative/

    https://www.channelstv.com/2020/03/24/buharis-chief-of-staff-abba-kyari-reportedly-tests-positive-for-coronavirus/ (Accessed on the 28th of March 2020)

    [3] Coronavirus Disease (Covid-19) Outbreak: Rights, Roles and Responsibilities Of Health workers, Including Key Considerations For Occupational Safety And Health”. https://www.who.int/docs/default-source/coronaviruse/who-rights-roles-respon-hw-covid-19.pdf?sfvrsn=bcabd401_0   (Accessed on the 26th of March 2020)

    [4] https://abcnews.go.com/Health/wireStory/collapsing-virus-pummels-medics-spain-italy-69789413 (Accessed on 26th March 2020)

    [5] https://www.washingtonpost.com/health/covid-19-hits-doctors-nurses-emts-threatening-health-system/2020/03/17/f21147e8-67aa-11ea-b313-df458622c2cc_story.html (Accessed on 28th of March 2020)

    [6] http://saharareporters.com/2020/03/28/exclusive-two-nurses-one-doctor-infected-coronavirus-abuja-hospital

    [7] Supra

    [8] https://www.dailytrust.com.ng/coronavirus-patient-rejects-bauchi-isolation-centre-returns-home.html (Accessed on 28th March 2020)

    [9] https://www.who.int/occupational_health/topics/hcworkers/en/(Accessed on 26th March 2020)

     

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    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem
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  • Prihatin: ‘No record’ individuals can make new applications, says IRB

    Prihatin: ‘No record’ individuals can make new applications, says IRB

    Prihatin: ‘No record’ individuals can make new applications, says IRB 3

    KUALA LUMPUR: Individuals who received a ‘no record’ result when checking the Bantuan Prihatin Nasional (BPN) aid via the Inland Revenue Board (IRB) official portal can make new applications online until April 30.

    All they have to do is to click on the ‘new application’ icon and follow the instructions given to make the application.

    IRB said in a statement today that manual applications using the form was not possible now as all IRB premises would be temporarily closed until the Movement Control Order (MCO) period ends on April 14.

    According to IRB, appeals on unsuccessful applications could be submitted through the agency’s official portal https://www.hasil.gov.my or https://bpn.hasil.gov.my starting April 3.

    However, Bantuan Sara Hidup (BSH) aid recipients in the B40 group and the M40 who have income tax data with the IRB do not need to register for the BPN.

    The BSH recipients are automatically eligible for BPN, while the M40 group will be evaluated based on the amount of income and other criteria set by the government.

    Due to high traffic to access the official portal, the public were advised to check their status during non-peak hours.

    The situation occurred because the application for BPN was opened today.

    BPN is part of the initiatives under the Prihatin Rakyat Economic Stimulus Package (Prihatin) announced by Prime Minister Tan Sri Muhyiddin Yassin recently.

    The Hasil Care Line (HCL) call centre, which resumed operation on March 30, operates throughout the MCO period from 9am to 5pm from Sundays until Fridays and could be reached at 03-89111000 or +603-89111000 for those who are abroad.

    Any enquires concerning the BSH can be directed to the toll-free line at 1800-88-2747. – Bernama

    Prihatin: ‘No record’ individuals can make new applications, says IRB
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    https://www.thesundaily.my/local/prihatin-no-record-individuals-can-make-new-applications-says-irb-AY2203929

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  • Joint Statement by QU Dongyu, Tedros Adhanom Ghebreyesus and Roberto Azevedo, Directors-General of the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Trade Organization (WTO)

    Millions of people around the world depend on international trade for their food security and livelihoods. As countries move to enact measures aiming to halt the accelerating COVID-19 pandemic, care must be taken to minimise potential impacts on the food supply or unintended consequences on global trade and food security. 

    When acting to protect the health and well-being of their citizens, countries should ensure that any trade-related measures do not disrupt the food supply chain. Such disruptions including hampering the movement of agricultural and food industry workers and extending border delays for food containers, result in the spoilage of perishables and increasing food waste. Food trade restrictions could also be linked to unjustified concerns on food safety. If such a scenario were to materialize, it would disrupt the food supply chain, with particularly pronounced consequences for the most vulnerable and food insecure populations. 

    Uncertainty about food availability can spark a wave of export restrictions, creating a shortage on the global market. Such reactions can alter the balance between food supply and demand, resulting in price spikes and increased price volatility. We learned from previous crises that such measures are particularly damaging for low-income, food-deficit countries and to the efforts of humanitarian organizations to procure food for those in desperate need.

    We must prevent the repeat of such damaging measures. It is at times like this that more, not less, international cooperation becomes vital. In the midst of the COVID-19 lockdowns, every effort must be made to ensure that trade flows as freely as possible, specially to avoid food shortage. Similarly, it is also critical that food producers and food workers at processing and retail level are protected to minimise the spread of the disease within this sector and maintain food supply chains. Consumers, in particular the most vulnerable, must continue to be able to access food within their communities under strict safety requirements.  

    We must also ensure that information on food-related trade measures, levels of food production, consumption and stocks, as well as on food prices, is available to all in real time. This reduces uncertainty and allows producers, consumers and traders to make informed decisions. Above all, it helps contain ‘panic buying’ and the hoarding of food and other essential items.

    Now is the time to show solidarity, act responsibly and adhere to our common goal of enhancing food security, food safety and nutrition and improving the general welfare of people around the world.  We must ensure that our response to COVID-19 does not unintentionally create unwarranted shortages of essential items and exacerbate hunger and malnutrition.

    Read More
    https://www.who.int/news-room/detail/30-03-2020-joint-statement-by-qu-dongyu-tedros-adhanom-ghebreyesus-and-roberto-azevedo-directors-general-of-the-food-and-agriculture-organization-of-the-united-nations-(fao)-the-world-health-organization-(who)-and-the-world-trade-organization-(wto)

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  • Medical Product Alert N°2/2020

    Medical Product Alert N°2/2020

    This Medical Product Alert relates to a confirmed falsified human immunodeficiency virus (HIV) in vitro diagnostic medical device (IVD) that has been identified circulating in Guyana and Kenya.

    Through its Global Surveillance and Monitoring System (GSMS) for substandard/falsified medical products,
    WHO was informed that at least 8,240 falsified rapid diagnostic tests to detect HIV-1/2 have been distributed in Guyana at end-user level. The product is Uni-Gold™ HIV and claims to be manufactured by
    Trinity Biotech plc. Subsequent reports
    revealed that the same falsified product is also circulating in Kenya.

    Uni-Gold™ HIV is a single-use rapid diagnostic test – an immunoassay for the qualitative detection of antibodies to HIV-1 and HIV-2 in serum, plasma and whole blood. Uni-Gold™ HIV is intended for use in point of care settings as an aid
    in diagnosis of HIV-1 and HIV-2 infection.

    The WHO testing strategy recommends three HIV reactive test results to confirm an HIV-positive status in a
    patient. The use of this falsified Uni-Gold™ HIV, subject of WHO medical product alert n°2 of 2020, is likely to lead to delayed diagnosis of HIV status.

    Table 1: Specific details of the falsified product Uni-Gold™ HIV, subject of WHO Medical Product Alert n°2 of 2020

    Product Name

    Uni-Gold™ HIV

    Lot Number

    HIV7120026

    Expiry Date

    5 DEC 2020

    Stated manufacturer

    Trinity Biotech

    The packaging of this falsified HIV test kit is in English.

    The genuine manufacturer (Trinity Biotech plc) has confirmed that:

    • They did not manufacture the falsified product in Table 1.
    • Genuine lot HIV7120026 was made by Trinity Biotech plc and expired in 2019.
    • The expiry date is incorrect and does not correspond with their batch manufacturing records.

    Photographs and advice to the public are available below.

    Figure 1 – Falsified Uni-Gold™ HIV, lot number HIV7120026, displaying falsified expiry date

     

    Falsified UniGold HIV Images 1 and 2 Alert

    Figure 2 – Falsified Uni-Gold™ HIV, displaying labelling inconsistencies

    Falsified UniGold HIV Image 3 Alert

     

    Advice on action to be taken by end-users:

    • Please check to see if any Uni-Gold™ HIV test kits in your facility have lot number HIV7120026.
    • If you are in possession of these falsified test kits with lot number HIV7120026:
    1. Please do not use.
    2. Please immediately contact the organization that supplied you with the product (either your HIV testing programme, nongovernmental organization or local distributor).
    3. Please contact Trinity Biotech plc

    Phone : +353 1 276 9800

    E-mail : hiv@trinitybiotech.com

    1. Please contact your national health authorities

    All medical products must be obtained from authentic and reliable sources. Their authenticity and condition should be carefully checked.

    Advice on action to be taken by national health authorities:

    WHO requests increased scrutiny within the supply chains of all countries, particularly at testing sites (health facilities, community-based), clinical laboratories, medical stores/warehouses, and at the facilities of relevant economic operators (agents,
    authorized representatives, distributors, wholesalers, etc.).

    If these falsified test kits with lot number HIV7120026 are discovered, please do not use.

    National health authorities are asked to immediately inform WHO, if these falsified products are discovered in their country using the WHO IVD complaint form.

    If you have any information concerning the manufacture, distribution, or supply of this product, please contact rapidalert@who.int

     

    WHO Global Surveillance and Monitoring System for Substandard and Falsified Medical Products

    For further information, please visit our website: https://www.who.int/medicines/regulation/ssffc/en/ 
     

    Medical Product Alert N°2/2020
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    https://www.who.int/news-room/detail/27-03-2020-medical-product-alert-n-2-2020

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  • New WHO Guide to help countries expand access to essential medicines

    New WHO Guide to help countries expand access to essential medicines

    WHO’s   new user guide for countries, ‘Selection of medicines at country level’, is based on the WHO Model List of Essential Medicines. It sets out the key actions countries should undertake to develop and update their own
    national essential medicines lists based on the treatment needs of their populations and their capacity to reimburse payments for medicines.

    The document also aims to support countries in progressing towards universal health coverage. Today, approximately half of the world’s population is unable to  access essential medicines. The large majority of these people live in poorer countries,
    but rising prices of new medicines are also becoming a challenge for health systems in wealthy countries.

    A careful selection of essential medicines is the first step in ensuring a population can obtain the quality-assured medicines it needs at an affordable price.  Countries need to do more to ensure that all people and communities can access highly
    effective medicines. WHO’s new manual is a resource to do just that. 

    The document, intended for policy makers in charge of national medicines and reimbursement lists, aims to increase transparency on how essential medicines are selected. Most national lists of essential medicines have several differences when compared
    with WHO’s model list, which lists only medicines of proven safety and efficacy. Some national lists include medicines that bring little extra benefit to patients. Decision-makers should refer to the WHO global list to gauge the public health
    value of listing certain medicines for their populations.

    The essential medicines concept 

    Essential medicines are: 

    • those that satisfy the priority health care needs of the population
    • selected with due regard to disease prevalence and public health relevance, evidence of efficacy and safety, and comparative cost-effectiveness
    • intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and community can afford.  

    The essential medicines concept is global and forward-looking. It incorporates the need to regularly update medicines selections to reflect new therapeutic options and changing therapeutic needs; the need to ensure drug quality; and the need for continued
    development of better medicines, medicines for emerging diseases and medicines to meet changing resistance patterns.

    Achieving universal health coverage and equity in public health depends on access to essential, high-quality and affordable health related technologies for all. To achieve access for all by 2030, at least two billion more people will need to have access
    to essential health services by 2030.

    In an effort to make the Model List of Essential Medicines more readily accessible, WHO recently developed an electronic version of the list, bringing the traditional EML to computer screens, tablets and smartphones in a freely accessible, downloadable,
    online database.

    Link to manual: Selection of essential medicines at country level

    Link to e-EML: Model List of Essential Medicines

    New WHO Guide to help countries expand access to essential medicines
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    https://www.who.int/news-room/detail/30-03-2020-new-who-guide-to-help-countries-expand-access-to-essential-medicines

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  • WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic

    WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic

    The COVID-19 pandemic is straining health systems worldwide. The rapidly increasing demand on health facilities and health care workers threatens to leave some health systems overstretched and unable to operate effectively.

    Previous outbreaks have demonstrated that when health systems are overwhelmed, mortality from vaccine-preventable and other treatable conditions can also increase dramatically. During the 2014-2015 Ebola outbreak, the increased number of deaths caused
    by measles, malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola
    [1,2]. 

    “The best defense against any outbreak is a
    strong health system,” stressed WHO Director-General Tedros Adhanom Ghebreyesus.
    “COVID-19 is revealing how fragile many of the world’s health systems and
    services are, forcing countries to make difficult choices on how to best meet
    the needs of their people.”

    To help countries navigate through these challenges, the World Health Organization (WHO) has updated operational planning guidelines in balancing the demands of responding directly to COVID-19 while maintaining essential health service delivery, and mitigating
    the risk of system collapse. This includes a set of targeted immediate actions that countries should consider at national, regional, and local level to reorganize and maintain access to high-quality essential health services for all.

    Countries should identify essential services that will be prioritized in their efforts to maintain continuity of service delivery and make strategic shifts to ensure that increasingly limited resources provide maximum benefit for the population. They
    also need to comply with the highest standard in precautions, especially in hygiene practices, and the provision of adequate supplies including personal protective equipment This requires robust planning and coordinated actions between governments
    and health facilities and their managers.

    Some examples of essential services include: routine vaccination; reproductive health services including care during pregnancy and childbirth; care of young infants and older adults; management of mental health conditions as well as noncommunicable diseases
    and infectious diseases like HIV, malaria and TB; critical inpatient therapies; management of emergency health conditions; auxiliary services like basic diagnostic imaging, laboratory services, and blood bank services, among others.

    Well-organized and prepared health systems can continue to provide equitable access to essential service delivery throughout an emergency, limiting direct mortality and avoiding increased indirect mortality. 
     

    The guidelines stress the importance of keeping up-to-date information. This requires frequent transparent communications with the public, and strong community engagements so the public   can maintain trust in the system to safely meet their
    essential needs and to control infection risk in health facilities. This will help ensure that people continue to seek care when appropriate, and adhere to public health advice.

    1. Elston, J. W. T., Cartwright, C., Ndumbi, P., & Wright, J. (2017). The health impact of the 2014–15 Ebola outbreak. Public Health, 143, 60-70.

    2. Parpia, A. S., Ndeffo-Mbah, M. L., Wenzel, N. S., & Galvani, A. P. (2016). Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerging infectious diseases, 22(3), 433.

     

    For interviews please contact:  Tarik Jasarevic

    To access the full guidance please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/maintaining-essential-health-services-and-systems

    For further information and guidance on COVID-19 please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

     

     

    WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic
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  • World TB Day 2020 Newsletter

    World TB Day 2020 Newsletter

    Latest news and updates from WHO

    World TB Day 2020 Newsletter 4

    Dear colleagues and friends,

    World TB Day, this year, comes at a sobering time – as the world grapples with the COVID-19 pandemic. We stand in solidarity with those affected, those at the frontlines of the fight to combat COVID-19, as well as those who continue efforts to support
    those ill with longstanding health problems like TB, HIV and other diseases. However, we cannot forget the millions and their families who battle TB every day and lose their lives to this ancient disease – which remains the world’s top
    infectious killer.

    As eloquently emphasized by WHO Director-General Dr Tedros Adhanom Ghebreyesus in his press briefing on COVID-19 yesterday, “I’d like to remind everyone that although COVID-19 is dominating the world’s attention-there is another respiratory
    disease that is both preventable and treatable, but kills 1.5 million people every year – that disease is tuberculosis”

    “It’s Time”, the focus for World TB Day this year is therefore on urgently accelerating the TB response to save lives and end suffering, even in times of crisis. This will be essential if we are to reach the targets and commitments made
    by Heads of State at the 2018 UN High Level Meeting on TB. 

    We have made important strides against the TB epidemic to date.

    We announced last year, that more people received life-saving treatment for tuberculosis in 2018 than ever before, largely due to improved detection and diagnosis. Globally, 7 million people were diagnosed and treated for TB – up from 6.4 million in 2017
    – enabling the world to meet one of the milestones towards the United Nations political declaration targets on TB and the WHO Director-General Flagship Initiative Find.Treat.All End TB jointly with Stop TB Partnership and the Global Fund. This
    has been a big win for the TB community.

    WHO is working with countries to roll out important guidelines, including a comprehensive package on TB preventive treatment released today, and updated MDR TB guidelines to promote the use of all-oral regimens for patients with drug-resistant TB which
    would be helpful – particularly at this point, when visiting health centers is a challenge. Furthermore, WHO has developed a note to guide and urge countries to ensure continuity of TB services during the COVID-19 pandemic.

    We are strengthening our collaboration with civil society – more information is highlighted in the WHO Civil Society Taskforce Progress Review released today.

    Youth mobilization is being ramped up through the WHO 1+1 Youth Initiative to end TB and the Global Youth Declaration to End TB. Multisectoral accountability is being promoted in countries through our framework and we have finalized a new global strategy
    on TB research and innovation, that will be reviewed by the World Health Assembly.

    Yet, the gains we have made are at risk – if there is any slackening of commitment and action, especially in times of crisis.

    We are at a crossroads and we need to unite forces to take the path of success that will save lives and end suffering.

    I was especially heartened today, to see the TB community coming together like never before. We all took our events to the virtual realm due to COVID-19 lockdowns. The WHO Online Talk Show held this afternoon, had a powerful line up of speakers that included,
    TB survivors and advocates, civil society, high level government representatives, heads of agencies, researchers and partners. As of this evening we have surpassed 10,000 views on YouTube. I also participated in townhalls organized by Stop TB Partnership.
    Our joint efforts have indeed ensured a continuing spotlight on those affected by TB, and clearly shows that no matter what the barrier, we can surpass it if we work together.

    I am proud to stand shoulder-to-shoulder with you all virtually – and recommit to champion End TB efforts till we reach the finish line.

    It’s time to deliver on our promises and ensure no one is left behind.

    It’s time to End TB!

    Dr Tereza Kasaeva
    Director
    Global TB Programme
    World Health Organization

    World TB Day Talk Show

    World TB Day 2020 Newsletter 5

    In the backdrop of the global battle against COVID-19, WHO organized a special online talk show to mark World TB Day 2020. The talk show had a powerful line up of speakers from among TB survivors and advocates, civil society, high-level government representatives,
    heads of agencies, researchers and partners. The video was streamed live on WHO’s Youtube channel crossing over 10,000 views in a few hours. Watch the talk show video

    Spotlight on TB Preventive Treatment

    New WHO recommendations to prevent tuberculosis aim to save millions of lives

    24 March 2020 News release

    Geneva –  New World Health Organization (WHO) guidance will help countries accelerate efforts to stop people with tuberculosis (TB) infection becoming sick with TB by giving them preventive treatment. A quarter of the world‘s population
    is estimated to be infected with TB bacteria. These people are neither sick nor contagious. However, they are at greater risk of developing TB disease, especially those with weakened immunity. Offering them TB preventive treatment will not only protect
    them from becoming sick but also cut down on the risk of transmission in the community. Read more

    The full package is available below and at our World TB Day Campaign Page

    WHO Civil Society Taskforce on TB: Progress Review

    The WHO Civil Society Taskforce provides a platform for meaningful engagement of civil society, building on the commitment of the Director-General, with emphasis on harnessing the untapped potential in engagement with civil society and affected communities
    al all levels. To mark World TB Day 2020, the Task Force has released a Progress Review highlighting key achievements since its formation in 2018.

    Access link here

    WHO eTB guidelines: A digital platform to promote adolopment of TB recommendations

    World TB Day 2020 Newsletter 6

    WHO Global TB Programme / McMaster University

    The WHO Global Tuberculosis (TB) Programme, in collaboration with McMaster University, Canada, is developing a smart platform to improve access to and use of all WHO recommendations on TB prevention and care. The WHO eTB guidelines platform will facilitate
    the adoption, adaptation and implementation (“adolopment”) by countries of recommendations across the continuum of care. This digital platform will provide a variety of users – TB programme managers, healthcare workers including
    nurses, researchers, patients and affected communities – with easy access to all essential information about WHO-s current policy guidance on TB.

    The first set of recommendations on TB preventive treatment were released on this new platform on World TB Day.

    WHO eTB guidelines platform

    Infographic

    TB and COVID-19

    24 March 2020 News release

    Geneva –  As the world comes together to tackle the COVID-19 pandemic, it is important to ensure that essential health services and operations are continued to protect the lives of people with TB and other diseases or health conditions. Health services,
    including national programmes to combat TB, need to be actively engaged in ensuring an effective and rapid response to COVID-19 while ensuring that TB services are maintained. Read more

    Let’s never forget: It’s time to end TB

    Ksenia Schenina

    World TB Day 2020 Newsletter 7

    Ksenia Schenina

    24 March 2020 Photo story

    On World TB Day 2020, the theme – “Its time” – stresses the urgency to end the TB epidemic. TB survivor and advocate, Ksenia Schenina, talks about her struggle with the disease, the persistence of stigma and the role that remembrance can play
    in fighting it.   Through her TB memorial project, she aims to remember those who passed away from this terrible and ancient disease. “We do it to show what kind of people they were – what kind of things they liked, what kind of music
    they listened to and what their favorite movies were; if they liked fishing or dreamt of a flight to space,” she says. Read more

    Commentary

    To end TB, we must invest in research and innovation

    24 March 2020 Commentary

    If the world is to get anywhere near ending TB, a disease that killed more than 1.5 million people in 2018, something significant needs to change.

    TB remains the world’s leading infectious killer and yet, in the last 50 years, only three new drugs and regimes have been developed to combat the disease. “What we need is more research and more tools in the pipeline; better diagnostics,
    more effective vaccines, and safer, shorter drug regimes,” explains Dr Tereza Kasaeva, Director of the World Health Organization Global Tuberculosis Programme. Read more

    Emily: A Day in the Life of a TB Nurse

    World TB Day 2020 Newsletter 8

    Maria Emily C. Ballesteros

    Watch this story of Emily, a nurse managing the tuberculosis (TB) program of the City Health Office in Tuguegarao City. Her dream for Tuguegarao is to one day see zero TB cases and that no one dies from this infectious disease. Nurses and healthcare workers
    play a critical role in TB prevention and care. It’s time to invest in them to improve healthcare for all. We thank all the nurses, midwives and healthcare workers working to #EndTB! Watch the video

    Updates and messages

    New research tool supports scale-up of digital technologies to End TB

    24 March 2020 TDR news item

    National anti-tuberculosis efforts are increasingly involving digital technologies, such as mobile applications to support treatment adherence and electronic surveillance systems that enable real-time monitoring of a country’s TB situation. Read more

    World TB Day 2020: It’s Time for solidarity

    24 March 2020 HIV/TB news item

    At this unique time in history when the world is grappling with the COVID-19 pandemic, the WHO Department of Global HIV, Hepatitis and STI Programmes stands in solidarity with governments and communities as they seek to maintain health services
    and continue to address the needs of patients suffering from HIV and tuberculosis (TB).  Read more

    New, shorter treatment to prevent TB to be rolled out in five high TB burden countries

    24 March 2020 news item

    Three-month regimen expected to prevent TB in those at highest risk of developing the disease, including people living with HIV and children under the age of five
    Today, the Aurum Institute and its partners, as part of the IMPAACT4TB project, announced that five high-burden TB countries will roll out a new, shorter drug regimen (known as 3HP) to prevent TB. The announcement comes as countries around the world mark World TB Day, which takes place every year on March 24th. Countries that will initially provide the new regimen with funding from Unitaid, U.S. PEPFAR and the Global Fund include Cambodia, Ethiopia, Kenya, Malawi, South Africa and Zimbabwe. More than 120,000 patient courses of 3HP will be delivered by the project to 12 countries in 2020. An additional 1 million patient courses are expected to reach low- and middle-income countries by the end of the year, through the combined support of Unitaid, Global Fund, the Stop TB Partnership’s Global Drug Facility (GDF) and PEPFAR. Read more
    World TB Day 2020 Newsletter
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