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Cost of Alcohol Abuse is Far Greater Than Drug Abuse in California, Says Study
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The misuse and abuse of alcohol and drugs can have various repercussions, not only on the individuals doing that and their families, but also on the society as a whole. One of its major consequences is financial burden. Besides causing health complications and raising concerns for public safety, alcohol and drugs cost the United States billions of dollars every year.

Like the impact, the economic cost of these substances varies immensely from one place to another. In fact, the cost of alcohol misuse is relatively far greater than the cost of drug misuse in most counties in the U.S. Since studies related to economic and social costs of alcohol and drug abuse are generally conducted at the state and national levels, this allows policymakers to better assess the problems within their jurisdiction and come up with countermeasures.

Similarly, a study, led by author Ted Miller and conducted at the Prevention Research Center of Pacific Institute for Research and Evaluation, sought to find out the consequences of alcohol and drug misuse in California and was published in the journal Alcoholism: Clinical and Experimental Research (ACER).

Alcohol abuse cost California $129 billion in 2010

The study highlighted the eye-opening economic burden of alcohol and drug related problems on the Californian taxpayer’s money across all 58 counties and 50 midsized cities. It was found that alcohol-related problems are more prevalent and costlier than drug-related problems in California. Moreover, both costs and repercussions varied greatly from one place to another. Some other findings are as follows:
- While alcohol-related problems cost $129 billion in 2010, which comes to $3,450 for every Californian, drug-related problems cost $44 billion in the same year.
- The highest per capita cost ($7,819) of alcohol problem was more than three times the lowest per capita cost ($2,588). Among the counties with drug-related problems the per capita cost varied between $608 and $3,786.
- The rates of alcohol and drug-related problems were found to be higher in the Californian cities. The highest per capita cost of alcohol-related problems in a city was $10,734, 11 times higher than the city with the lowest costs. Among the cities, the highest per capita cost of drug-related problems was $7,159, almost 19 times higher than the city with the lowest cost.
Correspondingly, the breakup of alcohol and drug-related costs are as follows:
- Crashes and accidents under the influence of alcohol cost $26 billion in 2010.
- Of the $10 billion cost borne due to violence associated to substance use, 73 percent was attributed to alcohol, while the remaining 27 percent was attributed to drugs.
- Of the $127 billion expenditure incurred due to other illnesses and injuries, 73 percent of the costs resulted from alcohol-related problems. Similarly, 82 percent of the $4 billion cost incurred due to nonviolent crimes were attributed to drug abuse.
- 74 percent of $2 billion incurred due to treatment expenditure was attributed to drug-related problems.
The study authors believe that the findings can assist policymakers and help the state in planning and allocating resources for substance abuse problems. In addition, this study provides a crucial tool for predicting and averting alcohol and drug-related problems, as well as a crucial means to plot localized cost estimates.

According to Dr. Miller, “Efficient funding of substance abuse prevention, enforcement and treatment hinges upon understanding the variation of alcohol and other drug problems from place to place. Because estimated costs combine data across many health and social issues, they provide an effective, comprehensible, and comprehensive measure for use in understanding how communities shape their distinctive social environments and for monitoring the effectiveness of our intervention strategies.”

Avoid the death trap

In 2010, problems related to alcohol and drugs in California led to 22,281 and 5,533 deaths, respectively. In addition, crimes related to alcohol and drugs were responsible for 350,000 and 164,000 deaths, respectively. These large and unsettling numbers are pertaining to only one of the 50 U.S. states, signaling a far greater magnitude of the problem.

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Source by Susan Navarez

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July 28, 2022
How to Overcome MLM Challenges – Multi Level Marketing Tips For Success

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There are plenty of helpful tips available to help you overcome your MLM challenges. In my opinion most of the challenges we face in MLM are avoidable but only if you start off on the right path. When I am faced with a challenge in my primary opportunity its usually around developing new techniques for marketing, lack of customers, or lack of money. As business owners in the field of MLM we are faced with difficult challenges but they aren’t unlike those that any other business owner faces. We do face different challenges because of the nature of our business but if you plan for the unexpected and have a vision for the day-to-day operations of your company you’ll be able to thrive in your business.

Every day businesses are birthed around the world within a dynamic and formidable marketplace where only the toughest survive. If you are in the network marketing industry you know that our environment is particularly fickle and can be a tough training ground for the almost 25,000 people that join Multi-level marketing business everyday in the U.S. and the 95% that fail within their first year.

Most people join network marketing companies not recognizing the importance of having a vision for how their business will grow and function in its infancy. There is concept that many large corporations use to lead their work on a daily basis and I think that it can be particularly effective for network marketers. Its called Strategic Planning. Planning is not a new concept to business corporations but it might be to those that don’t know about its extreme effectiveness for providing a roadmap for any business for periods of 6-months, to 3 years, to 20 years.

By understanding the importance of this process and the questions that go into taking you through it, you can gain a better sense of preparedness for your company’s growth. As someone new to this industry you need as much structure in the beginning as possible to understand how to plan and set and meet your goals. By taking the first step in this process you will exhibit your commitment to your business and your leadership for your organization.

You have to believe in something yourself first, before you can get others to believe.– Ashraf Seddeck, Oracle Corporation.

What does your company do?

What product or service do you provide?

What is your mission statement?

What are your company’s values?

What is your plan for your first 30 days, 6 months, 1 year?

What are your weaknesses/strengths?

How will you market your business?

Who is your competition?

What might be challenges that prevent you from reaching your goal?

What is your plan to grow your business over the next 12 months?

What is your plan for recruiting for your business?

What resources do you have to build your business?

What is your budget for your business?

What does your organization look like and what types of people are your recruiting?

What actions are you taking on a daily basis to build your business?

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Source by Inger L McDowell

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July 28, 2022
Gender Wars: Has The Time Come For Men And Women To Heal Their Emotional Wounds?

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When it comes to the mainstream culture, it is not uncommon for men to be put down and to be seen as the bane of the earth. This doesn't mean that women are not also seen as the problem, but this could be seen as something that takes place underground, to speak.
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So, while there are plenty of newspapers and TV stations that are only too happy to paint all men as being a certain way; there are also plenty of websites and videos online that are happy to paint all women as being a certain way. It could then be said that it is socially acceptable to put men down but the same can't be said when it comes to putting women down, which is why this has to be done in a more covert manner.

Plenty of Fuel

It seems that not a day goes by when there isn't something in the mainstream media that doesn't add to the view that men are worthless human beings. Sometimes, something small will be used to prove this, while at others, it will be something that is far bigger.

For example, when a woman in the public eye claims that she has been harassed by a man, not a lot of thought is given as to whether or not this actually took place. There are at least two reasons for this: firstly, women are often portrayed as innocent and pure and, secondly, all men are often portrayed as primitive beings that can't control their urges.

The Accepted Narrative

Thus, regardless of whether or not a man is actually guilty, he is going to be used to support the view that all men are the same. Clearly, if a man is found to be guilty the appropriate action should be taken, but, without the evidence that he has done anything wrong, it shouldn't be assumed that he has done anything wrong.

The people in the media who support this view of men don't seem to care about the damage that something like this could do to an innocent man's life. It's as though a man deserves to have his whole life ruined, irrespective of if he has done anything wrong.

Validation

And, if a woman believes that are men are the same, it is going to be music to her ears to hear the mainstream media talk about men in this way. A woman like this may have been in a number of abusive relationships, for instance.

Seeing a man go from a position of power to being destroyed is then going to be extremely satisfying. She probably won't have met this man, but seeing him go down will allow her to indirectly experience revenge.

The Other Side

When it comes to what is taking place away from the mainstream media, there is plenty of content that basically goes into how worthless women are. One of the main themes is that women can't be trusted and that if they find another guy who has more money / status, they will soon disappear.

And, if a man has been in a relationship where the woman walked away or if he has found it hard to experience fulfilment in this area of his life, for instance, he can be only too happy to hear other men say that women are useless and good for one thing. It will be as though they are enslaved to their biology, are heartless, and are not consciousness beings, unlike men who are in control of their urges, have a heart, and are aware.

Letting of Steam

Due to what a man has been through he will no doubt carry a lot of anger, anger that is likely to allow him to avoid feeling powerless and helpless, for instance. The experiences what he reads about online will end up enforcing what he already believes.

This is then likely to create even more distance between him and women and make it even harder for him to experience fulfilment in this area of his life. Even so, what this will do is allow him to be right, and this is one of the ego minds greatest needs – being wrong is seen as something that will lead to death.

A Messy Situation

There are then women who hate all men and men who hate all women, along with men who hate themselves and pedestalize women and women who hate themselves and pedestalize men. Therefore, even though it is not possible to say that it is only men who are under attack, it is undoubtedly more socially acceptable to attack men.

If someone believes that all men / women are the same and is happy to see a man / woman suffer, it is likely to show that they are carrying a number of emotional wounds. If they were able to get in touch what how they feel below their anger and rage, they may find that they feel rejected, powerless, helpless and worthless, amongst other things.

A Reactive Existence

Being in touch with these feelings is then likely to cause them to feel incredibly vulnerable; whereas being in touch with the more surface level emotions (such as anger and rage) is likely to allow them to feel strong and powerful. But, while living in this way can allow them to feel strong and powerful, it is going to cause them to be controlled by how they feel.

Not only this, it will stop them from being able to realize that not all men / women are the same and to see them as individuals. What they believe will define how they experience life, thereby stopping them from being able to experience anything that goes against what they believe.

A Deeper Look

When it comes to the emotional wounds that someone can carry, what has happened in their adult life is certainly going to play a part. Yet, what is likely to play an even bigger part is what took place during their early years, and what has been passed down from their ancestors can also play a part.

What took place during their early years that can be what is defining how they perceive men / women and the kind of men / women women they will be attracted to and attract. If someone had a father or mother who was abusive, for instance, it would have most likely caused them to experience a lot of trauma, and, it would have laid down the foundations for them to be drawn to men / women who would also abuse them.

Two Levels

How they were treated at this stage of their life would have become familiar, and what is familiar is what is classed as safe to the ego mind / unconscious mind. The years would then have passed but they are still going to carrying the trauma of being violated and abused.

It is then not going to matter what their conscious mind wants to experience, as their unconscious mind will want to experience what took place all those years ago. The trouble is that if someone is not aware of how their early years are affecting their adult life, it will be normal for them to feel like a victim and to blame all men / women.

Self-Victimization

If going within and working through emotional wounds was easy, it would be a part of everyone's life One of the biggest challenges to doing this type of work is that the mind disconnects from the body to avoid pain, which can result in someone's inner wounds being projected onto others.

The people who they come into contact with will then press their buttons, so to speak, but they won't be able to see that these people are mirroring back what they need to resolve within their own being. Without this understanding, they can end up seeing themselves as a victim and other people as perpetrators.

Conclusion

If someone wants to grow and develop and no longer wants to feed into this drama, they may need to reach out for external support. With the assistance of a therapist or a healer, for instance, they will be able to gradually work through their emotional wounds.

But, if someone is caught up on their own stuff due to their current level of consciousness, there will be no reason for them to change. As a result of this, they will continue to live a reactive life and to play out their early drama.

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Source by Oliver JR Cooper

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July 27, 2022
Understanding Young Living: Can You Really Make Money With Young Living?
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Young Living is a Muli-Level Marketing company founded in 1993 offering essential oils and other related products. Additionally, they offer a business or income opportunity for those interested in marketing the company or their products to make an income stream. Something I think is neat is Young Living also has a non-profit organization that helps communities and families in impoverished areas in Ecuador, Croatia, and Uganda.

The Thing:

Young Living has a ton of products available based around essential oils. Some of the items they offer are Aroma Oils, Massage Oils, Diffusers, Oral Care Products, Healthy Cooking Oils, Animal Care Oils, Home Purification Oils, and of course accessories to carry your oils.
1. Idaho Blue Spruce – This oil is designed to relax both mind and body and sells Retail value for $37.83.
2. Animal Shampoo – No Kidding. This product contains several different oils including YLTG oil formulated by D. Gary Young and sells Retail Value for $20.72.
3. Thieves Fresh Essence Mouthwash – This mouthwash is designed to thoroughly clean your mouth and comes in Spearmint and Peppermint flavor, selling 8 oz Retail Value for $14.47.
It’s important to note, Young Living offers several different types of products! The categories of products and actual product in which I explained are far from all Young Living has to offer!

The Opportunity:

The question still remains; can you really make money with Young Living? In order to answer this question, we must look into their compensation plan!

There are 3 Main payouts for people affiliated with Young Living such as Fast Start Bonus, Start Living Bonus, and Retail Earnings.
1. Fast Start Bonus – You can earn 25% on your first-level personally enrolled distributors’ orders during the first three months of being a member. You can also earn an additional 10% on your second-level personally enrolled distributors’ orders.
2. Start Living Bonus – Each time you enroll a distributor with a Premium Starter Kit, you can earn a one-time $25 cash bonus.
3. Retail Earnings – With this payout you’ll be able to earn the 24% difference between the Retail and Wholesale price for the orders of your personally enrolled retail customers.
To Conclude, Yes, You Can Make Money With Young Living!

The Cost:

For some, this is the most important question that has to be answered before even considering joining this business! I would be more than happy to be the provider of that answer!

But first, understand that if you want to get involved with Young Living and begin making money, what you are doing is opening up your own business from home! All businesses require some type of start-up fee! However, in the world of Multi-Level Marketing, the price is generally much cheaper in comparison to a traditional type company. For example, in a traditional type business, such as Construction, you could spend around $5,000 to $10,000 just getting the thing started! In this industry, you likely will spend far less than that! Since we have been able to get that understood, let’s move on.

In order to become involved and get started with Young Living, you will need to purchase a Starter Kit! They have several starter kits available; I will give a brief explanation of three of them!
1. Basic Starter Kit – $45.00. This kit includes one 5ml Stress Away Oil, AromaGlide Roller Fitment, 10 Sample Packets, 10 Love It? Share It! Business Cards, 10 Love It? Share It! Sample Oil Bottles, 2 NingXia Red 2-oz. samples, Product Guide and Product Price List, Essential Oil Magazine, Essential Edge, and member resources.
2. Thieves Premium Kit – $160.00. This kit is a specialty premium starter kit and includes 15-ml Thieves Oil, Thieves AromaBright Toothpaste, Thieves Fresh Essence Plus Mouthwash, 2 Thieves Cleaner, 2 Thieves Foaming Hand Soap, 2 Thieves Spray, 2 Thieves Waterless Hand Purifier, and everything included in the Basic Starter Kit mentioned above.
3. NingXia Premium Kit – $170.00. This kit is also a specialty premium kit and includes NingXia Red 2-Pack, 30 NingXia Red Single Oils, NingXia Nitro, and everything includes in the Basic Started Kit above.
Final Thoughts:

The products offered by Young Living are interesting and definitely have some kind of originality to them. They also have a ton of products to choose from!

The business opportunity is something you can definitely make money from. However, in my opinion, I believe their compensation plan is kind of weak in a comparison level to other companies in which I have done reviews over. If you know exactly what you are doing and are a professional Network Marketer, you will do fine with this company and even prosper. However, if you are a total newbie and have no idea how to generate massive income from Network Marketing, you will have difficult times making money in this company.

The cost is overall pretty inexpensive. Their Basic Starter Kit is only $45.00 and their most expensive kit is $260.00. That means, you can start a business and begin generating income all from home for a little under $300.00, which is awesome!

*Dustin Hale is NOT affiliated with Young Living or their business/income opportunity

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Source by Dustin Hale

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July 27, 2022
Commemorating Smallpox Eradication – a legacy of hope, for COVID-19 and other diseases

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Notes to the media

Smallpox stamp

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

Smallpox Eradication dates

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

Museum Exhibition

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

Read More
https://www.who.int/news-room/detail/08-05-2020-commemorating-smallpox-eradication-a-legacy-of-hope-for-covid-19-and-other-diseases

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

Proceedings of the meeting

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

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

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

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

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

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

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

Advice to WHO

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

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

A clearer picture of the global impact

New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.

The
results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world.

Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization.

Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world.

What is maternal sepsis and how does it lead to maternal death?

Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.

The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.

Few
previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.

A better understanding of maternal infection

GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.

The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.

GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
which are not usually recorded as maternal sepsis, including post-abortion and indirect infections.

The result is a more complete understanding of the frequency and impact of maternal infections in health facilities.

GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk.

Putting global numbers on maternal infection and sepsis

Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management.

Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.

Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
haemorrhage.

This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.

Preventing, identifying and treating maternal infection and sepsis

Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.

GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively.

For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.

GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.

This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
providers to manage the frequency and outcome of maternal infections.

An opportunity to implement evidence-based practice

GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives.

WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
on 5 May which celebrates the central role played by nurses and midwives in clean health care.

In addition, WHO will publish a global sepsis epidemiology report around the 73rd World Health Assembly (WHA) in May, as requested in the
2017
WHA Resolution on Improving the prevention, diagnosis and clinical managementof sepsis.

Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.

Related publications

WHO recommendations for prevention and treatment of maternal peripartum infections

WHO Clinical practice handbook for safe abortion

Global guidelines on the prevention of surgical site infection

WHO statement on maternal sepsis

World Health Assembly resolution on Improving the prevention, diagnosis and clinical management of sepsis

Health Topics

Antimicrobial resistance

Infection Prevention and Control

Water Sanitation Hygiene

Other links

Global Maternal Sepsis Study

SAVE LIVES: Clean Your Hands 5 May 2020

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May 9, 2020
INFOSAN Quarterly Summary, 2020 #1

Food safety incidents

During the first quarter of 2020, the INFOSAN Secretariat was involved in 38 food safety incidents involving 109 WHO Member States and 9 territories of WHO Member States. There were 25 incidents involving a biological hazard (Salmonella spp. [8], Listeria monocytogenes [5], Norovirus [3] Shiga-toxin producing Escherichia coli [2], Clostridium botulinum [2] Bacillus cereus [2], Cronobacter spp. [1], Shigella sonnei [1], unspecified biological hazard [1]), 6 involving an undeclared allergen (milk [3], peanut (1), egg [1], gluten [1]), 5 involving a physical hazard (undetermined foreign matter [2], glass [1], metal [1], plastic [1]), one involving a chemical/toxin hazard (histamine), and one linked to an unspecified hazard.

The food categories that were most commonly involved in the 38 incidents during the first quarter of 2020 involved fish and other seafood (8), herbs and spices (4), legumes and pulses (4), milk and dairy products (3), nuts and oilseeds (3), snacks, desserts and other foods (3), cereals and cereal-based products (2), composite food (2), fruit and fruit products (2), meat and meat products (2), vegetables and vegetable products (2), products of special nutritional use (1), and food for infants and small children (1). One incident involved an unknown food source.

During such international food safety incidents, the INFOSAN Secretariat relies on the swift action of national INFOSAN Emergency Contact Points to respond to requests for information. Rapid sharing of information through INFOSAN enables members to implement appropriate risk management measures to prevent illness in their respective countries.

Geographic scope

The outlined incidents involved Member States from all WHO regions: Europe (39), followed by the Americas (24), Africa (24), the Western Pacific (18), the Eastern Mediterranean (8) and South-East Asia (6).

Recall in several countries of frozen spring roll sheets from Singapore due to the presence of an undeclared allergen

In February 2020, the INFOSAN Secretariat was notified by the European Rapid Alert System for Food and Feed (RASFF) and INFOSAN colleagues in Australia of a recall in Australia and several European countries of frozen spring roll sheets due to the detection of an undeclared allergen (milk), imported from Singapore. In collaboration with RASFF, the INFOSAN Secretariat was informed that the implicated frozen spring roll sheets were distributed internationally to 46 Member States from four WHO regions and 4 territories in Europe and the Western Pacific. Moreover, through engagement with the INFOSAN Emergency Contact Point (ECP) in Singapore, the INFOSAN Secretariat also received details of further distribution of implicated products to additional WHO Member States from all WHO regions, taking the total number of Member States involved to 65. It was also reported that the products involved had been redistributed by some countries to Europe, the Americas and Africa. Consequently, several countries recalled the implicated products to relabel them and investigated the issue to identify illnesses related to the consumption of the implicated frozen spring roll sheets. No illnesses were reported to the INFOSAN Secretariat.

This incident has highlighted undeclared allergens as an important category of hazards that can result in a largescale international response to implement risk management measures and prevent illness. In addition, it exemplified efficient communication among INFOSAN members and the Secretariat.

Outbreak of Listeriosis in the United States of America linked to enoki mushrooms imported from the Republic of Korea

In March 2020, the INFOSAN Secretariat was made aware by the United States (US) Centers for Disease Control and Prevention (CDC) of an outbreak of Listeriosis in the US linked to the consumption of enoki mushrooms, imported from the Republic of Korea. In total, 36 cases including 4 deaths have been reported in the US. Following investigations in Canada, carried out in collaboration with the US, the INFOSAN Secretariat was informed of 6 cases of Listeriosis between 2017 and 2019 in Canada potentially related by whole genome sequencing (WGS) to the ongoing outbreak in the USA. In addition, food isolates (from enoki mushrooms from the Republic of Korea) genetically associated with the cluster of cases have been collected in 2019 by authorities in Canada. The WGS information pertaining to the cases and food isolates were shared on the INFOSAN Community Website to assist the identification of cases in other countries.

The INFOSAN Secretariat engaged the INFOSAN Emergency Contact Point (ECP) in the Republic of Korea to seek details on any further international distribution of the implicated enoki mushrooms. Investigations are ongoing.

News & activities

Food Sector and the COVID-19 outbreak

On 31 December 2019, WHO was alerted to several cases of pneumonia of unknown origin in the city of Wuhan, Hubei Province, China. The virus, a previously unknown coronavirus has been named SARS-CoV-2 and is the cause of the COVID-19 disease.

The WHO Epidemic Information Network (EPI-WIN) aims to share information tailored to specific sectors, including food and agriculture. The INFOSAN Secretariat has recently developed a guidance document for food businesses with regards to COVID-19 and food safety which is now available online. The guidance has also been disseminated through EPI-WIN and presented during two webinars.

Call for applicants: INFOSAN Train-the-Trainer Workshop

In February, the INFOSAN Secretariat issued a call for applications for the INFOSAN Train-the-Trainer workshop. With the constant growth of the network, and the increased need for training that this entails, the INFOSAN Secretariat, in collaboration with the Canadian Food Inspection Agency (CFIA), has announced this workshop which aims to increase the human resources available to train INFOSAN members on a range of INFOSAN-related topics, online or in-person. As a result, it is expected that the understanding of the roles and responsibilities of INFOSAN members will be improved, resulting in greater participation that will enhance speed and efficiency during the response to food safety emergencies at the global level. The INFOSAN Secretariat, together with CFIA, look forward to hosting this important workshop later this year.

Developing the new INFOSAN Community Website

The INFOSAN Community Website (ICW) continues to be an effective tool for the network to disseminate information during food safety emergencies. Over the past year, through the INFOSAN member survey, the Secretariat has gained a better understanding of how members use the ICW and how it can be improved to enhance information sharing. The information collected, together with the experience of members of the Secretariat, has provided numerous innovative ideas to guide the development of the new ICW. The Secretariat is pleased to announce that the competitive process to select the vendor that will develop the new INFOSAN Community Website has concluded and the work on the creation of the new ICW has begun.

Voice of an active network member

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May 9, 2020
WHO urges countries to move quickly to save lives from malaria in sub-Saharan Africa

Severe disruptions to insecticide-treated net campaigns and in access to antimalarial medicines could lead to a doubling in the number of malaria deaths in sub-Saharan Africa this year compared to 2018, according to a new modelling analysis released by
WHO and partners ahead of World Malaria Day (25 April).

WHO urges countries to move fast and distribute malaria prevention and treatment tools at this stage of the COVID-19 outbreak in sub-Saharan Africa, and to do their utmost to safely maintain these essential malaria control services.

The analysis considers nine scenarios for potential disruptions in access to core malaria control tools during the pandemic in 41 countries, and the resulting increases that may be seen in cases and deaths.

Under the worst-case scenario, in which all insecticide-treated net (ITN) campaigns are suspended and there is a 75% reduction in access to effective antimalarial medicines, the estimated tally of malaria deaths in sub-Saharan Africa in 2020 would reach
769 000, twice the number of deaths reported in the region in 2018. This would represent a return to malaria mortality levels last seen 20 years ago.

According to the World malaria report 2019, sub-Saharan Africa accounted for approximately 93% of all malaria cases and 94% of deaths in 2018. More than two-thirds of deaths were among children under the age of five.

A window of opportunity

To date, the number of reported cases of COVID-19 in sub-Saharan Africa has represented only a small proportion of the global total, though cases are increasing every week. This means that countries across the region have a critical window of opportunity
to minimize disruptions in malaria prevention and treatment and save lives at this stage of the COVID-19 outbreak.

Mass vector control campaigns should be accelerated, while ensuring that they are deployed in ways that protect health workers and communities against potential COVID-19 transmission. WHO and partners commend the leaders of Benin, the Democratic Republic of the Congo, Sierra Leone and Chad
for initiating ITN campaigns during the pandemic. Other countries are adapting their net distribution strategies to ensure households receive the nets as quickly and safely as possible.

Preventive therapies for pregnant women and children must be maintained. The provision of prompt diagnostic testing and effective antimalarial medicines are also essential to prevent a mild case of malaria from progressing to severe illness and death.

WHO and partners have developed guidance to ensure that those suffering from malaria can safely receive the care they need within the package of essential health services to be delivered in COVID-19 settings. Tailoring malaria interventions in COVID-19 response includes guidance on the prevention of infection through vector control and chemoprevention, testing, treatment of cases, clinical services, supply chain and laboratory activities.

Note to the editor

The modelling analysis was conducted by WHO in close collaboration with partners, including PATH, the Malaria Atlas Project and the Bill & Melinda Gates Foundation.

The analysis is subject to uncertainties. It does not consider, for example, the effects of an interruption in indoor residual spraying or seasonal malaria chemoprevention (except in Burkina Faso); a suspension of these core malaria prevention tools would
also lead to considerable loss of life.

In addition, there is limited understanding of the spread of COVID-19, its epidemiology and interactions with malaria. The model will be updated as such data become available, and countries will be provided with relevant information to tailor their responses
accordingly.

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May 9, 2020
A meeting on digital innovations, TB and implementation research organised by WHO and the European Respiratory Society

WHO’s Global Tuberculosis Programme (WHO/GTB) and the European Respiratory Society convened a technical meeting on digital innovations, TB and implementation research, in Geneva on 7 February 2020. This meeting brought together funders,
partners, representatives of national TB programmes, civil society and scientists to discuss the challenges and opportunities when evaluating, integrating and scaling up digital technologies under programmatic settings. Specifically, this meeting
sought to receive input on the elements of a toolkit on implementation research that is currently being developed by WHO/GTB and the Special Programme for Research and Training in Tropical Diseases (TDR) to support evidence-informed use of
digital technologies under programmatic settings. Th etoolkit will be launched in mid-2020. Considering that several countries are updating their national TB strategic plans and preparing funding proposals for submission to the Global Fund, this meeting
also sought to create mutual understanding on the importance of resourcing implementation science to bridge the divide between research and practice.

This present meeting, is the latest in a series of efforts by WHO/GTB to facilitate the meaningful use of digital technologies for TB prevention and care. It
was preceded by a one-day workshop on 6 February held at the same venue for partner agencies of the ASCENT project. ASCENT is a UNITAID-funded project that started in 2019 with the aim of increasing demand and adoption of affordable digital technologies for TB medication adherence. The project is led by KNCV in partnership with Aurum Institute for Health
Research, PATH and the London School of Hygiene and Tropical Medicine. Activities are running in Ethiopia, the Philippines, South Africa, Ukraine and Tanzania UR. This was the first in a series of annual meetings that will be coordinated by the WHO/GTB
to assess progress in implementation of country activities and results from the interventions.

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April 10, 2020