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Statement of the Twenty-Fourth IHR Emergency Committee
The Twenty-fourth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened by the Director General on 26 March 2020 with committee members only attending
via teleconference, supported by the WHO Secretariat. In order to ease the burden on affected State Parties in the exceptional situation following the determination of the COVID-19 outbreak as a Public Health Emergency of International Concern
(PHEIC) on 30 January 2020, characterized as a pandemic on 11 March 2020, the invited State Parties were asked to present their reports electronically only instead of attending via teleconference. Reports were received from Afghanistan, Burkina
Faso, Central African Republic, Cote d’Ivoire, Democratic Republic of Congo (DR Congo), Ethiopia, Ghana, Pakistan, and Philippines.

The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV). The WHO Secretariat presented a report of progress for affected IHR States Parties subject to Temporary Recommendations.

Wild poliovirus

The Committee remains gravely concerned by the significant increase in WPV1 cases globally in 2019 and 2020, with 175 cases in 2019 compared to 33 in 2018, and already 32 cases as at 17 March 2020, compared to six for the same period in 2019, with no
significant success yet in reversing this trend.

In Pakistan transmission continues to be widespread, as indicated by both acute flaccid paralysis (AFP) surveillance and environmental sampling. While the issues of vaccine hesitancy and refusals by individuals and communities and problems with management
of the national polio program are being addressed, these are yet to have impact on the current worrying epidemiology. The added pressure on the program due to detection of cVDPV2 and ongoing spread in several provinces (see below) has continued
into 2020.

In Afghanistan, the security situation remains very challenging. Inaccessibility and missed children particularly in the Southern Region have led to a large cohort of susceptible children in this part of Afghanistan. The risk of a major upsurge
of cases is growing, with other parts of the country that have been free of WPV1 for some time now at risk of outbreaks. This would again increase the risk of international spread.

The Committee noted that based on sequencing of viruses, there were recent instances of international spread of viruses from Pakistan to Afghanistan and also from Afghanistan to Pakistan. The recent increased frequency of WPV1 international
spread between the two countries suggests that rising transmission in Pakistan and Afghanistan correlates with increasing risk of WPV1 exportation beyond the single epidemiological block formed by the two countries.

The Committee noted the continued cooperation and coordination between Afghanistan and Pakistan, particularly in reaching high risk mobile populations that frequently cross the international border and welcomed the all-age vaccination now being taken
at key border points between the two countries.

Vaccine derived poliovirus (VDPV)

The multiple cirulating VDPV (cVDPV) outbreaks in four WHO regions (African, Eastern Mediterranean, South-east Asian and Western Pacific Regions) are very concerning, with two new countries reporting outbreaks since the last meeting (Malaysia and Burkina
Faso). Unlike historical experience, cross border spread of cVDPV2 has become quite common, with recent spread from Angola to DR Congo and Zambia, and from Chad and CAR to Cameroon, and from Ghana to Burkina Faso. In addition, local emergences
attributable to mOPV2 use have recently occurred in Togo, Chad and Ethiopia.

The Committee noted that the GPEI has published a strategy to address cVDPV2 outbreaks but was extremely concerned that the monovalent OPV2 stockpile was still depleted. The Committee strongly supports the development and proposed Emergency Use
Listing of the novel OPV2 vaccine which should become available mid-2020, and which it is hoped will result in no or very little seeding of further outbreaks.

Impact of COVID-19

The Committee noted the very recent policy guidance of the GPEI:
- GPEI recommendations for countries during the COVID-19 pandemic. This document summarizes the recommendations from the Polio Oversight Board meeting on 24 March 2020 which calls for postponement of both preventive and outbreak response campaigns,
  while ensuring surveillance and nOPV2 development and roll out plans continue in full.
- The COVID-19 Polio programme continuity plan. The operational guide was developed in collaboration with the regional polio eradication teams and the GPEI Partners to ensure essential GPEI functions continue, polio programme personnel and staff are
  kept safe, and to plan for a fast and effective resumption of polio eradication activities including supplementary immunization activities as soon as the public health situation with COVID-19 allows.
The Committee is extremely concerned about the impact of the COVID-19 pandemic on the risk of heightened transmission of polio and consequently the potential for international spread and significant reversal of polio eradication.

Conclusion

The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months. However
noting that some if not many international borders are closed to prevent international spread of COVID-19, State Parties may not currently be able to enforce the Temporary Recommendations in all places. The Committee strongly urges countries
subject to these recommendations to maintain a high state of readiness to implement them as soon as possible ensuring the continued safety of travelers as well as health professionals . The Committee recognizes the concerns regarding the lengthy
duration of the polio PHEIC, but concludes that the current situation is extraordinary, with clear ongoing risk of international spread and ongoing need for coordinated international response. The Committee considered the following factors in reaching
this conclusion:
- Rising risk of WPV1 international spread: The progress made in recent years appears to have reversed, with the Committee’s assessment that the risk of international spread is at the highest point
  since 2014 when the PHEIC was declared. This risk assessment is based on the following:
  - the WPV1 exportation in 2019 from Pakistan to Iran and to Afghanistan, and more recently spread from Afghanistan to Pakistan;
  - ongoing rise in the number of WPV1 cases and positive environmental samples in Pakistan, and to a lesser extent Afghanistan;
  - the quickly increasing cohort of unvaccinated children in Afghanistan, with the risk of a major outbreak imminent if nothing is done to access these children;
  - the urgent need to overhaul the leadership and strategy of the program in Pakistan, which although already commenced, is likely take some time to lead to more effective control of transmission
    and ultimately eradication;
  - increasing community and individual resistance to the polio program.
- Rising risk of cVDPV international spread: The clearly documented increased spread in recent months of cVDPV2 demonstrate the unusual nature of the current situation, as international spread of cVDPV
  in the past has been very infrequent. The number of new emergences of cVDPV2 in Africa raises further concern. The risk of new outbreaks in new countries is considered extremely high, even probable.
- COVID-19: This new and unprecedented pandemic is likely to substantially negatively impact the polio eradication program and outbreak control efforts. There is a risk of exportation of both
  WPV1 and cVDPV to known high risk countries, to which it may take a lot of time and effort to adequately respond.
- Falling PV2 immunity: Global population mucosal immunity to type 2 polioviruses (PV2) continues to fall, as the cohort of children born after OPV2 withdrawal grows, exacerbated by poor coverage
  with IPV particularly in some of the cVDPV infected countries.
- Multiple outbreaks: The evolving and unusual epidemiology resulting in rapid emergence and evolution of cVDPV2 strains is extraordinary and not yet fully understood and represents an additional risk
  that is yet to be quantified.
- Weak routine immunization: Many countries have weak immunization systems that can be further impacted by various humanitarian emergencies including COVID19, and the number of countries in which immunization
  systems have been weakened or disrupted by conflict and complex emergencies poses a growing risk, leaving populations in these fragile states vulnerable to outbreaks of polio.
- Surveillance gaps: The appearance of highly diverged VDPVs in the Philippines, Somalia and Indonesia are examples of inadequate polio surveillance, heightening concerns that transmission could be missed
  in various countries. Furthermore, the missed transmission in China for a year illustrates that even countries with generally good surveillance can miss VDPV transmission. COVID-19 is likely to have a negative impact on polio surveillance
  also.
- Lack of access: Inaccessibility continues to be a major risk, particularly in several countries currently infected with WPV or cVDPV, i.e. Afghanistan, Nigeria, Niger, Somalia and Myanmar, which all
  have sizable populations that have been unreached with polio vaccine for prolonged periods.
- Population movement: The risk is amplified by population movement, whether for family, social, economic or cultural reasons, or in the context of populations displaced by insecurity and returning refugees.
  There is a need for international coordination to address these risks. A regional approach and strong crossborder cooperation is required to respond to these risks, as much international spread of polio occurs over land borders.
Risk categories

The Committee provided the Director-General with the following advice aimed at reducing the risk of international spread of WPV1 and cVDPVs, based on the risk stratification as follows:
- States infected with WPV1, cVDPV1 or cVDPV3, with potential risk of international spread.
- States infected with cVDPV2, with potential risk of international spread.
- States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV.
Criteria to assess States as no longer infected by WPV1 or cVDPV:
- Poliovirus Case: 12 months after the onset date of the most recent case PLUS one month to account for case detection, investigation, laboratory testing and reporting period OR when all reported AFP cases with onset within 12 months of last case have been tested for polio and excluded for WPV1 or cVDPV, and environmental or other samples collected within 12 months of the last case have also tested negative, whichever is the longer.
- Environmental or other isolation of WPV1 or cVDPV (no poliovirus case): 12 months after collection of the most recent positive environmental or other sample (such as from a healthy child) PLUS one month to account for the laboratory testing and reporting period
- These criteria may be varied for the endemic countries, where more rigorous assessment is needed in reference to surveillance gaps (e.g. Borno State, Nigeria)
Once a country meets these criteria as no longer infected, the country will be considered vulnerable for a further 12 months. After this period, the country will no longer be subject to Temporary Recommendations, unless the Committee has concerns based on the final report.

TEMPORARY RECOMMENDATIONS

States infected with WPV1, cVDPV1 or cVDPV3 with potential risk of international spread

WPV1

Afghanistan                               (most recent detection 25 February 2020)

Pakistan                                                (most recent detection 2 March 2020)

Nigeria                                      (most recent detection 27 Sept 2016)

cVDPV1

Malaysia                                     (most recent detection 26 October 2019)

Myanmar                                   (most recent detection 9 August 2019)

Philippines                                 (most recent detection 28 October 2019)

These countries should:
- Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency and implement all required measures to support polio eradication; where such declaration has already been made, this emergency status should be maintained as long as the response is required.
- Ensure that all residents and longterm visitors (i.e. > four weeks) of all ages, receive a dose of bivalent oral poliovirus vaccine (bOPV) or inactivated poliovirus vaccine (IPV) between four weeks and 12 months prior to international travel.
- Ensure that those undertaking urgent travel (i.e. within four weeks), who have not received a dose of bOPV or IPV in the previous four weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travelers.
- Ensure that such travelers are provided with an International Certificate of Vaccination or Prophylaxis in the form specified in Annex 6 of the IHR to record their polio vaccination and serve as proof of vaccination.
- Restrict at the point of departure the international travel of any resident lacking documentation of appropriate polio vaccination. These recommendations apply to international travelers from all points of departure, irrespective of the means of conveyance (e.g. road, air, sea).
- Further intensify crossborder efforts by significantly improving coordination at the national, regional and local levels to substantially increase vaccination coverage of travelers crossing the border and of high risk crossborder populations. Improved coordination of crossborder efforts should include closer supervision and monitoring of the quality of vaccination at border transit points, as well as tracking of the proportion of travelers that are identified as unvaccinated after they have crossed the border.
- Further intensify efforts to increase routine immunization coverage, including sharing coverage data, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication.
- Maintain these measures until the following criteria have been met: (i) at least six months have passed without new infections and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until the state meets the above assessment criteria for being no longer infected.
- Provide to the Director-General a regular report on the implementation of the Temporary Recommendations on international travel.
States infected with cVDPV2s, with potential or demonstrated risk of international spread

Afghanistan           (most recent detection 8 January 2020)

Angola                      (most recent detection 9 February 2020)

Benin                        (most recent detection 9 December 2020)

Burkina Faso          (most recent detection 11 January 2020)

Cameroon              (most recent detection 30 January 2020)

CAR                           (most recent detection 5 February 2020)

Chad                         (most recent detection 5 February 2020)

Cote d’Ivoire          (most recent detection 11 February 2020)

China                        (most recent detection 25 April 2019)

DR Congo                 (most recent detection 22 January 2020)

Ethiopia                (most recent detection 21 February 2020)

Ghana                      (most recent detection 28 January 2020)

Malaysia                 (most recent detection 18 January 2020)

Niger                         (most recent detection 3 April 2019)

Nigeria                  (most recent detection1 January 2020)

Pakistan                   (most recent detection 12 February 2020)

Philippines              (most recent detection 16 January 2020)

Somalia                    (most recent detection 4 February 2020)

Togo                          (most recent detection 10 January 2020)

Zambia                     (most recent detection 25 November 2019)

These countries should:
- Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency and implement all required measures to support polio eradication; where such declaration has already been made, this emergency status should be maintained.
- Noting the existence of a separate mechanism for responding to type 2 poliovirus infections, consider requesting vaccines from the global mOPV2 stockpile based on the recommendations of the Advisory Group on mOPV2.
- Encourage residents and longterm visitors to receive a dose of IPV four weeks to 12 months prior to international travel; those undertaking urgent travel (i.e. within four weeks) should be encouraged to receive a dose at least by the time of departure.
- Ensure that travelers who receive such vaccination have access to an appropriate document to record their polio vaccination status.
- Intensify regional cooperation and crossborder coordination to enhance surveillance for prompt detection of poliovirus, and vaccinate refugees, travelers and crossborder populations, according to the advice of the Advisory Group.
- Further intensify efforts to increase routine immunization coverage, including sharing coverage data, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication.
- Maintain these measures until the following criteria have been met: (i) at least six months have passed without the detection of circulation of VDPV2 in the country from any source, and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until the state meets the criteria of a ‘state no longer infected’.
- At the end of 12 months without evidence of transmission, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.
States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV

WPV1
- none
  cVDPV
  - Kenya cVDPV2 (last env positive specimen 21 March 2018)
  - Mozambique cVDPV2 (last virus detected 17 December 2018)
  - PNG cVDPV1 (last environmental positive specimen 6 November 2018)
  - Indonesia cVDPV1 (last virus detected 13 February 2019)
These countries should:
- Urgently strengthen routine immunization to boost population immunity.
- Enhance surveillance quality, including considering introducing supplementary methods such as environmental surveillance, to reduce the risk of undetected WPV1 and cVDPV transmission, particularly among high risk mobile and vulnerable populations.
- Intensify efforts to ensure vaccination of mobile and crossborder populations, Internally Displaced Persons, refugees and other vulnerable groups.
- Enhance regional cooperation and cross border coordination to ensure prompt detection of WPV1 and cVDPV, and vaccination of high risk population groups.
- Maintain these measures with documentation of full application of high quality surveillance and vaccination activities.
- At the end of 12 months without evidence of reintroduction of WPV1 or new emergence and circulation of cVDPV, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.
Additional considerations

Impact of COVID-19 on the polio program:
- The committee urges all countries, but particularly those at high risk of polio, to maintain a high level of polio surveillance throughout the pandemic period, noting that the postponement of polio immunization campaigns whether preventive or in response to outbreaks may lead to an increase in polio transmission including international spread. Maintainenance of access to laboratory diagnosis in the face of widespread transport and shipping disruption is critical.
- Secondly, countries affected by campaign postponement should strive to maintain a high degree of operational readiness in order that immunization activities, including border vaccination, can resume quickly adhering to principles of good hygiene and safety for the vaccinee as well as for the health professionals to prevent COVID-19 spread. This includes ensuring teams have access to appropriate personal protective equipment.
- Given the risk of international spread, countries need to ensure that they are ready to use appropriate vaccines, as recommended by the Strategic Advisory Group of Experts on Immunization, in response to new outbreaks.
- The committee urged countries to maximize the use of polio assets to synergistically address the COVID19 pandemic, noting that polio affected countries may be vulnerable to poorer outcomes in the pandemic due to health care system fragility and poorer health status of the population generally.
- Lastly the pandemic should serve as a reminder to high risk countries with poor immunization coverage that infectious disease outbreaks can lead to social and economic disruption as well as straining the health care system, and countries can increase their population resilience and recovery through prioiritising robust immunization programmes. This is relevant not only to polio, but to all other vaccine preventable diseases particularly measles.
Based on the current situation regarding WPV1 and cVDPV, and the reports provided by affected countries, the Director-General accepted the Committee’s assessment and on 7 April 2020 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV. The Director-General endorsed the Committee’s recommendations for countries meeting the definition for ‘States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread’, ‘States infected with cVDPV2 with potential risk for international spread’ and for ‘States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV’ and extended the Temporary Recommendations under the IHR to reduce the risk of the international spread of poliovirus, effective 7 April 2020.

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April 9, 2020
WHO and Global Citizen announce: ‘One World: Together at home’ Global Special to support healthcare workers in the fight against the COVID-19 pandemic

‘One World: Together At Home’ global special to air on Saturday, 18 April 2020 in celebration and support of healthcare workers, broadcast to feature real experiences from doctors, nurses and families around the world.

Powered by commitments from supporters and corporate partners in benefit of the COVID-19 Solidarity Response Fund, Broadcast special to also benefit local and regional charities that provide food, shelter and healthcare to those that need help most.

Historic broadcast to be hosted by Jimmy Fallon of ‘The Tonight Show,’ Jimmy Kimmel of ‘Jimmy Kimmel Live’ and Stephen Colbert of ‘The Late Show with Stephen Colbert,’ Friends from Sesame Street Also on hand to help unify and inspire people around the world to take meaningful actions that increase support for the global COVID-19 response.

Curated in collaboration with Lady Gaga, broadcast to include Alanis Morissette, Andrea Bocelli, Billie Eilish, Billie Joe Armstrong of Green Day, Burna Boy, Chris Martin, David Beckham, Eddie Vedder, Elton John, FINNEAS, Idris and Sabrina Elba, J Balvin, John Legend, Kacey Musgraves, Keith Urban, Kerry Washington, Lang Lang, Lizzo, Maluma, Paul McCartney, Priyanka Chopra Jonas, Shah Rukh Khan and Stevie Wonder.

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Geneva/New York – International advocacy organization Global Citizen and the World Health Organization today
announced the One World: Together At Home — a globally televised and streamed special in support of the fight against the COVID-19 pandemic. One World: Together At Home will be broadcast live on Saturday, 18 April 2020 at 5:00
p.m. PDT/8:00 p.m. EDT/12:00 a.m. GMT airing on ABC, NBC, ViacomCBS Networks, iHeartMedia and Bell Media networks and platforms in Canada. Internationally, BBC One will run the program on Sunday 19 April 2020. Additional
international broadcasters include beIN Media Group, MultiChoice Group and RTE. The virtual broadcast will show unity among all people who are affected by COVID-19 and will also celebrate and support brave healthcare
workers doing life-saving work on the front lines.

Hugh Evans, Co-Founder and CEO of Global Citizen, said “As we honor and support the heroic efforts of community health workers, ‘One World: Together At Home’ aims to serve as a source of unity and encouragement in the global fight
to end COVID-19. Through music, entertainment and impact, the global live-cast will celebrate those who risk their own health to safeguard everyone else’s.”

One World: Together At Home will also be a multi-hour digital broadcast streaming online on multiple global platforms, including: Alibaba, Amazon Prime Video, Apple, Facebook, Instagram, LiveXLive, Tencent, Tencent Music Entertainment Group, TIDAL, TuneIn, Twitch, Twitter, Yahoo and
YouTube. This digital special will include additional artists and performances from all over the globe as well as unique stories from the world’s healthcare heroes. For information about how to tune in and take action, visit
www.globalcitizen.org/togetherathome.

“The World Health Organization is committed to defeating the coronavirus pandemic with science and public health measures, and supporting the health workers who are on the frontlines of the response,” said Dr Tedros Adhanom Ghebreyesus,
Director-General of WHO. “We may have to be apart physically for a while, but we can still come together virtually to enjoy great music. The ‘One World: Together At Home’ concert represents a powerful show of solidarity against
a common threat.”

“The United Nations system is fully mobilized: supporting country responses, placing our supply chains at the world’s disposal and advocating for a global cease-fire. We are proud to join forces with ‘One World: Together At Home’
to help suppress the transmission of the virus, minimize social-economic impacts on the global community and work together now to advance Global Goals for the future,” said António Guterres, Secretary-General of the United Nations.
“There is no greater case for collective action than our joint response to COVID-19 – we are in this together and we will get through this together.”

Last month in response to the global pandemic, Global Citizen launched an urgent campaign in support of the COVID-19 Solidarity Response Fund for WHO, powered by the UN Foundation. Calling on individuals to take action,
and asking world leaders and corporations to support the response with sufficient resources, Global Citizens from over 130 countries around the world have taken tens of thousands of actions in support of the response fund.

At this critical moment in history, Global Citizen is also calling on philanthropists to join and support immediate COVID-19 response efforts as part of the organization’s Give While You Live effort. Investors, changemakers and foundation
leaders are being urged to actualize their giving and invest quickly in related efforts like stronger health systems and vaccine development.

Over the past three weeks, the Together At Home series has featured performances from artists including,
Chris Martin, John Legend, Charlie Puth, Common, Shawn Mendes, Camila Cabello, Ryan Tedder of OneRepublic, Niall Horan, Steve Aoki, Jennifer Hudson, Miguel, H.E.R., Anthony Hamilton, Rufus Wainwright, Hozier and Julianne Hough, among others in
support of WHO and Global Citizen’s campaign.

Commitments from supporters and corporate partners will go to the COVID-19 Solidarity Response Fund for WHO to support and equip frontline healthcare workers around the world, with masks, gowns and other vital equipment, and to local charities that provide food, shelter, and healthcare to those that need it most. These local groups have been verified
to ensure that they are helping communities impacted by COVID-19.

For more information about Global Citizen and the campaign to support the WHO’s Solidarity Response Fund, please visit globalcitizen.org and
follow @GlblCtzn Twitter, Facebook and Instagram using #GlobalCitizen.

To learn more about WHO’s response to the pandemic and the COVID-19 Solidarity Response Fund, please go to www.who.int/COVID-19 and follow @WHO on Twitter, Facebook, Instagram,
LinkedIn and TikTok.

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About Global Citizen:

Global Citizen is the world’s largest movement of action takers and impact makers dedicated to ending extreme poverty by 2030. With over 10 million monthly advocates, our voices have the power to drive lasting change around sustainability, equality,
and humanity. We post, tweet, message, vote, sign, and call to inspire those who can make things happen to act — government leaders, businesses, philanthropists, artists, and citizens — together improving lives. By downloading our
app, Global Citizens learn about the systemic causes of extreme poverty, take action on those issues, and earn rewards, which can be redeemed for tickets to concerts, events, and experiences all over the world. To date, the actions of our community,
along with high-level advocacy efforts and work with partners, has resulted in commitments and policy announcements from leaders valued at over $48 billion, affecting the lives of more than 2.25 billion people by 2030. For more information, visit
www.GlobalCitizen.org.

About the World Health Organization:

The World Health Organization (WHO) is the United Nations’ specialized agency for health. It is an inter-governmental organization and works in collaboration with its Member States usually through the Ministries of Health. The World Health Organization
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. Learn more at www.who.int.

About the United Nations Foundation:

The UN Foundation brings together the ideas, people, and resources the United Nations needs to drive global progress and tackle urgent problems. To support the work of the World Health Organization (WHO) in its global work on COVID-19, UN Foundation
helped launch the COVID-19 Solidarity Response Fund that has raised more than $100 million in less than two weeks for lifesaving work around the world. Learn more about the COVID-19 Solidarity Response Fund at www.covid19responsefund.org. Learn more about the UN Foundation at www.unfoundation.org.
Follow @unfoundation on Twitter and Instagram, and @United Nations Foundation on Facebook.

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Note to Editors:

Resources donated to the COVID-19 Solidarity Response Fund will be spent in alignment with the WHO Strategic Preparedness and Response Plan and support the work of multiple organizations. These include WHO, for tracking the virus spread, equipping
health workers, making lab and testing tools available, and providing communities and frontline responders with the latest guidance; enabling UNICEF to equip children and families globally with evidence-based guidance to protect them from COVID-19,
providing water, sanitation and hygiene, and basic infection prevention and control measures to vulnerable countries, and caring for vulnerable families and children; and to CEPI, the Coalition for Epidemic Preparedness Innovations, a key partner
leading the financing for research and development for novel vaccines to combat COVID-19.

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April 8, 2020
WHO to continue support for Chagas disease programme that promotes patient self-care
The World Health Organization (WHO) and the Catalan Ministry of Health say they’ll collectively support the dissemination of a programme that gives support to sufferers affected by Chagas disease to handle their very own well being and promote self-care.

The Catalonian ‘Expert Patient Programme on Chagas disease’ includes interplay and sharing of knowledge amongst individuals affected by the disease and is performed by an knowledgeable patient. The programme is taken into account to have completed very properly because it was first initiated in 2017.

“Over the previous few years we now have seen exceptional improve in consciousness and confidence amongst sufferers to pursue medical care and follow-up with physicians” stated Dr Pedro Albajar Vinas, who’s accountable for WHO’s Chagas disease programme. “When sufferers discuss to each other there may be higher deal with general perceptions of well being, life-style, bettering shallowness, self-care and particular person satisfaction.”

The programme additionally encourages self-responsibility and features as a part of the Chronic Disease Prevention and Care Programme of the Government of Catalonia. It is predicated on three key approaches:
- support supplied by sufferers and observing professionals to these in power part of the disease;
- promote interplay in teams by 9 fastidiously deliberate periods;
- consider efficiency of previous periods by questionnaires earlier than a brand new session begins.
Many individuals who attended the programme over time say they might suggest it to household and associates because it vastly helps to enhance information about disease.

Initiators of the programme are assured that the methodology used, and classes discovered can type a part of a broader technique to push for complete care for a disease that continues to be largely uncared for. For instance, regardless of the efforts of the previous decade, the worldwide detection fee for Chagas disease is lower than 10%.

Through this settlement, WHO will present support in facilitating the interpretation of supplies and paperwork in languages utilized in its Member States in addition to help within the improvement of any mobile-based software if the necessity arises. The Government of Catalonia will print and distribute for advocacy functions.

To promote international advocacy for the disease, the World Health Assembly – WHO’s decision-making physique – in 2019 adopted a call to have a good time World Chagas Disease Day on 14 April.

The disease

Chagas disease was as soon as confined to rural areas of Latin American international locations the place the primary route of transmission is vectorial transmission.

But over the previous many years, the disease has been more and more reported in lots of international locations exterior Latin America primarily due to motion of populations and migration.

According to WHO estimates, round 6-7 million individuals are contaminated with Trypanosoma cruzi – the protozoan parasite that causes Chagas disease.

Vectorial transmission happens when people are available in contact with the faeces or urine of triatomine bugs (referred to as ‘kissing bugs’, amongst many different native names).

These bugs – the vectors that carry the parasites – reside within the wall or roof cracks of properties – the place they disguise in the course of the day and lively at evening after they feed on human blood. They often chew an uncovered space of pores and skin such because the face (therefore its widespread identify ‘kissing bug’).

Right after a chew, the bug defecates/urinates shut to the chew space. The parasites enter the physique when the particular person instinctively reacts to the chew and smears the bug faeces or urine into the chew, the eyes, the mouth, or into any pores and skin break.

The parasite may also be transmitted by:
- consumption of meals contaminated with T. cruzi by, for instance, contact with faeces or urine of contaminated triatomine bugs or marsupials (this type of transmission sometimes causes outbreaks with extra extreme morbidity and better mortality – infecting teams of individuals concurrently with extra frequent instances of extreme disease and better variety of deaths);
- blood or blood product transfusion from contaminated donors;
- passage from an contaminated mom to her new child throughout being pregnant or childbirth;
- some organ transplants utilizing organs from contaminated donors; and
- laboratory accidents.
There is not any vaccine in opposition to Chagas disease. Domiciliary vectorial management and transfusional management, along with congenital transmission, stay the simplest strategies of stopping transmission in Latin America.

Chagas disease was named after Carlos Ribeiro Justiniano Chagas, a Brazilian doctor and researcher who found the disease in 1909.

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April 3, 2020
Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

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

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

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

b)     Manifesting incompetence in the assessment of a patient;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Health workers should:

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

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

•treat patients with respect, compassion and dignity;

•maintain patient confidentiality;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

·         provide access to mental health and counselling resources; and

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[7] Supra

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

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

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April 2, 2020
Joint Statement by QU Dongyu, Tedros Adhanom Ghebreyesus and Roberto Azevedo, Directors-General of the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Trade Organization (WTO)

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

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

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

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

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

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

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April 1, 2020
Sabah, Sarawak not excluded from Prihatin

PUTRAJAYA: The Federal government will cooperate with state governments, specifically in Sabah and Sarawak, to ensure all assistance announced under the people-centric economic stimulus package (Prihatin) reaches them as quickly as possible.

Prime Minister Tan Sri Muhyiddin Yassin (pix) said he was aware that those living in longhouses in Sarawak, Orang Asal settlements and in remote areas in every part of the country might worry that aid would reach them late.

“The Federal government will cooperate with state governments, specifically in Sabah and Sarawak, to ensure all assistance provided by the government will reach them fast,” he said in announcing the RM250 billion package on live television today.

Muhyiddin said besides ensuring the country’s economic activity continued, the government will also pay attention to domestic investment activities that had high multiplier effects and maintained employment.

For that purpose, the government has identified several small-scale projects such as improving road conditions, upgrading dilapidated schools in Sabah and Sarawak, cleaning places of worships and police stations as well as enhancing tourism facilities that would benefit G1 to G4 Grade contractors.

“For that, an allocation of RM2 billion has been set aside,” he said, adding that small-scale projects worth RM2 billion as announced in the previous package would be implemented this April.

He said these included the RM600 million infrastructure projects in Felda and other areas, RM350 million upgrading of dilapidated schools in Sabah and Sarawak and RM150 million upgrading of public housing for the hardcore poor. — Bernama

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March 27, 2020
Schistosomiasis elimination: refocusing on snail control to sustain progress
Substantial progress has been made during the past decade to prevent and control schistosomiasis (also known as bilharziasis) globally. The disease affects more than 230 million people, mostly in sub-Saharan Africa.

Progress is mainly due to large-scale periodic treatment of affected populations with praziquantel, the only medicine recommended by the World Health Organization (WHO) against all forms of schistosomiasis. Regular treatment cures mild symptoms and prevents
progression to severe, chronic disease.

“Through progressive scale-up of periodic large-scale treatment
to control morbidity in many endemic countries, we are closer to
achieving the minimum target of 75% global coverage of all school‐aged
children,” said Dr Amadou Garba Djirmay, who leads WHO’s global schistosomiasis control programme. “But
if we want to achieve elimination, we must go a step further to
introduce snail control in hot spots and in areas targeting elimination.
This is bound to increase impact and accelerate progress towards
interruption of transmission.”

Expansion of treatment is largely supported by donated praziquantel from Merck KGaA of up to 250 million tablets annually. In 2018, almost 78 million children were treated, representing 63% of all school‐aged children eligible for treatment.

Transmission: role of snails

Schistosomiasis is an acute, chronic parasitic disease caused by infection with trematode worms of the genus Schistosoma. It is prevalent in tropical and subtropical areas, especially in poor, rural communities that have little or no access to
safe drinking‐water and basic sanitation. Infection is transmitted when people suffering from schistosomiasis contaminate freshwater sources when evacuating urine and faeces containing the parasite’s eggs.

Once an egg comes into contact with fresh water, it releases miracidia (hatchlings) which enter a snail and produce hundreds of cercariae (larvae) daily. The cercariae enter the human body on contact with the skin and develop into adult worms.

Besides treatment with praziquantel, eliminating snail hosts and improving sanitation are important methods for sustainable prevention of the disease. Dam and irrigation projects are known to be potential sites for outbreaks of the disease. Snail management,
often achieved through mollusciciding, can help to reduce transmission by eliminating these intermediate snail hosts.

Vector control

In 2017, the World Health Assembly – WHO’s decision making body – adopted resolution WHA70.16 on the Global Vector Control
Response, calling on Member States to develop or adapt national vector control strategies and operational plans. The strategy aims to reduce by at least 40% the incidence of vector borne diseases, including schistosomiasis, by 2025.

In response, WHO is reinforcing snail control as part of its strategic approach to achieve the target of eliminating schistosomiasis as a public health problem and, ultimately, the goal of elimination of transmission. Snail control will complement mass
treatment campaigns and sustain the public health impact of this core intervention.

To facilitate implementation of snail control, in 2019 WHO published on specific, standardized procedures and criteria for efficacy
testing and evaluation and in 2017 a manual on the use of molluscicides in the field. WHO is also planning to strengthen capacities
of health staff in medical malacology in order to reinforce snail control activities in countries.

In the past, molluscicides (particularly niclosamide¹ based products) were widely used in schistosomiasis control programmes. For example, in China programmes largely relied on snail control for over 30 years to overcome the disease as a public
health problem. In other parts of the world, however, snail control programmes were gradually discontinued and competencies faded away.

“Snail control is a crucial component of the global schistosomiasis elimination strategy,” said Dr Rajpal Yadav, Scientist, WHO Department of Control of Neglected Tropical Diseases. “It
is time we look for new snail control products that are cost–effective
and of low risk to humans and the environment. Some efforts are being
made to explore molluscicide compounds from plants, marine algae and
microorganisms.”

An integrated control strategy involving mass treatment with praziquantel, snail control and environmental modification, wider access to sanitation and safe water, economic and environmental development, health education and poverty-alleviation can greatly
contribute to sustainable control and elimination of schistosomiasis.

WHO’s new road map on neglected tropical diseases for 2021–2030, due to be launched later this year, advocates enhanced financial and political support to achieve the target of interruption of transmission. Additional research to address gaps,
develop tools and optimize the impact of existing programmes with snail control will complement the core strategic approach.

Schistosomiasis: forms of the disease

There are two major forms of schistosomiasis – intestinal and urogenital.

Intestinal schistosomiasis usually results in diarrhoea and blood in the stool; enlargement of the liver and of the spleen and portal hypertension are common in advanced cases.

Urogenital schistosomiasis is characterized by the presence of blood in the urine. Chronic infection results in fibrosis of the bladder and ureter that can evolve to hydronephrosis and create conditions for bladder cancer.

In women, urogenital schistosomiasis can cause vaginal bleeding, pain during sexual intercourse and nodules in the vulva, a condition now described as female genital schistosomiasis. In men, urogenital schistosomiasis can induce disease in the seminal
vesicles and prostate.

¹Limitations with the use of formulations based on niclosamide include restrictions on the usage of water immediately after application and temporary toxicity to non-target aquatic organisms including
fish, amphibians and invertebrates.
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March 27, 2020
Coronavirus: Stop Wasting Testing Kits On Politicians, AIED Tells NCDC

NCDC

The Advocacy for Integrity and Economic Development has urged the Nigeria Centre for Disease Control to stop wasting “limited testing kits” on political office holders and government officials.

In a statement on Thursday by its Director of Media and Publicity, Comrade O’Seun John, the organisation said the unchecked usage of the scarce testing kits for COVID-19 on government officials and politicians is appalling and a disservice to ordinary Nigerian, who deserve to be truly tested.

The statement reads, “We have noticed with utmost dismay the unending wastage of scarce testing kits for COVID-19 on politicians and political office holders at the detriment of the masses.

“We find this endeavour as a disservice to the people of Nigeria who should be the primary focus of the Nigerian Centre for Disease Control and Ministry of Health.

“From several reports, the NCDC conducts an average of two tests on governors, senators, House of Representatives and Assembly members, Chief of Staff to the President amongst other influential figures in the country.

“These individuals have been solely responsible for the decades of decay and backwardness our health care system is facing. They stood aloof and budgeted billions of naira for frivolous expenses while the citizens suffer in penury, they do not deserve to enjoy the benefits from magnanimous philanthropists who have inconvenient themselves to help Nigerians.

“It is also on record that most, if not all, of the cases recorded or perceived in the corridors of power have been caused by the sheer refusal to submit to simple emergency protocols and checks at the airports. Nigerians should not then be the ones suffering for the ego and pride of these few ones.

“While we acknowledge that not every Nigerian will get tested for COVID-19, it is extremely important that these testing kits are kept safely for the primary use of the average Nigerian.

“The present statistics of less than 200 individuals who have received testing from the NCDC is disgraceful for a population of almost 200 million people. NCDC must channel its resources on improving the testing rates for Nigerians.

“The NCDC should leave the politicians alone and focus on Nigerians who are more in number and at a greater risk. If any politician feels the need to get tested, such politician can charter a flight to Europe, Asia or America where they get their routine medical check-up.”

PUBLIC HEALTH

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March 27, 2020
Ensuring continuity of TB services during the COVID-19 pandemic

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

In the lead- up to World TB Day, Dr Tedros Adhanom Ghebreyesus, WHO Director-General emphasized in a news release, “COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be. The world committed to end TB by 2030; improving prevention is key to making this happen.”

The World Health Organization (WHO) Global TB Programme, along with WHO regional and country offices, has developed an information note, in collaboration with stakeholders. This note is intended to assist national TB programmes and health personnel to urgently maintain continuity of essential services for people affected with TB during the COVID-19 pandemic, driven by innovative people-centred approaches, as well as maximizing joint support to tackle both diseases.

“We stand in solidarity with those affected by COVID-19 and those at the frontlines of the fight to combat the disease,” said Dr Tereza Kasaeva, Director of the WHO Global TB Programme. “We need to act with urgency to ensure that in line with our vision of Health for All, no one with TB, COVID-19 or any health condition will miss out on the prevention and care they need. It’s time for action.”

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March 25, 2020
WHO Information Note: Ensuring continuity of TB services during the COVID-19 pandemic

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

In the lead- up to World TB Day, Dr Tedros Adhanom Ghebreyesus, WHO Director-General emphasized in a news release, “COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be. The world committed to end TB by 2030; improving prevention is key to making this happen.”

WHO Global TB Programme, along with WHO regional and country offices, has developed an information note, in collaboration with stakeholders. This note is intended to assist national TB programmes and health personnel to urgently maintain continuity of essential services for people affected with TB during the COVID-19 pandemic, driven by innovative people-centred approaches, as well as maximizing joint support to tackle both diseases.

“We stand in solidarity with those affected by COVID-19 and those at the frontlines of the fight to combat the disease,” said Dr Tereza Kasaeva, Director of the WHO Global TB Programme. “We need to act with urgency to ensure that in line with our vision of Health for All, no one with TB, COVID-19 or any health condition will miss out on the prevention and care they need. It’s time for action.”

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March 25, 2020