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Immunization is the best protection against tick-borne encephalitis

In a new position paper, published in the Weekly
Epidemiological Record today, WHO recommends vaccination against
tick-borne encephalitis in people of all ages where the disease is
highly endemic. Where the prevaccination incidence of the disease is
moderate or low or is limited to particular geographical locations or
certain outdoor activities, immunization should target individuals in
the most severely affected groups. People travelling from non-endemic
areas to endemic areas should be offered vaccination if their visits
will include extensive outdoor activities.

Since the incidence of tick-borne encephalitis may vary
considerably between and even within geographical regions, public
immunization strategies should be based on risk assessments conducted at
country, regional or district level, and should be appropriate to the
local endemic situation.

Immunization offers the most effective protection against
tick-borne encephalitis. Currently, there are four widely used vaccines
of assured quality: FSME-Immun and Encepur, manufactured in Austria and
Germany respectively, and TBE-Moscow and EnceVir, manufactured in the
Russian Federation. The four vaccines are considered to be safe and
efficacious.

Tick-borne encephalitis virus is an important cause of viral
infections of the central nervous system in eastern, central and
northern European countries, and in northern China, Mongolia, and the
Russian Federation.

Approximately 10 000–12 000 clinical cases of tick-borne
encephalitis are reported each year, but this figure is believed to be
significantly lower than the actual total. Most infections with the
virus result from tick bites acquired during outdoor activities in
forested areas.

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February 27, 2020
World failing to provide children with a healthy life and a climate fit for their future: WHO-UNICEF-Lancet
As climate and commercial threats intensify, WHO-UNICEF-Lancet Commission presses for radical rethink on child health

No single country is adequately protecting children’s health, their environment and their futures, finds a landmark report released today by a Commission of over 40 child and adolescent health experts from around the world. The Commission was convened by the World Health Organization (WHO), UNICEF and The Lancet.

The report, A Future for the World’s Children?, finds that the health and future of every child and adolescent worldwide is under immediate threat from ecological degradation, climate change and exploitative marketing practices that push heavily processed fast food, sugary drinks, alcohol and tobacco at children.

“Despite improvements in child and adolescent health over the past 20 years, progress has stalled, and is set to reverse,” said former Prime Minister of New Zealand and Co-Chair of the Commission, Helen Clark. “It has been estimated that around 250 million children under five years old in low- and middle-income countries are at risk of not reaching their developmental potential, based on proxy measures of stunting and poverty. But of even greater concern, every child worldwide now faces existential threats from climate change and commercial pressures.

“Countries need to overhaul their approach to child and adolescent health, to ensure that we not only look after our children today but protect the world they will inherit in the future,” she added.

Intensifying climate change threatens every child’s future

The report includes a new global index of 180 countries, comparing performance on child flourishing, including measures of child survival and well-being, such as health, education, and nutrition; sustainability, with a proxy for greenhouse gas emissions, and equity, or income gaps. [Top & Bottom 10 countries; Full Global Index on pp. 35-38] [1]

According to the report, while the poorest countries need to do more to support their children’s ability to live healthy lives, excessive carbon emissions – disproportionately from wealthier countries – threaten the future of all children. If global warming exceeds 4°C by the year 2100 in line with current projections, this would lead to devastating health consequences for children, due to rising ocean levels, heatwaves, proliferation of diseases like malaria and dengue, and malnutrition.

The index shows that children in Norway, the Republic of Korea, and the Netherlands have the best chance at survival and well-being, while children in Central African Republic, Chad, Somalia, Niger and Mali face the worst odds. However, when authors took per capita CO2 emissions into account, the top countries trail behind: Norway ranked 156, the Republic of Korea 166, and the Netherlands 160. Each of the three emits 210% more CO2 per capita than their 2030 target. The United States of America (USA), Australia, and Saudi Arabia are among the ten worst emitters.

“More than 2 billion people live in countries where development is hampered by humanitarian crises, conflicts, and natural disasters, problems increasingly linked with climate change,” said Minister Awa Coll-Seck from Senegal, Co-Chair of the Commission. “While some of the poorest countries have among the lowest CO2 emissions, many are exposed to the harshest impacts of a rapidly changing climate. Promoting better conditions today for children to survive and thrive nationally does not have to come at the cost of eroding children’s futures globally.”

The only countries on track to beat CO2 emission per capita targets by 2030, while also performing fairly (within the top 70) on child flourishing measures are: Albania, Armenia, Grenada, Jordan, Moldova, Sri Lanka, Tunisia, Uruguay and Viet Nam.

Harmful commercial marketing preys on children – with childhood obesity increasing 11-fold

The report also highlights the distinct threat posed to children from harmful marketing. Evidence suggests that children in some countries see as many as 30,000 advertisements on television alone in a single year, while youth exposure to vaping (e-cigarettes) advertisements increased by more than 250% in the USA over two years, reaching more than 24 million young people.

Professor Anthony Costello, one of the Commission’s authors, said: “Industry self-regulation has failed. Studies in Australia, Canada, Mexico, New Zealand and the USA – among many others – have shown that self-regulation has not hampered commercial ability to advertise to children. For example, despite industry signing up to self-regulation in Australia, children and adolescent viewers were still exposed to 51 million alcohol ads during just one year of televised football, cricket and rugby. And the reality could be much worse still: we have few facts and figures about the huge expansion of social media advertising and algorithms aimed at our children.”

Children’s exposure to commercial marketing of junk food and sugary beverages is associated with purchase of unhealthy foods and overweight and obesity, linking predatory marketing to the alarming rise in childhood obesity. The number of obese children and adolescents increased from 11 million in 1975 to 124 million in 2016 – an 11-fold increase, with dire individual and societal costs.

A manifesto for immediate action on child and adolescent health

To protect children, the independent Commission authors call for a new global movement driven by and for children. Specific recommendations include:
1. Stop CO2 emissions with the utmost urgency, to ensure children have a future on this planet;
2. Place children and adolescents at the centre of our efforts to achieve sustainable development;
3. New policies and investment in all sectors to work towards child health and rights;
4. Incorporate children’s voices into policy decisions;
5. Tighten national regulation of harmful commercial marketing, supported by a new Optional Protocol to the UN Convention on the Rights of the Child.
Dr. Richard Horton, Editor-in-Chief of The Lancet family of journals, said: “The opportunity is great. The evidence is available. The tools are at hand. From heads-of-state to local government, from UN leaders to children themselves, this Commission
calls for the birth of a new era for child and adolescent health. It will take courage and commitment to deliver. It is the supreme test of our generation.”

“From the climate crisis to obesity and harmful commercial marketing, children around the world are having to contend with threats that were unimaginable just a few generations ago,” said Henrietta Fore, UNICEF Executive Director. “It
is time for a rethink on child health, one which places children at the top of every government’s development agenda and puts their well-being above all considerations.”

“This report shows that the world’s decision makers are, too often, failing today’s children and youth: failing to protect their health, failing to protect their rights, and failing to protect their planet,” Dr Tedros Adhanom Ghebreyesus,
Director-General of the World Health Organization said. “This must be a wakeup call for countries to invest in child health and development, ensure their voices are heard, protect their rights, and build a future that is fit for children.”

Notes to editors

[1] About the index; please see pp. 35-38 of the report, with technical details in the Annex, pp. 19-72

[2] This Commission was funded by the Bill & Melinda Gates Foundation.

For more information or to set up interviews with report authors, please contact any of the listed media contacts.

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February 27, 2020
Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12 February 2020
The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) to review the current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) took place on Wednesday, 12 February 2020, from 14:00 to 16:45 Geneva time (CEST).

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference.

The Secretariat welcomed the Committee and thanked them for their support. The meeting was turned over to the Chair, Dr Robert Steffen.

Dr Steffen also welcomed the Committee and gave the floor back to the Secretariat.

Representatives of WHO’s legal department and the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting.

The Chair then reviewed the agenda for the meeting and introduced the presenters.

Presentations were made by representatives of the Ministry of Health of the Democratic Republic of the Congo (DRC), the WHO Secretariat, and the UN Ebola Emergency Response Coordinator.

The current situation in the DRC was reviewed. As of 10 February 2020, there were a total of 3431 cases, of which 3308 were confirmed and 123 were probable. 2253 persons have died (66%). Between 3 and 9 February 2020, three new confirmed cases were reported in Beni Health Zone, North Kivu. These three cases were already registered as contacts and two were under surveillance at the time of detection. More than 2000 contacts are being followed. There has been an increase in the number of security incidents in recent months.

Challenges that remain include: strengthening of community acceptance for full commitment to response measures; protection of personnel at strategic health checkpoints; improvement of infection prevention and control practices in health facilities; strengthening of the local health system; and comprehensive treatment and support for patients in recovery.

The WHO Secretariat gave an overview of the epidemiological situation, which shows an overall encouraging trend in case incidence and geographic spread. It was noted that sustaining this progress depends on the security situation and control of the well-known drivers of transmission, particularly in traditional health facilities, and on continued trust and communication with the community.

A risk communication and community engagement programme has been developed, as has an EVD survivors programme. It is critical to ensure the long-term sustainability of these two initiatives.

The situation in countries neighbouring DRC was reviewed, as was preparedness in nonaffected areas of DRC. An EVD operational readiness standardized approach has been implemented in 9 priority countries. More than 2400 alerts have been investigated, and more than 14,600 health workers have been vaccinated.

The UN Ebola Emergency Response Coordinator gave a brief report on operational support, focused on security challenges and preparations for any resurgence of disease.

Context and Discussion

The Committee noted a great deal of progress in the situation since its last meeting and commended the response, under the leadership of the DRC Ministry of Health and the multisectoral coordination commission established in July 2019. Support provided by WHO, UN agencies, nongovernmental organizations and other partners has also contributed to limiting the spread and impact of this virus in a difficult context. An increase in the number of alerts was attributed to strong and proactive community surveillance.

Conclusions and Advice

It was the unanimous view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC) under the IHR (2005).

The Committee acknowledged the revised risk assessment, which puts the risk now as high at national and regional levels, and low at the global level.

The Committee was concerned that withdrawing the PHEIC now might have adverse consequences for the response efforts through diminishing focus. Additionally, although the primary concern of the Committee is EVD, there are serious ongoing outbreaks of other diseases, including measles and cholera, in DRC. The country continues to need support to combat infectious diseases as well as to strengthen its health system. Further, there remains an urgent need to maintain international solidarity for the response.

The Committee noted the ongoing discussions about the interpretation in the text of the IHR (2005) of the terms international and regional spread, and about creating an intermediate level of response between the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations on the Regulations. The Committee supports these discussions, as an intermediate level would be as useful for gradually ending a PHEIC and for signaling the potential for one to be declared.

The Committee provided the following advice to the Director-General for his issuance as revised Temporary Recommendations under the IHR (2005).

For DRC:
- Sustain the political commitment and multisectoral coordination approach to the response.
- Continue to engage and build trust with associations of survivors to facilitate rapid detection of any cases arising from exposure to infected bodily fluids of survivors.
- Continue to strengthen capacity, implementation, and coordination for community awareness and engagement, including a focus on hotspots, preventing resurgence where cases have declined, and to support survivors in their communities.
- Further enhance the acceptance of response measures and address access and security issues by engaging influencers and decision makers for all interventions.
- Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision, including in private-sector and traditional health facilities.
- Continue cross-border screening and step up monitoring at checkpoints around hotspots and at main roads.
- Continue to implement and share real-time full-genome genetic sequencing of all new confirmed cases.
- Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision.
- Strengthen preparedness in non-affected provinces of DRC, and more generally strengthen the health system across the country to respond to concurrent health emergencies.
- Continue to implement optimal vaccine strategies that have proven maximum impact on curtailing the outbreak, as recommended by WHO’s Strategic Advisory Group of Experts (SAGE).
For countries at risk:
- At-risk countries should maintain their work with partners to improve their preparedness for detecting and managing imported or locally acquired cases, including the transparent sharing of detailed information on suspect cases, as required by the International Health Regulations (2005), and sharing laboratory samples of suspect cases for confirmatory testing in accordance with WHO norms and guidance.
- Countries should continue to map population movements and sociological patterns that can predict risk of disease spread.
- Risk communications and community engagement, especially at points of entry, should be maintained.
For all countries:
- As recommended previously, no country should close its borders or place any restrictions on travel and trade.
- The Committee does not consider entry screening at airports or other ports of entry outside the region to be necessary.
The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.

Based on this advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 12 February 2020 maintained the Ebola outbreak in the Democratic Republic of the Congo as a Public Health Emergency of International Concern (PHEIC).

The Director-General endorsed the Committee’s advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of Ebola, effective 12 February 2020. The Director-General thanked the Committee Members and Advisors for their advice and requested their reassessment of this situation within two months or earlier if the situation requires.

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February 27, 2020
WHO Global Initiative for Childhood Cancer: progress on all fronts

Peru shows the way forward and the courage of Ander Martinez

“When Ander was diagnosed, I didn´t have the possibility to cover the cost of the treatment. It was very expensive, and I had nothing,” says Rosalina Tocto, 29 years mother of Ander Martínez Tocto. Ander had just been diagnosed with acute leukemia at the young age of 6 years. From the beginning, the odds were stacked against him. He and his family lived in a rural town, six hours from the nearest city. His parents did not have a formal job, placing the family under financial strain.

Ander and his family were not alone in this situation. “In Peru, nearly 1800 children and adolescents are diagnosed with cancer every year; however, up to 70% will have a late stage, often metastatic due to delays in diagnosis,” says Dr. Juan García, medical chief of the Pediatric Department of in the National Institute of Neoplastic Diseases (INEN) in Lima, Peru. “Most of our patients come from outside Lima and the majority of parents do not have formal employment and therefore do not have any type of insurance.”

Fortunately, Peru has made a strong commitment to Universal Health Coverage. In 2009, a law was passed to improve access to care by introducing a mandatory health insurance system and registering everyone living in extreme poverty under Seguro Integral de Salud (SIS), regardless of age or circumstance.

Dr. Reina Bustamante, Executive Director of the Division of Prevention and Control of Cancer of the MINSA says “UHC is an important step in public health particularly for those who lack public or private insurance like Ander. In this context, we are trying to follow WHO guidance to achieve UHC and ensure all individuals and communities receive the health services they need without suffering financial hardship.”

In 2019, Peru was selected as a focus country for the WHO Global Initiative for Childhood Cancer as the first focus country in the Region. The Global Initiative aims to improve survival for all children with cancer to at least 60% by 2030 while reducing suffering, altogether with the potential to save an additional one million lives.

Four main goals were formulated for the national pediatric cancer plan: (1) improve early diagnosis of childhood cancer, (2) decrease treatment abandonment, (3) implement a national pediatric cancer registry and (4) improve the quality of services in pediatric oncology units.

Dr. Liliana Vasquez, pediatric oncologist who works as an external consultant for the Division of Prevention and Control of Cancer of MINSA said, “Ten working groups have been established to achieve the goals.”

Dr. Vivian Perez, advisor of the Non-Communicable Diseases Office in PAHO-Peru added “the initial focus for the Initiative will be on six cancers selected as tracers for monitoring progress across the health system, alongside engagement of at least six focus countries with a record of strong political commitment and foundational efforts supporting children with cancer.”

For Ander, his health care team, the commitments from the government of Peru and partners and Global Initiative have made it possible to be successfully treated and will now allow him to dream of a healthy future though better access to surveillance monitoring and psycho-oncological support aimed at childhood cancer survivors.

Peru is showing what is possible for all countries. By concerted action and promoting universal health coverage, every child in the world can have access to high-quality care with the greatest likelihood of survival, and every family should be protected from financial hardship. We can do more together.

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February 27, 2020
Remarks by Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme at media briefing on COVID-19 on 13 February 2020

Good afternoon everyone and apologies for being late, and apologies too from Dr Tedros, who is just about to land in the Democratic Republic of the Congo where he is following up on important Ebola matters and meeting with President Tshisekdi and many others to look at the future post-Ebola of the health system in Congo.

I’m sure you’ll understand how important a task and mission that is given the last year-and-a-half in Congo and the ongoing struggles in that country to deliver effective healthcare and reduce suffering and mortality from infectious diseases.

Let me start by updating you on the latest numbers.

In the last 24 hours China has reported 1,820 laboratory-confirmed cases, bringing the total to 46,550.

In addition, China reported 13,332 clinically confirmed cases in Hubei province, and crucially, we understand that most of these cases relate to a period going back over days and weeks and are retrospectively reported as cases, sometimes back to the beginning of the outbreak itself.

So this increase that you’ve all seen in the last 24 hours is largely down to a change in how cases are being diagnosed and reported.

So, in other words, in Hubei province only, a trained medical professional can now classify a suspected case of COVID-19 as a clinically-confirmed case on the basis of chest imaging, rather than having to have a laboratory confirmation.

This allows clinicians to move and report cases more quickly, not having to wait for lab confirmation, ensuring that people get to clinical care more quickly, and also allows public health responses in terms of contact tracing and other important public health measures to be initiated.

As you’ve noticed with suspect cases, there have been some backlogs in testing and this is also going to help ensure that people get adequate care and adequate public health measures can be taken.

So we are not dealing, from what we understand, with a spike in cases of 14,000 on one day.

To an extent this is an artefact of the reporting and we are working with our colleagues in China, and our team there are working very hard to see exactly how many days and weeks and how those numbers are spread across those days and weeks.

In the rest of China and the rest of the world, laboratory confirmation for reporting is still required.

WHO will continue to track both laboratory and clinically-confirmed cases in Hubei province.

We’ve seen this spike in the number of cases reported in China, but this does not represent a significant change in the trajectory of the outbreak.

Outside China, there are 447 cases from 24 other countries, and now two deaths. In addition to the death in the Philippines, there is now one more death in Japan.

We have said consistently that we need to be cautious when drawing conclusions from daily reported numbers. I think we were having that discussion yesterday and I think the numbers today speak to that.

We need to be very careful when interpreting any extremes. Be it in incubation period, be it in daily numbers, we must take all numbers into account, we must look at all numbers seriously but we also must try and interpret what those numbers mean and not react directly to the number itself.

The number of countries reporting cases has still not changed and outside the cases on the Diamond Princess cruise ship, we’re not seeing a dramatic increase in transmission outside China.

That is the current picture. We’re still saying to governments around the world that we still have an opportunity to prepare for the potential spread of the virus.

Regarding the Diamond Princess cruise ship, which is currently quarantined in Yokohama, 218 passengers have tested positive for the virus, which does represent the largest cluster of COVID-19 cases outside China.

This morning, I briefed health ministers from the European Union, convened by Croatia, the presidency, about COVID-19 and our teams are working with governments and partners of the European Union to ensure that the latest information is disseminated, that preparations are made and there’s good coordination between ourselves and the European Union and our WHO Regional Office for Europe.

And we very much welcome the strong support from the European Union in supporting countries with weaker health systems and ensuring that other countries have the investment and support needed to prepare for the arrival of the virus.

In terms of the international mission, the advanced team and their Chinese counterparts have now finalized the scope of work and design of the mission and we expect the rest of the international team to start arriving in China over the weekend.

Thank you.

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February 27, 2020
WHO and FIND formalize strategic collaboration to drive universal access to essential diagnostics

Geneva, Switzerland – 10 February 2020 – The World Health Organization (WHO) and the Foundation for Innovative New Diagnostics (FIND) announced today that a memorandum of understanding has been signed by the two organizations to formalize a strategic collaboration that will strengthen diagnosis in resource-poor countries by closing major diagnostic gaps at country level and bolstering disease surveillance that will inform public health initiatives and enhance outbreak preparedness and response.

“This collaboration is an inspiring development that will take us a long way towards ensuring access to diagnostics to all who need them,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Global health challenges such as the ongoing novel coronavirus (2019-nCoV) outbreak demonstrates that without these essential elements of health systems, we cannot hope to promote health, keep the world safe, and serve the vulnerable. I look forward to working closely with FIND to determine what countries need and to forge a path to deliver these innovations so that no one is left behind.”

Diagnosis is a driver of patient, financial and health systems impact, and a critical enabler of universal health coverage, but it is also the weakest link in the care cascade. This is especially true in primary healthcare settings in low- and middle-income countries. A unique and unprecedented opportunity exists to expand the role and impact of diagnostics to fully realize their potential to address major health security threats and evolving disease burdens through technological and digital advances.

FIND has been an active partner with WHO since 2008 and a WHO Collaborating Centre since 2014, acting in the areas of laboratory strengthening and diagnostic technology evaluation. This expanded collaboration will put in place the building blocks necessary to enable transformative change in a move toward a country-led diagnostics alliance. Initial workstreams will focus on demand-driven access to essential diagnostics and the development of national Essential Diagnostics Lists, alongside collection of data that assist the scale up of diagnostics to support low- and middle-income countries on their paths to universal health coverage.

“Each and every person has the right to a quality, timely diagnosis,” said Catharina Boehme, CEO of FIND. “Comprehensive diagnostic services underpin functional and efficient health systems not only to manage day-to-day healthcare needs, but also to ensure new disease outbreaks can be spotted and contained quickly. Working closely with WHO as part of a country-led alliance, we will strive to ensure that low- and middle-income countries have what they need to develop their own comprehensive, data-driven diagnostic strategies that enable universal health coverage and empower disease surveillance. Our ambition is that all patients, providers and decision-makers have access to the diagnostic solutions needed for optimal health outcomes.”

The strategic collaboration agreement will initially run for a period of 5 years, until 2025.

# # #

About FIND

FIND is a global non-profit organization that drives innovation in the development and delivery of diagnostics to combat major diseases affecting the world’s poorest populations. Our work bridges R&D to access, overcoming scientific barriers to technology development; generating evidence for regulators and policy-makers; addressing market failures; and enabling accelerated uptake and access to diagnostics in low- and middle-income countries (LMICs). Since 2003, we have been instrumental in the development of 24 new diagnostic tools used in 150 LMICs. Over 50 million FIND-supported products have been provided to our target markets since the start of 2015. A WHO Collaborating Centre, we work with more than 200 academic, industry, governmental, and civil society partners worldwide, on over 70 active projects that cross six priority disease areas. FIND is committed to a future in which diagnostics underpin treatment decisions and provide the foundation for disease surveillance, control and prevention. For more information, please visit www.finddx.org

About WHO

The World Health Organization is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. WHO is committed to the enjoyment of the highest attainable standard of health as one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. WHO’s current global programme of work sets out three interconnected strategic priorities: ensuring healthy lives and well-being for all at all ages; achieving universal health coverage; and addressing health emergencies and promoting healthier populations. These priorities are linked to three ambitious targets, the “triple billion”: one billion more people to benefit from universal health coverage; one billion more people better protected from health emergencies; and one billion more people enjoying better health and well-being.

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February 27, 2020
Online training as a weapon to fight the new coronavirus

More than 25 000 people across the globe have accessed real-time knowledge from WHO experts on how to detect, prevent, respond to and control the new coronavirus in the 10 days since the launch of an open online training.

The learning team of the WHO Health Emergencies Programme worked with technical experts to quickly develop and publish the online course on 26 January – 4 days before the 2019-nCoV outbreak was declared a public health emergency of international concern.

Approximately 3000 new users have registered for the training every day since its launch, demonstrating the high level of interest in the virus among health professionals and the general public. In addition, more than 200 000 people have viewed the introductory video to the course on YouTube.

The high engagement levels emerged as the international community launched a US$675 million preparedness and response plan to fight further spread of the new coronavirus and protect states with weaker health systems.

The free learning resource is available to anyone interested in novel coronavirus on WHO’s open learning platform for emergencies, OpenWHO.org. The platform was established 3 years ago with emergencies such as nCoV in mind, in which WHO would need to reach millions of people across the globe with real-time, accessible learning materials.

The online training – entitled “Emerging respiratory viruses, including nCoV: methods for detection, prevention, response and control” – is currently being produced in all official UN languages and Portuguese.

“Our job is to work with technical health experts to package knowledge using adult learning principles, quickly so that it is most useful to health workers and our staff,” said Heini Utunen, who manages OpenWHO for the WHO Health Emergencies Programme (WHE). “Our online platform – OpenWHO – is already accessed by users from every country on earth, providing more than 60 courses in 21 languages. Delivering trainings in the local language of responders is really important, especially in an emergency”.

WHE has been investing in learning and training to strengthen preparedness and real-time response to health emergencies. The programme developed its first-ever learning strategy in 2018 and has a small dedicated Learning and Capacity Development Unit that allows WHE to develop trainings quickly and get know-how to those who most need it at the front line.

For the latest information on the new coronavirus, visit the 2019-nCoV page.

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February 27, 2020
US$675 million needed for new coronavirus preparedness and response global plan
To fight further spread of the new coronavirus (2019-nCoV) outbreak in China and globally, and protect states with weaker health systems, the international community has launched a US$675 million preparedness and response plan covering the months of February through to April 2020.

“My biggest worry is that there are countries today who do not have the systems in place to detect people who have contracted with the virus, even if it were to emerge,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Urgent support is needed to bolster weak health systems to detect, diagnose and care for people with the virus, to prevent further human to human transmission and protect health workers.”

The Strategic Preparedness and Response Plan (SPRP) for the new coronavirus lays out activities and resources needed by international health organizations globally, including WHO, to implement priority public health measures in support of countries to prepare and respond to nCoV-2019 for a period February-April 2020. The objectives of the plan are to limit human-to-human transmission of the virus, particularly in countries most vulnerable if they were to face an outbreak; identify, isolate and care for patients early; communicate critical risk and event information; minimize social and economic impact; reduce virus spread from animal sources; and address crucial unknowns.

The plan focuses on:
- Rapidly establishing international coordination and operational support;
- Scaling up country readiness and response operations;
- Accelerating priority research and innovation.
“The effectiveness of outbreak response depends on the preparedness measures put in place before outbreaks strike,” said Dr Mike Ryan, head of WHO’s Health Emergencies Programme. “That is why we are seeking resources to safeguard the most vulnerable countries to protect people from the new coronavirus before it arrives on the doorstep.”

As noted in the SPRP, WHO assesses that the outbreak poses a very high risk in China, and high risk regionally and globally. The risk assessment was based on factors including the likelihood of further spread, the potential impact on human health, and the varying levels of effectiveness in national preparedness and response measures. Accelerated action, as called for in the plan, can address these risks and areas requiring support.

As of 10 a.m. Central European Time on 5 February, 25 countries have reported confirmed cases of the new coronavirus, including China, where 24,363 people had contracted the virus, or over 99% of all cases. In all other countries, 191 cases have contracted the virus.

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https://www.who.int/news-room/detail/05-02-2020-us-675-million-needed-for-new-coronavirus-preparedness-and-response-global-plan

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February 27, 2020
Female Genital Mutilation Hurts Women and Economies

Female genital mutilation (FGM) exacts a crippling economic as well as human cost, according to World Health Organization (WHO).

“FGM is not only a catastrophic abuse of human rights that significantly harms the physical and mental health of millions of girls and women; it is also a drain on a country’s vital economic resources,” said Dr Ian Askew, Director of WHO’s Department of Sexual and Reproductive Health and Research. “More investment is urgently needed to stop FGM and end the suffering it inflicts.”

New modelling reveals that the total costs of treating the health impacts of FGM would amount to USD 1.4 billion globally per year, if all resulting medical needs were addressed. For individual countries, these costs would near 10% of their entire yearly expenditure on health on average; in some countries, this figure rises to as much as 30%.

The interactive modelling tool that generated these data was launched on the International Day of Zero Tolerance for Female Genital Mutilation.

Severe physical and mental health impacts for women and girls

Women and girls living with FGM face serious risks to their health and well-being. These include immediate consequences after being cut, such as infections, bleeding or psychological trauma, as well as chronic health conditions that can occur throughout life.

Women who have undergone the procedure are more likely to experience life-threatening complications during childbirth. They may face mental health disorders or suffer chronic infections. They may also have pain or problems when they menstruate, urinate or have sexual intercourse.

All of these conditions warrant much-needed medical attention and care.

“High healthcare costs for countries mount because of the tragic personal impacts on women and girls. Governments have a moral responsibility to help end this harmful practice,” says Dr Prosper Tumusiime, Acting Director for Universal Health Coverage and the Life Course in the African Regional Office of WHO. “FGM hurts girls, imposes lifelong health risks on the women they become, and strains the healthcare systems that need to treat them.”

Preventing FGM brings major benefits for women, girls, communities and economies

Using data from 27 high-prevalence countries, the Cost Calculator demonstrates clear economic benefits from ending FGM. If it were abandoned now, it shows that the associated savings in health costs would be more than 60% by 2050.

In contrast, if no action is taken, it is estimated that these costs will soar by 50% over the same time period, as populations grow and as more girls undergo the procedure.

Since 1997, great efforts have been made to end FGM, through work within communities, research, and changes in legislation and policy. 26 countries in Africa and the Middle East now explicitly legislate against FGM, as well as 33 other countries with migrant populations from FGM-practicing countries.

WHO is also working with countries to raise awareness of the harmful impacts of the practice among their health workers, and to engage them in prevention efforts.

“Many countries and communities are showing that abandoning female genital mutilation is possible,” states Dr Christina Pallitto, scientist at WHO. “If countries invest to end female genital mutilation, they can prevent their girls from undergoing this harmful practice and promote the health, rights and well-being of women and girls.”

Female genital mutilation is internationally recognized as a human rights violation. It has no medical benefits and causes only harm. WHO’s position is that FGM must never be carried out.

Further information

The FGM Cost Calculator will be available here, as of 00:30 CET 6 February 2020:
www.who.int/news-room/detail/06-02-2020-economic-cost-of-female-genital-mutilation

More on FGM

Notes for Editors

About FGM

FGM includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. More than 200 million girls and women alive today are estimated to have undergone the practice across 30 countries in Africa, the Middle East and Asia where FGM is concentrated.

FGM is mostly carried out on young girls between infancy and 15 years of age.

About the FGM Cost Calculator

The WHO FGM Cost Calculator shows the economic cost of treating the health complications caused by FGM across 27 high-prevalence countries. These costs were calculated using the WHO One Health tool and other available scientific evidence.

Users of the tool can calculate costs by country in a ‘business as usual’ scenario; a scenario of partial abandonment of FGM, and full abandonment of FGM over a 30-year period. In addition, the distribution of costs by different types of health complications is presented by country.

The tool does not consider other indirect costs that hit families and communities, or the socio-economic impacts of the practice, which would be significantly higher still.

The 27 countries modelled include Benin, Burkina Faso, Central African Republic, Còte d’Ivoire, Cameroon, Chad, Djibouti, Egypt, Eritrea, Ethiopia, Ghana, Guinea, Gambia, Guinea-Bissau, Iraq, Kenya, Mali, Mauritania, Niger, Nigeria, Soudan, Senegal, Sierra Leone, Somalia, Togo, United Republic of Tanzania, Yemen.

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