Tag: Treatment

  • GENERAL ADVICE TO WOMEN ON SEX SUBJECTS

    GENERAL ADVICE TO WOMEN ON SEX SUBJECTS

    In this lesson the writer seeks to direct the attention of his women readers to certain subjects upon which the average woman is not well informed, and upon which she usually requires sound, sane, clean, frank information. In many cases women hesitate to ask even their family physicians for such information, and, although there is no rational reason for it, they even shrink from consulting better informed and capable women concerning these subjects.

    Sexual Feeling. Owing to erroneous teachings, and irrational prejudices arising from ancient distorted and perverted ideals of sex, many women have grown to maturity under the erroneous belief that it is a sign of immorality, or at least low ideals and depraved nature, for a woman to experience sexual emotions or feelings, wishes or desires. So true is this that even many married women seek to withhold from their husbands the knowledge that any sexual feeling is experienced by the wife.

    Such a belief is of course absurd. It is as natural for a woman to experience normal sexual feeling as it is for her to experience any other feeling aroused by natural instincts and organism. Without such instinct and the feelings arising therefrom, there would be no mating or marriage, and no perpetuation of the race. The woman experiencing such feelings should not allow herself to imagine that she is depraved or perverted, or immoral in thought and feeling. Incredible as it may appear to a normal, healthy-minded man, it is true that thousands of young women have lost self-respect, and have lapsed into a morbid state of mind, because of the occasional manifestation of their normal sexual feeling.

    This does not, of course, mean that the woman must necessarily manifest into action the feeling experienced by her. On the contrary, she must acquire self-mastery and self-control, just as she must in other phases of her life. It may help some women of this kind to realize that the sex feeling and impulses, arising unbidden (and often unwelcomed) from the depths of their subconscious mentality, are essentially creative impulses. If the woman be unmarried, or if married and placed under conditions in which the marital relation with the husband is impossible or undesirable, then she can transmute this creative energy in some form of creative work—in work which leads to the creation, manufacture, building-up, or composing something. There is a hint here which will prove a great blessing to the woman who will understand and apply the principle suggested—for many other women have found it so.

    As for the married woman, there is no reason whatsoever why she should seek to withhold from her husband the knowledge that she is possessed of normal, natural, healthy sexual feeling. In fact, the withholding of such information, and the concealment and deception arising therefrom, has often done much to bring marital inharmony between husband and wife. If there is any deception to be practiced in the marital association of husband and wife, it should rather be in the opposite direction, i. e., in the direction of pretending the emotional feeling when it exists only partially or is absent. The last matter, however, is one for the exercise of the judgment and conviction of each individual woman; but the first mentioned admonition is one which should be observed, as it is based on honesty, truth, and good judgment as well.

    Alcohol and Sexuality. It needs no extended argument to convince the average person that an individual will do things when under the influence of drink that he or she would not do when perfectly sober. It is an old saying that “When the wine is in, the wits are out.” But there is a deeper connection and relation between alcoholic drink and sexual indiscretions than is usually realized by the average person. Besides the commonly known weakening of will-power and self-control arising from the influence of strong drink, there are certain influences concerning the sexual nature and arising from the presence of alcohol in the system, which are not known to most persons. So true is this that the writer has thought it well to utter a few words of warning to his women readers concerning these things.

    In the first place, there is an exhilarating effect arising from certain kinds of liquor, wines, and other forms of alcoholic drinks, which manifests directly in an excitement of the sexual centers and organism. In many cases a strong sexual excitement, absent at other times, is aroused, and the person is carried away with the force of passion unknown under other circumstances. Added to this the weakened will-power arising from too much drink, and we have an explanation of many cases of “mistakes” of women. It would appear that women are even more susceptible than are men to unusual sexual excitement arising from alcoholic drinks; and that, therefore, they should be especially cautious in the indulgence in such drinks, particularly when in the company of strange men, or men careless in regard to sexual morality and respect for women in their company.

    But there is still a deeper reason, based upon the latest discoveries in psychology, why caution in this respect should be observed by women. We allude to the discovery that alcohol first affects the mental and emotional tendencies of more recent racial acquirement, acting so as to paralyze and inhibit the activities thereof, and to thus release the activity of the more primitive emotions and motive activities. Thus, the woman under the influence of alcohol finds that the more recent racial traits, such as sexual control, restraint, sexual morality, conventional observations, etc., are practically temporarily paralyzed in inhibitual—or to use the current slang phrase, are “put out of commission” for the time being; and, at the same time, the old elemental, savage, barbaric, “cave man” instincts, habits, and methods of action, are brought to the surface, and proceed to manifest their activity if opportunity be granted for the same—and the opportunity is usually granted. This being seen to be true, it is seen that the woman so under the influence of liquor is, for the time being, little more than a “cave woman,” or barbarian, with all the lax sex morality of the latter, and with all the tendencies to manifest into activity the primitive impulses arising in her nature and demanding expression. Added to this the weakening of will-power always accompanying the alcoholic influence, it is seen that the woman under the influence of strong drink is an easy prey to designing men, and a willing victim to her own lower passions.

    An authority of sex subjects says: “That Bacchus, the god of wine, is the strongest ally of Venus, the goddess of love, using the term Love in its physical sense, as the French use the word ‘amour,’ has been well known to the ancient Greeks and Romans, as it is well known today to every saloon-keeper and every keeper of a disreputable house. And all measures to combat venereal diseases and to prevent girls from making a false step will only be partially successful if we do not at the same time carry on a strong educational campaign against alcoholic indulgence. * * * Of what use are warnings to a girl, when under the influence of a heavy dinner and a bottle of champagne, to which she is unaccustomed, her passion is aroused to a degree she has never experienced before, her will is paralyzed and she yields, though deep down in her consciousness something tells her she shouldn’t? She yields, becomes pregnant, and is in the deepest agony for several months, and has a wound which will probably never heal for the rest of her life. Of what use have all the lectures, books, and maternal injunctions been to her? * * * I believe that the sex instinct can be stimulated artificially beyond the natural needs, and among the artificial stimulants of the sex instinct alcohol occupies the first place. And bear in mind that alcohol produces even a stronger effect upon women, in exciting the sexual passion, than it does on men. Women are more easily upset by stimulants and narcotics, and that is the reason why it is more dangerous for women to drink than it is for men. It is impossible to give statistics and exact or even approximate figures. But there is no question in my mind, in the mind of any careful investigator, that if alcoholic beverages could be eliminated, the number of cases of venereal infection would be diminished by about one-half. And what is true of venereal disease is also true of the seduction of young girls. Alcohol is the most efficient weapon that either the refined Don Juan or the vulgar pimp has in his possession.”

    Our advice to the woman who is asked to drink liquor when in the company of a man outside of her immediate family circle is emphatically this: DON’T DO IT!

    The Menstrual Period. As strange as it may appear to those women who have had the advantage of intelligent maternal advice, it is a fact known to all physicians that many mothers permit their young daughters to enter into the stage of puberty, with the accompanying menstrual flow, without having first instructed the daughter as to the meaning and character of this phenomenon of her nature, and without having given her advice concerning the proper care of herself during this period.

    Physicians constantly experience cases in which the young girl to whom the first menstrual flow having come, without previous knowledge on her part, has supposed it to be the result of a wound, or of a diseased condition, and has attempted to stop the flow by the application of cold water. Even where a partial knowledge has been attained by the girl, she is found to lack the knowledge of the proper hygienic care of herself during the period. The mothers in such cases are criminally negligent, and have alluded a false modesty or prudery to interfere with a natural and necessary maternal duty.

    The approach of the first menstruation is often accompanied by unusual physical, mental and emotional changes in the young girl. Her nervous system is affected, and she is apt to become irritable or morbid, or even somewhat “flighty.” Her appetite may become irregular, and there is often present a craving for indigestible food. A physical languor is often experienced, and there may be pains in the back and legs, chilliness and headaches, and a general upsetting of the usual physical condition, accompanied by a manifestation of peevishness and irritability. These unpleasant symptoms usually disappear when the periodical menstrual flow is permanently established. In fact, they are frequently superseded by the awakened energy and heightened spirits of healthy, normal adolescence.

    The time of the beginning of the menstrual period varies according to climate, race, condition of health, and temperament. In the tropical countries, menstruation begins from the tenth to the fourteenth year; in temperate countries, from the thirteenth to the sixteenth; in cold countries, from the fifteenth to the twentieth year. The Italian, Hebrew, Spanish, or French girl is apt to menstruate earlier than the English, German, or Swedish girl. The Negro girl menstruates early, as a rule. The full-blooded girl usually menstruates earlier than the anemic one.

    Normally, menstruation should proceed naturally and without pain or suffering. When pain or suffering is experienced in connection with menstruation, it is simply because of some lack of health in the general system; and when such general health is restored, the trouble ceases. Painful menstruation is called “dysmenorrhea,” and arises from several causes, principal among which are the following: Errors in diet, errors in dress, undue exposure, constipation, lack of proper exercise, or to a contracted or congested condition of the Uterus or the Fallopian Tubes. The pain, however, cannot be considered as a feature of normal menstruation, for the latter is no more painful than a normal movement of the bowels—the painful condition results from abnormal conditions, the removal of these conditions resulting in the cure of the complaint.

    Dysmenorrhea should be treated by the discarding of all unhygienic clothing, tight shoes, etc., and their replacement by rational clothing; the dietary should be carefully scanned, and improper articles replaced by nourishing elements of food—discard the pastries, pickles, confections, and stimulants, and substitute sensible articles of diet; if constipation is present, remove it by eating articles of food which promote free movements of the bowels, and drink more water each day; take a proper amount of exercise—housework is as good a form of exercise as any; many authorities advocate the free drinking of water prior to and during the menstrual period—some going so far as to say that where there is painful menstruation there is always a lack of a proper amount of water taken into the system. In some cases Dysmenorrhea is due to disorders of the general nervous system, and treatment therefore should be sought at the hands of a capable physician.

    Amenorrhea, another disorder arising in connection with the menstrual process, consists of the retention or suppression of the menses, or of “scanty” menses, or occasional “skipping” of the periods. This condition is apt to be manifest in cases of extreme obesity or “fatness;” the nervous system being burdened with superfluous flesh, its menstrual rhythm is often affected. Suppression of the menses also sometimes results from exposure and disturbing mental emotions. The most approved treatment is that of remedying the abnormal general physical condition, proper diet, and the use of hot drinks, hot sitz baths, and hot enemas about the time of the beginning of the normal period.

    Menorrhagia, another menstrual-period disorder, consists of very profuse flowing—it is, in fact, a mild form of hemorrhage. It usually arises from general debility, shocks, too violent exercise or labor, and also in many cases from undue and too frequent sexual intercourse. Sometimes the excessive flow occurs during the regular menstrual period, while in other cases it may manifest itself out of season—sometimes as often as two or three times a month. The duration of the normal period of menstrual flow, however, varies greatly among different women; the normal period may be said to last from two to six days, so what might be an excessive flow for one woman would be only normal for another—temperament plays a large part in determining the quantity of the menses.

    Some of the accompanying symptoms of Menorrhagia, or profuse flow, are lassitude, shortness of breath, faintness, dizziness, headache, irritability and nervousness, and often also leucorrhea between periods. The general treatment consists in measures calculated to bring the general health of the woman back to the normal. The building up of the general system, by means of nourishing food, proper exercise, etc., will almost always result in curing this disorder.

    A well-known authority has well said: “The hygiene of menstruation can be expressed in two words: Cleanliness and Rest.”

    So far as Rest is concerned, the woman need not be urged to take it at this period—that is, if she is able to do so. Care should be taken not to exercise unduly at this time, and under the head of exercise may be included dancing, horseback riding, and automobiling, as well as the more common forms of athletic work.

    It would seem that common sense and the general desire for cleanliness and daintiness would cause all women to observe the plain hygienic laws of Cleanliness at the time of the menstrual period. And, indeed, it is probable that such would be the case were it not for the fact that some ancient superstitions still exert their power over the mind of many women, in regard to the use of water during the menstrual period. While it is true that cold baths, or cold-water bathing, are not advisable for the average woman during the menstrual period (although some especially robust women bathe and swim as usual during this period), this prohibition does not apply to the use of warm water during the period. Lukewarm baths are permissible at this time; and the woman should wash the external genital parts with warm water, with soap if desired, every morning and evening of the period. A vaginal douche of lukewarm water is an excellent adjunct to the bathing of the parts.

    It is astonishing to meet with the superstitious prejudice existing in the minds of some women concerning the use of the vaginal douche; these good creatures seem tothink that it is either unnatural and unhealthy, or else is something “not respectable,” and fit only for the use of immoral women. These women should get in touch with modern hygienic methods, and learn to use the douche at least during their menstrual periods. At this time, if the plain rules of cleanliness are not observed, there often occurs a decomposition of the blood which has gathered in or about the genitals, and an offensive odor is manifested. Some women, while feeling distressed about this odor, are afraid to use lukewarm water in washing themselves, owing to some old unexplored superstition handed down from the great-grandmother’s time.

    The napkins should be changed at least every morning and evening. Unclean napkins may lead to infection, and it is probable that many cases of leucorrhea have their origin in lack of cleanliness concerning the napkins, cloths, or rags, used during menstruation. It may seem almost incredible to the average woman reader, but physicians know of cases (usually among the poorer and more ignorant foreign classes) in which the girl is instructed by her mother, grandmother, or aunts, that she must wear the original cloth or rag during the entire period, as she will “catch cold” by a change to a clean, fresh cloth while the flow continued. Imagine the result of such a practice! This last is an extreme instance, of course, but it will serve to show the absurd and harmful notions prevalent concerning this important natural function, and its incidents.

    Leucorrhea. A very common disorder among women is that known as Leucorrhea, or “the whites.” It consists of a discharge from the Vagina, or the Uterus through the Vagina. It is, in fact, of a catarrhal nature, and results from an over-secretion of the mucus fluids which, in proper quantity, keep the mucus membrane of the said organs in good condition. The discharge manifests in various shades and degrees of consistency. From the character of the discharge, physicians are able to determine whether it comes from the Vagina or the Uterus. The discharge from the Vagina usually is a light creamy fluid; that from the neck of the Uterus is a sticky, thick fluid flowing rather freely; that from the lining of the Uterus is alkaline, and generally precedes and follows menstruation; and that accompanying ulceration of the womb is semi-purulent and offensive in odor.

    Leucorrhea has many causes, among which may be mentioned the following: getting chilled feet or body, particularly during the menstrual period; over exertion and overwork standing on one’s feet; chills following dancing in overheated rooms; excessive worry or emotional strain, etc. It is a quite common complaint, and some assert that fully twenty-five per cent (perhaps more) of all women suffer from it to at least some extent.

    The general treatment of Leucorrhea consists of the building up of the entire system by the proper hygienic methods. Constipation should be removed, and the system is built up by the proper articles of food, exercise, etc. The use of the proper douches are also advised by the best practitioners. Physicians also treat inflamed areas by local treatments consisting of painting the Vagina or neck of the Uterus with certain medicinal solutions. Certain suppositories and douches are also employed in some cases. It is always better to consult a good physician in these cases, particularly where the trouble is aggravated or of long standing.

    A popular writer on the subject gives the following prescription for a vaginal injection: White Fluid Hydrastics, 2 ounces; Borax, 1/2 ounce; Distilled Witch Hazel Extract, 1 pint. Use of this preparation one ounce, diluted in a pint of lukewarm water, as a vaginal injection, taken twice each day.

    A well-known authority gives the following advice concerning treatment of Leucorrhea: “One of the simplest things is an alum tampon. You take a piece of absorbent cotton, about the size of a fist, spread it out, put about a tablespoonful of powdered alum on it, fold it up, tie a string around the center, insert it in the vagina as far as it will go, and leave it in twenty-four hours. Then pull it gently by the string and syringe yourself with a quart or two of warm water. Such a tampon may be inserted every other day or every third day, and I have known where this simple treatment alone produced a cure. In some cases, however, douches work better, and the two best things for douching are: tincture of iodine and lactic acid. Buy, say, four ounces of tincture of iodine, and use two teaspoonsful in two quarts of hot water in a douche bag. This injection should be used twice a day, morning and night. Of the lactic acid you buy, say, a pint, and use two tablespoonsful to two quarts of water. The lactic acid has the advantage over the tincture of iodine that it is colorless, while the iodine is dark and stains whatever it comes in contact with. Sometimes I order the use of the tincture of iodine and the lactic acid alternately: for one douche the tincture of iodine, for the next the lactic acid, and so on. When the condition improves, it is sufficient to use one teaspoonful of the tincture of iodine and one tablespoonful of the lactic acid to two quarts of water. These injections are quite efficient and have the advantage of being perfectly harmless. One point about the injections: they should be taken not in the standing or squatting position (in which position the fluid comes right out), but while laying down, over a douche pan. The douche bag should be only about a foot above the bed, so that the irrigating fluid may come out slowly; the patient, after each injection taken in the daytime, should remain at least half an hour in bed (in the nighttime she stays all night in bed.) This gives the injection a better chance to come in contact with all the parts of the vagina, and a portion of it comes in contact with the cervix, where it exerts a healing effect. Avoid the use of patent medicines.”

    Uterine Displacement. The woman suffering from Uterine Displacement should, of course, consult a competent physician and be governed by his advice. The following suggestions, however, will be found to be of service in many cases:

    In the case of Prolapsus, or falling of the womb, many women have found great relief, and in many cases permanent improvement, by taking occasional rests in bed for an hour or so, with the feet and lower part of the legs raised at least eight inches above the level of the head. In this plan, the Uterus is replaced by gravitation. Some authorities advise practicing waist-breathing while lying in this position, thus exercising the abdominal muscles. Dr. Taylor says: “Increase the pump-like action of the chest, and it will be found that the displaced viscera will return to their normal position.” Some have also found relief from the use of alum-water vaginal injections once or twice each day. The alum-water is prepared by dissolving one heaping teaspoonful of powdered alum in a pint of lukewarm water. This last treatment often strengthens the vaginal muscles whose yielding has at least partially been the cause of the falling womb.

    In cases of Retroversion, in which the Uterus is turned or bent backward, the “knee and chest” position will often aid in causing the organ to regain its normal position. In this position the woman kneels, and rests her chest upon the bed, thus causing the hips to be elevated.

    In cases of Antroversion, in which the Uterus is turned or bent forward, relief is often obtained by the woman resting upon the back, using a pillow to elevate her hips.

    Intercourse During Menstruation. It would seem that the natural esthetic repulsion to the exercise of the marital relations during the menstrual period should be sufficient to deter men and women from indulgence at this time; but many seem to have overcome this instinctive repulsion, and to these a stronger reason must be given—and the reason is at hand. The reasons in question are as follows: first, that congestion of the Uterus and Ovaries sometimes results from this unnatural practice; second, that the man may possibly contract an inflammation of the urethra by infection from the degenerated membrane, tissue, blood, etc., of the menstrual flow; and third, that such practices may result in the aggravation of discharges from the woman, such as leucorrhea, etc.

    Intercourse During Pregnancy. The best authorities advise total abstinence from sexual intercourse during the period of pregnancy; but in view of the fact that such abstinence is very difficult for most men, and that few will persist in it, it is thought well to point out the fact that at least an extreme moderation is desirable in such cases. A leading authority says on this point: “During the first four months of pregnancy, no change need be made in the usual sex relations; their intensity should be moderated, their frequency need not. During the fifth, sixth, and seventh months, intercourse should be indulged in at rarer intervals—once in two or three weeks—the act should be performed without any violence or intensity. During the eighth and ninth months relations had best be given up altogether. And this abstinence should last until about six weeks after the birth of the child. During this period the uterus undergoes what we call involution; that is, it goes back to the size and shape it had before pregnancy, and it is best not to disturb this process by sexual excitement, which causes engorgement and congestion.”

    Sterility in Women. Sterility, or barrenness, i. e., the inability to bear children, is frequently met with among married people. It is usually blamed upon the woman, whereas in at least one-half of the cases the fault is with the man.

    The causes of sterility in women are usually one or more of the following: Inflammation of the Fallopian Tubes, which may have been caused by gonorrhea or ordinary inflammation—in some rare cases childbirth has been known to set up an inflammation in this region, which has prevented the woman from future childbearing—the inflammation causes the tubes to clog up or become closed, so that no more ova can pass through them from the ovaries to the womb; in some cases, also, severe cases of leucorrhea have caused sterility, as the discharge is sometimes fatal to the life of the spermatozoa and destroys them; in other cases misplacement of the womb causes sterility; also severe inflammation of the neck or mouth of the womb operates in the same way, in some cases. In cases of sterility, the woman should have an examination made by a competent physician, and it often will be found that the cure of the disorders above noted will work a cure of the sterility.

    But, in all cases of sterility, it will be found that the husband should be examined as well as the wife—in fact, many authorities insist that the husband should be examined first. Venereal diseases frequently produce sterility in the man, although he is loath to admit this and is apt to place the blame entirely upon the woman.

    Miscarriage and Abortions. The terms “miscarriage,” and “abortion,” respectively, mean the expulsion of the fetus from the womb before its natural time of delivery. In common usage, the term “miscarriage” is usually employed to indicate instances in which the premature delivery has occurred without any voluntary act on the partof the woman, or other persons acting with her permission; the term “abortion” being reserved for instances in which the miscarriage has been voluntarily produced.

    When the fetus dies within the womb of the mother, it is usually expelled spontaneously within a few days or even a few hours. Some women suffer from certain weakness which result in habitual miscarriage; such women seem unable to carry the child for the full natural term, and lose it at some time during the period of gestation. Like results often arise from certain diseases, principal among which is syphilis. In some cases the physician produces what is known as “therapeutic abortion,” for the purpose of saving the life of the woman—this is sanctioned by medical custom and by law. Other forms of abortion, performed for the purpose of preventing the progress of the gestation, and designed for the destruction of the embryo or fetus, are known as “criminal abortion,” and are punishable by several legal penalties.

    Abortions are frequently followed by severe illness, invalidism, or even death for the woman. Many women have had their entire lives ruined by this evil practice. It is one of the curses of modern civilization, and one which must be removed by means of rational instruction and education along the lines of sexual science if the race is to be prevented from deterioration. The subject will be further considered in the subsequent lessons in this book.

    The best advice to those who have contemplated the performance of abortion is simply this: Don’t; Don’t; DON’T!

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • Medical Product Alert N°4/2020

    Medical Product Alert N°4/2020

    This Medical Product Alert relates to a number of confirmed falsified chloroquine products circulating in the WHO region of Africa. Please note that this Medical Product Alert n°4/2020 will be updated as new reports of falsified chloroquine are received and validated by WHO.

    Between 31 March and 2 April 2020, the WHO global surveillance and monitoring system on substandard and falsified (SF) medical products received nine reports of confirmed falsified chloroquine products from three countries. All reported products were identified at patient level and all have been confirmed as falsified.

    This WHO medical product alert N°4/2020 refers to nine different falsified chloroquine products, with different presentations (see Table 1). It is important to note that widespread vigilance is required from all countries, regardless of where the product was originally identified.

    Table 1: List of identified falsified chloroquine products, subject of WHO Alert N°4/2020
    table1

    All the products listed in Table 1 are confirmed as falsified, on the basis that they deliberately/fraudulently misrepresent their identity, composition or source. Indeed, it can be noted that:

    • either: the products do not contain the correct amount of the active pharmaceutical ingredient, based on the results of preliminary or full compendial analysis;
    • and/or: the products were not produced by the manufacturer whose name is stated on the product labels, and the variable data (batch number and dates) of the above products do not correspond to genuine manufacturing records;
    • and/or: the manufacturer whose name is stated on the product labels does not exist.

    Chloroquine phosphate or sulfate is referenced on the WHO Model List of Essential Medicines for the treatment of Plasmodium vivax infection (malaria). Large clinical trials are under way to generate the robust data needed to establish the efficacy and safety of chloroquine and hydroxychloroquine in the treatment of COVID-19. These medicines are currently authorized for malaria and certain autoimmune diseases and it is important that patients do not face shortages caused by stockpiling or use outside the authorized indications. 
    Both chloroquine and  hydroxychloroquine can have serious side effects, especially at high doses or when combined with other medicines.

    The SOLIDARITY trial, led by WHO, is reviewing potential treatments for COVID-19. Please refer to  WHO medical product alert n°3/2020 for general information on falsified medical products in relation to the management 
    of COVID-19.

    For photographs of products listed in Table 1, please refer to the WHO Medical Product Alert website, and 
    to the annex of this medical product alert n°4/2020 (see pages 3-7).

    WHO requests increased vigilance within the supply chains of countries likely to be affected by these falsified products. Increased vigilance should include hospitals, clinics, health centres, wholesalers, distributors, pharmacies and any other suppliers of medical products.

    If you are in possession of the above products, please do not use. If you have used these falsified products, or if you suffer an adverse reaction/event having used these products, you are advised to seek immediate medical advice from a qualified healthcare professional, and to report the incident to the National Regulatory Authorities/National Pharmacovigilance Centre.

    All medical products must be obtained from licensed, authentic and reliable sources. Their authenticity and condition should be carefully checked. Seek advice from a healthcare professional in case of doubt.

    National regulatory/health authorities are advised to immediately notify WHO if these falsified products are discovered in their country. If you have any information concerning the manufacture, distribution, or supply of these products, please contact: rapidalert@who.int. 

    WHO Global Surveillance and Monitoring System for Substandard and Falsified Medical Products
    For more information, please visit: www.who.int/medicines/regulation/ssffc/en/ 

    Annex: Photographs of falsified chloroquine products circulating in the WHO region of Africa, Medical Product Alert N°4/2020

    CAMEROON

    Photographs of confirmed falsified Chloroquine Phosphate (100mg)
    ChloroquinePhosphate250mgCameroon-1

    Photographs of confirmed falsified Chloroquine Phosphate (250mg)
    ChloroquinePhosphate250mgCameroon-2

    Photographs of confirmed falsified Chloroquine Phosphate 250mg
    ChloroquinePhosphate250mg-Cameroon 3

    DEMOCRATIC REPUBLIC OF CONGO

    Photographs of confirmed falsified CLOROQUINE 250MG
    ChloroquinePhosphate250mgDRC1

    Photographs of confirmed falsified Chloroquine Phosphate 250mg
    ChloroquinePhosphate250mgDRC2

    NIGER

    Photographs of confirmed falsified Samquine 100 (100mg)

    Samquine100-100mgNiger 1

    Photographs of confirmed falsified Chloroquine phosphate tablets B.P 100mg

    Chloroquine-phosphate-tabletsB.P100mgNiger2

    Photographs of confirmed falsified Niruquine (100mg)
    Niruquine00mgNiger3

     

    Medical Product Alert N°4/2020
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    https://www.who.int/news-room/detail/09-04-2020-medical-product-alert-n4-2020

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  • WHO public consultation on draft Target Product Profiles for Tuberculosis Preventive Treatment

    Tuberculosis (TB) is a major yet preventable global health problem, with an estimated 10 million new cases worldwide in 2018, resulting in more than 1.5 million deaths, making it the leading infectious disease cause of death worldwide. An estimated one fourth of the world’s population is infected with the TB bacterium, of whom 5–10% advance to active TB disease in their lifetime.

    Prevention of TB is a crucial component of the World Health Organization (WHO) End TB Strategy that calls for 90% coverage of TB preventive treatment (TPT) among persons living with HIV (PLHIV) and household contacts of infectious TB cases by 2035. The UN high-level meeting on TB, in September 2018, further emphasized the need to strengthen implementation of TPT and called for 30 million people, including 4 million children under 5 years of age to receive TPT by 2022.

    However, uptake and scale-up of TPT have been slow, mainly due to the limitations of both diagnostic assays and available regimens (long duration, cost, toxicity, adherence issues, and operational aspects), indicating the need for new short, safe, efficacious and easy-to-take regimens for the treatment of TB infection and prevention of TB disease. The WHO has developed draft Target Product Profiles (TPPs) for TPT to align developers’ performance and operational targets for new TPT regimens with the needs of end-users.

    The draft TPPs are now available online for comment.

    WHO invites comments or feedback from all stakeholders by 27 April 2020 via this link:

    Based on the comments received on this draft, WHO will prepare the final non-draft TPP (version 1.0), which will be posted on WHO’s website and uploaded into the (WHO) Product Profile Directory by October 2020.

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    https://www.who.int/news-room/detail/31-03-2020-who-public-consultation-on-draft-target-product-profiles-for-tuberculosis-preventive-treatment

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  • Strengthening accountability to end TB

    WHO today released a Checklist to enable Member States and their partners to assess the status of work at the national level to strengthen accountability to End TB, principally: national commitments made, actions taken on those commitments, monitoring & reporting approaches, and the nature of any high-level review mechanisms. The Checklist has been developed in response to requests from Member States, regions, civil society and partners as a tool to support the adaptation and implementation of the WHO Multisectoral Accountability Framework (MAF-TB) released in 2019. It responds also to the UN General Assembly request to WHO to ensure implementation of the Framework.

    There are four components of the MAF-TB that form a cycle for strengthening accountability: Commitments, Actions, Monitoring and Reporting, and Review, that were released during the World Health Assembly in May, 2019. In the political declaration of the first UN high-level meeting on TB, world leaders called for WHO to finalize the framework and ensure its implementation in 2019.

    After its publication in May, 2019, WHO began work with pathfinding country counterparts who were seeking to move ahead on key elements including, among others: formal adoption of country-specific targets for 2022 for increased TB case detection and treatment in line with the global targets in the political declaration; updating or development of new national TB strategic plans based on 2022 and 2030 targets and other new commitments; coordination platforms across sectors and stakeholders; formalizing engagement with civil society across End TB efforts;  producing robust performance reports; and, using those reports to inform high-level review bodies that will assess and drive faster progress.  Based on the MAF-TB document, relevant country experiences, and specific requests from countries and partners, WHO developed the MAF-TB Checklist. The Checklist is especially relevant for high TB burden countries, but has content relevant to all countries.  The appropriateness of different approaches may vary, according to national constitutional, legal and/or regulatory frameworks or other relevant factors.

    The MAF-TB Checklist has three annexes on:

    1. engagement across government ministries and bodies;
    2. engagement of civil society and affected communities; and,
    3. adoption  and implementation of WHO TB guidance.

    In releasing this MAF-TB Checklist today, Dr Tereza Kasaeva, Director of the WHO Global TB Programme noted,  “At this enormously difficult time, all countries and partners are focused on the COVID-19 pandemic.  Lessons learnt from ongoing TB programmes are helping the response. Likewise, TB efforts will benefit from learning underway on collaboration, innovation and accountability in confronting the virus.”

    WHO will be helping Ministries of Health and partners to use the Checklist, hold related consultations and move forward with more effective collaboration and review mechanisms.  The WHO Civil Society Task Force on TB also will support countries and civil society partners, using the Checklist. Progress in strengthening accountability will be assessed in the 2020 Report of the UN Secretary-General on progress since the 2018 TB UN high-level meeting, as well as in the WHO Global TB Report 2020.

    The WHO TB Civil Society Task Force, National TB  Programme Managers and other country officials, WHO staff at all levels, consultants working with WHO and The Global Fund, and staff of partner agencies, contributed content to, and/or provided feedback on, the MAF-TB Checklist during its development.   Access the Checklist and 3 annexes.  

    An online form of the checklist will be available shortly here, along with additional information.  

    Translations of the Checklist and annexes, as soon as available in Arabic, Chinese, French, Russian and Spanish, will be posted at the above link as well.   Kindly contact gtbprogramme@who.int if you have questions regarding the MAF-TB Checklist or to request versions in MS Word format if needed.

     

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  • #ThanksHealthHeros – World Health Day Message

    Today is World Health Day! This day is especially poignant as the focus is on nurses and health workers, who are on the frontline of the COVID-19 response across the world. They are the real heroes risking their lives to save the millions
    affected by COVID-19 as well as other deadly diseases like tuberculosis (TB).  They play a major role in providing high quality, respectful treatment and care, and leading community dialogue to address fears and questions. It is imperative that
    we come together to invest more, empower and protect the nursing and health workforce.

    Without nurses and health workers, we cannot achieve “Health for All” or end diseases like TB which claim millions of lives each year. The World Health Organization is calling for your support on World Health Day to ensure that the nursing
    and midwifery workforces are strong enough to ensure that everyone, everywhere gets the healthcare they need.

    Today, we would like to salute and thank nurses, midwives and other health workers around the world who are battling difficult situations to save lives and we pay tribute to those who lost their lives protecting others.

    Emily: A Day in the Life of a TB Nurse

    <div><small><a href=”https://youtubeembedcode.com/pl/”>youtubeembedcode pl</a></small></div><div><small><a href=”http://add-link-exchange.com”>w://add-link-exchange.com</a></small></div>

    Watch this story of Emily, a nurse managing the TB programme of the City Health Office in Tuguegarao City, Philippines. Her dream for Tuguegarao is to one day see zero TB cases and that no one dies from this infectious disease.

    Nurses and healthcare workers play a critical role in TB prevention and care. It’s time to invest in them to improve healthcare for all.

    We thank all the nurses and healthcare workers working to #EndTB!

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    https://www.who.int/news-room/detail/07-04-2020-thankshealthheros—world-health-day-message

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  • COVID-19: NCDC Urged To Increase Transparency Around Number Of Tests Conducted

    COVID-19: NCDC Urged To Increase Transparency Around Number Of Tests Conducted

    COVID-19: NCDC Urged To Increase Transparency Around Number Of Tests Conducted 1

    COVID-19: NCDC Urged To Increase Transparency Around Number Of Tests Conducted 2


     

    The Nigeria Center for Disease Control has been urged to make public the daily number of Nigerians screened for Coronavirus.

    A coalition of civil society groups led by Civic Media Lab said the figures will help Nigerians and the world know the true state of the COVID-19 pandemic in the country.

    “The fight against Coronavirus is a common fight in which all Nigerians are enlisted.

    “However, as stakeholders in the fight against Coronavirus this disease, we request to have this critical piece of the puzzle so that we would know how far along we are in securing a victory,” CML Director, Oluwaseun Akinfolarin, said in a statement on Tuesday. 

    Akinfolarin said the strategy that has worked in places that have seen significant reduction in the number of cases has been due to four factors namely: testing, isolation, treatment and tracing. 

    See Also

    COVID-19: NCDC Urged To Increase Transparency Around Number Of Tests Conducted 3

    Sahara Reporters

    Civic Media Lab Calls For Transparency In NCDC Testing Figures


    “Testing is the most critical of these four critical success factors, without testing, it is difficult to know who has been infected and stopping the spread through innocent infection of others is not feasible. “While not trying to second guess the knowledge and wisdom of the professionals in NCDC, we can follow the simple logic that we cannot control what you cannot see and the simple way of seeing is by doing these tests,” Akinfolarin said.

    According to the World Health Organisation, diagnostic testing for COVID-19 is critical in helping to track the virus, understand the epidemiology, inform case management, and to suppress transmission.

    Akinfolarin explained that the countries that are successfully managing this crisis tested thousands of citizens daily at the outset. 

    Nigeria is falling behind when compared to other countries, according to him.

    He said the coalition will support the Federal Government and NCDC in every way possible during this crisis but wishes to demand cooperation, transparency, accountability and proactive disclosure of information from all those concerned.

    Other members of the coalition are The Interactive Initiative for Social Impact, HEDA Resource Centre, Civil Society Network against Corruption, Reboot, Centre for Advocacy, Transparency and Accountability Initiative, and PARE.

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  • Virtual Press Conference on COVID-19- 06 April 2020

    Virtual Press Conference on COVID-19- 06 April 2020

    Originally broadcast live on 06 April 2020, the daily press briefing on coronavirus COVID-19, direct from WHO Headquarters, Geneva Switzerland with Dr Tedros WHO Director-General, Dr Micheal Ryan, Executive Director of the Health Emergencies Programme, and Dr Maria Van Kerkhove, Technical lead, WHO Health Emergencies Programme with special guests Lady Gaga and Hugh Evans, CEO and Co-founder of Global Citizen.

    Transcript:

    Speaker key:

    TJ        Tarik Jasarevic

    TAG    Dr Tedros Adhanom Ghebreyesus

    LG       Lady Gaga

    HE       Hugh Evans

    MR      Dr Michael Ryan JA  Jamie

    MK      Dr Maria Van Kerkhove KA Kai

    KT       Kate

    IN        Innocent

    YA      Yang

    00:00:19

     

    TJ        Good evening to everyone from Geneva and WHO headquarters. Welcome to the regular press conference on COVID-19. Journalists who are online can ask their questions by clicking  raise hand if  you are
    on Zoom.  Today we have a special guest but  I will  let Dr Tedros do his opening remarks and introduce them.  Before I give  the floor  to Dr Tedros, just to remind you, we will also be sending you some news from other
    WHO offices around the world with the audio file  from this  press briefing a little  bit  later. I give  the floor  immediately to Dr Tedros.

     

    00:01:07

     

    TAG    Good morning, good  afternoon and good  evening.  The COVID-19 pandemic continues to take a heavy toll on families, communities and nations the world over but it’s also giving rise to incredible acts of generosity,
    solidarity and co-operation. We have said consistently that we’re all in this together and we can only succeed together. We need an all- of-society approach with everyone playing their part. That includes  people  in  the entertainment
    industry.

     

    Today I’m very delighted to be joined by one of the biggest names in entertainment in the world, Lady Gaga, and my friend Hugh Evans, the founder and CEO of Global Citizen.

    WHO has been working with Global Citizen for several weeks on the Together At Home concert series with artists like Chris Martin and John Legend giving free online performances.

    Now we’re working with Lady Gaga and Global Citizen to take this concept and make it even bigger through the  One World  Together  At Home virtual  global  special on Saturday 18th April. It’s now my great pleasure to invite
    Lady Gaga and Hugh Evans to say more about this very special event, One World.

    00:03:10

     

    LG       Thank you very much, Dr Tedros. Good morning, good afternoon  and good  evening to everyone who’s listening and watching. I would  like  to thank the World  Health Organization and the
    United Nations as well as Global Citizen; thank you very much, Dr Tedros and Hugh Evans, for all of your leadership in this fight against COVID-19 and thank you very much to the World Health Organization  for asking  me to collaborate 
    with  you on this special.

    We are also very grateful to all of the healthcare professionals across the country and around the world who are on the front lines during COVID-19. This  global  pandemic  is  a catastrophe. I’m so thankful to them and I’m also
    praying for those who are sick. It’s been a pleasure to partner with Global Citizen  and we’ve been working  all together  behind  the scenes to raise money for the World Health Organization.

    I would also like to send my prayers as well to people  that are losing  their  jobs  and are having a hard time feeding themselves  and their  children.  We are raising  money  for  the World Health
    Organization’s COVID-19 Solidarity  Response  Fund and seven days ago we held a  call with more than 68 corporate leaders from some of the world’s biggest and most generous companies and I asked them to join my corporate kindness
    list as there have been many corporations and philanthropists that have been very, very generous during this time.

    00:04:38

     

    Since then we have also been calling on philanthropists around the world as well and tech companies included. I’d like  to reiterate our deep gratitude  to the medical  community.  My heart is very, very aching and warm for those
    who are ER doctors as well as nurses who are sleeping in cars to make sure they don’t infect their families  or  their  patients.  What you’re doing is putting  yourselves  in  harm’s way to help the world 
    and we all salute  you and you are a triumph truly.

    I am proud to say that over the past seven days we’ve raised a total of $35 million for the Solidarity Fund. This money will [inaudible]  essential PPE, supplies  and testing kits around  the world and will help improve lab capacity
    to rapidly process tests. It will also [inaudible] research development. It is so important to think globally and to support the World Health Organization to curb the pandemic and prevent future outbreaks.

    I know Dr Tedros is particularly concerned about Africa and [inaudible]. We also need to act globally by supporting local charities  and initiatives so that the front-line health  workers in most immediate need have the resources they need
    to survive during this time. It has been an honour to help with this huge broadcast event, which will take place on April 18th, where we need to tell the stories of and celebrate the front-line community, healthcare workers and their acts of kindness.

    We will be on different networks, many networks actually and I want to [inaudible] about what we’re going to be doing. What’s very important is that two things happen for all of us; that we celebrate and we highlight the singular, kind global community
    that is arising right now. Two, we want to highlight the gravity of this historically unprecedented cultural movement and, three, we want to celebrate and encourage the power of the human spirit.

    00:06:47

    I would like to, on behalf of  the World  Health Organization  and Global  Citizen,  thank Dr Tedros as well as everyone that has donated so far. We are going to continue fundraising but I would like to also let you know that
    this broadcast special is not actually a fundraiser. We all wanted to raise the money before we went on air so when we do  air  live  on  April  18th  put your wallets away, put your credit  cards away, anything 
    away that you need to and just  sit back and enjoy the show that you all very much deserve.

    I’d like to pass this now to Hugh Evans, who’s been a wonderful partner of mine. Hugh, thank you so much and thank you, Dr Tedros.

    HE       Good morning, good afternoon,  good  evening  and thank you,  Dr Tedros  and thank you, Lady Gaga. Your Excellencies,  ladies  and gentlemen;  Lady Gaga, Dr Tedros, 
    you’ve both demonstrated extraordinary leadership at an unprecedented moment when our society is being challenged like never before and we are so thankful for your leadership. I’d like to echo Lady Gaga’s sentiment and commend the incredible acts
    of bravery demonstrated by the front-line community  health  workers around the world  and I hope  that we as a shared humanity emerge from this moment forever grateful for the work of doctors, nurses, teachers, grocery store workers and all of those who are
    the backbone of our communities.

    Global health is at the very core of the global citizen mission and we must  ensure that the world’s poorest and most  marginalised  people  have  access to resources to cope with and tackle this health crisis. Through One
    World:  Together At Home on April 18th  we’ll be calling on philanthropists, corporations and governments to fund critical global COVID-19 response efforts including distribution of resources and PPE to critical front-line healthcare
    workers.

    00:09:09

    In our partnership with the WHO and United Nations Global Citizen is committed to driving action to help ensure our global health systems are strong enough to stop a future pandemic before it happens. April 18th is going to be a moment of global unity
    connecting the world through a historic global broadcast. We are bringing together the greatest artists in the world under the passionate and extremely talented curation of Lady Gaga.

    In alphabetical order some of the artists we’ll be announcing today include Alanis Morissette, Andrea Bocelli,  Billie  Eilish,  Billy  Joe Armstrong  of Green Day, Burna Boy, Chris Martin, Sir David Beckham, Eddie Vedder,
    Sir Elton John, Finneas, Idris and Sabrina Elba, J Balvin, John Legend, Kacey Musgraves, Keith Urban, Kerry Washington,  Lang Lang,  Lizzo, Maluma, Sir Paul McCartney, Priyanka Chopra Jonas, Shah Rukh Khan, Stevie Wonder and many more to be announced over the coming weeks from all corners of the globe under the passionate and extremely talented curation of Lady Gaga.

    We’re grateful to all of you for participating and supporting this critical effort. One World Together At Home will be broadcast live on Saturday April 18th 2020 at 5:00pm PDT, 8:00pm EDT and 12:00am BST, airing on ABC, NBC, Viacom and CBS networks,
    IHeartMedia, and Bell media networks and platforms in Canada. Internationally BBC1 will run the programme on Sunday April 19th and additional  international  broadcasters include BN Media Group, Multi-Choice Group and RTE in Ireland.

    00:11:43

    The digital broadcast will celebrate and support brave community  health workers who are doing life-saving work on the front line and we’ve all seen the limitations of world leaders around this world to step up and face this extraordinary challenge 
    and we want to do our best to support the essential work of the World Health Organization, driving action and raising critical funds. Thank you again, Dr Tedros, and thank you, Lady Gaga, for your leadership.

    Thank you all.

    TJ        Thank you very much to our guests for their remarks. Dr Tedros, I guess you would like to thank them too.

    TAG    Once again I would like  to thank Lady Gaga and Hugh Evans for their  partnership. We had a call last week and I was so amazed by the energy and passion of Lady Gaga. It’s incredible commitment to humanity and that’s
    when I said, I think what she has planned can happen. It’s bringing the world together to improve awareness and to mobilise  resources to fight the pandemic so I thank her for her incredible passion and commitment  and leadership and
    also to my friend, Hugh Evans, for connecting all the dots and for his leadership.

    We all look forward to joining you for the One World: Together  At Home concert on 18th April. As the pandemic continues we recognise that individuals and governments want to do everything they can to protect themselves and others and so do we.
    We understand that some countries have recommended or are considering the use of both medical  and non-medical masks in the general population to prevent the spread of COVID-19.

    00:14:21

    First and foremost medical masks must be prioritised for health workers on the front lines  of  the response. We know medical masks can help to protect health workers but they’re in short supply globally.  We’re concerned that the mass
    use of medical  masks by the general population could exacerbate the shortage of these specialised masks for the people who need them most. In some places these shortages are putting health workers in real danger.

    In healthcare facilities WHO continues to recommend the use of medical masks, respirators and other personal protective equipment for  health workers. In the community we recommend the use of medical masks by people who are sick and those who
    are caring for a sick person at home.

    WHO has been evaluating the use of medical and non-medical masks for COVID-19 more widely. Today WHO is issuing guidance and criteria to support countries in making that decision. For example countries could consider using masks in communities where other measures such as cleaning hands and physical distancing are harder to achieve because of lack of water or cramped living conditions.

    If masks are worn they must be used safely and properly. WHO has guidance on how to put on, take off and dispose of masks. What’s clear is that there is limited research in  this  area. We encourage countries that are considering the use
    of masks for the general population to study their effectiveness so we can all learn. Most importantly masks should only  ever be used as part of a comprehensive package of interventions. There is no black or white answer and no silver bullet.
    Masks alone cannot stop the pandemic. Countries must continue to find, test, isolate and treat every case and trace every contact. Mask or no mask, there are proven things all of us can do to protect ourselves and others.

    00:17:13

    Keep your distance, clean your hands, cough or sneeze into your elbow  and avoid  touching your face. Less than 100 days since WHO was notified about the new coronavirus  research has accelerated at incredible speed. The viral genome
    was mapped  in  early January and shared globally, which enabled tests to be developed and vaccine research to start. More than 70 countries have joined WHO’s Solidarity Trial to accelerate the search for an effective treatment and about
    20 institutions and companies are racing to develop a vaccine.

    WHO is committed to ensuring that as medicines and vaccines are developed they’re shared equitably with all countries  and people.  I want to thank the  Medicines  Patent Pool and Unitaid for the initiative they announced last
    Friday to include medicines and diagnostics for COVID-19 in their licensing pool.

    I also want to thank the President of Costa Rica, President Carlos Alvadaro, and the Health Minister, Daniel Salas, for their proposal to create a pool of rights to tests, medicines and vaccines with free access or licensing on reasonable and affordable
    terms for all countries. Muchas gracias, Mr President. I support this proposal and we’re working with Costa Rica to finalise the details.

    00:19:09

    Poorer countries and fragile  economies  stand to face the biggest  shock from this  pandemic and leaving anyone unprotected will  only  prolong  the health crisis  and harm economies  more.  I call
    on all countries, companies and research institutions to support open data, open science and open collaboration so that all people can enjoy the benefits of science and research.

    Finally we’re nearing the end of the Ebola outbreak in the Democratic Republic of the Congo. This is one piece of good news. If there are no more cases the Government of the Democratic Republic of Congo could declare the outbreak over  as early
    as this  Sunday.  We’re not  there yet and we remain in full response mode. We’re continuing to investigate alerts and to test samples.

    This would not have been possible without the incredible  health workers who have put themselves at risk for more than 18 months to stop this outbreak, just as health workers are putting themselves in danger to save lives from COVID-19. Health
    workers in DRC faced the 
    double threat of fighting a deadly virus in one of the world’s most dangerous and unstable regions, exposing themselves to Ebola and bullets.

    Tomorrow, as you know, is WHO’s birthday, a day we celebrate each year as World Health Day. This year we’re paying tribute to the incredible contribution of all health workers, especially nurses and midwives. Nurses and midwives are the backbone of
    every health system. They’re there from the first moments of life to the last. Tomorrow we’re publishing our first report on the state of the world’s nursing which highlights gaps and makes recommendations for all countries.

    00:22:00

    One of the lessons I hope the world learns from COVID-19 is that we must invest in health workers, not only to protect lives but also to protect livelihoods. I thank you.

    TJ        Thank you very much, Dr Tedros. Also, as always, we have Dr Mike Ryan and Dr Maria Van Kerkhove, who will be answering questions. We will  now open the floor.  I will  go to one question
    that I received by email this morning and I promised to answer; that’s Ankit Kumar from India Today. Ankit is asking; we have recently seen a spike in  cases caused through religious gatherings in India, in fact almost a third of new cases
    were linked to one gathering in India. We have also seen incidents of violence against health workers due to fear and misinformation. Is WHO concerned with these developments, what is WHO’s message to religious and community leaders and their
    followers?

    MR      First and foremost the idea of violence against health workers is driven by fear and it’s driven by misunderstanding but it’s  really  unacceptable. We ask everyone and every community to see our health workers
    as our heroes and to support them in every way we can.

    With regard to gatherings of any type, be they religious or be they for other  purposes,  there are always risks associated with such gatherings in the midst of a major epidemic. WHO has issued guidance on that. Many of these gatherings
    are now postponed or cancelled.  We’ve been working very, very closely with religious  and faith-based organisations  all  over the world including  groups  from the Islamic  tradition,  Christian 
    traditions  and others and continue to work through faith-based organisations to communicate  using  our  Epiwin platform.

    00:24:21

    We’re also continuing to develop guidance specifically  for the holy  month  of Ramadan and are working through our Eastern Mediterranean regional office to be able to advise governments and religious institutions on how best to manage
    the risks associated with such holy events.

    But it’s very important again; having COVID-19 is not anybody’s fault. Every case is a victim and every case needs to be  treated with sensitivity,  as the health workers who treat them so it’s very important that we’re not profiling COVID-19
    along  racial,  along  religious,  along ethnic lines. This is not helpful.

    TJ        Thank you very much. This was a question  from Ankit  Kumar from India  Today. Now we will go to journalists online. We will start with Jamie from Associated Press. Jamie, can you hear us?

    JA        Hi, yes. Can you hear me? TJ            Yes. Please go ahead.

    JA        Great, thank you very much. I wanted to ask you about… Over the weekend Dr Anthony Fauci mentioned that – if I understood it correctly – as much as 50% of transmission could be asymptomatic. Just aligned 
    with that, if  you could  give  us a little  bit  more  about what you’re thinking about the fact that some countries have said that this outbreak is more infectious than influenza. The CDC is saying that it’s up
    to three times more infectious than influenza so what do you have to say about that? Thanks.

    00:26:13

    MK      I’ll start and then perhaps Mike or DG would like to supplement. The modes of transmission and the way in which this virus is transmitted  are of significant  interest to all of us. What we are doing is working
    with member states, we’re working with everyone that’s affected by this, looking through the research and trying to understand  when most transmission is happening, when any transmission is happening.

    What we know from reports, what we know from published literature is that the predominant way in which transmission is occurring is amongst symptomatic individuals  and these are people that can be very early on in symptoms, even when they start
    to feel a little bit unwell. This is supported by some data that attempts to catch a virus from individuals who are symptomatic.

    We also know that it’s possible that people can transmit in the few days before they become symptomatic or in their pre-symptomatic  phase. There have been some studies  that have come out and we learned about this when we were on mission
    in China back in January or early February, that there are individuals that can shed virus one to three days before they develop symptoms.

    However it’s very important to note that even if you are pre-symptomatic or even if you don’t have any recognised symptoms you still have to transmit through  droplets,  you still  have to have these infectious particles that come out
    of your nose and your mouth. So while we know that that is possible we do not believe that it’s a major driver of transmission.

    00:27:42

    We’ve also seen modelling estimates that suggest that there’re large numbers of unrecognised transmission and I used unrecognised on purpose because I’m not saying asymptomatic. I’m saying that we may be missing people who are out there who are infected
    but we’re missing them because of current surveillance strategies. That is certainly possible in many parts of the globe.

    Whether or not those individuals are asymptomatic; we will have to wait until we see the results of serologic studies, which we hope we’ll be seeing in the coming days if not weeks.

    So what we can say is that most people are transmitting this virus while they are symptomatic.

    JA        Hi, Jamie. Just in addition because I think – I would never in any way contradict my good friend, Tony Fauci, such an eminent man. There are many different estimations of what might represent asymptomatic
    transmission or other infections in the community and we do know and everyone accepts that when the seroepidemiology studies do come online we will probably find more people who’ve been infected unknowingly; there’s no question of that.

    The thing we need to address in all of this is  very often the idea of  severity versus infection and there is a huge association  between the dose  of exposure  and the severity  of infection. We see this in many other
    infectious diseases so we also probably need to look  at who is getting sick and very sick and is the dose and the type of exposure they’re getting different to those who may be exposed and seroconverted in the community.

    00:29:26

    So it’s not just a matter of looking at how many people in the community are infected but are there specific elements  of exposure  that cause individuals  to have  a higher dose of exposure or a specific route of exposure 
    that causes more severe infection?  There is  also that concept of infectious dose when we talk about the different types of transmission. If somebody is exposed to a high dose from another individual directly or from a surface that’s
    heavily contaminated you can imagine the large dose.

    In other circumstances individual particles or virus particles potentially floating through  the air; it can be demonstrated that that may happen in certain circumstances, certainly in healthcare settings. But is that significant  in 
    terms of driving  infection,  is  that significant, does that produce an infectious dose that can successfully infect another individual?

    These are all very important things that still need to be studied. Again we’re only a number of weeks into this. I think we need to have the seroepi studies. I think  we need more information on what is the infectious  dose  and particularly 
    the relationship  between the dose  of exposure or infection and the severity of disease subsequently, which has been seen with many, many other diseases in the past including cholera, Ebola and others.

    TJ        Thank you very much, Mike and Maria. We will go now to our next question; that’s Kai Kupferschmidt. Kai, can you hear us?

    00:31:01

    KA      Yes, Tarik. Thanks a lot for taking my question. I wanted to ask about the global  push  to try and find a pre-exposure  prophylaxis  or a post-exposure  prophylaxis. I understand there’re
    several trials going on, most of them with chloroquine  or hydroxychloroquine.  I was just wondering whether you can speak a little bit to what role this could potentially play.

    Of course also there’re a lot of smaller studies going on. Is there any way to make sure that they all lead to results that can be proved in the end?

    MR      Maria can give you more detail but certainly one of the Solidarity trials – I think Solidarity 3 or 4 – we have one of the trials under design which will be a multi-centre study which will look at prophylaxis in healthcare workers to see whether there’s evidence that giving lower doses of drugs like chloroquine or hydroxychloroquine to healthcare workers would reduce their risk of becoming infected in a healthcare environment.

    Those studies are certainly underway and again there are a number of those studies underway in smaller studies around the world but again as WHO we’re trying  to bring  together  a larger set of collaborative studies that will give
    us the answers we need.

    In terms of post-exposure prophylaxis I don’t believe  we have at the moment  studies  planned but Maria can speak to that but there is certainly evidence for the use of – not proven  evidence of effectiveness but there are a number
    of studies underway and trials underway that use hyperimmune globulin  in  the treatment  of disease; in  other words  they use that purified plasma of recovered individuals to give an antibody boost to people who are
    suffering the disease.

    00:32:49

    Similar approaches have been used in post-exposure prophylaxis for other diseases but Maria may be aware of studies underway in that area.

    MK      Only to add that, as you mentioned, there are a number of smaller studies that are happening globally and across a large number of countries.  We have teams through  our science division and through GOARN,
    through the Global Outbreak Alert Network, who are pulling together  available  literature  on a number  of topics,  one  of which is  looking  at different types of therapeutics and drugs.

    The idea is until we can have a study that pulls together enough of a sample size to get these answers to these questions we’re trying  to evaluate  every piece of evidence  that is  published so that we can look at the way in
    which these studies were done, we can look at the strengths, we can look at the limitations so that can help guide us closer  towards an effective treatment for COVID-19.

    TJ        Thank you very much. The next question is from BFM Radio. Is is Kate who is with us?

    KT       Yes, hi. Good evening or good morning.  I’m from BFM Radio  Malaysia. My question is, many countries around the world have imposed lock-downs or some sort of restrictions on movement. I was wondering
    what WHO’s guidance would  be; what’s the sweet spot, the kind of data that governments need to consider before lifting or relaxing  some  of these lock- downs? Thank you very much.

    00:34:29

    MR      Thank you. It is a difficulty for governments right  now  because the lock-downs  in many situations are proving effective in dampening the flames of the epidemic  in  those countries but those
    lock-downs are also causing great economic hardship and everybody especially in the developing world needs to get to a more sustainable way of managing this epidemic and controlling COVID-19 without continuing to damage economic and social life.

    The transition strategy out  of lock-down  requires  a calibrated,  step-wise approach.  It would be probably very inadvisable just to lift a complete lock-down, all of the measures because lock-downs are a general term that
    include closure of schools, closure of  churches, stay-at- home orders, closure of workplaces. It’s a mixture of different things and I think each government needs to break out, what does our lock-down actually constitute, what are the elements
    of our lock-down, where is that happening in the country, do we now understand the epidemiology of the disease in each area in which we have an element of lock-down or shut- down.

    Then to chart the path out, you have to build strong public health capacity to take over from the lock-down. In other words the lock-down is pushing the disease down by putting people back in their homes, by separating communities. Once you raise
    the lock-down you have to have an alternative method to suppress the infection. The  way to do that is active  case finding, testing, isolation of cases, tracking of contacts, quarantining of contacts and strong community education and
    participation and ownership around normal physical distancing, hygiene and giving communities the power to control infection by in effect managing their own physical distance, managing their own capacities to support the response.

    00:36:32

    In that situation, if you’ve strong public health capacity, if you’ve got a community that’s mobilised and empowered and if you’ve strengthened your health system then you’re potentially in a position to start unlocking or unwinding the lock-down.
    The specific parameters you need to be looking at are on two sides.

    One is, it would be very inadvisable to lock down [sic] if the number  of cases coming  through the hospital is already at a level where your  occupancy of  beds is  nearly at 100%.  You need to be in a position where
    you now have free beds in your system so that you’re managing and coping with the caseload and that means you have some absorption capacity left.

    You need to look at things like the doubling  rate; how  many days does it  take for the  number of cases to double? You need to look at positivity rates; what proportion of all samples that we test are positive? You’ll see in
    somewhere like Korea two to 6% of the samples  they test are positive. Last week in New York 37% of tested samples were positive so you need to carefully look at what proportion of people you test are positive.

    00:37:45

    You need to look at the number of contacts that are generated per case and it goes on and on and WHO will be issuing guidance to countries that is a much more specific around the parameters they should be looking at. There are no absolutes here, there
    are no answers, there are no numbers that say if this number is this then you do that. That doesn’t exist but what we can do is offer countries very specific  measurements  that they need to look  at to chart the path out of lock-down.

    That step-wise approach of unlocking somewhat and then waiting to see; I think you need to say, we will stop doing this element of the shut-down  and then we will  wait and we will  look at the data and if that works we go to the next
    stage and the next stage. So a careful, calibrated, step-wise exit from lock-down with putting in place public health capacities, putting in place community capacity, building the capacity of the health system to cope should the disease bounce back up; that’s the safe path out of lock-down.

    We want to achieve it as quickly as possible and we want to avoid many countries going  into that circumstance and we still have many countries around the world who are not in a locked- down situation. In fact their epidemiology would suggest
    they can avoid the worst of this and we need to support them to avoid them going into that situation.

    The most damaging lock-downs are in many developing countries  where people  – as the  DG has said many times – can live from hand to mouth, not from pay cheque to pay cheque but from day to day and we have to find adaptive solutions
    around lock-down and around disease control in vulnerable periurban populations living in poverty,  in  poor  rural communities.  We have to find alternative, adapted ways to manage lock-downs or slow-downs or shut-downs in
    those situations.

    00:39:41

    TJ        Thank you very much. This was Kate from BFM Radio in Malaysia. Now we will  go to Nigeria to Natural Star and it’s Innocent. Innocent, can you hear us?

    IN        Thank you. Can you hear me?

    TJ        Not very well but we will try. Please go ahead.

    IN        Okay, thank you for taking my questions. I have two questions to ask. One; how will WHO assess African countries on what they’ve done concerning the lock-down and management of COVID-19?

    Then the second one; there’s news going around that vaccines are to be tested on Africans when they’re developed. How true is that and is there a window that’s in the nearer future when a vaccine will be developed for COVID-19? Thank you.

    Hello?

    TJ        Yes, we are just trying to make sure that we understood the question but we will try. MR     I think this is Nigeria. Is it?

    TJ        Yes.

    00:41:08

    MR      Maria may answer the question around vaccine development. With regard to our general assessment on lock-down – and the Director-General may wish to comment on this because he’s been speaking with many leaders in Africa
    and, I believe, spoke with  the whole of the African Union leadership and countries late last week so therefore is in a much better position than me to speak about that.

    We would characterise so far, Africa’s actually doing well in this response thus far. Countries have essential capacities for testing, many countries are taking strong action and want to really focus on finding cases and doing contact tracing and trying to stop this disease becoming much more extensive given the fact that health systems are not as strong in many countries. 

    They need support in that though, they need support in testing, they need support with protective gear and they need to be given the resources to be able to mount those types of responses so I would characterise that Africa has not suffered the worst
    of this pandemic so far. The worst of it can be avoided with very, very swift action to support those countries in Africa who really do want to take a comprehensive approach to this disease.

    With the many vulnerable  people  including  refugees and migrants  who live  in  those countries it is our responsibility to provide that support but, DG, you may wish to speak about your interactions with the African
    Union countries.

    00:42:46

    MK      I’ll answer the question  around vaccines. What we can say is  that there are a number of vaccines that are in development and vaccines will be tested through clinical trials with all ethical considerations
    in place in whichever  populations  are under  study  with informed consent, with open and transparent communication. This is of the utmost importance, that not only do we have strong, robust  scientific  evidence 
    but  we ensure that all  of the studies  that are done are done with appropriate and the highest level of ethical considerations.

    One thing on the first question around Africa is that there are a number of countries in Africa right now which have very few cases and Mike has alluded to this in his earlier response.

    Some only have imported cases and there is an opportunity here, this  window  of opportunity that the DG has spoken about exists  in  many countries  still.  There is  an opportunity to prevent the worst from happening
    in a number of countries across Africa and across countries that are still seeing their first case; in some island countries.

    We need to support those governments, those countries, all of the people in those areas to prevent the worst from happening, to prevent these individual cases from becoming clusters, these clusters from becoming community transmission. I think that’s
    where we need to put  a lot of emphasis and support so that we can prevent countries  from reaching a point  where they need to put in these very restrictive movement restrictions.

    TAG    Thank you. Thank you for that question, my brother from Nigeria. On the situation, as Mike said, of course when you see the number of cases the African continent has the lowest number of cases so far but that doesn’t mean that
    the situation will not deteriorate. It may.

    00:45:06

    So Africa should do everything to prevent this situation from getting worse and that’s why African leaders are doing their best. I had a chance to participate in a meeting, a Leaders’ Coalition which was arranged or invited by the current Chairperson
    of the African Union, the President of South Africa, President Ramaphoza and many leaders from all corners of the continent have actually participated.

    The main agenda is to have a continental strategy and also make sure that that continental strategy helps the national strategy but in addition to a coalition of political leaders or the heads of state and government they have also agreed to have a coalition of business leaders. Business leaders in Africa are also getting together because Africa will need resources and one of the major problems that was identified during the discussion
    was especially shortage of equipment starting from medical equipment, PPE and test kits and so on.

    The leaders have agreed to look for concrete solutions to address the problem and they also believe that considering the number of cases we have in the continent testing cases, tracing contacts and isolating them, meaning using the comprehensive approach,
    will actually  help. They believe that lock-downs alone may not help or the physical distancing alone cannot help and they have agreed to do everything to follow the comprehensive approach.

    From WHO’s side we have been supporting and we increased, improved  the testing capacity in Africa significantly in the past two months and many countries in Africa have now testing capability although we may have a shortage of test kits but 
    we’re working  on that too and we’re finding different ways of addressing the gap.

    00:48:06

    But we will support the African Union, we will support the Africa CDC and also we will continue working through our WHO regional office in Congo Brazzaville and continue to support and fight the pandemic together.

    Then on the vaccines issue there was, I think, a comment last week from a couple of

    scientists who said the testing ground for the new vaccines will be Africa. To be honest,  I was so appalled and it was a time when I said, when we needed solidarity these kind of racist remarks actually would not help, it goes against the solidarity.

    Africa cannot and will not be a testing ground for any vaccine. We will follow all the rules to test any vaccine or therapeutics all over the world using exactly the same rules. Whether it’s

    in Europe, Africa or wherever we will use the same protocol and if there is a need to be tested elsewhere to treat human beings the same way, equally.

    The hangover from a colonial mentality has to stop — and WHO will  not  allow  this  to happen. It was a disgrace actually  and appalling  to hear during the 21st century from scientists that kind of remark and we condemn
    this in  the strongest  terms possible  but  we assure you  that this will not happen in Africa and will not happen elsewhere, in any country. Proper protocols will be followed and human beings will be treated as human
    beings because we’re all human beings.

    00:50:37

    Then after saying this the vaccine development; we’re addressing two issues and we will be announcing as soon as possible, hopefully during this week, a big initiative to accelerate the research and development and production of vaccines and also
    design mechanisms for equitable distribution of the vaccines.

    While we’re looking for vaccines, unless we break the barriers to equitable distribution of the products, whether it’s vaccines or therapeutics, we will have a problem, so we need to address the problem ahead of time, we need to address the problem
    of access or challenges to access ahead of time.

    That’s why we will put together a mechanism and we will appoint senior people from the North and South that will work out the details on how they can accelerate production but at the same time how they can ensure equitable distribution. Solidarity
    is very important here. When a vaccine or a medicine is ready we have to be able to deliver it all over the world.

    There should not be a divide between the haves and the have-nots.

    If we say solidarity, solidarity should be in its full form and I hope each and every individual, each and every human being will go for that kind of solidarity. I thank you.

    TJ        Thank you, Dr Tedros. We’ll take a couple more questions. We go to Yang from Xinhua news agency. Yang, can you hear us?

    00:52:58

    YA      Can I hear you?

    TJ        Yes, we can hear you. Please go ahead.

    YA      As World Health Day is approaching  what do you  have to say to the  front-line medical workers in China and around the world in  the global  anti-virus  efforts? This  question is
    for Dr Tedros. Thank you.

    TJ        If we understood well, the question is what is the message to health workers in China and around the world. Maybe you can repeat the question one more time, please.

    YA      Okay. As World Health Day is approaching what would you say and what message do you want to deliver to the front-line medical workers in China  and around the world  in  the global anti-virus effort?

    TAG    I think I have said it earlier;  as you  know,  this  is  the year of  the nurse and the midwife, 2020. We were ready to celebrate it in a big way and it was supposed to be the main event in our
    Assembly in mid-May. Unfortunately we’re in this situation but  we will  be launching a report tomorrow which is the first of its kind.  It’s a report on the  state of nursing. We will launch it tomorrow during the World Health
    Day.

    00:55:01

    But while launching that report, although it’s about nursing, we will celebrate all health workers, midwives, pharmacists, doctors, you name it. I think the world is now seeing the importance and the central role that health workers play. People,
    when they’re asked, of course, to choose they would say health first because it’s only when you’re healthy that you can aspire to anything, whether it’s wealth or fame or anything. It doesn’t matter if you’re not healthy.

    If you’re not healthy the first thing you ask for is to get back your health and our health workers are making sure that happens and they’re central and very important for any individual. So not only during COVID but during other times too health
    professionals are very important because they are safeguarding that very important aspect of life — that’s health.

    So we have to celebrate them every day. Of course during COVID we can see to what extent they’re sacrificing. We have lost many of them. They’re dying while  saving lives  so my message first is to the public at large; that each and every individual 
    should  recognise, whether it’s during normal times or pandemics like now, the role of health  professionals  and help them, protect them, really appreciate and respect what they are doing.

    To the health workers, although especially during this COVID pandemic you’re working in a difficult situation you should know that your work is the most blessed one, your work is something  special to the extent of losing  your  life 
    while  helping  others to live.  We respect you and appreciate you for that and we also believe in you and that you will do everything to control this pandemic.

    00:58:11

    But you should know that you have – and the world understands – the most important job. We can see the humility which is coming from some leaders because of this pandemic. I know they’re seeing, starting from their own lives, the whole world through 
    a different  prism  and they will also see your role.

    But the most important is not the recognition from the public or from leaders but the internal commitment and passion you have and believing that you’re doing the most blessed thing  and you have all our respect and appreciation and we believe in 
    you,  that together  we will  finish this pandemic. All the respect and appreciation we have to you, the greatest respect and appreciation ever. Thank you.

    TJ        Thank you very much, Dr Tedros. I think this important message will be heard from everyone and we will  conclude  this  press briefing with these important  words from Dr Tedros. We will
    have an audio file available in the minutes to come and we invite you for our next briefing on Wednesday. Thank you.

    TAG    [Inaudible] and see you on Wednesday – tomorrow actually for the launch. Yes, see you tomorrow.

    01:00:18

    Virtual Press Conference on COVID-19- 06 April 2020
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  • Making available free paediatric medicine can accelerate elimination of congenital Chagas disease

    Making available free paediatric medicine can accelerate elimination of congenital Chagas disease

    The donation of an essential antiparasitic medicine can potentially accelerate the elimination of Chagas disease infection in children. A pediatric presentation of benznidazole with accurate dosage and will soon be made available freely to address
    a long-standing gap in the treatment of congenital infections of Chagas disease.  

    The donation, by the Mundo Sano Foundation1 and INSud Pharma2 group to the World Health Organization (WHO), is expected to become effective soon.

    “Making benznidazole freely available for the treatment of newborns and children until the age of 19 will be a game-changer in the fight against Chagas disease” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control
    of Neglected Tropical Diseases. “This can save future generations from developing life-threatening and fatal complications and also boost up diagnosis and treatment contributing to congenital Chagas disease elimination.”

    The three-year agreement will make available 108 000 tablets of benznidazole3 – one of the two antiparasitic medicines against Chagas disease. Treatment4 with benznidazole in the early stages of infection can cure Chagas
    disease, prevent or curb disease progression and prevent congenital transmission in pregnant women.

     “We have now added the systematic detection and treatment of all newborns and children under 19 which was not part of  our recent switch from control to elimination of congenital Chagas disease” said Dr Pedro Albajar
    Vinas, Medical Officer, WHO Department of Control of Neglected Tropical Diseases. “In addition, screening of pregnant women at risk of infection who have not had past antiparasitic treatment provides an excellent opportunity for prevention of posterior transmission throughout pregnancy and birth.”

    Each year, an estimated 15 000 children are born from infected mothers. 

    The agreement

    The donation by Mundo Sano Foundation for the duration of the agreement comprises benznidazole:

    • 105,000 tablets of 100mg
    • 3,000 tablets of 12.5mg

    Furthermore, the Foundation may donate funds to support activities associated with distribution of medicines and is ready to consider extending this agreement beyond the specified duration of three years.

    The disease

    Chagas disease, also known as American trypanosomiasis, is a potentially life-threatening illness caused by the protozoan parasite Trypanosoma cruzi (T. cruzi).

    Although considerable progress has been achieved, particularly in reducing vector transmission and screening of blood and organ supply, reaching, diagnosing and providing healthcare for people most affected has been a challenge.

    Currently, under-diagnosis of Chagas disease cases is as high as 90% and under-diagnosis of congenital and paediatric cases is believed not to be lower.

    Globally, an estimated 6-7 million people are infected with T. cruzi.

    The disease is found mainly in endemic areas of 21 continental Latin American countries5. But movement of people to urban areas and to other continents has expanded its transmission through non vectorial routes, such as blood transfusion,
    congenital transmission, organ transplants and oral transmission through food contamination.

    Considering that neglected tropical disease as a growing public health problem in many countries, the World Health Assembly – WHO’s decision-making body – decided in May 2019 to commemorate World Chagas Disease Day on 14 April.

    The inaugural celebration happens this year.


    1Mundo Sano is a nonprofit international foundation working with the public and private sectors, academia, and other international organizations to provide solutions to the affected communities and generate scientific knowledge.
    In 2012, it led a public-private consortium in 2012 to produce benznidazole in Argentina.

    2Insud Pharma (formerly known as Chemo Group) specializes in research, development, manufacture, sale and marketing of active pharmaceutical ingredients and medicinal products for human and veterinary use.

    3In 2017, the United States Food and Drug Administration (FDA) approved benznidazole for the treatment of children aged 2–12, making it the first treatment approved in the United States for Chagas disease.

    4Nifurtimox is also 100% effective in curing Chagas disease if given soon after onset of infection, including cases of congenital infection. It is donated by Bayer who pledged more than 7.5 million tablets for the period 2012-2021.

    5Argentina, Belize, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, French Guiana, Guatemala, Guyana, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Suriname, Uruguay, and Venezuela
    (Bolivarian Republic of).

     

     

     

     

    Making available free paediatric medicine can accelerate elimination of congenital Chagas disease
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  • Chagas disease: providing free paediatric medicine can enhance diagnosis and treatment

    Documentation resulting in the donation of an important antiparasitic medicine for the treatment of Chagas illness to the World Health Organization (WHO) is within the ultimate stage of preparation.

    A 3-year settlement, between the Mundo Sano Foundation1 (Brazil) and WHO, is anticipated to make obtainable 108 000 tablets of the paediatric formulation of benznidazole2 – a first-line medicine towards Chagas illness. Treatment3 with benznidazole within the early levels of an infection can treatment Chagas illness.

    “Making benznidazole freely obtainable for the treatment of newborns till the age of 18 might be a game-changer within the battle towards Chagas illness” mentioned Dr Mwelece Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical
    Diseases. “This is not going to solely save future generations from growing life-threatening and deadly issues however can even increase up diagnosis and treatment.”

    Each yr, an estimated 15 000 youngsters are born from contaminated moms. A freely obtainable paediatric presentation of benznidazole with correct dosage is essentially anticipated to contribute to deal with congenital infections.

    “Treating newborns and youngsters was the lacking hyperlink, as we transfer decisively to advocate for the mixing of diagnosis of an infection amongst pregnant ladies and women of child-bearing age into different surveillance programmes, together with HIV and syphilis” mentioned Dr Pedro Albajar Vinas, Medical Officer with WHO’s Department of Control of Neglected Tropical Diseases.  “Diagnosing and treating ladies of this age group earlier than being pregnant can increase successfully stop congenital transmission.” 

    The settlement

    The donation by Mundo Sano Foundation at some point of the settlement includes benznidazole:

    • 105,000 tablets of 100mg
    • 3,000 tablets of 12.5mg

    Furthermore, the Foundation might donate funds of as much as US$100 000 at some point of the settlement to help actions related to distribution of medicines and conferences. The Foundation additionally makes provision for an extension of this settlement past
    the required length of three years.

    The illness

    Chagas illness, often known as American trypanosomiasis, is a doubtlessly life-threatening sickness brought on by the protozoan parasite Trypanosoma cruzi (T. cruzi).

    Although appreciable progress has been achieved, significantly in decreasing vector transmission and screening of blood and organ provide, reaching and diagnosing individuals most affected has been a problem.

    Currently, under-diagnosis of Chagas illness instances is as excessive as 90% and under-diagnosis of congenital transmission is believed to be even greater.

    Globally, an estimated 6-7 million individuals are contaminated with T. cruzi.

    The illness is discovered primarily in endemic areas of 21 continental Latin American international locations4. But motion of individuals to city areas and to different continents has expanded its transmission by means of non vectorial routes, akin to blood transfusion, congenital
    transmission, organ transplants and oral meals contamination.

    Considering the illness as a rising public well being drawback in lots of international locations, the World Health Assembly – WHO’s decision-making physique – determined in May 2019 to commemorate World Chagas Disease Day on 14 April.

    The inaugural celebration occurs this yr.


    1 Mundo Sano is a nonprofit worldwide basis working with the general public and personal sectors, academia, and different worldwide organizations to supply options to the affected communities and generate scientific information. In 2012, it led a public-private consortium in 2012 to provide benznidazole in Argentina.

    2 In 2017, the United States Food and Drug Administration (FDA) accepted benznidazole for the treatment of kids aged 2–12, making it the primary treatment accepted within the United States for Chagas illness.

    3 Nifurtimox can be 100% efficient in curing Chagas illness if given quickly after onset of an infection, together with instances of congenital an infection. It is donated by Bayer who pledged greater than 7.5 million tablets for the interval 2012-2021.

    4 Argentina, Belize, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, French Guiana, Guatemala, Guyana, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Suriname, Uruguay, and Venezuela
    (Bolivarian Republic of).

    Chagas disease: providing free paediatric medicine can enhance diagnosis and treatment
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    https://www.who.int/news-room/detail/02-04-2020-chagas-disease-providing-free-paediatric-medicine-can-enhance-diagnosis-and-treatment

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