General Science & Health

Once again, nowhere is safe in Gaza. WHO is gravely concerned about the resumption of hostilities, including heavy bombardment in Gaza, and reiterates its appeal to Israel to take every possible measure to protect civilians and civilian infrastructure, including hospitals, as per the laws of war.  

We have seen what happened in northern Gaza. This cannot be the blueprint for the south. Gaza cannot afford to lose another hospital as health needs continue to soar.

As more civilians in southern Gaza receive immediate evacuation orders and are forced to move, more people are being concentrated into smaller areas, while the remaining hospitals in those areas run without sufficient fuel, medicines, food, water, or protection of health workers. 

WHO and other partners are less able to provide support, given dwindling access to our supplies or any assurance of safety when we move supplies or staff. 

This morning WHO was contacted with advice to move as many medical supplies as possible from a warehouse in Gaza, situated in an area ordered to be evacuated. Access to storage could become challenging over the coming days due to ground operations.

Intensifying military ground operations in southern Gaza, particularly in Khan Younis, are likely to cut thousands off from health care – especially from accessing Nasser Medical Complex and European Gaza Hospital, the two main hospitals in southern Gaza – as the number of wounded and sick increases. 

Lack of access would also limit WHO’s ability to deliver aid to these hospitals.

About 1.9 million people, nearly 80% of Gaza's population, are estimated to be internally displaced. Recent evacuation orders cover 20% of Khan Younis and localities east of Khan Younis, which prior to the hostilities were home to nearly 117 000 and 352 000 people, respectively. 

In less than 60 days, the number of functioning hospitals has dropped from 36 to 18. Of these, three are only providing basic first aid, while the remaining hospitals are delivering only partial services. Those able to admit patients are delivering services well over their intended capacities, with some treating two to three times as many patients as they were designed for. The 12 hospitals that are still operational in the south are now the backbone of the health system. 

On a recent visit to Nasser Medical Complex in Khan Younis, the WHO team described the situation inside as catastrophic, with the building and hospital grounds grossly overcrowded with patients and displaced people seeking shelter. The emergency ward is overflowing with patients. There is a shortage of health workers compared to the overwhelming needs. Those who are available have been working non-stop and are exhausted. Many patients are being treated on the floor. Bed capacity has been overwhelmed. Patients and families sheltering at the hospital are scared for their security.

Disease surveillance systems are hampered, but syndromic surveillance has noted increases in infectious diseases, including acute respiratory infections, scabies, jaundice, diarrhoea, and bloody diarrhoea. Shelters in the south are also reporting cases of acute jaundice syndrome, a worrisome signal of hepatitis. 

From 7 October to 28 November, WHO recorded an unprecedented number of attacks on health care: 203 attacks on hospitals, ambulances, medical supplies, and the detention of health-care workers. This is unacceptable. There are means to protect civilians and civilian infrastructure, and they should be instituted.   

The only viable solution is a sustained ceasefire.

Note to editors:

On 3 December alone, 349 people were killed and 750 injured according to reports from the Ministry of Health. 

According to the Ministry of Health, the bed occupancy rate at operational hospitals stands at 171%, while in the intensive care units the occupancy rate is up to 221%. 

Currently, there are 1000 patients and thousands of people sheltering at the 350-bed Nasser Medical Complex, and 1000 patients and an estimated 70 000 people sheltering at the 370-bed European Gaza Hospital. Both hospitals are three times beyond their capacity.

As of 3 December, per Ministry of Health reports, more than 15 899 people have died, over two-thirds of them women and children. An additional 42 003 people, also mostly women and children, have been injured.

Credit: PAHO

It is with immense sadness that I learned today of the passing of our dear friend, Dr Carissa F. Etienne.

Dr Etienne, a native of Dominica, served as Director of the Pan American Health Organization and as WHO Regional Director for the Americas from 2013 to 2023, during which the Americas made impressive progress towards universal health coverage, and against both communicable and noncommunicable diseases.

Dr Etienne also demonstrated exemplary leadership in response to the COVID-19 pandemic and to other health emergencies.

As a valued member of WHO’s senior leadership, Dr Etienne provided trusted advice and support to the Organization’s mission to expand access to health services for people in the Americas and globally.

Dr Etienne also served in multiple other roles for WHO, including as Assistant Director-General for Health Systems and Services at WHO headquarters in Geneva, Switzerland. 

Her dedication to public health and significant contributions to WHO leave a legacy in the health of the people of Dominica, the Americas and the world.

On behalf of WHO, I extend our heartfelt condolences to Dr Etienne’s family, friends, and colleagues.

She will be greatly missed.

For World AIDS Day, marked on 1 December, the World Health Organization (WHO) is joining international partners to acknowledge the resilience, dedication and innovation exemplified by community leaders and organizations in the response to the HIV epidemic.

From fighting stigma and discrimination, to advocating for access to affordable interventions, and community led services that put people with lived experience at the centre, communities have shaped the HIV response for decades.

“People living with or affected by HIV have left an indelible mark on the world with their activism,” said Dr Tedros. “The affected communities who fought for tools to prevent, test and treat HIV enabled 30 million people to access antiretroviral therapy, and helped to avert an unknowable number of infections. We stand together with communities to help end AIDS as a public health threat by 2030.”

Several decades of investments and learnings from the HIV epidemic have catalysed broader advancements in global health and national health systems. The response to HIV strengthened healthcare systems and increased access to services beyond HIV testing and treatment. Investments and infrastructure from the HIV response enabled strong and swift responses to many diseases including COVID-19 and mpox.

Despite significant progress, HIV remains a pressing public health issue

Globally, 9.2 million people do not have access to the HIV treatment that they need. Each day 1700 lives are lost from HIV-related causes, and 3500 people are infected, with many not knowing their status or having access to treatment.

Innovations in HIV tools, such a powerful once a day pill for HIV treatment and accessible viral load testing, have enabled significant progress. The fact that people living with HIV, who take their HIV treatment as prescribed and have no virus detectable in their blood, have zero risk of transmitting HIV to their sexual partners, is just one such example. This was the result of years of advocacy and investment, and is a reminder that the target of ending AIDS as a public health threat by 2030 is achievable, provided there is sufficient political will and sustained investments.

Funding, criminalization, and limitations placed on the roles of community champions hinder the progress achieved by community leaders and slow global progress to ending AIDS as a public health threat. Many communities, such as key populations of men who have sex with men, transgender people, sex workers, people who use drugs, and adolescents, still lack access to the prevention, treatment, and care services that they need and deserve. These inequalities continue to drive the uneven progress on HIV.

With less than 7 years to reach this goal, there is still an urgent need for continued funding to HIV programmes so that community leaders can continue reaching those affected. These efforts are essential to close the gaps in diagnosis and treatment for children living with HIV, and help all countries move closer to the 95-95-95 targets, which aim for 95% of people living with HIV knowing their status, 95% of those diagnosed receiving antiretroviral therapy and 95% of those on treatment having suppressed viral loads. WHO will continue to work with partners and call on leaders to prioritize the needs of affected populations.

“We call for global solidarity with communities today and every day,” said Dr Meg Doherty, WHO Director of Global HIV, Hepatitis, STI Programmes. “The leadership of affected communities has been vital to moving forward the HIV response, despite the legal, economic and social barriers they face.”

Partnership with people living with and affected by HIV is critical to the sustainability and ultimate success of the HIV response. WHO stands with global partners to applaud the role of the communities in closing the testing, treatment and care gaps for those left behind and in driving progress towards ending AIDS as a global public health threat. 

In a full day of meetings on 20 November, WHO leaders and a Canadian government delegation reflected on their decades-long cooperation and sought to sharpen their strategic engagement on shared global health priorities, notably, health-systems strengthening, universal health coverage, embedding gender equality, equity and rights across WHO’s programmes, sustainable financing, health emergencies and pandemic preparedness.

The delegation was led by Mr Jean-Bernard Parenteau, Director General, Health and Nutrition Bureau of Global Affairs Canada and Patricia McCullagh, Deputy Permanent Representative of Canada to the United Nations in Geneva.

WHO representatives from across the Organization gave presentations on health emergencies, sexual and reproductive health and research; gender, equity and rights; primary health care as a foundation for universal health coverage; vaccine manufacturing; the International Health Regulations; and the work of the Intergovernmental Negotiating Body, which is drafting a pandemic treaty for consideration by the World Health Assembly next May.

Canada is currently the eighth largest contributor to WHO, and the fifth largest Member State contributor. For the 2022-23 biennium, Canada has contributed nearly US$ 175 million.

“Canada remains committed to the WHO as the centre of the global health ecosystem and deeply appreciates its pivotal role in helping the world prevent, prepare for, and respond to health emergencies, including the COVID-19 pandemic,” Mr Parenteau said. “As we renew our focus on primary health care and equitable and resilient health systems, we must take a gender-responsive, human rights and equity-based approach, including to advance sexual and reproductive health and rights for all. We welcome WHO’s leadership in these areas, and to continued collaboration.”

WHO Health Emergencies Programme Executive Director Dr Mike Ryan commended Canada for its support for WHO, and to emergencies in particular. Canada is the fourth-largest contributor to WHO’s Contingency Fund for Emergencies, having provided US$ 8.3 million since 2015.

He said one of the vulnerabilities highlighted by the COVID-19 pandemic was the lack of access to life-saving medical countermeasures faced by many countries, and that collaboration with Canada and other global health leaders on timely and equitable access to medical countermeasures against pandemic threats is critical.

“We look forward to continuing this crucial dialogue with Canada, committing to equity and solidarity,” Dr Ryan said. “Together, we can ensure that no one is left behind when the next pandemic strikes.”

The delegation also met with Dr Bruce Aylward, WHO Assistant Director-General, Universal Health Coverage, Life Course, who expressed WHO’s appreciation for Canada’s active, constructive participation in the ongoing development of WHO’s 14th General Programme of Work. He recognized the country’s support for strengthening universal health care, maternal and child health, and sexual and reproductive health and rights, as well as Canada’s important role in the Universal Health Coverage Partnership.

^{Patricia McCullagh, Deputy Permanent Representative of Canada to the United Nations in Geneva and Jean-Bernard Parenteau, Director General, Health and Nutrition Bureau of Global Affairs Canada, led a delegation to WHO headquarters on 20 November. ©WHO/Bernard Dizier}

In the run-up to COP28, the World Health Organization (WHO) together with the global health community, is raising its voice to ensure that the impact of climate change on health takes centre stage in the negotiations. It is imperative to broaden the focus to human health in global discussions, leaving no room for excuses, and compelling negotiators to recognize that they bear the responsibility for the well-being of our most invaluable asset: the health of populations worldwide.

"Prioritizing health is not just a choice; it is the foundation of resilient societies,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Leaders must deliver in Dubai, providing the strong health outcomes their peoples expect and their economies urgently need. We must change the conversation and demonstrate the massive benefits of bolder climate action on our health and well-being.”

The extreme weather events around the world in recent months offer a terrifying glimpse of what lies ahead in a rapidly heating world. The IPCC report says about 3.5 billion people – nearly half of humanity – live in areas highly vulnerable to climate change. Heat-related deaths among those aged over 65 years have risen by 70% worldwide in two decades, according to WHO’s figures. Only a dramatic and dedicated effort to limit warming to 1.5 °C will prevent a future much worse than what we see now.

Increasingly frequent and severe extreme weather events, such as droughts, floods and heatwaves, will also strain healthcare infrastructure. Last year's floods in Pakistan displaced 8 million people and affected 33 million overall. Forecasts from the World Bank indicate that without bold and immediate action, climate change could displace approximately 216 million people by 2050.

As the climate crisis jeopardizes lives and livelihoods, global food systems struggle to sustain a growing population, and compromised water sources compound the challenges. In parallel, climate change is catalyzing a surge in infectious diseases like dengue and cholera, endangering millions. Now is the time for decisive and collaborative action to mitigate the health impacts of the climate crisis and build a sustainable future for all.

As climate change poses an unprecedented challenge to health systems worldwide, it is also imperative that we strengthen our systems to be resilient, low carbon and sustainable. Failure to act swiftly will render health systems worldwide vulnerable to the overwhelming impacts of climate change.

Climate change is not a distant threat; it is a present danger affecting our health on multiple fronts. The health community asserts that climate change is already affecting our health, contributing to the spread of infectious diseases and vector-borne illnesses. There is an urgent need for negotiators to comprehend that climate change is a direct threat to global health that can no longer be ignored or downplayed.

Adapting our health systems means upgrading key interventions such as vector control, epidemiological surveillance, and access to safe water and sanitation. Additionally, the training of health staff is crucial, and support is needed to align health systems with the guidance included in WHO's operational framework for building climate resilient and low carbon health systems.

To reduce the negative impact on health, the health community stresses the importance of reducing and stopping emissions. According to WHO, 7 million premature deaths annually are attributed to air pollution. Urgent mitigation measures, including transitioning to clean energy sources, are necessary to protect human health and create sustainable outcomes.

The health community recognizes the role health systems play in contributing to emissions, and advocates for greening the health sector. This involves decarbonizing health systems, digitalizing medicine and implementing sustainable practices in hospitals and health-care facilities to significantly reduce the 5% global emissions attributed to the health sector.

Over 1 billion people worldwide are served by health-care facilities with unreliable electricity or no electricity at all. For low-income countries lacking access to electricity, the health community calls for an acceleration of access to clean energy. WHO is working with partners to accelerate electrification of health-care facilities through renewable energies and to harmonize medical supplies and lead a transformative change towards cleaner energy sources, better services and reduced reliance on diesel and gas.

Recognizing the financial disparity in health systems

Acknowledging the financial gap in health systems, the health community calls for increased financing from new sources. The plea is to divest from and end subsidies for fossil fuels, and to mobilize new funds to support health systems in coping with climate change.

The WHO-led Alliance for Transformative Action on Climate and Health (ATACH) is dedicated to realizing the goals set at COP26 by leveraging the collective influence of WHO Member States and stakeholders to advance climate-resilient health systems. ATACH also focuses on identifying financing needs.

With the health sector grappling with unprecedented challenges, it is imperative to address the glaring disparity in financial support. Currently, the sector receives a mere 0.5% of global climate financing. To effectively confront the many challenges ahead – from the ongoing global health crisis to the ever-evolving landscape of medical research and technological advancements – a substantial increase in resources is not only warranted but essential. By multiplying financial support, we can strengthen the sector's ability to innovate, adapt and provide optimal care, ensuring a resilient healthcare infrastructure for the challenges of today and the uncertainties of tomorrow.

WHO urgent call for climate and health action at COP28

As the world unites at COP28, the health community calls for decisive action. We urge negotiators to recognize that climate action is health action, and failure to address this reality will have profound consequences for the well-being of current and future generations.

The WHO call to action unites the health community in demanding a commitment to building resilient health systems, reducing emissions, and prioritizing health. The first-ever Health Day is set to elevate the global profile of the climate and health nexus and integrate health within the climate change agenda.

Health Day and Ministerial session

The first-ever Health Day is set to elevate the global profile of the climate and health nexus and integrate health within the climate change agenda. For the very first time, a record number of health ministers will be attending COP28. The presence of a significant number of health ministers underscores the commitment to prioritize health in the context of climate discussions and reinforces our commitment to creating a healthier and more sustainable future. The Ministerial session promises to amplify the urgency for action by bringing together global leaders to implement sustainable solutions. This historic gathering will focus on addressing the crucial intersection of health and climate change.

The legacy of COP 28 will be a commitment to a healthier planet, where the health arguments for climate action are not just heard but lead to tangible results.

On 22 November, in cooperation with the Palestine Red Crescent Society, WHO participated in another joint-UN mission to transfer 151 patients, relatives and health workers accompanying them from Al-Shifa hospital in northern Gaza. The mission was undertaken following specific requests from health authorities and hospital officials in Gaza. 

WHO has made an official request to China for detailed information on an increase in respiratory illnesses and reported clusters of pneumonia in children.  

At a press conference on 13 November 2023, Chinese authorities from the National Health Commission reported an increase in incidence of respiratory diseases in China. Chinese authorities attributed this increase to the lifting of COVID-19 restrictions and the circulation of known pathogens such as influenza, mycoplasma pneumoniae (a common bacterial infection which typically affects younger children), respiratory syncytial virus (RSV), and SARS-CoV-2 (the virus that causes COVID-19). Authorities stressed the need for enhanced disease surveillance in healthcare facilities and community settings, as well as strengthening the capacity of the health system to manage patients.   

On 21 November, media and ProMED reported clusters of undiagnosed pneumonia in children in northern China. It is unclear if these are associated with the overall increase in respiratory infections previously reported by Chinese authorities, or separate events. 

On 22 November, WHO requested additional epidemiologic and clinical information, as well as laboratory results from these reported clusters among children, through the International Health Regulations mechanism. We have also requested further information about recent trends in the circulation of known pathogens including influenza, SARS-CoV-2, RSV and mycoplasma pneumoniae, and the current burden on health care systems. WHO is also in contact with clinicians and scientists through our existing technical partnerships and networks in China.  

Since mid-October, northern China has reported an increase in influenza-like illness compared to the same period in the previous three years. China has systems in place to capture information on trends in influenza, influenza-like illnesses, RSV and SARS-CoV-2, and reports to platforms such as the Global Influenza Surveillance and Response System.   

While WHO seeks this additional information, we recommend that people in China follow measures to reduce the risk of respiratory illness, which include recommended vaccination; keeping distance from people who are ill; staying home when ill; getting tested and medical care as needed; wearing masks as appropriate; ensuring good ventilation; and regular hand-washing.   

WHO will continue to provide updates.   

• More than 330 000 doses of WHO-recommended RTS,S malaria vaccine arrived last night in Cameroon – a historic step towards broader vaccination against one of the deadliest diseases for African children
• Malaria burden is the highest on the African continent, which accounted for approximately 95% of global malaria cases and 96% of related deaths in 2021
• With several African countries now finalizing roll-out plans, an additional 1.7 million doses are set for delivery to Burkina Faso, Liberia, Niger and Sierra Leone in the coming weeks
• These shipments signal that malaria vaccination is moving out of its pilot phase, and lay the groundwork for countries to begin vaccinations through Gavi-supported routine immunization programmes in Q1 2024 

Shipments of the world’s first WHO-recommended malaria vaccine, RTS,S, have begun with 331 200 doses landing last night in Yaoundé, Cameroon. The delivery is the first to a country not previously involved in the malaria vaccine pilot programme and signals that scale-up of vaccination against malaria across the highest-risk areas on the African continent will begin shortly.

Nearly every minute, a child under five dies of malaria. In 2021, there were 247 million malaria cases globally, which led to 619 000 deaths. Of these deaths, 77 per cent were children under 5 years of age, mostly in Africa. Malaria burden is the highest on the African continent, which accounts for approximately 95% of global malaria cases and 96% of related deaths in 2021.

A further 1.7 million doses of the RTS,S vaccine are expected to arrive in Burkina Faso, Liberia, Niger and Sierra Leone in the coming weeks, with additional African countries set to receive doses in the months ahead. This reflects the fact that several countries are now in the final stage of preparations for malaria vaccine introduction into routine immunisation programmes, which should see first doses administered in Q1 2024.

Comprehensive preparations are needed to introduce any new vaccine into essential immunisation programmes – such as training of healthcare workers, investing in infrastructure, technical capacity, vaccine storage, community engagement and demand, and sequencing and integrating rollout alongside the delivery of other vaccines and health interventions. Delivering the malaria vaccine has the added challenge of a four-dose schedule which requires careful planning to effectively deliver.

Since 2019, Ghana, Kenya, and Malawi have been administering the vaccine in a schedule of 4 doses from around 5 months of age in selected districts as part of the pilot programme, known as the Malaria Vaccine Implementation Programme (MVIP). More than 2 million children have been reached with the malaria vaccine in the three African countries through MVIP – resulting in a remarkable 13% drop in all-cause mortality in children age-eligible to receive the vaccine, and substantial reductions in severe malaria illness and hospitalizations. Other key findings from the pilot programme show that vaccine uptake is high, with no reduction in use of other malaria prevention measures or uptake of other vaccines. MVIP is coordinated by WHO in collaboration with PATH, UNICEF and other partners, and funded by Gavi, the Global Fund, and UNITAID, with donated doses from GSK, the manufacturer of the RTS,S vaccine.

The data from the pilot have shown the impact and safety of the RTS,S vaccine and provided important evidence on vaccine acceptability and uptake that helped inform the recent WHO recommendation of a second malaria vaccine – R21, manufactured by the Serum Institute of India (SII). Results of a phase 3 trial for R21 showed that the vaccine has a good safety profile in the clinical trial setting and reduces malaria in children. It is expected that, like RTS,S, when R21 is implemented it will have similar high public health impact.  The choice of which vaccine to be used in a country should be based on programmatic characteristics, vaccine supply, and affordability.

The R21 vaccine is currently under review by WHO for prequalification. The availability of two malaria vaccines is expected to increase supply to meet the high demand from African countries and result in sufficient vaccine doses to benefit all children living in areas where malaria is a public health risk. In preparation for scaled-up vaccination, Gavi, WHO, UNICEF and partners are working with countries that have expressed interest and/or have confirmed rollout plans on the next steps.

These developments mean that broad implementation of malaria vaccination in endemic regions has the potential to be a gamechanger for malaria control efforts, and could save tens of thousands of lives each year. However, malaria vaccines are not a standalone solution. They should be introduced in the context of the WHO-recommended package of malaria control measures which include insecticide-treated nets, indoor residual spraying, intermittent preventive treatment in pregnant women, antimalarials, effective case management, and treatment, all of which have helped to reduce malaria-related deaths since 2000. Importantly, the MVIP showed that delivering vaccines alongside non-vaccine interventions can reinforce the uptake of other vaccines and the use of insecticide treated nets, and overall boost access to malaria prevention measures.

“The world needs good news – and this a good news story,” said David Marlow, CEO of Gavi, the Vaccine Alliance. “Gavi is proud that our Alliance of stakeholders, with African countries at the forefront, took the decision to invest in the malaria vaccine as a public health priority, and that this support has played a part in the availability of a new tool that can save the lives of thousands of children each year. We are excited to rollout this historic vaccine through Gavi programmes and work with partners to ensure it is delivered alongside other vital measures.”

“This could be a real gamechanger in our fight against malaria,” said UNICEF Executive Director Catherine Russell. “Introducing vaccines is like adding a star player to the pitch. With this long-anticipated step, spearheaded by African leaders, we are entering a new era in immunization and malaria control, hopefully saving the lives of hundreds of thousands of children every year.”

“This is another breakthrough moment for malaria vaccines and malaria control, and a ray of light in a dark time for so many vulnerable children in the world. The delivery of malaria vaccines to new countries across Africa will offer life-saving protection to millions of children at risk of malaria,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “But we must not stop here. Together, we must find the will and the resources to bring malaria vaccines to scale, so more children can live longer, healthier lives.”

“This is a significant advancement towards scaling up malaria vaccination in the region. The vaccine, which protects children from the severe forms of the disease, is a vital addition to the existing set of malaria prevention tools and will help bolster our efforts to reverse the rising trend in cases and further reduce deaths,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

Quotes from countries and stakeholders

"The arrival of the RTS,S/AS01 malaria vaccine in Burkina Faso marks a historic milestone in our efforts to combat malaria, which remains a major public health threat. Malaria is in fact the primary cause for consultations, hospitalization and death in our health facilities. Children under 5 pay the heaviest price. We are hopeful that the introduction of this vaccine into routine immunisation for children aged 0 to 23 months will have the potential to reduce the burden of this disease and save many lives," said Dr Robert Lucien Jean-Claude Kargougou, Burkina Faso's Minister of Health and Public Hygiene.

"We are committed to ensuring that the vaccine reaches eligible children, and we encourage all parents to take advantage of this life-saving intervention." "The government remains committed to strengthening other malaria prevention and control measures". “The arrival of the vaccines marks a historic step in our efforts to control malaria, which remains a major public health threat in the country. We’re grateful for the support of our partners with whom we’re committed to working to ensure that the vaccines reach the children and protect them from this deadly disease,” said Hon Dr Malachie Manaouda, Minister of Public Health of Cameroon. “As we vaccinate children, the government also remains committed to strengthening other prevention and control measures so that we can lower the huge burden of malaria.”

"The introduction of the RTS,S/AS01 malaria vaccine in Liberia marks a significant milestone in our efforts to combat malaria which is the leading cause of infant and under five mortality. This vaccine has the potential to save many lives and reduce the burden of this disease on our population,” said Hon Dr Wilhemina Jallah, Minister of Health of Liberia. “We are committed to ensuring that the vaccine reaches those who need it the most, and we encourage all parents of eligible children to take advantage of this life-saving intervention."

“Today’s announcement is welcome news given that malaria remains a primary cause of childhood illness and death in sub-Saharan Africa,” said Peter Sands, Executive Director of the Global Fund. “Using this vaccine, appropriately prioritized in the context of existing tools, could help prevent malaria and save tens of thousands of young lives each year.”

“I am thrilled that the RTS,S vaccine, which is the result of so many years of work by PATH, GSK, and African partners, has arrived in Cameroon and will soon reach even more children at risk of malaria,” said Nikolaj Gilbert, President and CEO of PATH. “All of us at PATH appreciate the efforts by Gavi, UNICEF, and WHO to accelerate access to this life-saving vaccine.”

“As the scale up of the world’s first malaria vaccine begins, the U.S. President’s Malaria Initiative congratulates the Gavi Secretariat and Ministries of Health throughout Africa,” said Dr David Walton, U.S. Global Malaria Coordinator. “This moment has been decades in the making and the U.S. has supported malaria vaccine development for decades. To maximize the benefit of this lifesaving tool, we will enthusiastically continue our partnerships with Ministries of Health and national, regional, and global partners to achieve a world in which no child dies from a mosquito bite.”

Notes to editors

Please explore links below for photos and multimedia content related to malaria vaccines, including photos and footage of the vaccines on the move from the GSK factory, and arriving in Cameroon.  Additional content will continue to be added in the coming days and weeks.

• Gavi https://media.gavi.org/?c=1923733&k=9e5596b28b
• UNICEF https://weshare.unicef.org/Package/2AM408LMATVA
• WHO photos https://photos.hq.who.int/galleries/1596/rtsss-vaccines-for-press-release and video https://we.tl/t-K5IOxBgv6m

For further information about these shipments, please see “Frequently Asked Questions". 

About Gavi, the Vaccine Alliance

Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate more than half the world’s children against some of the world’s deadliest diseases. The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. View the full list of donor governments and other leading organisations that fund Gavi’s work here. 

Since its inception in 2000, Gavi has helped to immunise a whole generation – over 1 billion children – and prevented more than 17.3 million future deaths, helping to halve child mortality in 78 lower-income countries. Gavi also plays a key role in improving global health security by supporting health systems and outbreak response as well as funding global stockpiles for Ebola, cholera, meningococcal and yellow fever vaccines. After two decades of progress, Gavi is now focused on protecting the next generation, above all the zero-dose children who have not received even a single vaccine shot. The Vaccine Alliance employs innovative finance and the latest technology – from drones to biometrics – to save lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency.

Learn more at  www.gavi.org 

About UNICEF

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children, visit www.unicef.org. Find out more about UNICEF’s work on the COVID-19 vaccines here, or about UNICEF’s work on immunization here.

About WHO

Dedicated to the well-being of all people and guided by science, the World Health Organization leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life. We are the UN agency for health that connects nations, partners and people on the front lines in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to promote health, keep the world safe and serve the vulnerable. www.who.int   

With heavy hearts, WHO announces the death of one of our staff in Gaza, in the occupied Palestinian territory. Dima Abdullatif Mohammed Alhaj, 29 years old, had been with WHO since December 2019. She worked as a patient administrator at the Limb Reconstruction Centre, a critical part of the WHO Trauma and Emergency Team.

Dima died today when her parents’ house in southern Gaza—where she had evacuated to from Gaza City—was bombed. She was tragically killed alongside her husband, their six-month old baby boy, and her two brothers. Reportedly, over 50 family and community members sheltering in the same house also died.  

Dima had a bachelor’s degree in Environmental and Earth Sciences from the Islamic University of Gaza, and continued to study and work on environmental issues and health.  She was a master’s student at Glasgow University, Scotland, UK, as part of the Erasmus exchange program from 2018-2019.  

On Women’s Day 2022, Dima said in a WHO social media post that she was proud of her work because “it contributes to giving people hope and a new lease on life.”  

Dr Rik Peeperkorn, the WHO representative in the occupied Palestinian territory said “she was a wonderful person with a radiant smile, cheerful, positive, respectful. She was a true team player. Her work was crucial, and she had been requested to take on even more responsibilities to support the Gaza suboffice and team. This is such a painful loss for all of us. We share our deepest condolences with her mother and father (a long-serving medical specialist in Gaza), her family, and her many friends.” 

The humanitarian community and UN family have lost other members since 7 October. MSF today lost two doctors. UNRWA has lost 108 colleagues. These are not just numbers, but people who were working so that others could have a better life.  

The death of Dima and her family is another example of the senseless loss in this conflict. Civilians have died in their homes, at their workplaces, while evacuating, while sheltering in schools, while being cared for in hospitals.    

When will it stop?    

We plead again with all those who hold in their hands the power to end this conflict to do so.    

All of the WHO stands alongside Dima’s family and colleagues in the occupied Palestinian territory, the Regional Office for the Eastern Mediterranean, and across the organization to mourn her loss.   

A second WHO-led joint UN mission, working in collaboration with the Palestine Red Crescent Society, earlier today evacuated 31 babies from Al-Shifa Hospital in northern Gaza, to a hospital in southern Gaza. The severely ill babies were transported in 6 ambulances supplied and staffed by the Palestine Red Crescent.  Other mission members included UN Mine Action, UNICEF and UNRWA. The mission was once again assessed as high-risk, due to the active combat taking place in close proximity to the hospital. 

These premature and low birthweight babies had earlier been moved from the neonatal unit in Al-Shifa to a safer area in the hospital, due to lack of electricity to run their life support, and security risks in the hospital. Yesterday and last night, two babies died before the evacuation could take place. (Note, there were 33 babies under care yesterday, according to a Ministry of Health update.)  

The babies were successfully transported to the neonatal intensive care unit at Al-Helal Al-Emarati Maternity Hospital in southern Gaza, where they are being assessed and stabilized. Doctors there say all the babies are fighting serious infections due to lack of medical supplies and impossibility to continue infection control measures in Al-Shifa Hospital. Eleven are in critical condition.  

Sadly, none of the infants were accompanied by family members, as the Ministry of Health has only limited information, and is not currently able to find close family members. Six health workers and 10 of their family members, who had been sheltering at the hospital, were also evacuated.   

The evacuation, which was requested by health workers and patients during the joint mission yesterday, became necessary as Al-Shifa Hospital is no longer able to function due to a lack of clean water, fuel, medical supplies, food, other essential items and the intense hostilities. WHO remains deeply concerned about the safety and health needs of patients and health workers who remain at Al-Shifa Hospital, and in the few partially functional hospitals in the north that face imminent closure.   

Al-Shifa Hospital, previously the largest and most advanced referral hospital in Gaza, together with other hospitals, must be fully restored to provide urgently needed health services in Gaza.  

Today’s mission was led by senior WHO staff, including a medical specialist and a doctor, and representatives from UNICEF, UNMAS and UNRWA as noted above. It included medical staff from the Palestine Red Crescent Society, along with their ambulances. WHO is grateful for their partnership, and the support of the rest of the UN, working together as One UN. 

The complex and high-risk operation, occurring in an active conflict zone, follows an assessment mission yesterday, 18 November, which included public health experts, logistics specialists, and security staff from OCHA, UNDSS, UNMAS/UNOPS, UNRWA and WHO. Today’s mission was deconflicted with the Israel Defense Forces and with the defacto authorities.  

There remain over 250 patients and 20 health workers at Al-Shifa, who all request immediate evacuation. Planning is ongoing to evacuate the remaining patients, their families and the health-care workers. Given the complex security and logistics constraints, these evacuations will take several days to complete. Priority will be given to the 22 dialysis patients and 50 patients with spinal injuries. WHO reaffirms its respect for the dedication, professionalism, humanity and courage of the health staff who have continued to care for their patients under unimaginably difficult conditions. 

WHO reiterates its plea for collective efforts to bring an end to the hostilities and humanitarian catastrophe in Gaza.  We call for an immediate ceasefire, the sustained flow of humanitarian assistance at scale, unhindered humanitarian access to all of those in need, the unconditional release of all hostages—many of whom have serious medical needs—and the cessation of attacks on health care and other vital infrastructure.   

Earlier today, a joint UN humanitarian assessment team led by WHO accessed Al-Shifa Hospital in northern Gaza to assess the situation on the ground, conduct a rapid situational analysis, assess medical priorities and establish logistics options for further missions. The team included public health experts, logistics officers and security staff from OCHA, UNDSS, UNMAS/UNOPS, UNRWA and WHO. 

The mission was deconflicted with the Israel Defense Forces (IDF) to ensure safe passage along the agreed route. However, this was a high-risk operation in an active conflict zone, with heavy fighting ongoing in close proximity to the hospital.

Earlier in the day, the IDF had issued evacuation orders to the remaining 2500 internally displaced people who had been seeking refuge on the hospital grounds. They, along with a number of mobile patients and hospital staff, had already vacated the facility by the time of the team's arrival. 

Due to time limits associated with the security situation, the team was able to spend only one hour inside the hospital, which they described as a “death zone,” and the situation as “desperate.” Signs of shelling and gunfire were evident. The team saw a mass grave at the entrance of the hospital and was told more than 80 people were buried there.

Lack of clean water, fuel, medicines, food and other essential aid over the last 6 weeks have caused Al-Shifa Hospital – once the largest, most advanced and best equipped referral hospital in Gaza – to essentially stop functioning as a medical facility. The team observed that due to the security situation, it has been impossible for the staff to carry out effective waste management in the hospital. Corridors and the hospital grounds were filled with medical and solid waste, increasing the risk of infection. Patients and health staff with whom they spoke were terrified for their safety and health, and pleaded for evacuation. Al-Shifa Hospital can no longer admit patients, with the injured and sick now being directed to the seriously overwhelmed and barely functioning Indonesian Hospital.

There are 25 health workers and 291 patients remaining in Al-Shifa, with several patient deaths having occurred over the previous 2 to 3 days due to the shutting down of medical services. Patients include 32 babies in extremely critical condition, 2 people in intensive care without ventilation, and 22 dialysis patients whose access to life-saving treatment has been severely compromised. The vast majority of patients are victims of war trauma, including many with complex fractures and amputations, head injuries, burns, chest and abdominal trauma, and 29 patients with serious spinal injuries who are unable to move without medical assistance. Many trauma patients have severely infected wounds due to lack of infection control measures in the hospital and unavailability of antibiotics.  

Given the current state of the hospital, which is no longer operational or admitting new patients, the team was requested to evacuate health workers and patients to other facilities. WHO and partners are urgently developing plans for the immediate evacuation of the remaining patients, staff and their families. Over the next 24–72 hours, pending guarantees of safe passage by parties to the conflict, additional missions are being arranged to urgently transport patients from Al-Shifa to Nasser Medical Complex and European Gaza Hospital in the south of Gaza. However, these hospitals are already working beyond capacity, and new referrals from Al-Shifa Hospital will further strain overburdened health staff and resources.  

WHO is deeply concerned about the safety and health needs of patients, health workers and internally displaced people sheltering at the few remaining partially functional hospitals in the north, which are facing the risk of closure due to a lack of fuel, water, medical supplies and food, and the intense hostilities. Immediate efforts must be made to restore the functionality of Al-Shifa and all other hospitals to provide urgently needed health services in Gaza.

WHO reiterates its plea for collective efforts to bring an end to the hostilities and humanitarian catastrophe in Gaza.  We call for an immediate ceasefire, the sustained flow of humanitarian assistance at scale, unhindered humanitarian access to all of those in need, the unconditional release of all hostages, and the cessation of attacks on health care and other vital infrastructure. The extreme suffering of the people of Gaza demands that we respond immediately and concretely with humanity and compassion.

World leaders, cervical cancer survivors, advocates, partners, and civil society are coming together today to mark the third Cervical Cancer Elimination Day of Action. The Initiative, which marked the first time Member States adopted a resolution to eliminate a noncommunicable disease, has continued to gain momentum, and this year's commemoration promises to be a beacon of hope, progress, and renewed commitment from nations around the world.

“In the last three years, we have witnessed significant progress, but women in poorer countries and poor and marginalized women in richer countries still suffer disproportionately from cervical cancer,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “With enhanced strategies to increase access to vaccination, screening and treatment, strong political and financial commitment from countries, and increased support from partners, we can realize our vision for eliminating cervical cancer.”

Governments and communities are leading the way by declaring commitment and developing strategies to eliminate cervical cancer and countries around the world are rallying behind WHO’s call to action on 17 November.

• Australia is on target to be among the first countries in the world to eliminate cervical cancer, which the country anticipates to achieve in the next 10 years.
• In Benin, the First Lady, Her Excellency, Claudine Talon will host an HPV screening campaign.
• The Democratic Republic of the Congo will join the day of action for the first time with a march across Kinshasa calling for cervical cancer elimination, organized by the Ministry of Health and women’s associations.
• In Norway, researchers have recently reported finding no cases of cervical cancer caused by the human papillomavirus (HPV) in 25-year-olds, the first cohort of women who were offered the vaccine as children through the national vaccination programme.
• Indonesia announced this week a declaration committing to reach the 90-70-90 targets for cervical cancer elimination through the national cervical cancer elimination plan (2023 to 2030).
• Japan is lighting up the country in teal to mark the day, and honour two years of the re-introduction of the HPV vaccine in the country.
• In Singapore, the Alliance for Active Action Against HPV (A4HPV) will host a spin cycling event to help raise awareness.
• In the United Kingdom, England’s National Health Service (NHS) pledged this week to eliminate cervical cancer by 2040.

Strong progress on HPV vaccination

Since the launch of the Global strategy to accelerate the elimination of cervical cancer as a public health problem three years ago, a further 30 countries, including countries with large populations and cervical cancer burden such as Bangladesh, Indonesia and Nigeria, introduced the HPV vaccine. As of today, 140 countries have introduced HPV vaccine into national immunization programmes.

The global HPV vaccination coverage of girls that received at least one dose of HPV vaccine has increased to 21% in 2022 – exceeding the pre-pandemic levels for the first time. If this rate of progress is maintained the world would be on track to meet the 2030 target to make HPV vaccines available to all girls everywhere.

WHO, in collaboration with GAVI and other partners, has initiated systematic efforts to catch-up vaccinations for girls who missed HPV vaccination as a result of pandemic disruptions and to revitalize HPV vaccination programmes towards reaching the 90% coverage target. 

In Nigeria, for example, HPV vaccine was introduced into the routine immunization programme with a single-dose schedule in October 2023. The country aims to vaccinate 7.7 million girls – the largest number in a single round of HPV vaccination in the region.

Weak progress on screening and treatment 

Countries have invested to improve access to screening all over the world. This year, together with Unitaid and its implementing partners, Ministries of Health in 14 low- and middle-income countries reached a milestone of screening over a million women.

In most countries, those diagnosed with cervical cancer still need better access to surgery, radiotherapy, chemotherapy and palliative care.  Still, only 65% of countries include cervical cancer screening services and 69% include radiotherapy for treatment of cervical cancer in the health benefit packages as part of universal health coverage schemes.

However, pioneering country experiences showcase progress that is being made on the ground:  

• El Salvador released new screening targets to achieve 70% coverage by 2030 and to provide access to treatment for 90% of women with cervical disease. The Ministry of Health now offers services in all 75 screening facilities throughout the country. The country also made progress on the treatment of precancerous lesions; and
• Bhutan, which was among the Member States that raised this agenda to the WHO Executive Board in 2019, continues to make remarkable strides in cervical cancer prevention and treatment. The country recently reported that it has screened 90.8% of eligible women for cervical pre-cancer and cancer through its health flagship project, of these, 92% of women with cervical pre-cancer were treated and all women with invasive cancer were managed.

To enhance screening quality, reduce costs and broaden access to health-care services, WHO now endorses HPV testing as the preferred method for cervical cancer screening. This includes support for self-sampling, which makes screening even more convenient. In addition, WHO prequalified a fourth HPV test in June 2023, providing an additional option for countries seeking to implement advanced screening methods to identify patients requiring treatment more effectively.

Notes for editors:

To eliminate cervical cancer, all countries must reach and maintain an incidence rate of below 4 per 100 000 women. Achieving that goal rests on three key pillars and their corresponding targets. The three key pillars are:

• 90% of girls fully vaccinated with the HPV vaccine by the age of 15;
• 70% of women screened using a high performance test by the age of 35, and again by the age of 45;
• 90% of women with pre-cancer treated and 90% of women with invasive cancer managed.

Each country should meet the 90–70–90 targets by 2030 to get on the path to eliminate cervical cancer within the next century. 

^{Mr Ingo Behnel, Ambassador Dr Katharina Stasch, Dr Gesa Miehe-Nordmeyer and Dr Catharina Boehme. ©WHO/Lindsay Mackenzie}

In a meeting on 3 November, Germany reaffirmed its support for WHO as the Organization takes on wide-ranging global health challenges and advocated prompt action to establish a pandemic accord – an international agreement that would pave the way for better collaboration on emergencies, science and research.

A German delegation that included Dr Katharina Stasch, UN Ambassador in Geneva; Ingo Behnel, Director-General of European and International Policy Issues at the German Ministry of Health; and Dr Gesa Miehe-Nordmeyer, Director General of the German Chancellery’s Department for Social, Health, Labor Market, Environment and Social Policy, met with WHO representatives including Assistant Director-General Dr Catharina Boehme, Emergencies Programme Executive Director Dr Michael Ryan and Chief Scientist Dr Jeremy Farrar.

During the meeting Germany also reaffirmed its support for flexible, sustainable funding to carry out WHO’s 14th General Programme of Work for 2025-28 (GPW14) towards vital objectives such as withstanding pandemics, responding to health emergencies, and confronting the threats to health posed by climate change and drug-resistant infections.

“Germany is very supportive of WHO, and also supportive of the pandemic agreement,” Dr Miehe-Nordmeyer said, adding that Member States have a clear window of opportunity to establish the pandemic agreement in time for the World Health Assembly next May.

Dr Ryan praised Germany for having been a “huge supporter of global health security over many years,” cited the country’s voluntary contributions to WHO’s Contingency Fund for Emergencies, its support during the COVID-19 pandemic for technology, science, innovation and operations, and for its hosting of the World Health Summit, a leading strategic forum for global health advocacy.

Germany is the largest donor to the WHO Contingency Fund for Emergencies (CFE), which enables WHO to respond without delay to health emergencies worldwide.

Dr Ryan called the Germany-supported WHO Hub for Pandemic and Epidemic Intelligence in Berlin “a physical manifestation of Germany’s commitment” to global health security. The Hub was launched in 2021 to provide the world with better data and analytics to detect and respond to health emergencies.

^{@WHO/Lindsay Mackenzie}

At the meeting Germany and WHO signed funding agreements to support emergency responses in Libya (€1 million) and Yemen (€3 million).

An afternoon session with WHO Chief Scientist Jeremy Farrar touched on embedding science and research action across the Organization, helping countries develop ecosystems for health research and science, and supporting the international community with a digitalization agenda.

Dr Farrar also discussed WHO’s aim to add WHO collaborating centres, particularly in the Global South, and branch out into new research areas. WHO has 847 collaborating centers in more than 80 countries.

“We’d like to see collaborating centres on digital, on A.I., on trust, or on horizon scanning for the future of science,” Dr Farrar said. “We would like to work more closely with the collaborating centres and for them to see themselves very much as a part of WHO,” Dr Farrar said.