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WHO concerned about escalating health crisis in West Bank

WHO news - 14.06.2024

WHO remains concerned about the escalating health crisis in the occupied Palestinian territory, including the West Bank, where attacks on health infrastructure and increased restrictions on movement are obstructing access to health care. 

A spike in violence in the West Bank, including East Jerusalem, since the war in Gaza started has resulted in the deaths of 521 Palestinians, including 126 children between 7 October 2023 and 10 June 2024. In addition, over 5200 people, 800 of them children, have been injured, adding to the growing burden of trauma and emergency care at already strained health facilities.

As of 28 May, WHO has documented 480 attacks on health care in the West Bank since 7 October 2023, resulting in 16 deaths and 95 injuries. The attacks affected 54 health facilities, 20 mobile clinics and 319 ambulances. Fifty-nine percent of the attacks occurred in the cities of Tulkarem, Jenin and Nablus. They include attacks on health infrastructure and ambulances, detention of health workers and patients, obstruction of their access to health facilities, use of force on health workers and militarized searches of ambulances and staff.

The closure of checkpoints, arbitrary obstructions, and detentions of health workers, rising insecurity, as well as the siege and closure of entire towns and communities has made movement within the West Bank increasingly restricted, impeding access to health facilities. Extensive infrastructure and housing damage, particularly in the northern West Bank, have compounded the situation by obstructing access for ambulances and first-aid responders. 

The long-standing fiscal crisis faced by the Palestinian Authority (PA) is further impacting the health system and has been worsened by Israel’s increased withholding of tax revenues meant for the occupied Palestinian territory since 7 October, and the overall deterioration of the economic situation in occupied Palestinian territory. The impact of the financial situation on health service delivery is significant – with health workers receiving only half of their salary for nearly a year and 45% of essential medications being out of stock.  In most areas of the West Bank, primary care clinics and outpatient specialty clinics are now operating two days per week, and hospitals are operating at approximately 70% capacity.

Between October 2023 and May 2024, 44% of 28 292 applications for patients to seek medical care outside the West Bank, in East Jerusalem or Israeli health facilities, have been denied or remain pending with access being mainly granted to cancer, dialysis and other lifesaving cases. In the same period, 48% of the 26 562 companion permit applications have been denied or remain pending.

A comparison between October 2022–May 2023 and October 2023–May 2024 shows a 56% decrease in the West Bank patient permit applications and 22% decrease in approvals, and a 63% decrease in companion permit applications and a 24% decrease in approvals. Prior to October 2023, over 300 patients required permits daily to cross from the West Bank to east Jerusalem and Israeli health facilities.

WHO is supporting the Ministry of Health with procurement of essential medications as well as with technical assistance to address some of the policies and procedures that contribute to the fiscal crisis in health. Additionally, WHO has pre-positioned supplies at key hospitals across the West Bank, including in East Jerusalem, and conducted community trauma management training for first aid responders in the affected communities to boost emergency preparedness, but worsening insecurity and accessibility for emergency health workers and field volunteers to reach the injured, combined with the ongoing strict curfews, pose significant risks to the health system and make it very difficult for responders to reach those in need of urgent care.

WHO calls for the immediate and active protection of civilians and health care in the West Bank. International humanitarian law must be respected, which means the sanctity of health care must be observed at all times. 

WHO releases report on state of development of antibacterials

WHO news - 14.06.2024

The World Health Organization (WHO) today released its latest report on antibacterial agents, including antibiotics, in clinical and preclinical development worldwide. Although the number of antibacterial agents in the clinical pipeline increased from 80 in 2021 to 97 in 2023, there is a pressing need for new, innovative agents for serious infections and to replace those becoming ineffective due to widespread use.

First released in 2017, this annual report evaluates whether the current research and development (R&D) pipeline properly addresses infections caused by the drug-resistant bacteria most threatening to human health, as detailed in the 2024 WHO bacterial priority pathogen list (BPPL). Both documents aim to steer antibacterial R&D to better counter the ever-growing threat of antimicrobial resistance (AMR).

AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to medicines, making people sicker and increasing the risk of spread of infections that are difficult to treat, illness and deaths. AMR is driven largely by the misuse and overuse of antimicrobials, yet, at the same time, many people around the world do not have access to essential antimicrobial medicines.

“Antimicrobial resistance is only getting worse yet we’re not developing new trailblazing products fast enough to combat the most dangerous and deadly bacteria,” said Dr Yukiko Nakatani, WHO’s Assistant Director-General for Antimicrobial Resistance ad interim. “Innovation is badly lacking yet, even when new products are authorized, access is a serious challenge. Antibacterial agents are simply not reaching the patients who desperately need them, in countries of all income levels."

Not only are there too few antibacterials in the pipeline, given how long is needed for R&D and the likelihood of failure, there is also not enough innovation. Of the 32 antibiotics under development to address BPPL infections, only 12 can be considered innovative. Furthermore, just 4 of these 12 are active against at least 1 WHO ‘critical’ pathogen – critical being the BPPL’s top risk category, over ‘high’ and ‘medium’ priority. There are gaps across the entire pipeline, including in products for children, oral formulations more convenient for outpatients, and agents to tackle rising drug resistance.

Encouragingly, non-traditional biological agents, such as bacteriophages, antibodies, anti-virulence agents, immune-modulating agents and microbiome-modulating agents, are increasingly being explored as complements and alternatives to antibiotics. However, studying and regulating non-traditional agents is not straightforward. Further efforts are needed to facilitate clinical studies and assessments of these products, to help determine when and how to use these agents clinically.

Looking at newly approved antibacterials, since 1 July 2017, 13 new antibiotics have obtained marketing authorization but only 2 represent a new chemical class and can be termed innovative, underscoring the scientific and technical challenge in discovering novel antibacterials that are both effective against bacteria and safe for humans.

In addition, 3 non-traditional agents have been authorized, all are faecal-based products for restoring the gut microbiota, to prevent recurrent Clostridioides difficile infection (CDI) following antibiotic treatment in adults.

The preclinical pipeline is active and innovative, with many non-traditional approaches, as part of a stable number of preclinical candidates over the last 4 years. Its focus remains Gram-negative pathogens, which are resistant to last-resort antibiotics. Gram-negative bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug resistant as well.

The shift towards antibacterial agents targeting a single pathogen appears to have plateaued. Agents targeting a single pathogen increase the need for widely available and affordably priced rapid diagnostics, to ensure the relevant bacteria are present in the infections to be treated.

Greater transparency in the pipeline would: facilitate collaboration around potentially innovative but challenging projects, help scientists and drug developers, and generate more interest and funding for drug development for novel antibacterial agents.

Efforts to develop new antibacterial agents need to be accompanied by parallel efforts to ensure they can be equitably accessed, particularly in low- and middle-income countries. Universal access to quality and affordable tools for preventing, diagnosing and treating infections is key to mitigating AMR’s impact on public health and the economy, as per WHO’s Strategic and Operational Priorities for Addressing AMR in the Human Health Sector, the AMR resolution adopted by the 77th World Health Assembly and the People-centred approach to addressing AMR and core package of AMR interventions.


Detention of United Nations and nongovernmental organization personnel in Yemen

WHO news - 13.06.2024

We, the Principals of the affected United Nations (UN) entities and international nongovernmental organizations (NGOs), call for the immediate and unconditional release of all personnel held in Yemen by the Houthi de facto authorities.

We are extremely concerned about the Houthi de facto authorities’ recent detention of 17 members of our organizations [UN entities and INGOs] and many others associated with civil society organizations, national and international NGOs, and other organizations supporting humanitarian activities.

These detentions are unprecedented – not only in Yemen but globally – and directly impede our ability to reach the most vulnerable people in Yemen, including the 18.2 million people who need humanitarian aid and protection.

We ask the de facto authorities to confirm the exact whereabouts of those detained and the conditions in which they are being held, as well as for immediate access to them.

International law prohibits the arbitrary deprivation of liberty. International Humanitarian Law requires all parties to armed conflict to respect and protect humanitarian personnel, including against harassment, mistreatment, and unlawful arrest or detention.

The targeting of humanitarian, human rights, and development workers in Yemen must stop. All those detained must be immediately released.


Signed by:

Achim Steiner, Administrator, UNDP

Amitabh Behar, Executive Director (interim), Oxfam International

Audrey Azoulay, Director-General, UNESCO

Catherine Russell, Executive Director, UNICEF

Cindy McCain, Executive Director, WFP

Inger Ashing, Chief Executive Officer, Save the Children International

Michelle Nunn, President and CEO, CARE

Tedros Adhanom Ghebreyesus, Director-General, WHO

Volker Türk, United Nations High Commissioner for Human Rights, OHCHR

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