Food delivery giant DoorDash has taken a first formal step toward a stock market debut.
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A Joint Statement on Tourism and COVID-19 – UNWTO and WHO Call for Responsibility and Coordination
As the current outbreak of the Coronavirus Disease (COVID-19) continues to develop, the World Health Organization (WHO) and the World Tourism Organization (UNWTO) are committed to working together in guiding the travel and tourism sectors’ response to COVID-19.
On 30 January 2020, the Director-General of the World Health Organization (WHO) declared the outbreak of COVID-19 to be a Public Health Emergency of International Concern and issued a set of Temporary Recommendations. WHO did not recommend any travel or trade restriction based on the current information available. WHO is working closely with global experts, governments and partners to rapidly expand scientific knowledge on this new virus, to track the spread and virulence of the virus, and to provide advice to countries and the global community on measures to protect health and prevent the spread of this outbreak.
Cooperation is key
The tourism sector is fully committed to putting people and their well-being first. International cooperation is vital for ensuring the sector can effectively contribute to the containment of COVID-19. UNWTO and WHO are working in close consultation and with other partners to assist States in ensuring that health measures be implemented in ways that minimize unnecessary interference with international traffic and trade.
Tourism’s response needs to be measured and consistent, proportionate to the public health threat and based on local risk assessment, involving every part of the tourism value chain – public bodies, private companies and tourists, in line with WHO’s overall guidance and recommendations.
UNWTO and WHO stand ready to work closely with all those communities and countries affected by the current health emergency, to build for a better and more resilient future. Travel restrictions going beyond these may cause unnecessary interference with international traffic, including negative repercussions on the tourism sector.
At this challenging time, UNWTO and WHO join the international community in standing in solidarity with affected countries.
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WHO launch eEML
The World Health Organization has launched a new easy-to-access, digital version of its Model list of Essential Medicines (EML). The move will revolutionize the way this core WHO reference tool is used.
More than 150 countries currently use the WHO list to work out which medicines best meet their national health contexts and priorities, so they can compile their own national essential medicines lists.
Essential medicines are those that satisfy the priority health care needs of a population. They are the medicines that need to be available in a functioning health system at all times, in appropriate dosage forms, of assured quality, and at prices individuals and the community can afford.
Keeping up-to-date lists of the most important medicines a country needs is key to achieving health for all in a sustainable way.
Since 1977, the WHO list has been revised every 2 years (most recently in 2019) by a group of experts and published in print or PDF formats. It includes information about available dose forms and strengths; specifications as to who should take a medicine; what conditions a medicine can treat and how it should be taken, as well as details about the clinical evidence supporting recommendations being made.
The new electronic version brings the traditional EML to smartphones and computer screens in a comprehensive, freely accessible, online database. Instead of flicking through pages of information, users can search by simply clicking on the name of a medicine, for example, or a health issue. They can also make their own customized lists by exporting the list – in full or in part – into an Excel or Word version.
The electronic EML is the latest step in WHO’s effort to harness digital technologies to drive improvements in global public health, and advance progress towards universal health coverage.
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WHO EB recommends the adoption of the strategy for elimination of cervical cancer
Co-sponsored by 20 Member States and the EU, the draft resolution for the
Seventy-Third World Health Assembly (WHA) was presented on 5 February,
2020, at EB146.The proposal followed Executive Board Members’ review of the Director-General’s report.
The proposed resolution recommends that the World Health Assembly adopt the global
strategy to accelerate the elimination of cervical cancer as a public
health problem and its associated goals and targets for the period
2020–2030. It also urges Member States to implement the
strategy, calling for the support of international organizations and
other relevant stakeholders, and includes a request for the Director
General to support Member states in this endeavor. The WHA will
consider the resolution when it convenes in May 2020.
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E-cigarettes are harmful to health
Globally, there are 1.1 billion adult smokers, 60% of them want or intend to quit. Much has been written and said about the potential of electronic nicotine delivery systems (ENDS) such as e-cigarettes to help tobacco users quit. While the evidence is still inconclusive, e-cigarettes are often used along with one or more tobacco products. As this is the practice with many ENDS users, the health effects of two or more products are combined. Governments who want to weigh the potential benefits and risks of e-cigarettes for their population should consider the following:
- Regarding the potential health effects for which the evidence is mounting, there is insufficient data to understand the full breadth of their impact on health as devices have not been on the market long enough. Especially the long-term effects of using e-cigarettes or being exposed to them are yet unknown.
- Nevertheless, the evidence is clear that the aerosols of the majority of ENDS contain toxic chemicals, including nicotine and substances that can cause cancer.ENDS on their own are associated with increased risk of cardiovascular diseases and lung disorders and adverse effects on the development of the fetus during pregnancy. ENDS are undoubtedly harmful, should be strictly regulated, and, most importantly, must be kept away from children. Nicotine is highly addictive and found in most e-cigarettes. Both tobacco products and e-cigarettes pose risks to health and the safest approach is not to consume either.
- It is of particular public health concern that increasingly children and adolescents take up the use of e-cigarettes in some countries. Most ENDS can be manipulated by the user. Some manufacturers also hold patents to remotely manipulate nicotine dosages and toxicant delivery. Furthermore, there is a growing body of evidence in some countries that never-smoker adolescents who use ENDS at least double their chance of starting to smoke cigarettes later in life. Exposing children and adolescents to nicotine can have long-lasting, damaging effects on brain development and lead to nicotine addiction.
WHO continues to monitor the evidence and technological developments and will adapt this statement accordingly.
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To eliminate cervical cancer in the next 100 years, implementing an effective strategy is critical
Vaccination, screening, treatment and palliative care are the key interventions of WHO’s Draft Global Strategy towards the Elimination of Cervical Cancer as a Public Health Problem,
the fourth most common cancer in women.On World Cancer Day, new estimates show that this strategy could save more than 62 million girls and women from a cervical cancer death and prevent 74 million cases within the next 100 years – but only if these interventions are used effectively
together.No single intervention can eliminate cervical cancer
These estimates, published by the WHO Cervical Cancer Elimination Modelling Consortium (CCEMC) in The Lancet, are based on the draft strategy’s targets to achieve a global coverage of 90% vaccination, 70% screening and 90% treatment by 2030.
Developed by Member States, UN agencies and other partners, the draft global strategy seeks to redress the unequal burden of cervical cancer around the world. Nine in 10 cervical cancer deaths occur in low and lower-middle-income countries, where
women lack access to health services.
As Dr Tedros Adhanom Ghebreyesus, WHO’s Director-General has said, “It doesn’t have to be this way. Cervical cancer
is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively.”This new analysis compares the impact of vaccination, screening and treatment of cervical pre-cancer lesions as single or combined interventions. Focusing on 78 countries where cervical cancer mortality is highest, the results clearly show that no
single intervention will be sufficient to reduce levels of cervical cancer in the next 100 years to below the elimination target of 4 cases per 100,000 women per year.Acting immediately on all three fronts is crucial.
90-70-90: a triple intervention by 2030 and beyond
Vaccinating girls against cancer-causing types of human papillomavirus (HPV) before the age of 15 is the foundation for bringing every country’s incidence rate of cervical cancer down to the agreed elimination level.
Right now, however, vaccination is not enough. As a single strategy, vaccination targets would only deliver a 0.1% reduction in cervical cancer mortality by 2030. Scaling up screening and treatment of cervical pre-cancer lesions at the same time would
reduce mortality by more than one third, or 300,000 deaths, in the same period.The evidence shows that when all adult women are screened for cervical cancer at least twice, at ages 35 and 45, abnormalities are more likely to be detected before they become cancerous. When cancer has developed, screening increases a women’s
likelihood of early and successful treatment, as well as palliative care if recovery is no longer an option.Meeting these triple-intervention targets would be a major contribution to target 3.4 of the UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030.
The future of cervical cancer elimination
WHO’s global strategy towards eliminating cervical cancer aims to set the world on the right track by 2030, but it is just the beginning.
At this pace, global elimination of cervical cancer is not predicted until 2120.
While high HPV vaccination coverage is the primary prevention intervention, ensuring every woman has two cervical screenings in her life would accelerate elimination by 11 – 31 years, depending on the country.
If no action is taken, cervical cancer deaths will rise almost 50% by 2030. Approval of the draft global strategy at the WHO World Health Assembly in 2020, and investment in mechanisms to deliver it, is vital.
As the new World Cancer Report shows, only 18% of countries that currently provide screening for cervical cancer reached the recommended target of more than 70% coverage. An estimated 55% of low-income countries that reported offering
cervical cancer screening generally lack accessible radiotherapy or surgery services.Elimination of cervical cancer is possible within the lifetime of today’s youngest girls, but the clock starts now and every intervention counts.
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WHO outlines steps to save 7 million lives from cancer
The World Health Organization (WHO) today spells out the need to step up cancer services in low and middle-income countries. WHO warns that, if current trends continue, the world will see a 60% increase in cancer cases over the next two decades. The greatest increase (an estimated 81%) in new cases will occur in low- and middle-income countries, where survival rates are currently lowest.
This is largely because these countries have had to focus limited health resources on combating infectious diseases and improving maternal and child health, while health services are not equipped to prevent, diagnose and treat cancers. In 2019, more than 90% of high-income countries reported that comprehensive treatment services for cancer were available in the public health system compared to less than 15% of low-income countries.
“This is a wake-up call to all of us to tackle the unacceptable inequalities between cancer services in rich and poor countries,” says Dr Ren Minghui, Assistant Director-General, Universal Health Coverage/ Communicable and Noncommunicable Diseases, World Health Organization. “If people have access to primary care and referral systems then cancer can be detected early, treated effectively and cured. Cancer should not be a death sentence for anyone, anywhere.”
Yet, progress in poorer countries is achievable. WHO and the International Agency for Research on Cancer (IARC) are releasing two coordinated reports on World Cancer Day (4 February), in response to government calls for more research into the scope and potential policies and programmes to improve cancer control.
“At least 7 million lives could be saved over the next decade, by identifying the most appropriate science for each country situation, by basing strong cancer responses on universal health coverage, and by mobilizing different stakeholders to work together”, said Dr Tedros Adhanom Ghebreyesus, Director-General, WHO.
WHO highlights a wide range of proven interventions to prevent new cancer cases. These include controlling tobacco use (responsible for 25% of cancer deaths), vaccinating against hepatitis B to prevent liver cancer, eliminating cervical cancer by vaccinating against HPV, screening and treatment, implementing high-impact cancer management interventions that bring value for money and ensuring access to palliative care including pain relief.
“The past 50 years have seen tremendous advances in research on cancer prevention and treatment,” says Dr Elisabete Weiderpass, Director of IARC. “Deaths from cancer have been reduced. High-income countries have adopted prevention, early diagnosis and screening programmes, which together with better treatment, have contributed to an estimated 20% reduction in the probability of premature mortality between 2000 and 2015, but low-income countries only saw a reduction of 5%. We need to see everyone benefitting equally.” The challenge will be for countries to select treatments balancing considerations including cost, feasibility and effectiveness. Each government is tasked with choosing the appropriate innovative cancer therapies, while recognizing that established treatments, many of which are very effective and affordable, can provide benefits for cancer without causing financial hardship.
Note to editors
World Health Organization
Report on Cancer: Setting priorities, investing wisely and providing care for all
The report aims to set the global agenda on cancer, mobilize stakeholders and help countries set priorities for investing in cancer control and universal health coverage. It introduces the principles, tools and current priority cancer control interventions in the context of the current and future cancer burden and opportunities.
International Agency for Research on Cancer
World Cancer Report “Cancer research for cancer prevention”
The report focuses on prevention and offers the most comprehensive overview of relevant research available to date, ranging from descriptive etiology, cellular and molecular biology, toxicology and pathology through to behavioural and social science. Key chapters include discussions on the impact of inequalities in cancer, vaccination and screening, genomic individual susceptibility to cancer and the finer identification of those at risk, which may allow ‘precision cancer prevention’.
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France pledges US$100 million (€90 million) for WHO Academy
Geneva: France’s Minister for Europe and Foreign Affairs, Mr Jean-Yves Le Drian, and Dr Tedros Adhanom Ghebreyesus, Director-General of WHO today met at the Permanent Mission of France to the United Nations in Geneva to discuss the WHO Academy, which will be the world’s largest and most innovative lifelong learning platform in global health.
The WHO Academy aims to reach millions of people worldwide, offering high-tech learning environments at a “hub” in Lyon with “spokes” in the six WHO regions. The Academy will provide learning opportunities for leaders, educators, researchers, health workers, WHO staff and the broader public, and will deliver high quality, multilingual learning, both online and in-person, alongside a cutting-edge simulation centre for health emergencies.
The discussion today follows a Declaration of Intent signed by Emmanuel Macron, President of the French Republic and Dr Tedros on 11 June 2019, and a pledge by France in the amount of US$ 100 million (€ 90 million) to WHO to support the creation of the WHO Academy, which will be established as an internal division within WHO.
“Technology and innovation in learning are creating exciting new opportunities to accelerate progress towards health for all in every country,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “The WHO Academy will support millions of learners to maximize health impacts with the best evidence, adult learning approaches and state-of-the-art technologies.”
By propelling and strengthening digital innovations and lifelong learning opportunities around the world, the WHO Academy will play an instrumental role towards achieving WHO’s triple billion goal by 2023 and the health Sustainable Development Goals: 1 billion more people will benefit from universal health coverage; 1 billion more will be better protected in health emergencies, and 1 billion more will enjoy improved health and wellbeing.
The funding from France represents a commitment to accelerate the development of the WHO Academy, and confirms the engagement of France — a longstanding partner of WHO and a key actor in global health – and its strong support to the ambitions of 13th WHO General Programme of Work to ensure healthy lives and well-being for all ages.
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Immunization is the best protection against tick-borne encephalitis
In a new position paper, published in the Weekly
Epidemiological Record today, WHO recommends vaccination against
tick-borne encephalitis in people of all ages where the disease is
highly endemic. Where the prevaccination incidence of the disease is
moderate or low or is limited to particular geographical locations or
certain outdoor activities, immunization should target individuals in
the most severely affected groups. People travelling from non-endemic
areas to endemic areas should be offered vaccination if their visits
will include extensive outdoor activities.Since the incidence of tick-borne encephalitis may vary
considerably between and even within geographical regions, public
immunization strategies should be based on risk assessments conducted at
country, regional or district level, and should be appropriate to the
local endemic situation.Immunization offers the most effective protection against
tick-borne encephalitis. Currently, there are four widely used vaccines
of assured quality: FSME-Immun and Encepur, manufactured in Austria and
Germany respectively, and TBE-Moscow and EnceVir, manufactured in the
Russian Federation. The four vaccines are considered to be safe and
efficacious.Tick-borne encephalitis virus is an important cause of viral
infections of the central nervous system in eastern, central and
northern European countries, and in northern China, Mongolia, and the
Russian Federation.Approximately 10 000–12 000 clinical cases of tick-borne
encephalitis are reported each year, but this figure is believed to be
significantly lower than the actual total. Most infections with the
virus result from tick bites acquired during outdoor activities in
forested areas.
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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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