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No Evidence That Shekau Received €5m Foreign Fund From An NGO

Boko Haram Terrorists

Fact-checkers at HumAngle online newspaper have described a news report published on Opera News that Abubakar Shekau’s faction of Boko Haram was in disarray after it received a donation of five mIllion euros from an “unidentified” international non-governmental organisation as false.

The publication claimed that senior members of the group have also turned against each other over how the fund should be shared within the group.

The story claimed that a military source said “Shekau is getting blind as such only the very close ones of his aides have access to him. The issue of €5m is causing serious disaffection in their camps.

“Shekau has been receiving such funding in the past and he was never able to build his terror infrastructure beyond what is currently being dismantled. Our commanders are not concerned that he is still defrauding those sponsoring him, if there is any concern it is that we should be able to capture him before his own fighters kill him,” the military source said as claimed by the news report.

Boko Haram Terrorists

But according to HumAngle newspaper, the Director of Nigerian Army Public Relations, Sagir Musa, when contacted to verify the claim said he was not aware of either the “verified intelligence reports” or the claim that Shekau received five million euros foreign fund through an NGO in the North-East.

The newspaper also said it searched autogist.com, the blog that the news was attributed to but could not find the story published on the blog.

“Fact-checkers at HumAngle contacted the Director of Nigerian Army Public Relations, Sagir Musa, to confirm the veracity of the claim and he said he was not aware of either the “verified intelligence reports” or the claim that Shekau received five million euros foreign fund through an NGO in the North-East.

“We searched autogist.com, the blog that the news was attributed to but could not find the story published on the blog. Also, no reliable medium reporting terrorism published the story. Other conflict and insurgency reporters were contacted by HumAngle but none was aware of the “verified intelligence report”.

“As the name of the NGO was not disclosed, it became difficult to trace its operation history.

“However, Nigeria’s military had suspended several NGOs from operating in the North-East following allegations of collaborating with the terrorist organisation. But no NGO has ever been charged to court by the authorities and the suspended NGOs were later allowed to resume operations in the region.

“Scholars and experts on Boko Haram have suggested different methods of terrorism financing, from state sponsorship to external support by other terror groups like ISIS and Alqa’eda. But Shekau’s faction of Boko Haram relies on self-funding streams through fishing, farming, crowdfunding, extortion, taxation, raids and ransom taking to finance its operations,” the newspaper published.

Quoting a report on Boko Haram sources of funding, it continued, “Much of Boko Haram’s funds are transported through human cash couriers, which are able to move rather easily between the porous borders of Nigeria, Niger, Cameroon and Chad… very little evidence of either Gulf or other foreign funding exists,” a report on Boko Haram sources of funding concluded.

“Due to the strict surveillance of monetary operations to avoid terrorist financing in Nigeria, financial regulations have forced Boko Haram to avoid remittances of funds online. Such a huge amount is not possible to be transferred without its being intercepted by international and local intelligence platforms.”

The newspaper further said Nigeria Financial Intelligence Unit follows any suspicious transaction with the aim of curbing terrorism financing.

“It collates information of all beneficiaries of humanitarian assistance to avert financing of terrorism through covert operations, thus making it impossible for any NGO to follow “previous channels and beneficiaries’ templates” of funding terrorism as claimed by the report.

“Humanitarian organisations work hand in hand with EFFC Department of Special Control against Money Laundering (SCUML) to checkmate their activities to curb terrorism financing, according to Abdurrashid Ibrahim a worker at the financial unit of an NGO in the North-East.

“Any transaction from five million naira must pass through a special control unit against money laundering (SCUML) clearance process be it for individual or corporate organisation,” he said.

Furthermore, there is no evidence that an NGO was allowed to operate after the military discovered that “Shekau has been receiving such funding in the past” as claimed by the news.

According to HumAngle findings, Abubakar Shekau does not operate or rely on an advisory council (Shura).

He is reported to be ruthless and brutal to any opposition within the group, making it unlikely for any Boko Haram commander to disagree with the leader.

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May 9, 2020
Commemorating Smallpox Eradication – a legacy of hope, for COVID-19 and other diseases

On 8 May 1980, the 33rd World Health Assembly officially declared: ‘The world and all its peoples have won freedom from smallpox.’

The declaration marked the end of a disease that had plagued humanity for at least 3 000 years, killing 300 million people in the 20th century alone.

It was ended, thanks to a 10-year global effort, spearheaded by the World Health Organization, that involved thousands of health workers around the world to administer half a billion vaccinations to stamp out smallpox.

The US$ 300m price-tag to eradicate smallpox saves the world well over US$ 1 billion every year since 1980.

Speaking at a virtual event hosted at WHO-HQ, involving key players in the eradication effort, WHO Director-General, Dr Tedros Adhanom Ghebreyesus said, “As the world confronts the COVID-19 pandemic, humanity’s victory over smallpox is a reminder of what is possible when nations come together to fight a common health threat.”

The world got rid of smallpox thanks to an incredible demonstration of global solidarity, and because it had a safe and effective vaccine. Solidarity plus science equalled solution!

Dr Tedros highlighted that smallpox eradication also offers hope for efforts to eliminate other infectious diseases, including polio, which is now endemic in just two countries. To date, 187 countries, territories and areas have been certified free of Guinea worm disease, with seven more to go. And the fight against malaria has so far resulted in 38 countries and territories certified as malaria-free. In the case of Tuberculosis (TB), 57 countries and territories with low TB incidence are on track to reach TB elimination.

At the event, Dr Tedros unveiled a commemorative postal stamp to recognize the global solidarity that drove the initiative and honour the efforts of health workers who ensured its success.

The stamp, developed by the United Nations Postal Administration (UNPA), in collaboration with WHO, signifies what national unity and global solidary can achieve. Numerous countries, such as Guinea, India, Nigeria, Philippines, Togo and others issued smallpox stamps to show support for, and raise awareness about WHO’s Intensified Smallpox Eradication Programme launched in 1967.

WHO Regional Director for Africa, Dr Matshidiso Moeti’s earliest memories of smallpox is of her father. “I was visiting WHO headquarters, and I saw a photo of my Dad, standing with the other experts on the Global Commission. I remember him going out, doing follow-up visits with patients. He often would go with a driver and disappear into the bush for days. I felt in awe of his tireless work. The strategies used to eradicate smallpox still apply today.”

“Lessons learned from smallpox are used today to respond to disease outbreaks. For example, house-to-house active case-finding underpins the polio eradication programme, and ring vaccination of contacts is helping to combat the spread of the Ebola virus disease. Similarly, surveillance, case-finding, testing, contact-tracing, quarantine, and communication campaigns to dispel misinformation are central to controlling COVID-19, “ explained David Heymann, Professor of Infectious Disease Epidemiology at The London School of Hygiene & Tropical Medicine (LSHTM) and Distinguished Fellow, Global Health Security at Chatham House, London.

Following smallpox eradication, WHO and UNICEF launched the Expanded Programme on Immunization, under which 85% of the world’s children are vaccinated and protected from debilitating diseases.

With the potential of a COVID-19 vaccine ahead, ensuring sufficient supplies and reaching people in hard to reach places is a high priority. Addressing vaccine hesitancy poses a significant challenge to stop the virus. Access to accurate public health information and education is critical to ensure that the public has the facts to keep themselves and others safe.

To permanently commemorate the eradication of smallpox and the lessons learned on a global scale, rather than every 10-years, WHO is calling museums, exhibition companies, designers, curators and associations to develop an immersive, interactive and educational exhibition on smallpox and its relevance for COVID-19 and global health security. The exhibition, which will be unveiled later this year, will promote a better understanding of public health and empower people to keep informed and safe during a pandemic.

Notes to the media

Smallpox stamp

The smallpox stamp is in the denomination of CHF 1,70. It was designed by Sergio Baradat (United Nations) in collaboration with the World Health Organization and is available for purchase at unstamps.org. The stamp can be used to mail postcards and letters around the world, provided that they are sent from the UN headquarters in New York, Geneva or Vienna respectively.

Smallpox Eradication dates

On 9 December 1979, a global commission certified that smallpox had been eradicated, and this certification was officially accepted by the 33rd World Health Assembly in 1980.

Museum Exhibition

Exhibition design companies, museums, curators and other companies/organizations in this field are invited to express their interest to develop an immersive, educational exhibition on smallpox and its relevance for COVID-19 and global health security by writing to privatesectorpartners@who.int

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May 9, 2020
Billions worldwide living with herpes

About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show, highlighting the need to improve awareness and scale up services to prevent and treat herpes.

About 13% of the world’s population aged 15 to 49 years were living with herpes simplex virus type 2 (HSV-2) infection in 2016, the latest year for which data is available. HSV-2 is almost exclusively sexually transmitted, causing genital herpes. Infection can lead to recurring, often painful, genital sores in up to a third of people infected.

Herpes simplex virus type 1 (HSV-1) is mainly transmitted by oral to oral contact to cause oral herpes infection – sometimes leading to painful sores in or around the mouth (“cold sores”). However, HSV-1 can also be transmitted to the genital area through oral sex, causing genital herpes.

Around 67% of the world’s population aged 0 to 49 had HSV-1 infection in 2016 – an estimated 3.7 billion people. Most of these infections were oral; however, between 122 million to 192 million people were estimated to have genital HSV-1
infection.

Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive
health” says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at the World Health Organization (WHO).

Herpes and HIV

People with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. Thus, HSV-2 likely plays a substantial role in the spread of HIV globally. Women are more susceptible to both HSV-2 and HIV. Women living in
the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection.

No cure: vaccine needed

There is no cure for herpes. Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

Better awareness, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. In addition, development of better treatment and prevention interventions is needed, particularly
HSV vaccines.

“A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

Authored by staff at the University of Bristol, the WHO, and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization, this new study estimates the global infection prevalence and incidence of HSV-1 and HSV-2
in 2016.

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May 9, 2020
WHO and European Investment Bank strengthen efforts to combat COVID-19 and build resilient health systems to face future pandemics
- WHO and the European Investment Bank enhance cooperation to support countries in addressing the health impact of COVID-19
- The first phase will address urgent needs and strengthen primary health care in ten African countries
- Enhanced WHO-EIB partnership will scale up financing to assure the chain of essential supplies, including personal protective equipment, diagnostics and clinical management
- New initiative will accelerate investment in health preparedness and primary health care with a focus on health work force, infrastructure, and water, sanitation and hygiene
- The initiative involves measures to address the growing threat of antimicrobial resistance
The World Health Organization and the European Investment Bank will boost cooperation to strengthen public health, supply of essential equipment, training and hygiene investment in countries most vulnerable to the COVID-19 pandemic.

The new partnership between the United Nations health agency and the world’s largest international public bank, announced at WHO headquarters in Geneva earlier today, will help increase resilience to reduce the health and social impact of future health emergencies.

“Combining the public health experience of the World Health Organization and the financial expertise of the European Investment Bank will contribute to a more effective response to COVID-19 and other pressing health challenges,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“WHO looks forward to strengthening cooperation with the EIB to improve access to essential supplies including medical equipment and training, and deliver better water, sanitation and hygiene where most needed. New initiatives to improve primary health care in Africa and support the EU Malaria Fund hint at the potential impact of our new partnership,” Dr Tedros concluded.

“The world is facing unprecedented health, social and economic shocks from COVID-19. The European Investment Bank is pleased to join forces with the World Health Organization as a key part of Team Europe’s efforts to address the global impact of the COVID-19 pandemic. The EU Bank’s new partnership with the WHO will help communities most at risk by scaling up local medical and public health efforts and better protect people around the world from future pandemics. This new cooperation will enable us to combat malaria, address anti-microbial resistance and enhance public health in Africa more effectively,” said Werner Hoyer, President of the European Investment Bank.

Improving local public health efforts to tackle coronavirus

The WHO and the EIB will increase cooperation to help governments in low- and middle-income countries to finance and secure access to essential medical supplies and protective equipment through central procurement.

Building resilient health systems in vulnerable countries across Africa

The WHO and the EIB will reinforce cooperation to support immediate COVID-19 needs and jointly develop targeted financing to enhance health investment and build resilient health systems and primary health care to address public health emergencies as well as accelerate progress towards Universal Health Coverage.

The partnership will benefit from the EIB’s planned 1.4 billion EUR response to address the health, social and economic impact of COVID-19 in Africa.

This will address immediate needs in the health sector and provide both technical assistance and support for medium-term investment in specialist health infrastructure.

The collaboration envisages rapid identification and fast-track approval of financing for health care, medical equipment and supplies.

The first phase of the collaboration will see public health investment in ten African countries.

Long-term collaboration to overcome market failures in global health

The agreement signed today establishes a close collaboration to overcome market failure and stimulate investments in global health, accelerating progress towards Universal Health Coverage. Increased cooperation between the WHO and the EIB will strengthen the resilience of national public health systems and enhance preparedness of vulnerable countries against future pandemics, thanks to investments in primary care infrastructure, health workers and improved water, sanitation and hygiene.

Future cooperation will strengthen the EIB’s 5.2 billion EUR global response to COVID-19 outside the European Union.

Scaling up investment to tackle antimicrobial resistance

The two organisations will also cooperate in an initiative to address investment barriers hindering development of new antimicrobial treatment and related diagnostics. Antimicrobial resistance is amongst the most significant global health threats.

The WHO and the EIB are working on a new financing initiative to support development of novel antimicrobials and address the estimated 1 billion EUR needed to provide medium-term solutions to antimicrobial resistance. Other crucial partners have been invited to join this discussion.

Improving the effectiveness of malaria treatment

Under the new agreement the EIB and WHO will support development of the EU Malaria Fund, a new 250 million EUR public-private initiative intended to address market failures holding back more effective malaria treatment.

Strengthening EIB support for healthcare, life science and COVID-19 investment

In recent years the European Investment Bank has provided more than 2 billion EUR annually for health care and life science investment.

In the context of the COVID-19 pandemic, the EIB is currently assessing over 20 projects in the field of vaccine development, diagnostic and treatment, leading to potential investments in the 700 million EUR range. The EIB will also take part in the EU’s rolling pledging effort for the coronavirus global response that is taking place on May 4th.

Background information

The European Investment Bank (EIB) is the long-term lending institution of the European Union owned by its Member States. It makes long-term finance available for sound investment in order to contribute towards EU policy goals.

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube

WHO’s information site on the COVID-19 pandemic

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May 9, 2020
Statement on the third meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of coronavirus disease (COVID-19)
The third meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the coronavirus disease (COVID-19), took place on Thursday, 30 April 2020, from 12:00 to 17:45 Geneva
time (CEST).

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference. Membership of the Emergency Committee was expanded
to reflect the nature of the pandemic and the need to include additional areas of expertise.

The Director-General welcomed the Committee, thanked them for their commitment to enhancing global public health, and provided an overview of the major achievements in the COVID-19 response since the last Emergency Committee meeting on 30 January 2020.
Representatives of the legal department and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities.

The Ethics Officer from CRE provided the members and advisers with an overview of the WHO Declaration of Interest process. The members and advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests
of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and
the work of the committee. Only those committee members and advisers who were not considered to have any perceived or direct conflict of interest participated in the meeting.

The Secretariat turned the meeting over to the Chair, Professor Houssin. He also welcomed the Committee and reviewed the objectives and agenda of the meeting.

The WHO Regional Emergency Directors and the Executive Director of the WHO Health Emergencies Programme (WHE) provided regional and the global situation overview. After ensuing discussion, the Committee unanimously agreed that the outbreak still constitutes
a public health emergency of international concern (PHEIC) and offered advice to the Director-General.

The Director-General declared that the outbreak of COVID-19 continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR.

The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General. The Director-General thanked the Committee for its work.

Advice to WHO

Coordination, planning, and monitoring
- Continue to lead and coordinate the global response to the COVID-19 pandemic in collaboration with countries, the United Nations (UN), and other partners.
- Work with fragile states and vulnerable countries that require additional technical, logistical and commodity support.
- Establish mechanisms to compile lessons learned from country and partner experiences and WHO missions and share the best practices and updated recommendations.
- Provide further guidance to countries about adjusting public health measures, taking into account the different epidemiological situations of the pandemic.
- Promote the inclusion of all interested countries, including low- and middle-income countries from all regions, in the Solidarity clinical trials for therapeutics and vaccines.
- Continue efforts with partners to obtain equitable access to personal protective equipment, diagnostics, and biomedical equipment essential to the pandemic COVID-19 response.
- Continue to coordinate global expert networks in epidemiology, laboratory, vaccines, clinical care, infection prevention and control, social sciences, and operational research; modelling; and other technical support.
One Health
- Work with the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO), and countries to identify the zoonotic source of the virus and the route of introduction to the human population, including
  the possible role of intermediate hosts. This should be accomplished through efforts such as scientific and collaborative field missions, which will enable targeted interventions and a research agenda to reduce the risk of similar events.
- Work closely with OIE and FAO to provide guidance on how to prevent SARS-CoV-2 infections in animals and humans and prevent the establishment of new zoonotic reservoirs.
- Work with partner organizations and countries to strengthen the global food supply chain, protect food workers, properly manage food markets, and mitigate possible disruptions to the food supply.
Essential Health Services
- Support countries to assess and manage the unintended consequences of public health measures implemented to control the COVID-19 pandemic, including gender-based violence and child neglect.
- Support countries to monitor their ability to provide and strengthen essential health services throughout a likely extended COVID-19 response. This should include, but is not limited to, essential prevention for communicable diseases, particularly
  vaccination; services related to reproductive health, including care during pregnancy and childbirth; care of vulnerable populations, such as young infants and older adults; provision of medications and supplies for the ongoing management of chronic
  diseases, including mental health conditions; continuity of critical inpatient therapies; management of emergency health conditions and common acute presentations that require time-sensitive intervention; and auxiliary services, such as basic
  diagnostic imaging, laboratory services, and blood bank services.
- Support countries to address shortages of essential medicines and health products, personal protective equipment, and other medical supplies and to establish sustainable risk management practices to prevent future shortages.
Risk communication and community engagement
- Continue risk communications and community engagement activities through the WHO Information Network for Epidemics (EPI-WIN) and other platforms to counter rumours and misinformation.
- Continue to regularly communicate clear messages, guidance, and advice about the evolution of the COVID-19 pandemic, how to reduce transmission, and save lives.
- Work with partners and countries to articulate potential long-term consequences of COVID-19 pandemic, emphasizing the need for strengthened cross-sectoral preparedness, transparency and global coordination.
Surveillance
- Clarify the testing strategy, support countries to increase testing capacity, and aim to provide equitable access to diagnostic tests and supplies in light of market failures and global shortages.
- Continue to provide guidance on monitoring disease trends using Severe Acute Respiratory Infections (SARI) and Influenza Like Illness (ILI) surveillance systems in anticipation of the co-circulation of influenza viruses.
- Develop qualitative and quantitative indicators that countries can use to assess and monitor SARS-CoV-2 transmission at all levels of public health response.
- Continue to support countries and partners by providing technical and operational guidance, training platforms, and tools such as Go.Data,to enhance case identification and contact tracing capacity, strengthen the public health workforce, and engage
  communities for contact tracing.
- Provide clear qualitative and quantitative indicators to monitor SARS-CoV-2 transmission to inform the adjustment of public health and social measures.
Travel and Trade
- Continue working with countries and partners to enable essential travel needed for pandemic response, humanitarian relief, repatriation, and cargo operations.
- Develop strategic guidance with partners for the gradual return to normal operations of passenger travel in a coordinated manner that provides appropriate protection when physical distancing is not feasible.
- Update recommendations on appropriate travel measures and analyze their effects on international transmission of COVID-19, with consideration of the balance between benefits and unintended consequences, including entry and exit screening, education
  of travelers on responsible travel behaviour, case finding, contact tracing, isolation, and quarantine, by incorporating evidence on the potential role of pre-symptomatic and asymptomatic transmission.
To all States Parties

Coordination and Collaboration
- Support WHO leadership and continue to collaborate with WHO at all levels of the organization and with other countries to enable effective global COVID-19 pandemic preparedness and response.
- Participate in global solidarity efforts to enable access to essential supplies for all.
- Document and share lessons learned from efforts to control the pandemic, including the timing, pace, and sequencing of the application and lifting of public health measures.
Preparedness
- Strengthen preparedness for health emergencies, and build resilient health systems, incorporating lessons learned during different stages of the pandemic, and sharing experiences with other countries.
Surveillance
- Work with WHO and multisectoral partners to interrupt transmission by maintaining robust surveillance systems; enhancing capacities for case detection, testing, isolation of cases, contact tracing, quarantine of contacts, and rapid response; strengthening
  the public health workforce; and actively engaging communities for contact tracing, with a particular focus on high risk areas.
- In settings where testing a large proportion of suspected cases is not possible, monitor overall trends; undertake early detection through laboratory confirmation of a limited number of cases with a focus on health workers; and rapidly implement
  public health measures.
- Share with WHO all data necessary to conduct global risk assessments through data platforms, such as the Global Influenza Surveillance and Response System and the IHR mechanism. These data should include SARI and ILI where available.
- Use the WHO qualitative and quantitative indicators to assess and monitor SARS-CoV-2 transmission at all levels of public health response.
Additional Health Measures
- Avoid restrictions on international transport of food, medical and other essential supplies and permit the safe movement of essential personnel required for an effective pandemic response.
- Implement appropriate travel measures with consideration of their public health benefits, including entry and exit screening, education of travelers on responsible travel behaviour, case finding, contact tracing, isolation, and quarantine, by
  incorporating evidence on the potential role of pre-symptomatic and asymptomatic transmission.
- Implement and monitor case finding and contact tracing of travellers, using digital tools where appropriate.
- Continue to review travel and trade measures based on regular risk assessments, transmission patterns at origin and destination, cost-benefit analysis, evolution of the pandemic, and new knowledge of COVID-19.
- Engage in global efforts to respond to the challenges of COVID-19 in managing maritime vessels.
- Do not implement trade restrictions beyond those considered to be of public health importance in accordance with relevant international agreements.
- Continue to provide appropriate public health rationale to WHO for additional health measures in accordance with IHR.
Health Workers
- Prioritize the protection of the health workforce through access to training and provision of personal protective equipment, infection prevention and control measures, improved working conditions, application of WHO recommended testing strategies,
  and prevention of stigma and attacks on health workers.
Food Security
- Work with WHO and partners to strengthen the global food supply chain, protect food workers, properly manage food markets, and mitigate possible disruptions to the food supply, especially for vulnerable populations.
One Health
- Promote sound practices to manage risks of trade of live animals in food markets and regulate trade of exotic wildlife.
Risk Communications and Community Engagement
- Continue to engage communities to address rumours and misinformation and keep the public informed, with a focus on vulnerable populations.
Research and development
- Address research gaps such as: routes of transmission, including the role of asymptomatic and pre-symptomatic infection droplet, contact, fomite and aerosol transmission; and viral shedding; and animal source and intermediate hosts, in collaboration
  with partners.
- Continue to support and conduct COVID-19 research, in line with the WHO Research and Development Blueprint, and the road map for COVID-19 vaccines, diagnostics, and therapeutics.
- Continue sharing full genome sequences to increase global understanding of virus evolution and phylogenetics and their application to public health practices.
Essential Health Services
- Maintain essential health services throughout a likely extended COVID-19 response. This should include essential prevention for communicable diseases, particularly vaccination; services related to reproductive health, including care during pregnancy
  and childbirth; care of vulnerable populations, such as young infants and older adults; provision of medications and supplies for the ongoing management of chronic diseases, including mental health conditions; continuity of critical inpatient
  therapies; management of emergency health conditions and common acute presentations that require time-sensitive intervention; and auxiliary services, such as basic diagnostic imaging, laboratory services, and blood bank services.
- Continue to track and document the impact of COVID-19 on essential health services.
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May 9, 2020
Massive proportion of world’s population are living with herpes infection

Virus causing genital herpes may put millions of people at greater risk of infection with HIV

About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show.

Authored by staff at the University of Bristol, World Health Organization (WHO), and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization,
the new study estimates the global infection prevalence and incidence of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 2016.

“Herpes infection affects millions of people across the globe and can have far-reaching health effects. We need more investment and commitment to develop better treatment and prevention tools for this infection.” says Dr Sami Gottlieb, Medical
Officer at WHO and an author of the study.

Prevalence and incidence

An estimated 491.5 million people were living with HSV-2 infection in 2016, equivalent to 13.2% of the world’s population aged 15 to 49 years. HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital
herpes).

An estimated 3.7 billion people had HSV-1 infection during the same year – around 66.6% of the world’s population aged 0 to 49. HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes). However,
HSV-1 can also be transmitted to the genital area through oral-genital contact – during oral sex – to cause genital herpes. Most HSV-1 infections were oral; however, between 122 million to 192 million people were estimated to have genital
HSV-1 infection, depending on the assumptions used in the estimation model.

Because herpes is a lifelong infection, estimated prevalence increased with age; HSV-2 prevalence was also higher among women and in the WHO African Region.

Health and social impacts

Most people living with herpes, caused by either HSV-1 or 2, are unaware they have the infection.

When symptoms do occur however, oral herpes infection can lead to painful sores around the mouth (“cold sores”). Genital herpes infection can cause recurring, often painful, genital sores, often referred to as genital ulcer disease.

WHO and partners published a study in March 2020 estimating that around 5% of the world’s population (187 million people) suffered from at least one episode of herpes-related genital ulcer disease in 2016 (1). Most of these episodes were due to
HSV-2, which can recur frequently over many years.

Recurrent symptoms of genital herpes can lead to stigma and psychological distress, and can have an important impact on quality of life and sexual relationships. However, in time, most people with herpes adjust to living with the infection.

“Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health”
says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at WHO.

Herpes and HIV

A strong association exists between HSV-2 infection and HIV infection. In 2019, WHO commissioned a modeling study to estimate how much HSV-2 infection might contribute to HIV incidence. The study estimated that almost 30% of new sexually acquired HIV
infections in 2016 worldwide were likely attributable to HSV-2 infection (2).

Evidence shows that people with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. HSV-2 leads to inflammation and small breaks in the genital and anal skin that can make it easier for HIV to cause infection.
In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others.

Women have higher biologic susceptibility to both HSV-2 and HIV. Women living in the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection, with negative implications for their health
and well-being.

For people living with HIV (or who are living with other conditions that compromise their immune systems) as well as HSV-2, the symptoms of herpes can be more severe and more frequent.

Neonatal herpes

Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. This is a rare condition, occurring in an estimated 10 out of every 100,000 births globally, but can lead to lasting neurologic disability or death. The risk
for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants.

No cure – better treatment and prevention needed

There is no cure for herpes. At present, antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally.

In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of HSV infections. Such research includes
the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.

“A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

Related publications

WHO guidelines for the treatment of Genital Herpes Simplex Virus

WHO preferred product characteristics for herpes simplex virus vaccines

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(1) Looker KJ, Johnston C, Welton NJ, et al. The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study. BMJ Glob Health. 2020;5(3):e001875. doi: 10.1136/bmjgh-2019- 001875.

(2) Looker KJ, Welton NJ, Sabin KM, et al.Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence: a population attributable fraction analysis using published epidemiological data. Lancet Infect Dis.2020;20(2):240-249. doi: 10.1016/S1473-3099(19)30470-0.

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May 9, 2020
Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

Indonesia recently completed the last of its annual large-scale treatment for lymphatic filariasis (also known as elephantiasis or Penyakit Kaki Gajah) in Malaka District located in its southernmost province, East Nusa Tenggara. Unprecedented
progress by the National Lymphatic Filariasis Elimination Programme has strongly placed the country on the path to achieving the elimination of lymphatic filariasis as a public health problem.

“We reached an estimated number of 40.7 million people living in the 118 high-risk districts during this month-long treatment campaign in October 2019” said Dr Anung Sugihantono, who recently retired as Director General of Diseases
Prevention and Control, Ministry of Health Indonesia. “Single doses of diethylcarbamazine citrate and albendazole facilitated by WHO were delivered to all eligible populations.”

In 2010, an estimated 125 million Indonesians were still at risk of the disease and required treatment.

But things changed considerably in 2015 when Indonesia mounted an annual national campaign to resolutely address transmission of the disease and to tackle the morbidity and disability associated with it. The results were apparent as early as 2017, with
remarkable progress.

In Indonesia, LF is considered a significant public health concern. In 2009, risk mapping identified a population of 124.5 million people needing treatment for LF. The country initiated a national level LF elimination campaign in 2015, addressing both
disease prevention and management.

“In 2017 and in just two years we managed to achieve 100% geographical coverage of all people requiring treatment” said Dr Sugihantono. “It meant achieving more than 78% epidemiological coverage – much higher than the generally recommended 65% to stop transmission.”

Transmission of lymphatic filariasis can be stopped through large-scale treatment (or mass drug administration – MDA) of entire at- risk communities with recommended medicines once a year. These medicines kill the microfilariae in an infected patient’s
blood preventing mosquitoes to transmit¹ the disease to others. Through mass treatment, the aim is to reduce the reservoir of microfilariae in the blood to a level insufficient to maintain transmission by the mosquito vector.

This strategy to interrupt transmission is the corner-stone of the World Health Organization’s (WHO) Global Program to Eliminate Lymphatic Filariasis (GPELF). Indonesia has been using the GPELF’s strategy since 2002 using a district or city
as its implementation unit.

In 2005, it listed the elimination of LF as a national priority for controlling infectious diseases and the medicines it has been using in large-scale treatment programmes are diethylcarbamazine citrate (DEC) and albendazole² which are
largely distributed by volunteer community health workers³.

“Community health volunteers are themselves members of the community and know how to reach people effectively to improve compliance” said Dr. Stefanus Bria Seran, the Regent of Malaka District, one of LF endemic district in Indonesia. “Besides ensuring every single person ingests the medicine given to them, these community workers help in disseminating information well before a large-scale treatment campaign and also assist in reporting activities related to each treatment campaign”.

Indonesia’s efforts to eliminate lymphatic filariasis began in the 1970s but faced numerous challenges including programme coordination in the many inhabited islands, conducting information, education and awareness programmes, lack of capacity and
insufficient medicines.

Furthermore, the situation in Indonesia is unusual than in many other countries endemic for lymphatic filariasis as the country is endemic for all three species of thread-like filarial worms – Brugia malayi, Brugia timori, and Wuchereria bancrofti –
that cause the disease. Most of the infections in Indonesia, however, are caused by B. malayi.

In the past, some of the factors that prevented access to the medicines (DEC and albendazole) were social stigmatization linked to the disease, the vast geography of the territory and challenges in reaching remote populations.

With an estimated population of 242 million, Indonesia is the world’s largest island nation and consists of approximately 17,000 islands, of which 5,000–6,000 are inhabited. It is the fourth most populated nation behind China, India, and the United
States.

Indonesia is endemic for many other neglected tropical diseases and an estimated 110 million Indonesians are believed to suffer from at least one neglected tropical disease (NTD), including lymphatic filariasis and soil-transmitted helminth infections.
Leptospirosis (not classified as NTD) is also widespread.

Indonesia is the only country of WHO’s South East Asia Region with endemic schistosomiasis. Like many other countries of the Region, it also faces recurrent threats of dengue outbreaks.

Global progress

The world has made significant progress towards the elimination of lymphatic filariasis as a public health problem.

Sixteen countries⁴ and one territory are now acknowledged by WHO to have achieved elimination of lymphatic filariasis as a public health problem.

Seven additional countries have successfully implemented recommended strategies, stopped large-scale treatment and are under surveillance to demonstrate that elimination has been achieved.

The disease

Lymphatic filariasis is caused by infection with parasitic worms living in the lymphatic system. The larval stages of the parasite (microfilaria) circulate in the blood and are transmitted from person to person by mosquitoes.

Infection involves asymptomatic, acute, and chronic conditions. Most infections are asymptomatic, showing no external signs while contributing to transmission of the parasite. Although asymptomatic, these infections still cause damage to the lymphatic
system and the kidneys and alter the body’s immune system.

When lymphatic filariasis develops into chronic conditions it leads to lymphoedema (tissue swelling) or elephantiasis (skin/tissue thickening) of limbs and hydrocele (scrotal swelling). Involvement of breasts and genital organs are common.

Manifestation of the disease after infection takes time and can result in an altered lymphatic system, causing abnormal enlargement of body parts, and leading to severe disability and social stigmatization of those affected.

¹Lymphatic filariasis is transmitted by different types of mosquitoes – e.g the Culex mosquito which widespread across urban and semi-urban areas; Anopheles, mainly found in rural areas; and, Aedes, mainly
in endemic islands in the Pacific.

²In 2017, WHO recommended an alternative three drug treatment to accelerate the global elimination of lymphatic filariasis. The treatment, known as IDA, involves a combination of ivermectin, diethylcarbamazine citrate and albendazole.
It is recommended annually in settings where its use is expected to have the greatest impact.

³Community health workers, also called ‘cadres’, are volunteers who form part of the communities they serve and work with local
communities to educate families. Their contribution in promoting health has been significant in the country.

⁴Cambodia, The Cook Islands, Egypt, Kiribati, Maldives, Marshall Islands, Niue, Palau, Sri Lanka, Thailand, Togo, Tonga, Vanuatu, Viet Nam, Wallis and Futuna, and Yemen

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May 9, 2020
New estimates highlight need to step up the response to hepatitis D

Lyon, France, 29 April 2020 – In a study published in the Journal of Hepatology,¹ Professor Anna Maria Geretti and Dr Alexander Stockdale from the University of Liverpool (United Kingdom), in collaboration with researchers
from the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), estimate that worldwide, hepatitis D virus (HDV) affects nearly 5% of people who have a chronic infection with hepatitis B virus (HBV) and that HDV
co-infection could explain about 1 in 5 cases of liver disease and liver cancer in people with HBV infection..

To map the epidemiology of HDV infection in the world, Professor Geretti and Dr Stockdale joined forces with the WHO Global Hepatitis Programme and IARC, alongside investigators in Germany, Malawi, and the United Kingdom. “Infection with HDV occurs
in about 1 in 22 cases of chronic HBV infection in the world,” Dr Stockdale says. “More high-quality data are needed, but we have identified several geographical hotspots of high prevalence of HDV infection: in Mongolia, the Republic of
Moldova, and countries in Western and Middle Africa.”

“Although it is less common than hepatitis B, hepatitis D is a serious disease that often affects underprivileged and vulnerable populations,” says Dr Meg Doherty, Director of the WHO Global Hepatitis Programme. Those who are more likely to
have HBV and HDV co-infection include people who inject drugs and people with hepatitis C virus or HIV infection. The risk of co-infection also appears to be higher in recipients of haemodialysis, men who have sex with men, and commercial sex workers.
Dr Doherty points out, “This information helps in identifying the groups with HBV among whom we should be looking for HDV.”

HDV (formerly known as the Delta agent) is a small virus – one of the smallest that is known to cause disease in humans – and can replicate only in the presence of HBV, from which HDV borrows some of its structures. Compared with people with
HBV infection alone, those who have a chronic infection with both HBV and HDV have a much higher risk of developing disease in the form of cirrhosis and liver cancer. “HDV is a significant contributor to severe liver disease and liver cancer,”
says IARC scientist Dr Catherine de Martel. “The findings from this study inform our work on the association between viral infections and cancer, which is focused on developing improved prevention strategies.”

Professor Geretti concludes, “HDV has long been neglected, because for decades the prevalence of infection remained uncertain and effective treatment was lacking. Mapping the epidemiology of the infection is just the first step. More efforts are
needed to reduce the global burden of chronic hepatitis B and develop medicines that are safe and effective against hepatitis D and are affordable enough to be deployed on a large scale to those who are most in need.”

¹ Stockdale AJ, Kreuels B, Henrion MYR, Giorgi E, Kyomuhangi I, de Martel C, Hutin Y, Geretti AM (2020). The global prevalence of hepatitis D virus infection: systematic review and meta-analysis. J Hepatol. Published online 23 April 2020;
https://doi.org/10.1016/j.jhep.2020.04.008

For more information, please contact

Véronique Terrasse, Communications Group, at +33 (0)6 45 28 49 52 or terrassev@iarc.fr or IARC Communications, at com@iarc.fr

The International Agency for Research on Cancer (IARC) is part of the World Health Organization. Its mission is to coordinate and conduct research on the causes of human cancer, the mechanisms of carcinogenesis, and to develop scientific strategies for
cancer control. The Agency is involved in both epidemiological and laboratory research and disseminates scientific information through publications, meetings, courses, and fellowships. If you wish your name to be removed from our press release emailing
list, please write to com@iarc.fr.

About University of Liverpool

Founded in 1881 as the original ‘red brick’, the University of Liverpool is one of the UK’s leading research-intensive higher education institutions. Consistently ranked in the top 200 universities worldwide, we are a member of the prestigious
Russell Group and have a global reach and influence that reflects our academic heritage as one of the country’s largest civic institutions. For more information please visit us at www.liverpool.ac.uk

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May 9, 2020
Global leaders unite to ensure everyone everywhere can access new vaccines, tests and treatments for COVID-19

Heads of state and global health leaders today made an unprecedented commitment to work together to accelerate the development and production of new vaccines, tests and treatments for COVID-19 and assure equitable access worldwide.

The COVID-19 pandemic has already affected more than 2.4 million people, killing over 160,000. It is taking a huge toll on families, societies, health systems and economies around the world, and for as long as this virus threatens any country, the entire world is at risk.

There is an urgent need, therefore, while following existing measures to keep people physically distanced and to test and track all contacts of people who test positive, for innovative COVID-19 vaccines, diagnostics and treatments.

“We will only halt COVID-19 through solidarity,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Countries, health partners, manufacturers, and the private sector must act together and ensure that the fruits of science and research can benefit everybody.”

Work has already started. Since January, WHO has been working with researchers from hundreds of institutions to develop and test vaccines, standardize assays and standardize regulatory approaches on innovative trial designs and define criteria to prioritize vaccine candidates. The Organization has prequalified diagnostics that are being used all over the world, and more are in the pipeline. And it is coordinating a global trial to assess the safety and efficacy of four therapeutics against COVID-19.

The challenge is to speed up and harmonize processes to ensure that once products are deemed safe and effective, they can be brought to the billions of people in the world who need them. Past experience, in the early days of HIV treatment, for example, and in the deployment of vaccines against the H1N1 outbreak in 2009, shows that even when tools are available, they have not been equally available to all.

So today leaders came together at a virtual event, co-hosted by the World Health Organization, the President of France, the President of the European Commission, and the Bill & Melinda Gates Foundation. The event was joined by the UN Secretary General, the AU Commission Chairperson, the G20 President, heads of state of France, South Africa, Germany, Vietnam, Costa Rica, Italy, Rwanda, Norway, Spain, Malaysia and the UK (represented by the First Secretary of State).

Health leaders from the Coalition for Epidemic Preparedness Innovations (CEPI), GAVI-the Vaccine Alliance, the Global Fund, UNITAID, the Wellcome Trust, the International Red Cross and Red Crescent Movement (IFRC), the International Federation of Pharmaceutical Manufacturers (IFPMA), the Developing Countries Vaccine Manufacturers’ Network (DCVMN), and the International Generic and Biosimilar Medicines Association (IGBA) committed to come together, guided by a common vision of a planet protected from human suffering and the devastating social and economic consequences of COVID-19, to launch this groundbreaking collaboration. They are joined by two Special Envoys: Ngozi Okonjo-Iweala, Gavi Board Chair and Sir Andrew Witty, former CEO of GlaxoSmithKline.

They pledged to work towards equitable global access based on an unprecedented level of partnership. They agreed to create a strong unified voice, to build on past experience and to be accountable to the world, to communities and to one another.

“Our shared commitment is to ensure all people have access to all the tools to prevent, detect, treat and defeat COVID-19,” said Dr Tedros. “No country and no organization can do this alone. The Access to COVID-19 Tools Accelerator brings together the combined power of several organizations to work with speed and scale.”

Health leaders called on the global community and political leaders to support this landmark collaboration and for donors to provide the necessary resources to accelerate achievement of its objectives, capitalizing on the opportunity provided by a forthcoming pledging initiative that starts on 4 May 2020. This initiative, spearheaded by the European Union, aims to mobilize the significant resources needed to accelerate the work towards protecting the world from COVID-19.

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May 9, 2020
Hard fought gains in immunization coverage at risk without critical health services, warns WHO

Shutting down immunization services in the COVID-19 pandemic risks triggering a resurgence of diseases that can be prevented with safe and effective vaccines, warns WHO in the lead-up to World Immunization Week (24-30 April).

When immunization services are disrupted, even for brief periods during emergencies, the risk of vaccine-preventable disease outbreaks, such as measles and polio, increase. Last year’s deadly measles outbreak in the Democratic Republic of the
Congo, which took more than 6000 lives in a country already facing its largest Ebola outbreak, highlights the importance of maintaining essential health services, such as immunization in times of emergency. Further disease outbreaks will also overwhelm
health systems already battling the impacts of COVID-19.

“Disease outbreaks must not remain a threat when we have safe and effective vaccines to protect us,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “While the world strives to develop a new vaccine for COVID-19 at record speed,
we must not risk losing the fight to protect everyone, everywhere against vaccine-preventable diseases. These diseases will come roaring back if we do not vaccinate.”

WHO is working with partners all over the world to accelerate research and development of a safe and effective vaccine and ensure equitable access for the billions of people who will need it.

But even with an expedited process, development of a vaccine for COVID-19 will take time. Precautionary measures are essential now to help keep us safe from disease, including diseases for which vaccines already protect children and adults.

Too many people are still excluded from the benefits of vaccines

Prior to the COVID-19 pandemic, the world had made immense progress in ensuring that children are vaccinated. In 2018, 86 percent of children under the age of five globally were vaccinated with three doses of diphtheria, tetanus and pertussis (DTP3) and
one dose of the measles vaccine, up from 72 percent in 2000 and 20 percent in 1980. The number of children paralyzed by polio has been reduced by 99.9 percent worldwide.

Yet, global vaccination coverage is still far from the 95 per cent coverage needed to fully protect communities against outbreaks of this vaccine-preventable disease.

In 2018 nearly 20 million children worldwide – more than 1 in 10 – missed out on lifesaving vaccines, such as measles, diphtheria and tetanus. Roughly, 13 million of the children have never received any vaccines, putting them and their communities
at risk of disease and death. The majority of these children live in countries with already fragile health systems, further limiting their access to essential health services when they fall sick.

Measles continues to remain an ever-present threat, especially if vaccination rates drops. Current projections indicate that the number of reported measles cases for 2019 will be at least 800 000. In 2020 there are increasing concerns about another
resurgence, especially if vaccination rates fall due to delay or suspension of scheduled immunization activities as a result of COVID-19.

Outbreaks of polio, diphtheria and yellow fever are also of high concern, especially in the countries least able to respond quickly and decisively to address an emerging outbreak, as seen in previous emergencies such as the polio outbreak in Syria in
2013.

Maintaining immunization services during COVID-19

As the response to COVID-19 continues, countries must act now protect immunization services, in order to further minimize disease outbreaks and loss of life. This includes, facilitating urgent catch up programmes in places where
services have been disrupted, ensuring strong supply chains, disease surveillance and trained health workers. Caregivers should also make sure they continue to vaccinate their children in line with national policies.

New WHO guidelines on immunization and COVID-19 recommend that governments temporarily pause preventive immunization
campaigns where there is no active outbreak of a vaccine-preventable disease. But it urges countries prioritize the continuation of routine immunization of children in essential service delivery, as well as adult vaccinations such as influenza
for groups most at risk. If immunization services must be suspended, urgent catch-up vaccinations should be rescheduled as soon as possible, prioritizing those most at risk.

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May 9, 2020