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The Twenty-fourth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on theinternational spread of poliovirus was convened by the Director General on 26 March 2020 with committee members only attending
via teleconference, supported by the WHO Secretariat. In order to ease the burden on affected State Parties in the exceptional situation following the determination of the COVID-19 outbreak as a Public Health Emergency of International Concern
(PHEIC) on 30 January 2020, characterized as a pandemic on 11 March 2020, the invited State Parties were asked to present their reports electronically only instead of attending via teleconference. Reports were received from Afghanistan, Burkina
Faso, Central African Republic, Cote d’Ivoire, Democratic Republic of Congo (DR Congo), Ethiopia, Ghana, Pakistan, and Philippines.
The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV). The WHO Secretariat presented a report of progress for affected IHR States Parties subject to Temporary Recommendations.
Wild poliovirus
The Committee remains gravely concerned by the significant increase in WPV1 cases globally in 2019 and 2020, with 175 cases in 2019 compared to 33 in 2018, and already 32 cases as at 17 March 2020, compared to six for the same period in 2019, with no
significant success yet in reversing this trend.
In Pakistan transmission continues to be widespread, as indicated by both acute flaccid paralysis (AFP) surveillance and environmental sampling. While the issues of vaccine hesitancy and refusals by individuals and communities and problems with management
of the national polio program are being addressed, these are yet to have impact on the current worrying epidemiology. The added pressure on the program due to detection of cVDPV2 and ongoing spread in several provinces (see below) has continued
into 2020.
In Afghanistan, the security situation remains very challenging. Inaccessibility and missed children particularly in the Southern Region have led to a large cohort of susceptible children in this part of Afghanistan. The risk of a major upsurge
of cases is growing, with other parts of the country that have been free of WPV1 for some time now at risk of outbreaks. This would again increase the risk of international spread.
The Committee noted that based on sequencing of viruses, there were recent instances of international spread of viruses from Pakistan to Afghanistan and also from Afghanistan to Pakistan. The recent increased frequency of WPV1 international
spread between the two countries suggests that rising transmission in Pakistan and Afghanistan correlates with increasing risk of WPV1 exportation beyond the single epidemiological block formed by the two countries.
The Committee noted the continued cooperation and coordination between Afghanistan and Pakistan, particularly in reaching high risk mobile populations that frequently cross the international border and welcomed the all-age vaccination now being taken
at key border points between the two countries.
Vaccine derived poliovirus (VDPV)
The multiple cirulating VDPV (cVDPV) outbreaks in four WHO regions (African, Eastern Mediterranean, South-east Asian and Western Pacific Regions) are very concerning, with two new countries reporting outbreaks since the last meeting (Malaysia and Burkina
Faso). Unlike historical experience, cross border spread of cVDPV2 has become quite common, with recent spread from Angola to DR Congo and Zambia, and from Chad and CAR to Cameroon, and from Ghana to Burkina Faso. In addition, local emergences
attributable to mOPV2 use have recently occurred in Togo, Chad and Ethiopia.
The Committee noted that the GPEI has published a strategy to address cVDPV2 outbreaks but was extremely concerned that the monovalent OPV2 stockpile was still depleted. The Committee strongly supports the development and proposed Emergency Use
Listing of the novel OPV2 vaccine which should become available mid-2020, and which it is hoped will result in no or very little seeding of further outbreaks.
Impact of COVID-19
The Committee noted the very recent policy guidance of the GPEI:
GPEI recommendations for countries during the COVID-19 pandemic. This document summarizes the recommendations from the Polio Oversight Board meeting on 24 March 2020 which calls for postponement of both preventive and outbreak response campaigns,
while ensuring surveillance and nOPV2 development and roll out plans continue in full.
The COVID-19 Polio programme continuity plan. The operational guide was developed in collaboration with the regional polio eradication teams and the GPEI Partners to ensure essential GPEI functions continue, polio programme personnel and staff are
kept safe, and to plan for a fast and effective resumption of polio eradication activities including supplementary immunization activities as soon as the public health situation with COVID-19 allows.
The Committee is extremely concerned about the impact of the COVID-19 pandemic on the risk of heightened transmission of polio and consequently the potential for international spread and significant reversal of polio eradication.
Conclusion
The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months. However
noting that some if not many international borders are closed to prevent international spread of COVID-19, State Parties may not currently be able to enforce the Temporary Recommendations in all places. The Committee strongly urges countries
subject to these recommendations to maintain a high state of readiness to implement them as soon as possible ensuring the continued safety of travelers as well as health professionals . The Committee recognizes the concerns regarding the lengthy
duration of the polio PHEIC, but concludes that the current situation is extraordinary, with clear ongoing risk of international spread and ongoing need for coordinated international response. The Committee considered the following factors in reaching
this conclusion:
Rising risk of WPV1 international spread: The progress made in recent years appears to have reversed, with the Committee’s assessment that the risk of international spread is at the highest point
since 2014 when the PHEIC was declared. This risk assessment is based on the following:
the WPV1 exportation in 2019 from Pakistan to Iran and to Afghanistan, and more recently spread from Afghanistan to Pakistan;
ongoing rise in the number of WPV1 cases and positive environmental samples in Pakistan, and to a lesser extent Afghanistan;
the quickly increasing cohort of unvaccinated children in Afghanistan, with the risk of a major outbreak imminent if nothing is done to access these children;
the urgent need to overhaul the leadership and strategy of the program in Pakistan, which although already commenced, is likely take some time to lead to more effective control of transmission
and ultimately eradication;
increasing community and individual resistance to the polio program.
Rising risk of cVDPV international spread: The clearly documented increased spread in recent months of cVDPV2 demonstrate the unusual nature of the current situation, as international spread of cVDPV
in the past has been very infrequent. The number of new emergences of cVDPV2 in Africa raises further concern. The risk of new outbreaks in new countries is considered extremely high, even probable.
COVID-19: This new and unprecedented pandemic is likely to substantially negatively impact the polio eradication program and outbreak control efforts. There is a risk of exportation of both
WPV1 and cVDPV to known high risk countries, to which it may take a lot of time and effort to adequately respond.
Falling PV2 immunity: Global population mucosal immunity to type 2 polioviruses (PV2) continues to fall, as the cohort of children born after OPV2 withdrawal grows, exacerbated by poor coverage
with IPV particularly in some of the cVDPV infected countries.
Multiple outbreaks: The evolving and unusual epidemiology resulting in rapid emergence and evolution of cVDPV2 strains is extraordinary and not yet fully understood and represents an additional risk
that is yet to be quantified.
Weak routine immunization: Many countries have weak immunization systems that can be further impacted by various humanitarian emergencies including COVID19, and the number of countries in which immunization
systems have been weakened or disrupted by conflict and complex emergencies poses a growing risk, leaving populations in these fragile states vulnerable to outbreaks of polio.
Surveillance gaps: The appearance of highly diverged VDPVs in the Philippines, Somalia and Indonesia are examples of inadequate polio surveillance, heightening concerns that transmission could be missed
in various countries. Furthermore, the missed transmission in China for a year illustrates that even countries with generally good surveillance can miss VDPV transmission. COVID-19 is likely to have a negative impact on polio surveillance
also.
Lack of access: Inaccessibility continues to be a major risk, particularly in several countries currently infected with WPV or cVDPV, i.e. Afghanistan, Nigeria, Niger, Somalia and Myanmar, which all
have sizable populations that have been unreached with polio vaccine for prolonged periods.
Population movement: The risk is amplified by population movement, whether for family, social, economic or cultural reasons, or in the context of populations displaced by insecurity and returning refugees.
There is a need for international coordination to address these risks. A regional approach and strong crossborder cooperation is required to respond to these risks, as much international spread of polio occurs over land borders.
Risk categories
The Committee provided the Director-General with the following advice aimed at reducing the risk of international spread of WPV1 and cVDPVs, based on the risk stratification as follows:
States infected with WPV1, cVDPV1 or cVDPV3, with potential risk of international spread.
States infected with cVDPV2, with potential risk of international spread.
States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV.
Criteria to assess States as no longer infected by WPV1 or cVDPV:
Poliovirus Case: 12 months after the onset date of the most recent case PLUS one month to account for case detection, investigation, laboratory testing and reporting period OR when all reported AFP cases with onset within 12 months of last case have been tested for polio and excluded for WPV1 or cVDPV, and environmental or other samples collected within 12 months of the last case have also tested negative, whichever is the longer.
Environmental or other isolation of WPV1 or cVDPV (no poliovirus case): 12 months after collection of the most recent positive environmental or other sample (such as from a healthy child) PLUS one month to account for the laboratory testing and reporting period
These criteria may be varied for the endemic countries, where more rigorous assessment is needed in reference to surveillance gaps (e.g. Borno State, Nigeria)
Once a country meets these criteria as no longer infected, the country will be considered vulnerable for a further 12 months. After this period, the country will no longer be subject to Temporary Recommendations, unless the Committee has concerns based on the final report.
TEMPORARY RECOMMENDATIONS
States infected with WPV1, cVDPV1 or cVDPV3 with potential risk of international spread
WPV1
Afghanistan (most recent detection 25 February 2020)
Pakistan (most recent detection 2 March 2020)
Nigeria (most recent detection 27 Sept 2016)
cVDPV1
Malaysia (most recent detection 26 October 2019)
Myanmar (most recent detection 9 August 2019)
Philippines (most recent detection 28 October 2019)
These countries should:
Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency and implement all required measures to support polio eradication; where such declaration has already been made, this emergency status should be maintained as long as the response is required.
Ensure that all residents and longterm visitors (i.e. > four weeks) of all ages, receive a dose of bivalent oral poliovirus vaccine (bOPV) or inactivated poliovirus vaccine (IPV) between four weeks and 12 months prior to international travel.
Ensure that those undertaking urgent travel (i.e. within four weeks), who have not received a dose of bOPV or IPV in the previous four weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travelers.
Ensure that such travelers are provided with an International Certificate of Vaccination or Prophylaxis in the form specified in Annex 6 of the IHR to record their polio vaccination and serve as proof of vaccination.
Restrict at the point of departure the international travel of any resident lacking documentation of appropriate polio vaccination. These recommendations apply to international travelers from all points of departure, irrespective of the means of conveyance (e.g. road, air, sea).
Further intensify crossborder efforts by significantly improving coordination at the national, regional and local levels to substantially increase vaccination coverage of travelers crossing the border and of high risk crossborder populations. Improved coordination of crossborder efforts should include closer supervision and monitoring of the quality of vaccination at border transit points, as well as tracking of the proportion of travelers that are identified as unvaccinated after they have crossed the border.
Further intensify efforts to increase routine immunization coverage, including sharing coverage data, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication.
Maintain these measures until the following criteria have been met: (i) at least six months have passed without new infections and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until the state meets the above assessment criteria for being no longer infected.
Provide to the Director-General a regular report on the implementation of the Temporary Recommendations on international travel.
States infected with cVDPV2s, with potential or demonstrated risk of international spread
Afghanistan (most recent detection 8 January 2020)
Angola (most recent detection 9 February 2020)
Benin (most recent detection 9 December 2020)
Burkina Faso (most recent detection 11 January 2020)
Cameroon (most recent detection 30 January 2020)
CAR (most recent detection 5 February 2020)
Chad (most recent detection 5 February 2020)
Cote d’Ivoire (most recent detection 11 February 2020)
China (most recent detection 25 April 2019)
DR Congo (most recent detection 22 January 2020)
Ethiopia (most recent detection 21 February 2020)
Ghana (most recent detection 28 January 2020)
Malaysia (most recent detection 18 January 2020)
Niger (most recent detection 3 April 2019)
Nigeria (most recent detection1 January 2020)
Pakistan (most recent detection 12 February 2020)
Philippines (most recent detection 16 January 2020)
Somalia (most recent detection 4 February 2020)
Togo (most recent detection 10 January 2020)
Zambia (most recent detection 25 November 2019)
These countries should:
Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency and implement all required measures to support polio eradication; where such declaration has already been made, this emergency status should be maintained.
Noting the existence of a separate mechanism for responding to type 2 poliovirus infections, consider requesting vaccines from the global mOPV2 stockpile based on the recommendations of the Advisory Group on mOPV2.
Encourage residents and longterm visitors to receive a dose of IPV four weeks to 12 months prior to international travel; those undertaking urgent travel (i.e. within four weeks) should be encouraged to receive a dose at least by the time of departure.
Ensure that travelers who receive such vaccination have access to an appropriate document to record their polio vaccination status.
Intensify regional cooperation and crossborder coordination to enhance surveillance for prompt detection of poliovirus, and vaccinate refugees, travelers and crossborder populations, according to the advice of the Advisory Group.
Further intensify efforts to increase routine immunization coverage, including sharing coverage data, as high routine immunization coverage is an essential element of the polio eradication strategy, particularly as the world moves closer to eradication.
Maintain these measures until the following criteria have been met: (i) at least six months have passed without the detection of circulation of VDPV2 in the country from any source, and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until the state meets the criteria of a ‘state no longer infected’.
At the end of 12 months without evidence of transmission, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.
States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV
WPV1
none
cVDPV
Kenya cVDPV2 (last env positive specimen 21 March 2018)
Mozambique cVDPV2 (last virus detected 17 December 2018)
PNG cVDPV1 (last environmental positive specimen 6 November 2018)
Indonesia cVDPV1 (last virus detected 13 February 2019)
These countries should:
Urgently strengthen routine immunization to boost population immunity.
Enhance surveillance quality, including considering introducing supplementary methods such as environmental surveillance, to reduce the risk of undetected WPV1 and cVDPV transmission, particularly among high risk mobile and vulnerable populations.
Intensify efforts to ensure vaccination of mobile and crossborder populations, Internally Displaced Persons, refugees and other vulnerable groups.
Enhance regional cooperation and cross border coordination to ensure prompt detection of WPV1 and cVDPV, and vaccination of high risk population groups.
Maintain these measures with documentation of full application of high quality surveillance and vaccination activities.
At the end of 12 months without evidence of reintroduction of WPV1 or new emergence and circulation of cVDPV, provide a report to the Director-General on measures taken to implement the Temporary Recommendations.
Additional considerations
Impact of COVID-19 on the polio program:
The committee urges all countries, but particularly those at high risk of polio, to maintain a high level of polio surveillance throughout the pandemic period, noting that the postponement of polio immunization campaigns whether preventive or in response to outbreaks may lead to an increase in polio transmission including international spread. Maintainenance of access to laboratory diagnosis in the face of widespread transport and shipping disruption is critical.
Secondly, countries affected by campaign postponement should strive to maintain a high degree of operational readiness in order that immunization activities, including border vaccination, can resume quickly adhering to principles of good hygiene and safety for the vaccinee as well as for the health professionals to prevent COVID-19 spread. This includes ensuring teams have access to appropriate personal protective equipment.
Given the risk of international spread, countries need to ensure that they are ready to use appropriate vaccines, as recommended by the Strategic Advisory Group of Experts on Immunization, in response to new outbreaks.
The committee urged countries to maximize the use of polio assets to synergistically address the COVID19 pandemic, noting that polio affected countries may be vulnerable to poorer outcomes in the pandemic due to health care system fragility and poorer health status of the population generally.
Lastly the pandemic should serve as a reminder to high risk countries with poor immunization coverage that infectious disease outbreaks can lead to social and economic disruption as well as straining the health care system, and countries can increase their population resilience and recovery through prioiritising robust immunization programmes. This is relevant not only to polio, but to all other vaccine preventable diseases particularly measles.
Based on the current situation regarding WPV1 and cVDPV, and the reports provided by affected countries, the Director-General accepted the Committee’s assessment and on 7 April 2020 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV. The Director-General endorsed the Committee’s recommendations for countries meeting the definition for ‘States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread’, ‘States infected with cVDPV2 with potential risk for international spread’ and for ‘States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV’ and extended the Temporary Recommendations under the IHR to reduce the risk of the international spread of poliovirus, effective 7 April 2020.
Read More
https://www.who.int/news-room/detail/08-04-2020-statement-of-the-twenty-fourth-ihr-emergency-committee
In 2012, mathematician Shinichi Mochizuki produced a proof claiming to solve the long-standing ABC conjecture, but no one understood it. Most mathematicians still don’t, but it will now be published in a journal Read More
https://www.newscientist.com/article/2239662-baffling-500-page-abc-maths-proof-to-be-published-after-eight-year-row/?utm_campaign=RSS%7CNSNS&utm_source=NSNS&utm_medium=RSS&utm_content=home
FIFA has joined forces with the United Nations (UN) and the World Health Organization (WHO) in supporting the #BeActive campaign launched on the UN International Day of Sport for Development and Peace to encourage people to be #HealthyAtHome as the world comes together in the fight against COVID-19, today and every day.
WHO recommends all healthy adults do at least 30 minutes a day of physical activity and children at least 60 minutes per day. As part of this, #BeActive and remain #HealthyAtHome include the following suggestions along with any other form of recreation
to stay healthy at home:
Taking some online exercise classes,
Dancing,
Playing active video games,
Jumping rope, and
Practising muscle strength and balance training.
“We are delighted that football is strongly supporting the International Day of Sport for Development and Peace by asking everyone to #BeActive and to remain healthy at home during this difficult time,” said António Guterres Secretary-General
of the United Nations. “FIFA has asked the football community, from member associations and clubs, to players and fans, to show their support, to put their rivalries aside and to show a new solidarity so we can overcome the coronavirus.
This is an important lesson not only for today, but for every day.”
“More than ever, especially now, one thing must be clear to everyone, health comes first,” said FIFA President Gianni Infantino. “FIFA is delighted to support both the United Nations and the World Health Organization in amplifying
the #BeActive campaign today, and we are encouraged that the football community is also playing an active role in ensuring the message understood globally. For the first time ever, we are all on the same team and together, with team spirit and
positive energy, we will win.”
“WHO is proud to collaborate as part of the UN family with FIFA and football lovers worldwide to promote the importance of being active for both physical and mental health,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “The #BeActive campaign supports WHO’s drive to help people be healthy at home.”
The campaign kicks off with Real Madrid CF, FC Barcelona, Liverpool FC and Manchester United FC asking football fans to set aside their rivalries and to come together to #BeActive in order to defeat the coronavirus. Other clubs, including Club América,
CD Guadalajara, Beijing Guoan FC, Shanghai Shenhua FC, Mohun Bagan AC, East Bengal FC, Melbourne City FC, Sydney FC, Auckland City FC, Team Wellington FC, CA River Plate, Olympique de Marseille, TP Mazembe, CR Flamengo and SE Palmeiras will also
join the initiative in the coming days.
As part of the campaign, world-famous players share the following message: “At this time, even rivals need to stick together. We have to keep our distance, but we do not lose our focus. We can show solidarity by being active, and active means
following the guidelines from the WHO.”
The video campaign will
be published on various FIFA digital channels, with regular subsequent updates from clubs and players across the world during subsequent days. #BeActive is also being supported with graphics toolkits for the 211 FIFA member associations and various
media agencies to facilitate additional localisation and to further amplify the message.
WHO, the UN’s specialized health agency, and FIFA, football’s world governing body, collaborate closely to promote healthy lifestyles through football globally and launched the “ Pass the message to kick out coronavirus” campaign last month to share advice effective measures to protect people from COVID-19.
The video campaign can also be downloaded here for editorial purposes.
Read More
https://www.who.int/news-room/detail/06-04-2020-beactive-for-the-un-international-day-of-sport-for-development-and-peace
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.
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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.
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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.
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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.
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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
Read More
https://www.who.int/news-room/detail/06-04-2020-virtual-press-conference-on-covid-19–06-april-2020
Much-loved children’s authors are becoming a member of an initiative to learn extracts of their books to tens of millions of children and young people at the moment dwelling in isolation amid the COVID-19 pandemic.
Read the World is a collaboration between theInternational Publishers Association (IPA), the World Health Organization (WHO) and UNICEF. It kicks off right now, on International Children’s Book Day, at 15.00 GMT/17.00 CET with Italian creator Elisabetta Dami, creator of the fashionable character Geronimo Stilton.
“These are uncharted waters for us all, and the psycho-social effects of prolonged isolation and social distancing are yet to be seen and understood,” mentioned IPA President Hugo Setzer. “All of us should take particular care of our mental health at the moment, and especially that of young minds. The IPA wanted to do something positive to bring children and their favourite writers closer, to stimulate their interest in books and to create a carefree moment for families to share during this difficult period of confinement.”
“Children’s lives and routines have been turned upside down in just a few short weeks,” mentioned UNICEF Executive Director Henrietta Fore. “Even when the outside world is out of bounds for now, reading can remind children and young people that the transportive power of books is unlimited.”
“WHO is committed to fighting the COVID-19 pandemic on all fronts, especially when it comes to protecting young people,” mentioned WHO Director-General Dr Tedros Adhanom Ghebreyesus. “We understand the fear and anxieties many feel and know how the joy of reading can stimulate young minds, ease tensions and provide hope.”
Elisabetta Dami will learn on her private Instagram account in English from 15.00-15.30 GMT 17.00-17.30 CET. Dami, whose books have offered greater than 180 million copies round the world and are printed in 50 completely different languages, will even reply to feedback and questions by way of the platform.
Several different famous children’s authors have agreed to be a part of the Read the World initiative, particulars of which will likely be out there quickly at https://www.unicef.org/coronavirus/read-the-world
About IPA
The IPA is the world’s largest federation of publishers associations. Established in 1896, it is an business physique with a human rights mandate, whose mission is to promote and shield publishing and elevate consciousness of publishing as a drive for financial, cultural and social improvement. Working in cooperation with the World Intellectual Property Organization (WIPO) and different supranational our bodies, the IPA champions the pursuits of e-book and journal publishing at nationwide and supranational stage. Internationally, the IPA actively opposes censorship and promotes copyright, freedom to publish (together with by the IPA Prix Voltaire), and literacy.
UNICEF works in a few of the world’s hardest locations, to attain the world’s most deprived children. Across greater than 190 international locations and territories, we work for each youngster, in every single place, to construct a greater world for everybody.
The World Health Organization (WHO) is the United Nations’ specialised company for well being. It is an inter-governmental group and works in collaboration with its Member States normally by the Ministries of Health. The World Health Organization is accountable for offering management on world well being issues, shaping the well being analysis agenda, setting norms and requirements, articulating evidence-based coverage choices, offering technical support to international locations and monitoring and assessing well being tendencies. Learn extra at www.who.int.
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https://www.who.int/news-room/detail/02-04-2020-ipa-who-and-unicef-launch-read-the-world-on-international-children-s-book-day-to-support-children-and-young-people-in-isolation
The world is gripped in the Coronavirus reality and the immense panic and disruption it brings along with it. This virulent scourge has cut a path less trodden by viruses, as it infects and spreads with little regard for all the norms of red tape that has allowed the murder and official disappearance of many, including my six brothers. By the time it begins to execute those whose death sentences it has written and signed it is always 10 steps ahead on the paperwork. That is almost eight steps ahead of professionals like Buhari.
The virus is a near perfect beta of a doomsday virus. Even the most hard-line sceptics have ended up dumbfound by just how profoundly serious Covid-19 is as a survivalist organism that is here to accomplish its apocalyptic mission. Though many medical experts have since been pressured, pressed and forced to promise a vaccine and possible cure within the next few months to a year; the truth is that the threat is clearly unprecedented.
In my case I went to sleep in a world where my priority was to deliver food and medical aid to my parents in Kaduna Prison; only to wake up and realize that there was an even larger number of factors in play. I slept knowing full well that it was an uphill battle against the entire regime of Major-General-Buhari and his army of punitive henchmen; to all of a sudden be confronted by a Diablo ex-Machina; courtesy of the novel corona virus AKA Covid-19.
Now all visits to prison by anyone and everyone were effectively and strictly forbidden. I understood and reasoned that it was the proper measure to prevent contagion of this clearly deadly disease. The last thing I would want is to be a part of what makes my already sickly parents sicker; or worse.
In spite of the fact that I had completed all arrangements to have doctors visit both my parents in Kaduna Prison, in order to provide them with relief for their existing medical conditions due to age and a plethora of wounds they sustained during the attack and subsequent ransacking of our home by the Nigerian Army. All of which have all gone untreated during the past five years.
I still thought and reasoned that a quarantine of the entire area was the best measure possible in the short term, considering the existing circumstances. As a result of this I made all the necessary apologies to cancel appointments with all the doctors and hospitals, to ensure that the quarantine in Kaduna Prison will hold and be maintained. I then did all in my power to send masks, hand sanitizers, gloves, soap and vitamins. All in an effort to stay safe and keep everyone safe.
I have now since been jolted out of the stupor of perceived safety by terrible news. There has been a violent incident inside Kaduna Prison, which has rendered my memory of the Zaria Massacre of 2015 raw. As the harrowing sounds of another rampage of gun fire was heard from Kaduna Prison, where my parents are currently being detained.
All my frantic calls to the Controller of Prisons and his deputy were not answered, as the sounds of gun fire continued to rage. All my efforts to learn what was really going on failed. I have however been able to learn a few things through the few answered calls. All of them agree on the following.
1. There has been a surge of Covid-19 symptomatic prisoners in Kaduna Prison.
2. Staff of the prison clinic have been avoiding three symptomatic prisoners particularly.
3. Three of them were removed and one was returned on Tuesday.
4. A number of Prisoners strongly objected to the re-introduction of the prisoners.
5. The prison staff tried to calm things down by trying to reason with them.
6. The Prison’s armed squad were then deployed, to supress an alleged prison break.
7. After a period of automatic fire in the air and on target, calm was restored.
8. The prisoners suspected of Covid-19 are among those reported shot and killed.
9. Bullet canisters were still littered all over the place 3 hours later.
10. Many of the Kaduna prison staff are visibly injured, some with serious injuries.
11. A significant number of the injured staff were seen walking around in blood-soaked uniforms.
12. So called normalcy has been enforced, and returned at an unknown cost.
The fact remains that the highly crowded, unsanitary conditions of Kaduna Prison remains a highly contagious environment, that is no place for my vulnerable mother and father, both of whom are above 50 years of age. Both of whom are un-healthy, both of whom are suffering from an unprecedented number of health issues that have remained untreated and unattended.
Due to a determination by the regime of Heil! Major-General Buhari and his now contagious Governor El-Rufai and their army of undertakers. It is unclear what is really going on at the site of all the intense gunfire that was heard in Kaduna Prison. Aside from the above stated facts, I can say no more.
If you?re searching for creative techniques to increase your social media following, but are handicapped by limited resources, then the Microsoft Dynamics case study will come in handy. The huge conglomerate understood that when it came to social media, it was the same as any other company.
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http://www.associationofmarketing.org/articles/view.php?article_id=14435
LONDON: Football Association chairman Greg Clarke has reportedly told the Premier League he does not believe the domestic football season will be completed because of the coronavirus pandemic.
The Premier League suspended all fixtures at an emergency meeting on Friday. Matches in the English Football League, FA Women’s Super League and Women’s Championship are also on hold.
“It was unanimously decided to suspend the Premier League with the intention of returning on April 4, subject to medical advice and conditions at the time,“ the Premier League said in a statement.
Clarke said at the meeting that he did not think it was feasible for the season to be completed, according to a report in the Times.
The virus is not expected to peak in Britain for many weeks, raising doubts over an early April re-start for the Premier League.
The Times said it is understood that Brighton and Hove Albion chief executive Paul Barber also questioned the brevity of the suspension.
Richard Masters, the Premier League chief executive, is reported to have said it would at least allow time to consider the potential consequences and debate the possible solutions.
The decision was taken after Arsenal manager Mikel Arteta and Chelsea winger Callum Hudson-Odoi tested positive for Covid-19.
Arteta welcomed the move to put the season on hold.
“Feeling better already,“ he tweeted. “We’re all facing a huge & unprecedented challenge. Everyone’s health is all that matters right now.”
Liverpool are 25 points clear at the top of the Premier League with nine games remaining, chasing their first English top-flight title for 30 years.
If results had gone their way this weekend they could have wrapped up the title at Everton on Monday but manager Jurgen Klopp said he supported the move to suspend football.
He said in a club statement: “If it’s a choice between football and the good of the wider society, it’s no contest. Really, it isn’t.”
Financial hit
Football clubs at all levels face enormous losses if the season is not completed.
One senior figure in broadcasting told the Times: “The commercial reality for the Premier League and (European governing body) UEFA is that if they don’t complete their seasons then they are in breach of their broadcasting contracts.
“You would have broadcasters from all around the world saying, ‘In that case we are not paying for the season.’ For the Premier League you are talking around £3 billion (RM15.75 billion) income a year from overseas and domestic TV rights. There would also be financial implications if the competitions were squeezed so fewer matches were played.”
Football finance expert Kieran Maguire told the BBC that clubs, especially in the lower divisions, would be hit hard by the disruption.
“I think many clubs are going to struggle significantly,“ he said. “Many clubs are surviving on a match-to-match basis and are reliant on the loyal few thousand turning up.
“We have to consider the staff at clubs, they are reliant on the income they get from football clubs to pay their own bills as well.”
The Premier League clubs are reportedly due to meet again next Thursday.
There are matches taking place on Saturday in the National League – the fifth tier of English football – but a number of games have been postponed, including the Yeovil v Barnet fixture.
“We currently have four staff that are showing symptoms of Covid-19 who are following government advice and self-isolating,“ Barnet said in a statement.
“As a consequence, we have taken measures to put all first-team staff into self-isolation.” — AFP
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https://www.thesundaily.my/sport/premier-league-may-not-finish-says-fa-chief-DC2127566
The writer probes on the complex world of W. Somerset Maughm’s protagonist in the novel Of Human Bondage, using the propositions the Jewish Portuguese philosopher Baruch Spinoza postulated in his book Ethics in 1674. Some of Spinoza’s propositions are as follows( Morgan, 2006, pp 108-120):
The following propositions of Spinoza enlighten the changing character of Philip in his own bildungsromans of his life. The force and increase of any passive emotion and its persistence in existing is defined not by the power whereby we ourselves endeavour to persist in existing, but by the power of external causes compared with our own power;
The force of any passive emotion can surpass the rest of man’s activities or power so that the emotion stays firmly fixed in him;
An emotion cannot be checked or destroyed except by a contrary emotion which is stronger than the emotion which is to be checked;
Knowledge of good and evil is nothing other than the emotion of pleasure or pain insofar as we are conscious of it;
An emotion whose cause we think to be with us in the present is stronger than it would be if we did not think the said cause to be with us;
We are affected toward a future thing which we imagine to be imminent mo intensely than if we were to imagine its time of existence tofarther away from the present. We are also affected by a remembrance of a thing we imagine to belong to the near past more intensely if we were to imagine it to belong to the distant past;
An emotion toward a thing which we think of as inevitable [necessarius] is more intense, other things being equal, than emotion toward a thing possible or contingent, that is, not inevitable;
Emotion toward a thing which we know not exist in the present, and which we imagine to be possible, is, other things being equal, more intense than emotion toward a contingent thing;
Emotion toward a contingent thing which we know not to exist in the present, is, other things being equal, feebler than emotion toward a thing past;
No emotion can be checked by the true knowledge of good and evil, insofar as it is true, but only insofar as it is;
Desire that arises from the true knowledge of good and evil can be extinguished or checked by many other desires that arise from the emotions by which we are assailed;
The desires that arises from a knowledge of good and evil insofar as this knowledge has regard to to the future can be the more easily checked or extinguished by desire of things that are attractive in the present;
Desire that arises from the true knowledge of good and evil insofar as this knowledge is concerned with contingent things can be even more easily checked by desire for things which are present;
Desire arising from pleasure is, other things being equal, stronger than desire arising from pain;
Every man, from the laws of his nature, necessarily seeks or avoids what he judges to be good or evil.
The more every man endeavours and is able to seek advantage, that is, to preserve his own being, the more he is endowed with virtue. On the other hand insofar as he neglects to preserve what is to his advantage, that is, his own being to that extent he is weak.
Philip is highly affected by nature. There is in Nature no individual thing that is surpassed in strength and power by some other thing. Whatsoever thing there is, there is another more powerful by which the said thing can be destroyed. And he was able to surpass all his problems because of the incoming different emotions, problems which proved to make him stronger if not released from “Human Bondage”.
The force whereby a man persist in existing is limited, and infinitely surpassed by the power of external causes.
Philip’s deformity limits his own persistence to live. But his meeting with Hayward, Clutton and Lawson, his former classmates in France, who taught him that life is all about passion and the pursuit of it, he became engross in his art. France did not also care about his clubfoot. Cronshaw taught him more philosophy in life about living in let live. Cronshaw even on his death bed, defied doctors’ prohibition. His life is anyway to end just like any other’s lives.
Set in Kent, England, a sub-urban near London, the novel presents the multifaceted personal, social, political and religious experiences of Philip carey from his childhood to his middle age of thirty. A bildungsroman (1991, Smiley) in style, which highlights the formation of a youngman’s character through education, travels and early life experiences. Philip at the age of nine, as a young boy, is set apart from his peers by some misfortune and undergoes a humiliating experience that later proves strengthening. his first experience of love is unsuccessful or problematic one that nevertheless paves the way to a happy marriage with a suitable mate. The novel has ample observation, if not criticism, with the character’s institutions such as schools, churches and class structures.
Philip’s personal life is truly an amalgam of life’s tragedies. But how he surpassed the seemingly insurmountable heap of oppressing weight, if not the meaninglessness or nothingness of life, is the focus of this attempt anchored on Spinoza’s propositions. To enumerate, at an early age, his mother died of tuberculosis and his father, a medical doctor, died of lung cancer. His innocence never understood the situation. He has only the temporary joy of travelling to Blackstable to live with his uncle William and childless Auntie Louisa. Forcibly liking his second family as an orphan, he is left reading his books without noise for his uncle, a Vicar in the community, is irated with children’s unruly behaviour. Aunt Louisa is incapable of understanding Philip. he is left with the care of the governess. His personal disability or deformity, being born with a club-foot, proves to be the stigma of his life forever. His early education in Kingston School, caused his early childhood bitter as his peers laughed at him, mocked and physically abused him because of his physical abnormality. Then, his adolescence which brings him to Heidelberg, Germany to study foreign languages, is never sweet. Girls chided him for his deformity. the consolation is meeting friends like Hayward and Miss Wilkinson, who flirted with him, to his disgust. His sojourn to France, albeit, his uncle’s disappointment, proves to be annihilating. His lack of talent in painting plus his deformity, made him a mediocre student. His classmate Fanny Price, who fell in love with him, on the pretext of sharing the same abnormality (hers is lack of beauty), committed suicide out of hunger and wretchedness.
Then everything escalated to its height, when realizing that painting is not his passion, he goes back to England. He decides to change again to pursue what his uncle William tells him to do: to follow the footsteps of his father. To be a doctor. feeling he has nothing to do, he embraces the new idea. Sauntering along the Parliamentary Street of London, he is driven to dine in a cafe where he meets the slatternly waitress Mildred Rogers who awakens his sexual desire. But his languid mien, caused by his club-foot proves to be a disadvantage. the waitress prefers rugged and rich men. But his desire to pursue the pale, anaemic, aloof Mildred, beomes a challenge to him. Gradually, the two becomeclose. But the ambitious and materialistic waitress always insults him because of his deformity. to slander him cripple, would totally “cripple” his mood and emotion. Even when Philip is generous to the moody Mildred, she hurt him by marrying a German businessman Miller. His desperation is tantamount to his yearning for Mildred. He is left believing that one day, he would see Mildred again. His concentration with his medical study is forlorned. And Mildred came back,looking sickly, with a child. His generosity and forgiveness for his first love, who hurts him the most, is even greater than life. The ingrate waitress after a little recovery from poverty, elopes with Griffith, Philip’s handsome and robust classmate. That is the height of Mildred’s shamelessness. So her expected return is welcomed with derision by the newly awakened Philip. Even when Mildred turns into a prostitute, Philip is only capable of compassion, without passion or sexual desire. She is freed at last. And Philip is extricated from the pains excruciatingly caused by the destitute Mildred.
His obsession to Mildred costs Philip his fortune and gradually his savings is left with seven pounds. He is forced to stop from his medical studies that brings him to experience unbelievable poverty. He meets the generous Athelneys who fed and sheltered him in his misery. His uncle’s death, leaving an average fortune, helps him to finish his medical studies. His fateful shelter with the Athelneys brings him to his final, harmonious and peaceful resolution to marry Sally Athelney and go on with his life beautifully. Shakespeare is affirmed by saying that “all is well that ends well.
At this juncture, it is noteworthy to enumerate Spinoza’s propositions to elucidate Philip’s “bondage” and his strength of his emotion. Spinoza in his preface to his philosophical treatise wrote:
I assign the term “bondage” to man’s lack of power to control and check the emotions. For a man at the mercy of his emotions is not his own master but is subject to fortune, in whose power he so lies that he is often compelled, although he sees the better course, to pursue the worse. In this Part I have set myself the task of demonstrating why is so, and also what is good and what is bad in emotions. But before I begin, I should like to make a few preliminary observations on perfection and imperfection, and on good and bad ( Morgan, 2006).
In the beginning, Philip is a slave if not a victim of his emotion. His physical deformity, his club-foot, caused him too much pain. He learned to hate his classmates and,worst, abandoned his belief in God. He could not appreciate the God of his uncle vicar when God cannot give him the miracle he wanted to have normal feet. His painful childhood in school changed him to be rough character. He never wanted to become a vicar anymore. His obsession to Mildred indeed showed his real weakness as a man, and even wretchedness as a human being because of his deformity. he would always think that women cannot love him as he is because of his deformity.
He who has undertaken something and has brought it to completion will say that the thing is completed; and not only he but everyone who rightly knew, or thought he knew, the intention and aim of the author of that work. For example, if anyone sees a work (which I assumed is not yet finished) and knows that the aim of author is to build a house, he will say the house is imperfect. On the other hand, as soon as he sees that the work has been brought to the conclusion that its author had intended to give it, he will say that the house is perfect. But if anyone sees a work whose like he had never seen before, and he does not know the artifecer’s intention, he cannot possibly know whether the work is perfect or imperfect.
This appears to have been the original meaning of these terms. But when men began to form general ideas and to devise ideal type of houses, buildings, towers, and so on, and to prefer some models to others, it came about that each called “perfect” that which he saw at variance with his own preconceived ideal, although in the artifecer’s opinion it had been fully completed. There seems to be no other reason why even natural phenomena (those not made by human hand) should commonly be called perfect or imperfect. For men there are wont to form general ideas both natural phenomena and artifacts, and these ideas they regard as models, and they believed that Nature (which they consider does nothing without an end in view) looks to this ideas and holds them before herself as models. So when they see something occurring in Nature at variance with their preconceived ideal of the thing in question, they believed that Nature has then failed or blundered and has left that thing imperfect from their own preconceptions rather than from true knowledge.
So perfection and imperfection are in reality only models of thinking, notions which we are wont to invent from comparing individuals of the same species or kind; and it is for this reason that I previously said (Def. 6, II) that by reality and perfection I mean the same thing. For we are wont to classify all the individuals in Nature under one genus which is called the highest genus, namely, the notion of Entity, which pertains to all the individuals in Nature without exception. Therefore insofar as we classify individuals in Nature under this genus and compare them with one another and find that some have more being or reality than others, to that extent we say that some are more perfect than the others. And insofar as we attribute to them something involving negotiation, such as limit, end, impotence and so on, to that extent we call them imperfect because they do not affect our minds as much as those we call perfect, and not because they lack something of anything except that which follows from the necessity of nature of its efficient cause; and whatever follows from the necessity of the nature of its efficient cause must be necessarily be so.
To be a master of his emotion is to attain perfection. It may not be physical but spiritual, mental and emotional. His challenges may have hardened him but enlightened him to loosen up and later, embrace the beauty of life. The unattainable perfection, was answered, through his friend Cronshaw, a poet whom he met in France, that the meaning of life cannot be answered unless one lives it. he realized that men are born, study, work, marry, have children and die is the most beautiful pattern that the Persian rug edifies.
As for the terms “good” and “bad,” they likewise indicate nothing positive in things considered in themselves, and nothing but models of thinking, or notions which we form from comparing things with one another. For one and the same thing can at the same time be good and bad, and also indifferent. For example, music is good for one who is melancholy, bad for one in mourning, and neither good or bad for the deaf. However, although this is so, these terms ought to be retained. For since we desire to form the idea of man which we may look to as model of human nature, we shall find it useful to keep these terms in the sense I have indicated. So in what follows I shall mean by “good” that which we certainly know to be the means for our approaching nearer to the model of human nature that we set before ourselves, and by “bad” that which we certainly know prevents us from reproducing the said model. For it is important to note that when I say somebody passes from a state of less perfection, to a state of greater perfection, and vice versa, I do not mean that he changes from one essence or to form to another (for example, a horse is as completely destroyed if it changes into a man as it would be if it were to change into an insect), but that we conceive his power of activity, insofar as this is understood through his nature, to be increased or diminished.
Philip may have been both good and bad due to circumstances. he was good in the Blackstable with his Auntie Louisa and Uncle William. he became bad in school because his classmates taunted him because of his clubfoot. In Heidelberg, he is good to all the people even if he did not understand their silence and even their insolence. In France, was forced to become bad, to protect himself from the looming abuses of other foreigners. The death of an anti-social fanny Price, showed him to be the only compassionate painting student.
Hence, after a series of Philip’s tragedy, his experiences, his meeting with different people, his education, his travel to Heidelberg, to Paris and to London, his affluence and reversal of his fortune to poverty taught him greatest lessons in life. That life can be beautiful if man knows to master his emotion, moderate his desire and be reasonable in every decision. A man is finally freed from the chains and cufflinks ” Of Human Bondage”.
References:
Maughm, Somerset W. (1991). Of Human Bondage.
Canada: Bantam Book Doubleday.
Morgan, Michael (ed.). (2006). The Essential Spinoza: Ethics And Related Writings.
