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UN releases US$15 million to help vulnerable countries battle the spread of the coronavirus

UN Humanitarian Chief Mark Lowcock today released US$15 million from the Central Emergency Response Fund (CERF) to help fund global efforts to contain the COVID-19 virus.

The announcement came as the World Health Organization (WHO) upgraded the global risk of the coronavirus outbreak to “very high” – its top level of risk assessment. The WHO has said there is still a chance of containing the virus if its chain of transmission is broken.

The sudden increases of cases in Italy, the Islamic Republic of Iran and the Republic of Korea are deeply concerning. There are now cases linked to Iran in Bahrain, Iraq, Kuwait and Oman, along with cases linked to Italy in Algeria, Austria, Croatia, Germany, Spain and Switzerland.

The UN funding has been released to the WHO and the United Nations Children’s Fund (UNICEF). It will fund essential activities including monitoring the spread of the virus, investigating cases, and the operation of national laboratories.

The WHO has called for US$675 million to fund the fight against coronavirus. There is a window of opportunity to contain the spread of the virus if countries take robust measures to detect cases early, isolate and care for patients, and trace contacts.

Emergency Relief Coordinator and Under-Secretary-General for Humanitarian Affairs, Mark Lowcock said: “We do not yet see evidence that the virus is spreading freely. As long as that’s the case, we still have a chance of containing it.

“But swift and robust action must be taken to detect cases early, isolate and care for patients, and trace contacts. We must act now to stop this virus from putting more lives at risk.

“This grant from the UN’s Emergency Fund will help countries with fragile health systems boost their detection and response operations. It has the potential to save the lives of millions of vulnerable people.”

This is a critical juncture in the outbreak. The focus is on containing COVID-19 by strengthening surveillance, conducting thorough outbreak investigations to identify contacts and applying appropriate measures to prevent further spread.

Tedros Adhanom Ghebreyesus, WHO Director-General, said: “The potential spread of the virus to countries with weaker health systems is one of our biggest concerns. These funds will help support these countries get ready for detecting and isolating cases, protecting their health workers, and treating patients with dignity and appropriate care. This will help us save lives and push back the virus”

UNICEF is leading on preventative actions in communities across the affected countries with risk communication, providing hygiene and medical kits to schools and health clinics and monitoring the impact of the outbreak to support continuity of care, education and social services.

“At this pivotal moment, every effort must be made to push back against the outbreak,” said UNICEF Executive Director Henrietta Fore. “These crucial funds will support our global efforts to bolster weaker health systems and inform children, pregnant women and families about how to protect themselves.”

Since it was launched in 2006, CERF has provided more than $6 billion to over 100 countries and helped hundreds of millions of people.

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https://www.who.int/news-room/detail/01-03-2020-un-releases-us-15-million-to-help-vulnerable-countries-battle-the-spread-of-the-coronavirus

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March 2, 2020
WHO steps up action to improve access to safe blood
The World Health Organization’s new action plan to speed up universal access to safe blood and blood products pulls together existing recommendations and recommends new improved ways of working. It’s the start of a four-year collaborative effort to improve blood transfusion and blood-based therapies in all countries.

Safe blood saves lives in all sorts of circumstances, not least in emergency and epidemic settings. Blood transfusion and blood products are critical for birth delivery for both the mother and baby; the survival and quality of life of patients suffering from life-threatening conditions such as haemophilia, thalassemia, immune deficiency and cancer; treating severe injuries and carrying out medical and surgical procedures.

But progress in blood safety and availability has been slow in many parts of the world, placing patients’ safety at risk and putting undue pressure on health workers. Progress is also mostly restricted to developed countries. Out of the approximate 118 million blood donations collected globally, 42% are collected in high-income countries, home to 16 % of the world’s population. And one out of four low-income countries do not test all donated blood, while 54% of countries do not have surveillance systems to securitise the supply chain from blood donor to patient.

Challenges include: slow implementation of national blood policies and weak blood regulatory systems; insufficient number of voluntary blood donors (who are considered the safest donors); poor quality management of screening tests, blood grouping and compatibility testing; inappropriate clinical use of blood; insufficient national funding for blood safety.

To address these, WHO has set out six key objectives for all countries and in particular those with weak blood systems:
- appropriately structured, well-coordinated and sustainably resourced national blood systems;
- regulatory capacity to ensure the quality and safety of blood;
- functioning and efficiently managed blood services;
- effective implementation of patient blood management to optimize transfusion practices;
- effective surveillance, haemovigilance and pharmacovigilance, supported by comprehensive and accurate data collection systems;
- partnerships, collaboration and information exchange to achieve key priorities and jointly address challenges and emerging threats at global, regional and national levels.
The Organization looks forward to working with partners worldwide to implement the plan, improve blood supply particularly in the low and middle-income countries where this is so urgently needed, and save lives. The plan will run from 2020-2024.

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https://www.who.int/news-room/detail/26-02-2020-who-steps-up-action-to-improve-access-to-safe-blood

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

Proceedings of the meeting

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

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

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

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

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

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

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

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

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

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

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

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

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

Context and Discussion

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

Conclusions and Advice

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

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

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

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

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

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

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

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

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https://www.who.int/news-room/detail/12-02-2020-statement-on-the-meeting-of-the-international-health-regulations-(2005)-emergency-committee-for-ebola-virus-disease-in-the-democratic-republic-of-the-congo-on-12-february-2020

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

Peru shows the way forward and the courage of Ander Martinez

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

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

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

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

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

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

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

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

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

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

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https://www.who.int/news-room/detail/14-02-2020-who-global-initiative-for-childhood-cancer-progress-on-all-fronts

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

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

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

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

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

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

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

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About FIND

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

About WHO

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

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https://www.who.int/news-room/detail/10-02-2020-who-and-find-formalize-strategic-collaboration-to-drive-universal-access-to-essential-diagnostics

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

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

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

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

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

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

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

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February 27, 2020
Is a common shoulder surgery useless?

New research casts doubt on the true effectiveness of a common type of surgery used to ease shoulder pain.

A British research team tracked outcomes for patients who underwent “decompression surgery” to treat shoulder impingement – a condition where a shoulder tendon rubs and catches in the joint.

In decompression surgery, a small area of bone and soft tissue in the shoulder joint is removed, opening up the joint to prevent the abrasion that happens when the arm is lifted.

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February 27, 2020
Overweight and obese type 2 patients show improvements with structured nutrition therapy

Researchers at Joslin Diabetes Center have announced the results of a study that may change how nutrition therapy is delivered to overweight and obese patients with type 2 diabetes. The “Nutrition Pathway Study” compared three models of nutrition therapy and found that a highly structured nutrition plan provides the most significant impact on A1C, body weight and lipid profiles. The study results were presented at the American Diabetes Association’s 76th Scientific Sessions in New Orleans, Louisiana.

Participants in the structured nutrition therapy arm of the study reduced A1C by an average of 0.67 percent and reduced body weight by an average of 3.5 Kg over 16 weeks. According to Osama Hamdy, M.D., Ph.D., Medical Director of the Obesity Clinical Program at Joslin Diabetes Center and lead investigator on the study, these results were achieved without increasing exercise, changing medications or undertaking behavioral changes.

“This drop in A1C due to nutrition therapy alone is much better than what we have been able to achieve with many of the current medications for type 2 diabetes ,” said Dr. Hamdy. “This is very encouraging since participants in the study have lived with type 2 diabetes for more than 10 years and were not able to control their blood glucose or weight with multiple medications.”

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February 27, 2020
Researchers explore epigenetic influences of chronic pain

Chronic pain is one of the most prevalent, disabling and expensive public health crises in the United States. It affects more than 100 million Americans, with annual costs estimated at $635 billion, says a 2014 report from the American Pain Society.

Despite the enormous societal impact of chronic pain, present treatment options are limited to nonsteroidal anti-inflammatory drugs (NSAIDS), opioids, anticonvulsants and antidepressants, which provide pain relief to only about half of patients. Furthering the problem, prescription opioid overdoses have quadrupled since 1999. There were more than 45,000 painkiller-related deaths in 2014 alone, according to the Centers for Disease Control and Prevention.

Now, researchers at Drexel University College of Medicine are aiming to identify new molecular mechanisms involved in pain. Their latest study, published this month in Epigenetics & Chromatin, shows how one protein – acting as a master controller – can regulate the expression of a large number of genes that modulate pain.

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February 27, 2020
Global study shows diabetes and heart disease can be a deadly combination

The combination of type 2 diabetes and coronary artery disease can be deadly.

New research from a global study led by a physician from UConn Health has found that patients with Type 2 diabetes admitted into the hospital for congestive heart failure face a one in four chance of dying over the next 18 months.

The results were presented on June 11 at the American Diabetes Association’s (ADA) annual meeting in New Orleans and published online in the ADA journal Diabetes Care. The findings paint a much grimmer picture of the outcome for diabetes patients with severe heart disease than was previously known.

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February 27, 2020