The devastating human, economic, and social cost of COVID-19 has highlighted the urgent need for coordinated action to build stronger health systems and mobilize additional resources for pandemic prevention, preparedness, and response (PPR).
The World Bank’s Board of Executive Directors today approved the establishment of a financial intermediary fund (FIF) that will finance critical investments to strengthen pandemic PPR capacities at national, regional, and global levels, with a focus on low- and middle-income countries. The fund will bring additional, dedicated resources for PPR, incentivize countries to increase investments, enhance coordination among partners, and serve as a platform for advocacy. The FIF will complement the financing and technical support provided by the World Bank, leverage the strong technical expertise of WHO, and engage other key organizations.
Developed with leadership from the United States, and from Italy and Indonesia as part of their G20 Presidencies, and with broad support from the G20 and beyond, over US$1 billion in financial commitments have already been announced for the FIF, including contributions from the United States, the European Union, Indonesia, Germany, the United Kingdom, Singapore, the Gates Foundation and the Wellcome Trust.
“I’m pleased by the broad support from our shareholders for a new Financial Intermediary Fund at the World Bank,” World Bank Group President David Malpass said. “The World Bank is the largest provider of financing for PPR with active operations in over 100 developing countries to strengthen their health systems. The FIF will provide additional, long-term funding to complement the work of existing institutions in supporting low- and middle-income countries and regions to prepare for the next pandemic.”
“Access to financing for pandemic prevention and preparedness is crucial. COVID-19 has exposed major gaps in preparedness capacities, which the Financial Intermediary Fund can address in a coherent manner, as part of the global architecture for health emergency preparedness and response,” said WHO Director General Dr Tedros Adhanom Ghebreyesus. “WHO will play a central role in the FIF, providing technical leadership for its work in close collaboration with the World Bank to realize this ambitious vision.”
The goal of the FIF is to provide financing to address critical gaps in pandemic PPR to strengthen country capacity in areas such as disease surveillance, laboratory systems, health workforce, emergency communication and management, and community engagement. It can also help address gaps in strengthening regional and global capacity, for example, by supporting data sharing, regulatory harmonization, and capacity for coordinated development, procurement, distribution and deployment of countermeasures and essential medical supplies.
In the coming weeks, the Bank and WHO will work closely with donors and other partners to develop the detailed scope and design of the FIF. The ongoing discussions will be informed by the extensive inputs provided through stakeholder engagement. The goal is to launch the FIF in fall 2022.
Drawing on its financial and legal platform, program management and operational expertise, and experience in managing FIFs, the World Bank will serve as the FIF’s Trustee and host the Secretariat, which will be staffed by the Bank and WHO. Drawing on its technical expertise, the WHO will also lead on supporting and coordinating the work of the FIF’s technical advisory panel. Implementing entities for FIF-financed projects in addition to the World Bank Group are expected to include WHO, other multilateral development banks and United Nations agencies, as well as other organizations. The FIF will build on the existing global health architecture for PPR, within the context of the International Health Regulations (IHR 2005) and associated monitoring mechanisms, with a central technical role for WHO.
Key principles of the FIF will be to complement the work of existing institutions that provide international financing for PPR, drawing on their comparative advantages and catalyzing funding from private, philanthropic, and bilateral sources. Further, the FIF is expected to incentivize countries to invest more in PPR, serve as an integrator of PPR efforts, and have the flexibility to work through a variety of existing institutions and adjust over time as needs and the institutional landscape evolve. The FIF’s structure will combine inclusivity and agility and operate with high standards of transparency and accountability.
WHO is scaling up its operations in eastern Africa as the region faces acute food insecurity caused by conflict, extreme weather events – including the worst drought in 40 years – induced by climate change, rising international food and fuel prices and the impact of the pandemic.
Over 80 million people in the eastern African region are food insecure and resorting to desperate measures to feed themselves and their families. Acute malnutrition is high, especially among children.
As malnutrition increases, the health needs in the region are mounting, especially among children, and clean water is becoming scarce. As people leave their homes in search of food, they can no longer access health services, and become more at risk from disease outbreaks.
“The cost of inaction is high,” said Dr Ibrahima Socé Fall, WHO Assistant Director-General for Emergency Response. “While the clear priority is to prevent people from starving, we must simultaneously strengthen our health response to prevent disease and save lives. Even one life lost from a vaccine-preventable disease, diarrhoea, or medical complications from malnutrition in today’s world is one life too many.”
Dr Fall was speaking in Nairobi where WHO convened a two-day meeting [26-27 June 2022] to plan its response across the seven countries affected by the health emergency – Djibouti, Ethiopia, Kenya, Somalia, South Sudan, Sudan and Uganda – and coordinate with other UN agencies and partners.
WHO’s emergency response is focused on ensuring affected populations can access essential health services, treating sick children with severe malnutrition, and preventing, detecting and responding to infectious disease outbreaks.
WHO is setting up a hub in Nairobi, from where it will coordinate the response and organize the delivery of life-saving medical supplies to where they are needed most. These supplies include medicines, vaccines, as well the medicines and equipment needed to treat children who are severely malnourished. Other than providing these critical supplies, WHO is working with ministries of health in the affected countries to set up robust disease surveillance systems to be able to quickly detect and respond to disease outbreaks.
Note to editors
The World Health Organization (WHO) welcomes the political declaration to be adopted by Member States during the High-level Meeting of the UN General Assembly on Global Road Safety. It commits to cut road traffic deaths and injuries by 50% by 2030, a milestone for road safety and sustainable mobility.
The meeting takes place on 30 June – 1 July 2022 under the theme “The 2030 horizon for road safety: securing a decade of action and delivery”.
Road safety affects everyone. We step from our homes every day onto roads that take us to our jobs, schools and to meet our vital daily needs. Yet our transport systems remain far too dangerous. No death should be acceptable on our roads. The future of mobility should promote health and well-being, protect the environment and benefit all,” said Dr Tedros Adhanom Ghebreyesus, Director-General, WHO. “It will require transformative leadership from the highest levels of government to act on the Political Declaration to make that vision a reality.”
Worldwide, road crashes currently kill around 1.3 million people each year – more than 2 every minute, and more than 90% occur in low- and middle-income countries. Crashes are the biggest killer of children and young people globally. More than 50 million people have died on the world’s roads since the invention of the automobile, more than the number of deaths in the First World War or in some of the worst global epidemics.
WHO is the lead agency for road safety in the United Nations and supported the President of the UN General Assembly in preparing this High-Level Meeting in collaboration with other UN agencies.
Through the declaration governments from around the world commit to provide leadership and coordination at the highest level of government to ensure all parts of the society are included to act on road safety and commit to boost policies and actions to reduce deaths and injuries. The declaration calls for the development and funding of national and local plans with clear targets and funding.
“Road traffic deaths upend countless lives and cost countries around 3% of GDP each year,” notes Dr Etienne Krug, Director of the Department for Social Determinants of Health, WHO. “This is an unacceptable price to pay for mobility. Putting safety at the heart of our mobility systems is an urgent health, economic and moral imperative. Let’s work together to scale up what works, save lives and build streets for life.”
In September 2020, the UN General Assembly adopted a resolution to proclaim the Decade of Action for Road Safety 2021–2030. WHO and the UN regional commissions, in cooperation with other partners in the UN Road Safety Collaboration, have developed a Global Plan for the Decade of Action, which was released in October 2021.
The plan calls for continued improvements in the design of roads and vehicles, enhancement of laws and law enforcement, and provision of timely, life-saving emergency care for the injured. In addition, it promotes healthy and environmentally sound modes of transport.
It also highlights that responsibility for road safety stretches far beyond health and transport. Urban planners and engineers must prioritize safety as a core value in all transport infrastructure while businesses can influence and contribute to strengthening road safety by applying safety-first principles to their entire value chains.
Countries and cities guided by the plan are seeing dramatic reductions in deaths. For example, the Colombian capital of Bogota halved deaths over 10 years through a set of integrated actions, including wide-ranging technical improvements and regulatory reforms that were driven by strong leadership.
The meeting will take place in New York on 30 June 2022, at 10:00 EST. The event will be broadcasted on UN Web TV.
The World Health Summit (WHS) and the World Health Organization (WHO) join forces to organize the 2022 edition of one of the world's leading international, inclusive and inter-sectoral global health conference to bring global health actors closer to setting agenda for a healthier future.
Registration for on-site participation is now open
The Summit will take place on 16-18 October 2022 in Berlin, Germany. Participants will focus on “Making the Choice for Health” by reflecting on pressing topics such as Investment for Health and Well-Being, Climate Change and Planetary Health, Architecture for Pandemic Preparedness, Digital Transformation for Health, Food Systems and Health, Health Systems Resilience and Equity, and Global Health for Peace.
See more information about the programme and the confirmed speakers here
WHS 2022 is a milestone in a long-term collaboration, as WHO has been a strategic partner of the World Health Summit since its start.
WHS 2022 aims to strengthen exchange, stimulate innovative solutions to health challenges, foster global health as a key political issue and promote the global health debate in the spirit of the UN Sustainable Development Goals: SDG 17 “Partnership for the Goals”
For more information, visit: https://www.worldhealthsummit.org
For media inquiries, follow: https://www.worldhealthsummit.org/whs-2022/media-center.html
More information available here
The WHO Director-General has the pleasure of transmitting the Report of the Meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the multi-country monkeypox outbreak, held on 23 June 2022, from 12:00 to 17:00 Geneva time (CEST). The WHO Director-General concurs with the advice offered by the IHR Emergency Committee regarding the multi-country monkeypox outbreak and, at present, does not determine that the event constitutes a Public Health Emergency of International Concern (PHEIC).
Since 11 May 2022, the WHO Secretariat alerted the States Parties to the IHR in relation to this event, through postings on the Event Information Site (a secured platform established by the WHO Secretariat for information sharing with States Parties to the IHR). These postings aimed to raise awareness about the extent of the outbreak, inform readiness efforts, and provide access to technical guidance for immediate public health actions recommended by the WHO Secretariat.
Convening an IHR Emergency Committee signals an escalation of the level of alert for States Parties to the IHR and the international public health community, and it represents a call for intensified public health actions in response to this event.
The WHO Director-General is taking the opportunity to express his most sincere gratitude to the Chair, Vice-Chair, and Members of the IHR Emergency Committee, as well as to its Advisers.
Proceedings of the meeting
Members of and Advisers to the Emergency Committee were convened in person (Chair and Vice-Chair) and by teleconference, via Zoom.
The WHO Secretariat welcomed the participants. The Representative of the Office of Legal Counsel briefed the Members and Advisers on their roles and responsibilities and identified the mandate of the Emergency Committee under the relevant articles of the IHR. The Ethics Officer from the Department of Compliance, Risk Management, and Ethics provided the Members and Advisers with an overview of the WHO Declaration of Interests process. The Members and Advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or actual conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the Committee. Each Member and Adviser was surveyed. No conflicts of interest were identified.
The Principal Legal Officer then facilitated the election of officers of the Committee, in accordance with the rules of procedures and working methods of the Emergency Committee. Dr Jean-Marie Okwo-Bele was elected as Chair of the Committee, Professor Nicola Low as Vice-Chair, and Dr Inger Damon as Rapporteur, all by acclamation. The meeting was handed over to the Chair who introduced the objectives of the meeting: to provide views to the WHO Director-General on whether the event constitutes a public health emergency of international concern, and if so, to provide views on potential temporary recommendations.
The WHO Director-General joined by video and welcomed the participants, welcoming the Committee’s advice on the event.
The WHO Secretariat presented the global epidemiological situation, highlighting that since the beginning of May 2022, 3040 cases have been reported to WHO from 47 countries. Transmission is occurring in many countries that have not previously reported cases of monkeypox, and the highest numbers of cases are currently reported from countries in the WHO European Region. Initial cases of monkeypox, detected in several countries in different WHO Regions, had no epidemiological links to areas that have historically reported monkeypox, suggesting that undetected transmission might have been ongoing for some time in those countries. The majority of confirmed cases of monkeypox are male and most of these cases occur among gay, bisexual and other men who have sex with men in urban areas and are clustered social and sexual networks.
The clinical presentation is often atypical, with few lesions localized to the genital, perineal/perianal or peri-oral area that do not spread further, and an asynchronous rash that appears prior to the development of a prodromal phase (i.e. lymphadenopathy, fever, malaise). There have been few hospitalizations to date, and one death in an immunocompromised individual was reported. Some preliminary research has estimated that the reproduction number (R0) to be 0.8 and, among cases who identify as men who have sex with men, to be greater than 1. The mean incubation period among cases reported is estimated at 8.5 days, ranging from 4.2 to 17.3 days (based on 18 cases in Netherlands). The mean serial interval is estimated at 9.8 days (95% CI 5.9-21.4 day, based on 17 case-contact pairs in the United Kingdom). To date, 10 cases of infection have been reported among health care workers, of which at least nine were non-occupational.
Representatives of Canada, the Democratic Republic of the Congo, Nigeria, Portugal, Spain, and the United Kingdom updated the Committee on the epidemiological situation in their countries and the current response efforts.
The WHO Secretariat then presented the draft “WHO Strategic Plan for the Containment of the Multi-Country Monkeypox Outbreak.” The plan emphasized that a strengthened, agile, and collaborative approach must be adopted, with a particular focus on raising awareness and empowering affected population groups to adopt safe behaviors and protective measures based on the risks they face, and on stopping further spread of monkeypox within those population groups.
The WHO Secretariat also presented their technical guidance, offered to countries in support of their efforts in responding to this event, and revolving around: enhanced surveillance; isolation of cases; contact identification and monitoring; strengthened laboratory and diagnostic capacities; clinical management and infection prevention and control measures within health care and community settings, including care pathways; engagement with affected population groups and effective communication to avoid stigmatization; robust care pathways, including the use of medical countermeasures under collaborative research frameworks, using standardized data collection tools to rapidly increase evidence generation on efficacy and safety of these products.
Following the presentations session, the Committee reconvened in a closed meeting to examine the questions in relation to whether the event constitutes a PHEIC or not, and if so, to consider the Temporary Recommendations, drafted by the WHO Secretariat in accordance with IHR provisions. At the request of the Chair, the WHO Secretariat reminded the Committee Members of their mandate and recalled the definition of a PHEIC under the IHR: an extraordinary event, which constitutes a public health risk to other States through international transmission, and which potentially requires a coordinated international response.
The Committee discussed key issues related to the outbreak, including: current observations of plateauing or potential downward trends in case numbers in some of the countries experiencing outbreak early on; the need for further understanding of transmission dynamics; the challenges related to contact tracing, particularly because of anonymous contacts, and potential links to international gatherings and LGBTQI+ Pride events conducive for increased opportunities for exposure through intimate sexual encounters; the need for continuous evaluation of interventions that appear to have had an impact on transmission; the identification of key activities for risk communications and community engagement, working in close partnership with affected communities to raise awareness about personal protective measures and behaviours during upcoming events and gatherings; the need to evaluate the impact of different interventions, including the evaluation of vaccination strategies implemented by certain countries in response to the outbreak, and the availability and equity in access and licensing of medical countermeasures.
The Committee was concerned about the potential for exacerbation of the stigmatization and infringement of human rights, including the rights to privacy, non-discrimination, physical and mental health, of affected population groups, which would further impede response efforts. Additionally, for the protection of public health, some Members of the Committee expressed the views that laws, policies and practices that criminalize or stigmatize consensual same-sex behaviour by state or non-state actors create barriers to accessing health services and may also hamper response interventions.
Additional knowledge gaps and areas of uncertainty, for which more information is needed rapidly to support a more comprehensive assessment of the public health risk of this event, include: transmission modes; full spectrum of clinical presentation; infectious period; reservoir species and potential for reverse zoonoses; the possibility of virus; and access to vaccines and antivirals and their efficacy in humans.
The Committee recognized that monkeypox is endemic in parts of Africa, where it has been noted to cause disease, including fatalities, for decades, and that the response to this outbreak must serve as a catalyst to increase efforts to address monkeypox in the longer term and access to essential supplies worldwide.
Conclusions and advice
The Committee noted that many aspects of the current multi-country outbreak are unusual, such as the occurrence of cases in countries where monkeypox virus circulation had not been previously documented, and the fact that the vast majority of cases is observed among men who have sex with men, of young age, not previously immunized against smallpox (knowing that vaccination against smallpox is effective in protecting against monkeypox as well). Some Members suggested that, given the low level of population immunity against pox virus infection, there is a risk of further, sustained transmission into the wider population that should not be overlooked. The Committee also stressed that monkeypox virus activity has been neglected and not well controlled for years in countries in the WHO African Region.
The Committee also noted that the response to the outbreak requires collaborative international efforts, and that such response activities have already started in a number of high-income countries experiencing outbreaks, although there has been insufficient time to have evaluated the effectiveness of these activities.
While a few Members expressed differing views, the committee resolved by consensus to advise the WHO Director-General that at this stage the outbreak should be determined to not constitute a PHEIC.
However, the Committee unanimously acknowledged the emergency nature of the event and that controlling the further spread of outbreak requires intense response efforts. The Committee advised that the event should be closely monitored and reviewed after a few weeks, once more information about the current unknowns becomes available, to determine if significant changes have occurred that may warrant a reconsideration of their advice.
The Committee considered that the occurrence of one or more of the following should prompt a re-assessment of the event: evidence of an increase in the rate of growth of cases reported in the next 21 days, both among and beyond the population groups currently affected; occurrence of cases among sex workers; evidence of significant spread to and within additional countries, or significant increases in number of cases and spread in endemic countries; increase in number of cases in vulnerable groups, such as immunosuppressed individuals, including with poorly controlled HIV infection, pregnant women, and children; evidence of increased severity in reported cases (i.e. increased morbidity or mortality and rates of hospitalization; evidence of reverse spillover to the animal population; evidence of significant change in viral genome associated with phenotypic changes, leading to enhanced transmissibility, virulence or properties of immune escape, or resistance to antivirals, and reduced impact of countermeasures; evidence of cluster of cases associated with clades of greater virulence detected in new countries outside West and Central African countries.
Finally, the Committee advised the WHO Director-General that countries, in the spirit of Article 44 of the IHR, should collaborate with each other and with WHO in providing the required assistance through bilateral, regional or multilateral channels, and should follow the guidance provided by WHO (see Monkeypox).
A new app for mobile phones that provides localized information on ultraviolet (UV) radiation levels has been launched by the World Health Organization (WHO), the World Meteorological Organization (WMO), the United Nations Environment Programme (UNEP) and the International Labour Organization (ILO). The SunSmart Global UV app provides five-day UV and weather forecasts at searchable locations. It highlights time slots when sun protection is required with the aim of helping people around the world know when to use sun protection, in an effort to reduce the global burden of skin cancer and UV-related eye damage.
The SunSmart Global UV app is available free of charge at both the Apple App and Google Play stores. It provides personalized options so that users can take actions to protect prolonged, excessive UV exposure, a major cause of skin cancer and other UV related diseases. The app allows the inclusion of national and local data streams and adaptation to multiple languages – it is currently available in Chinese, English, French, German, Russian, Dutch and Spanish.
“Evidence shows that overexposure to UV is the major cause of skin cancer. So it’s vital for people to know when and how to protect themselves,” said Dr Maria Neira, WHO Director, Department of Environment, Climate Change and Health. ”We encourage everyone to use the application to protect themselves and their children, and to make this a daily habit.”
Globally, it is estimated that over 1.5 million cases of skin cancer (melanoma and non-melanoma combined) were diagnosed globally in 2020. During the same period, more than 120,000 people across the world lost their lives to this highly preventable disease. One of the main factors contributing to these cancers is excess UV radiation from thinning of the earth’s stratospheric ozone layer resulting from the release of certain manmade chemicals. Under the international treaty known as the Montreal Protocol, all UN Member States are phasing out the production and consumption of those substances according to a specific timetable. As a result of these continuing efforts, the ozone level is projected to recover by mid-century. In the meantime, individuals need to be particularly cautious to protect themselves from receiving too much UV exposure - this is where the UV app plays an important awareness role.
“The Montreal Protocol protects the stratospheric ozone layer which, in turn, protects human health and the environment by blocking most of sun’s harmful ultraviolet radiation from reaching the earth’s surface. Skin cancer can result from overexposure to the sun, so it is imperative for everyone to remain vigilant and ensure they protect themselves adequately with hats and sunscreen. The SunSmart App is a fantastic UV monitoring tool, and I would encourage everyone to use it,” advises Ms. Meg Seki, Executive Secretary of UNEP's Ozone Secretariat.
Everyone needs some sun, mainly for the production of vitamin D which helps to prevent the development of bone diseases such as rickets, osteomalacia and osteoporosis. But too much sun can be dangerous – and even deadly. The summer months
hide real danger.
The UV App has been launched to coincide with the first day of summer in the northern hemisphere. By increasing the public’s awareness and helping to reduce the incidence of skin cancer, this application ultimately supports the achievement of UN Sustainable Development Goal 3, which aims to ensure healthy lives and well-being worldwide by 2030.
“This app combines meteorological, environmental and health expertise to help protect people from the sun both at work and in their leisure. It is unique because it uses data from country-level weather and UV measuring stations to provide accurate and location-specific UV Index readings,” said WMO Secretary-General Professor Petteri Taalas. “It is a great example of science serving society.”
Much of UV-related illness and death can be avoided through a set of simple prevention measures:
Protecting children from extended periods in the sun is particularly important as excessive sun exposure during these early years can significantly increase the risk of UV related diseases later in life.
“This app is a useful tool to assist companies and workers in identifying hazardous work and planning safety and health measures. The International Labour Conference adopted on 10 June a Resolution recognizing a safe and healthy work environment as a new Fundamental Principle and Right at Work. It is a global call for increased efforts to prevent work-related injuries and diseases. Tools such as SunSmart Global UV are a small but useful contribution to this endeavour,” said Vera Paquete-Perdigão, Director of the ILO’s Governance and Tripartism, Department.
The app is based on the UV Index, which describes the level of solar UV radiation at the earth’s surface. The UV Index is reported on a scale of 1 (or “Low”) to 11 and higher (or “Extreme”). The higher the index value, the greater the potential for damage to the skin and eye, and the less time it takes for harm to occur. The maximum UV Index is at the solar noon when the sun is highest in the sky. Adapting outdoor activities and using sun protection are recommended when the UV Index is 3 or above. UV damage is cumulative and UV can be harmful when people are exposed for long periods – even at low levels.
The app seeks to bring worldwide consistency to UV reporting and public health messaging. It was developed by the Cancer Council Victoria and the Australian Radiation Protection and Nuclear Safety Agency, both WHO Collaborating Centres in Australia where a similar app demonstrated improved UV protection public awareness when it was used to support a decades-long, systematic public health campaign promoting sun-smart behaviour.
The Global Solar UV Index was developed jointly by the World Health Organization (WHO), the World Meteorological Organization (WMO), the United Nations Environment Programme (UNEP), the International Commission on Non-Ionizing Radiation Protection (ICNIRP)
and the German Federal Office for Radiation Protection (Bundesamt für Strahlenschutz, BfS) to inform and alert the general public of the potential health risk associated with high UV solar radiation levels.
The Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC) is an independent group of experts that has continued to assess the public health implications of emerging SARS-CoV-2 Variants of Concern (VOC) on the performance of COVID-19 vaccines in order to issue timely recommendations on potential modifications to vaccine strain composition. Since the designation of the Omicron VOC by the World Health Organization (WHO) in November 2021, the TAG-CO-VAC has closely followed the impact of Omicron on the performance of currently licensed COVID-19 vaccines to consider whether a change in COVID-19 vaccine composition may be warranted. Further to the interim statement published on 8 March 2022, this TAG-CO-VAC statement is intended to offer Member States, vaccine developers and regulatory authorities considerations as to whether a modified vaccine composition may be warranted and, if so, how this may be achieved to fulfil the public health objectives of COVID-19 vaccination.
Is a modified COVID-19 vaccine composition warranted?
Since the classification of Omicron as a VOC, there has been rapid and relatively synchronous displacement of other circulating variants by Omicron that has caused substantial epidemic waves in all 6 WHO regions. Omicron is characterized by a large number of mutations, including many in antigenically important regions of the spike (S) protein. Its transmission advantage over other variants has largely been driven by immune escape properties, and Omicron has infected many who had been previously vaccinated and/or infected. Several sublineages within Omicron, notably BA.1, BA.2, BA.3, BA.4 and BA.5, have been identified, which share many of the same S protein mutations.
In this context, the primary goals of COVID-19 vaccination using currently licensed vaccines continue to be to reduce hospitalization, severe disease and death, and to protect health systems. A primary series of currently licensed vaccines based on the
virus that was identified from the first cases of COVID-19 in December 2019 (termed the index virus e.g. GISAID: hCoV-19/Wuhan/WIV04/2019) confers lower levels of protection against severe disease outcomes for Omicron, compared to prior VOCs. However,
a booster dose of the currently licensed COVID-19 vaccines based on the index virus appears to restore protection against severe disease and death against currently circulating variants (1) at levels that remain acceptable (2).
Nevertheless, there has been substantial virus evolution, particularly in the S protein, since the first cases of COVID-19 and it is likely that this evolution will continue, resulting in the emergence of new variants in the future. There is uncertainty about the timing of the emergence, extent of global circulation and antigenic characteristics of future variants. In this context, immunity elicited against as broad a range of SARS-CoV-2 S protein antigens as possible may be desirable to retain and potentially improve protection against future variants. Therefore, it may be prudent to pursue an additional objective of COVID-19 vaccination to achieve immune responses that both:
As such, a modified COVID-19 vaccine composition may be warranted to broaden immune protection against divergent SARS-CoV-2 S protein antigens.
If a modified COVID-19 vaccine composition is deemed to be necessary, what is the recommended strain composition of the vaccine?
The TAG-CO-VAC has considered the comparative epidemiological and virological characteristics of VOCs to date, including Omicron. This included, but was not limited to, published and unpublished data on the antigenic characteristics and antibody escape
of various VOCs including Omicron, the cross-protection of Omicron specific responses following vaccination or infection with prior VOCs, and following Omicron infection and/or Omicron-specific vaccine candidates (see Annex). Importantly, the TAG-CO-VAC
acknowledges that at this time, limited animal model and human data have been published on Omicron-specific vaccine candidates, and these will continue to be reviewed as more data become available.
Omicron is the most antigenically distinct SARS-CoV-2 VOC to have spread globally – much more so than Alpha, or Delta, which are more antigenically similar to the index virus. This has been demonstrated by the substantially reduced neutralization
activity against Omicron as compared to earlier VOCs, both in vaccinated individuals and in those who had been previously infected with earlier VOCs. Furthermore, antibody responses in previously naïve (unprimed) individuals exposed to Omicron
are strong, but they do not cross-react well with previous variants, including other VOCs. In contrast, in individuals who have been previously primed by SARS-CoV-2 infection (i.e., index virus, Alpha, Delta) or COVID-19 vaccination (based on the
index virus), infection with Omicron elicits a broadly cross-reactive antibody response. Similar observations have also been seen in animal models and preliminary clinical data in humans assessing Omicron-specific vaccine candidates. Collectively,
the data show that repeated exposure to SARS-CoV-2 antigens (either through breakthrough infection, vaccination following infection, or ≥ 3 vaccine doses) enhances the magnitude of the antibody response and an increase in breadth is observed after
Omicron infection in previously primed humans.
Therefore, available data indicate that the inclusion of Omicron in an updated vaccine composition is likely to be beneficial in populations that have already received a COVID-19 vaccination primary series. For an Omicron-specific vaccine product, the
TAG-CO-VAC recognizes that viruses or viral genetic sequences very closely related to hCoV/South Africa/NICD-N21668/2021 or hCoV/USA/CA-CDC-4358237-001/2021 are some of the most antigenically distant from the index virus to date and are likely to
enhance the magnitude and breadth of the antibody response.
Importantly, the TAG-CO-VAC considers that the protection offered by an Omicron-specific vaccine product is likely to differ in those who have already received a COVID-19 vaccine primary series (primed), as compared to those who have not (unprimed). Based
on the data to date, it is inferred that an Omicron-specific monovalent vaccine product administered as a booster dose for those who have already received a primary vaccine series may elicit greater breadth in the immune response.
In contrast, an Omicron-specific monovalent vaccine product as a standalone formulation for the primary series is not advised as it is not yet known whether Omicron-specific vaccines will offer similar
cross-reactive immunity and cross-protection from severe illness caused by other VOCs in unprimed individuals as the index virus-based vaccines have done.
Although bi- or multivalent products have yet to be approved by regulatory authorities, vaccines containing index virus and Omicron in a single product may be able to achieve similar outcomes as the proposed sequential approach. However, at this time,
only limited data are available to assess whether the cross-reactive immune responses in humans using an Omicron-containing bi/multivalent product will be equivalent to those elicited with a sequential vaccine approach.
The TAG-CO-VAC recognizes that the inclusion of Omicron, as the most antigenically distinct VOC to date, in a variant-specific formulation and administered as a booster dose, does not preclude the consideration of other variant-specific formulations by
regulatory authorities. The key additional objective of modified COVID-19 vaccine formulations is to achieve breadth of cross-reactive immunity to previous, currently circulating and/or emerging variants.
The use of currently licensed vaccines based on the index virus confers high levels of protection against severe disease outcomes for all variants, including Omicron with a booster dose. As such, the continued use of currently licensed vaccines for primary
vaccination and as a booster dose is appropriate to achieve the primary goals of COVID-19 vaccination. Given the uncertainties of the genetic and antigenic characteristics of future SARS-CoV-2 variants, it may be prudent to pursue an additional objective
of COVID-19 vaccination of achieving a greater breadth in the antibody response against circulating and emerging variants, while retaining protection against severe disease and death. In this context, available data indicate that the inclusion of
Omicron, as the most antigenically distinct SARS-CoV-2 VOC, in an updated vaccine composition may be beneficial. Available data also indicate that this would be best administered as a booster dose to those who have already received a COVID-19 vaccination
primary series, if such vaccines were to be made available.
The TAG-CO-VAC acknowledges that this position is based on limited data from animal models, inference from Omicron infection in primed and unprimed individuals, and preliminary clinical data in humans vaccinated with an Omicron vaccine candidate. The
TAG-CO-VAC therefore recognizes that considerable uncertainties remain. Firstly, uncertainty in the trajectory of SARS-CoV-2 evolution is such that there is a risk that this update may not align with variants that emerge in the future. However, a
modified vaccine composition that includes Omicron will likely broaden the antibody response in primed individuals. Secondly, there are assumptions as to the potential performance of variant-specific vaccines, including Omicron-containing vaccines.
It is assumed that the safety, reactogenicity and immunogenicity of the updated vaccine composition will be comparable to those of the currently licensed vaccines based on the index virus. The TAG-CO-VAC therefore strongly encourages the generation
of clinical data on immune responses in humans to a primary series and/or booster dose of Omicron-specific vaccines, across different vaccine platforms. These additional data may then be considered by TAG-CO-VAC and will allow the Strategic Advisory Group of Experts (SAGE) on Immunization and its COVID-19 Vaccines Working Group to issue policy recommendations on the
use and timing of Omicron-specific vaccines.
The statement reflects the current vaccine performance and landscape of licensed COVID-19 vaccines as of June 2022. The statement will therefore be updated as further data become available.
1. WHO. COVID-19 Weekly Epidemiological Update. 8 June 2022. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---8-june-2022
2. WHO. Target Product profiles for COVID-19 vaccines. Revised April 2022. Available from: https://www.who.int/publications/m/item/who-target-product-profiles-for-covid-19-vaccines
In less than a month, the Security Council resolution that allows the United Nations and our implementing partners to provide lifesaving humanitarian aid to northwest Syria from across the border with Türkiye will expire.
The 15-member Security Council will decide whether to renew it or not.
This decision is critical for the lives and wellbeing of 4.1 million people trapped in the non-Government-controlled northwest of Syria bordering Türkiye. Many rely on humanitarian aid to survive, especially people who are displaced. Some 80% of those in need are women and children. Over 3.2 million people are food insecure and need food assistance.
Our priority and only goal is to get humanitarian aid to families who need it in the safest, most direct and efficient way, away from political calculations or agendas. Last year alone, critical aid
from the UN and our partners crossed the border into northwest Syria helping and protecting 2.4 million people each month.
Over the past year, we were able to send convoys from Government-controlled areas of Syria across internal frontlines into northwest Syria with nutrition, health, food and education supplies for more than 40 000 people. That is welcome progress, and we
continue to increase these deliveries. However, much more is needed.
In addition to the important assistance provided via convoys, affected people also need comprehensive access to basic services.
We urge the members of the Security Council to renew UN Security Council Resolution 2585, authorizing continued cross-border assistance for an additional 12 months. We must also secure regular access to northwest Syria from Government-controlled areas. We must increase the number of channels of humanitarian assistance and maximize humanitarian access.
Failure to renew the resolution will have dire humanitarian consequences. It will immediately disrupt the UN’s lifesaving aid operation, plunging people in northwest Syria into deeper misery and threatening their access to the food, medical care,
clean water, shelter and protection from gender-based violence currently offered by UN-backed operations.
Over the years, funding for this lifeline operation has been dwindling. Amid other critical crises globally, we call for predictable funding to support the delivery of assistance to northwest Syria.
The lives of millions of people depend on it.
We are counting on members of the Security Council to enable our vital work to continue. The people of Syria will be counting on them to make the right choice.
For further information, please contact:
Jens Laerke, OCHA, +41 79 472 97 50, firstname.lastname@example.org
Malene Jensen, UNICEF, +1 917 470 2019, email@example.com
Eddie Wright, UNFPA, +1 917 831 2074, firstname.lastname@example.org
Paul Dillon, IOM, +41 79 636 98 74, email@example.com
Abeer Etefa, WFP Cairo, +20 106 6634352, firstname.lastname@example.org
Shaza Moghraby, WFP New York, +1 929 289 9867 email@example.com
In Amman: Rula Amin, UNHCR/Amman, firstname.lastname@example.org +962790045849
In Geneva: Mathew Saltmarsh, UNHCR Geneva, email@example.com +41799679936Christian Lindmeier, WHO, +41 22 791 2222, firstname.lastname@example.org
The World Health Organization today released its largest review of world mental health since the turn of the century. The detailed work provides a blueprint for governments, academics, health professionals, civil society and others with an ambition to support the world in transforming mental health.
In 2019, nearly a billion people – including 14% of the world’s adolescents – were living with a mental disorder. Suicide accounted for more than 1 in 100 deaths and 58% of suicides occurred before age 50. Mental disorders are the leading cause of disability, causing 1 in 6 years lived with disability. People with severe mental health conditions die on average 10 to 20 years earlier than the general population, mostly due to preventable physical diseases. Childhood sexual abuse and bullying victimization are major causes of depression. Social and economic inequalities, public health emergencies, war, and the climate crisis are among the global, structural threats to mental health. Depression and anxiety went up by more than 25% in the first year of the pandemic alone.
Stigma, discrimination and human rights violations against people with mental health conditions are widespread in communities and care systems everywhere; 20 countries still criminalize attempted suicide. Across countries, it is the poorest and most disadvantaged in society who are at greatest risk of mental ill-health and who are also the least likely to receive adequate services.
Even before the COVID-19 pandemic, just a small fraction of people in need had access to effective, affordable and quality mental health care. For example, 71% of those with psychosis worldwide do not receive mental health services. While 70% of people with psychosis are reported to be treated in high-income countries, only 12% of people with psychosis receive mental health care in low-income countries. For depression, the gaps in service coverage are wide across all countries: even in high-income countries, only one third of people with depression receive formal mental health care and minimally-adequate treatment for depression is estimated to range from 23% in high-income countries to 3% in low- and lower-middle-income countries.
Drawing on the latest evidence available, showcasing examples of good practice, and voicing people’s lived experience, WHO’s comprehensive report highlights why and where change is most needed and how it can best be achieved. It calls on all stakeholders to work together to deepen the value and commitment given to mental health, reshape the environments that influence mental health and strengthen the systems that care for people’s mental health.
WHO Director-General Dr Tedros Adhanom Ghebreyesus said, “Everyone’s life touches someone with a mental health condition. Good mental health translates to good physical health and this new report makes a compelling case for change. The inextricable links between mental health and public health, human rights and socioeconomic development mean that transforming policy and practice in mental health can deliver real, substantive benefits for individuals, communities and countries everywhere. Investment into mental health is an investment into a better life and future for all.”
All 194 WHO Member States have signed up to the Comprehensive mental health action plan 2013–2030, which commits them to global targets for transforming mental health. Pockets of progress achieved over the past decade prove that change is possible. But change is not happening fast enough, and the story of mental health remains one of need and neglect with 2 out of 3 dollars of scarce government spending on mental health allocated to stand-alone psychiatric hospitals rather than community-based mental health services where people are best served. For decades mental health has been one of the most overlooked areas of public health, receiving a tiny part of the attention and resources it needs and deserves.
Dévora Kestel, Director of WHO’s Mental Health and Substance Use Department called for change: “Every country has ample opportunity to make meaningful progress towards better mental health for its population. Whether developing stronger mental health policies and laws, covering mental health in insurance schemes, developing or strengthening community mental health services or integrating mental health into general health care, schools, and prisons, the many examples in this report show that the strategic changes can make a big difference.”
The report urges all countries to accelerate their implementation of the Comprehensive mental health action plan 2013–2030. It makes several recommendations for action, which are grouped into 3 paths to transformation that focus on shifting attitudes to mental health, addressing risks to mental health and strengthening systems of care for mental health. They are:
1. Deepen the value and commitment we give to mental health. For example:
Stepping up investments in mental health, not just by securing appropriate funds and human resources across health and other sectors to meet mental health needs, but also through committed leadership, pursuing evidence-based policies and practice, and establishing robust information and monitoring systems.
Including people with mental health conditions in all aspects of society and decision-making to overcome stigma and discrimination, reduce disparities and promote social justice.
2. Reshape environments that influence mental health, including homes, communities, schools, workplaces, health care services, natural environments. For example:
Intensifying engagement across sectors, including to understand the social and structural determinants of mental health and intervening in ways that reduce risks, build resilience and dismantle barriers that stop people with mental health conditions participating fully in society.
Implementing concrete actions to improve environments for mental health such as stepping up action against intimate partner violence and abuse and neglect of children and older people; enabling nurturing care for early childhood development, making available livelihood support for people with mental health conditions, introducing social and emotional learning programmes while countering bullying in schools, shifting attitudes and strengthen rights in mental health care, increasing access to green spaces, and banning highly hazardous pesticides that are associated with one fifth of all suicides in the world.
3. Strengthen mental health care by changing where, how, and by whom mental health care is delivered and received.
Building community-based networks of interconnected services that move away from custodial care in psychiatric hospitals and cover a spectrum of care and support through a combination of mental health services that are integrated in general health care; community mental health services; and services beyond the health sector.
Diversifying and scaling up care options for common mental health conditions such as depression and anxiety, which has a 5 to 1 benefit–cost ratio. Such scale up includes adopting a task-sharing approach that expands the evidence-based care to be offered also by general health workers and community providers. It also includes using digital technologies to support guided and unguided self-help and to deliver remote care.
A new, open, transparent sublicence agreement between the Medicines Patent Pool (MPP) on behalf of C-TAP, and South African pharmaceutical company Biotech Africa will accelerate the manufacture and sale of a COVID-19 serological antibody technology around the world.
The World Health Organization welcomes the sublicence agreement, the first of its kind to be signed under the auspices of the WHO’s COVID-19 Technology Access Pool (C-TAP) initiative. C-TAP was set up in 2020 to facilitate the timely, equitable and affordable access to COVID-19 health products.
The new agreement builds on a licensing agreement announced by WHO and MPP last year with Spain’s National Research Council (CSIC). The non-exclusive sublicence allows Biotech to manufacture and commercialize CSIC’s COVID-19 serological test worldwide.
“The most effective way to get – and keep – ahead of COVID-19 is to keep testing,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new agreement means we can take advantage of untapped manufacturing capacity so more people in more countries can have easier access to affordable diagnostics.”
The test effectively checks for the presence of anti-SARS-CoV-2 antibodies developed either in response to a COVID-19 infection or to a vaccine. The agreement covers all related patents and the biological material needed to manufacture the test. CSIC will provide all know-how to Biotech as well as training. The licence will be royalty-free for low- and middle-income countries and will remain valid until the date the last patent expires.
“BioTech Africa is honoured to have been selected to be the first biotechnology company in Africa to collaborate with C-TAP in order to facilitate the local manufacture of affordable COVID-19 surveillance devices,” said Jenny Leslie, Biotech Africa Chief Operations Officer.
“This recognition is a product of our perseverance and dedication to become a global player in the manufacture of the highest quality recombinant proteins. The signing of this agreement emphasizes the company’s ongoing goal to support diagnostics needs around the world,” Leslie said.
“We are thrilled to see the COVID-19 Technology Access Pool initiative bearing fruits with the goal of providing equitable access to life-saving health products for the world´s most vulnerable people,” said Charles Gore, MPP Executive Director.
Launched in 2020 by the WHO Director-General and the President of Costa Rica, and supported by 44 WHO Member States, C-TAP aims to facilitate timely, equitable and affordable access to COVID-19 health products by boosting their production and supply through open, non-exclusive licensing agreements.
The C-TAP platform provides a global one-stop-shop for developers of COVID-19 therapeutics, diagnostics, vaccines and other priority health technologies to share knowledge and data and license their intellectual property to additional manufacturers through public health-driven, voluntary, non-exclusive and transparent licences.
By pooling technologies, developers of COVID-19 health products can boost manufacturing capacity in all regions and expand access to life-saving tools.
A global research consultation convened by the WHO R&D Blueprint gathered over 500 experts and more than 2000 participants to discuss knowledge gaps and research priorities for monkeypox, in view of the recent outbreaks of the disease in both endemic and non-endemic countries.
Researchers and high-level experts from all over the world met virtually for two days to review the available evidence on the epidemiology of the virus; its transmission dynamics; the clinical characteristics; One Health research; community engagement; and countermeasures for managing the disease, including clinical care, treatments and vaccines. They agreed that effective countermeasures should be made available based on where the need was greatest.
Improved control of monkeypox in endemic countries is critical to address increases in disease incidence, and to control importations and outbreaks elsewhere. Participants agreed that strengthened collaboration among researchers in endemic countries, who have a wealth of experience and data on the disease – along with researchers from other countries – will ensure that scientific knowledge advances more quickly.
Experts underlined the need for expedited studies to better understand the disease epidemiology, its clinical consequences, and the role of various modes of transmission. In addition, the following research needs were highlighted: a comprehensive One Health approach to understand animal-to-human transmission and animal reservoirs; development and evaluation of better diagnostic tools that can be available around the world; improved approaches to communicate and engage communities in affected areas; studies to optimize supportive clinical care; documentation of the best control and treatment practices; and prompt and transparent communication of data and scientific evidence.
Experts also emphasized the need for clinical studies of vaccines and therapeutics to better document their efficacy and understand how to use them in this and future outbreaks.
Implementing without delay public health activities – such as communicating prevention information, enhanced disease surveillance, contact tracing, isolation of cases and optimized care of of people with the virus – should be used to limit spread and help the people affected, no matter where they are.
This consultation is part of a range of WHO activities in response to this multi-country outbreak.
About the R&D Blueprint
The R&D Blueprint is a global strategy and preparedness plan that allows the rapid activation of R&D activities during epidemics. Its aim is to fast-track the availability of effective tests, vaccines and medicines that can be used to save lives and avert large scale crisis.
For each of these diseases, R&D roadmaps and, where relevant, target product profiles (TPPs) and generic protocols are developed through broad and open consultations with leading experts and other stakeholders. In addition, efforts to strengthen national regulatory and ethics bodies to respond to public health emergencies are being implemented.