New Ebola outbreak detected in northwest Democratic Republic of the Congo; WHO surge team supporting the response
The Government of the Democratic Republic of the Congo announced today that a new outbreak of Ebola virus disease is occurring in Wangata health zone, Mbandaka, in Équateur province. The announcement comes as a long, difficult and complex Ebola outbreak in eastern Democratic Republic of the Congo is in its final phase, while the country also battles COVID-19 and the world’s largest measles outbreak.
Initial information from the Ministry of Health is that six Ebola cases have so far been detected in Wangata, of which four have died and two are alive and under care. Three of these six cases have been confirmed with laboratory testing. It is likely more people will be identified with the disease as surveillance activities increase.
“This is a reminder that COVID-19 is not the only health threat people face,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Although much of our attention is on the pandemic, WHO is continuing to monitor and respond to many other health emergencies.”
This is the Democratic Republic of the Congo’s 11th outbreak of Ebola since the virus was first discovered in the country in 1976. The city of Mbandaka and its surrounding area were the site of Democratic Republic of the Congo’s 9th Ebola outbreak, which took place from May to July 2018.
“It’s happening at a challenging time, but WHO has worked over the last two years with health authorities, Africa CDC and other partners to strengthen national capacity to respond to outbreaks,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “To reinforce local leadership, WHO plans to send a team to support scaling up the response. Given the proximity of this new outbreak to busy transport routes and vulnerable neighbouring countries we must act quickly.”
WHO is already on the ground in Mbandaka supporting the response to this outbreak, as part of capacity built during the 2018 outbreak. The team supported the collection and testing of samples, and reference to the national laboratory for confirmation. Contact tracing is underway. Work is ongoing to send additional supplies from North Kivu and from Kinshasa to support the government-led response. A further 25 people are expected to arrive in Mbandaka tomorrow. WHO is also working to ensure that essential health services are provided to communities despite these emergency events.
The Democratic Republic of the Congo’s 10th outbreak of Ebola, in North Kivu, South Kivu and Ituri provinces, is in its final stages. On 14 May 2020, the Ministry of Health began the 42-day countdown to the declaration of the end of that outbreak.
New outbreaks of Ebola are expected in the Democratic Republic of the Congo given the existence of the virus in an animal reservoir in many parts of the country.
Note to Editors - key figures
COVID-19 in the Democratic Republic of the Congo
- As of 31 May 2020: 3195 cases have been reported, including 72 deaths.
Measles in the Democratic Republic of the Congo
- Since 2019: 369 520 measles cases and 6779 deaths have been reported.
Recent Ebola outbreaks in the Democratic Republic of the Congo
11th outbreak: Mbandaka, Équateur province.
- Ongoing. Declared on 1 June 2020.
- 6 cases (3 confirmed, 3 probable). Of those, 4 people died and 2 are alive
10th outbreak: North Kivu, South Kivu and Ituri provinces
- Ongoing. Declared on 1 August 2018.
- 3463 cases (3317 confirmed and 146 probable). Of these, 2280 people died and 1171 survived.
9th outbreak: Mbandaka, Équateur province.
- Declared on 8 May 2018 and ended on 24 July 2018.
- 54 cases (38 confirmed and 16 probable). Of those, 33 died and 21 survived.
The WHO Chemical Risk Assessment Network was recently joined by new institutions.
As of 1 June 2020 the WHO Chemical Risk Assessment Network counts 88 institutions participating from 50 Member States.
GENEVA - Prevention and treatment services for noncommunicable diseases (NCDs) have been severely disrupted since the COVID-19 pandemic began, according to a WHO survey released today. The survey, which was completed by 155 countries during a 3-week period in May, confirmed that the impact is global, but that low-income countries are most affected.
This situation is of significant concern because people living with NCDs are at higher risk of severe COVID-19-related illness and death.
“The results of this survey confirm what we have been hearing from countries for a number of weeks now,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Many people who need treatment for diseases like cancer, cardiovascular disease and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”
The main finding is that health services have been partially or completely disrupted in many countries. More than half (53%) of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49% for treatment for diabetes and diabetes-related complications; 42% for cancer treatment, and 31% for cardiovascular emergencies.
Rehabilitation services have been disrupted in almost two-thirds (63%) of countries, even though rehabilitation is key to a healthy recovery following severe illness from COVID-19.
In the majority (94%) of countries responding, ministry of health staff working in the area of NCDs were partially or fully reassigned to support COVID-19.
The postponement of public screening programmes (for example for breast and cervical cancer) was also widespread, reported by more than 50% of countries. This was consistent with initial WHO recommendations to minimize non-urgent facility-based care whilst tackling the pandemic.
But the most common reasons for discontinuing or reducing services were cancellations of planned treatments, a decrease in public transport available and a lack of staff because health workers had been reassigned to support COVID19 services. In one in five countries (20%) reporting disruptions, one of the main reasons for discontinuing services was a shortage of medicines, diagnostics and other technologies.
Unsurprisingly, there appears to be a correlation between levels of disruption to services for treating NCDs and the evolution of the COVID-19 outbreak in a country. Services become increasingly disrupted as a country moves from sporadic cases to community transmission of the coronavirus.
Globally, two-thirds of countries reported that they had included NCD services in their national COVID-19 preparedness and response plans; 72% of high-income countries reported inclusion compared to 42% of low-income countries. Services to address cardiovascular disease, cancer, diabetes and chronic respiratory disease were the most frequently included. Dental services, rehabilitation and tobacco cessation activities were not as widely included in response plans according to country reports.
Seventeen percent of countries reporting have started to allocate additional funding from the government budget to include the provision of NCD services in their national COVID-19 plan.
Encouraging findings of the survey were that alternative strategies have been established in most countries to support the people at highest risk to continue receiving treatment for NCDs. Among the countries reporting service disruptions, globally 58% of countries are now using telemedicine (advice by telephone or online means) to replace in-person consultations; in low-income countries this figure is 42%. Triaging to determine priorities has also been widely used, in two-thirds of countries reporting.
Also encouraging is that more than 70% of countries reported collecting data on the number of COVID-19 patients who also have an NCD.
”It will be some time before we know the full extent of the impact of disruptions to health care during COVID-19 on people with noncommunicable diseases,” said Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO. “What we know now, however, is that not only are people with NCDs more vulnerable to becoming seriously ill with the virus, but many are unable to access the treatment they need to manage their illnesses. It is very important not only that care for people living with NCDs is included in national response and preparedness plans for COVID-19 -̶ but that innovative ways are found to implement those plans . We must be ready to “build back better” ̶ strengthening health services so that they are better equipped to prevent, diagnose and provide care for NCDs in the future, in any circumstances.”Editor’s note
Noncommunicable diseases kill 41 million people each year, equivalent to 71% of all deaths globally. Each year, 15 million people die from an NCD between the ages of 30 and 69 years; more than 85% of these "premature" deaths occur in low- and middle-income countries.
Thirty countries and multiple international partners and institutions have signed up to support the COVID-19 Technology Access Pool (C-TAP) an initiative aimed at making vaccines, tests, treatments and other health technologies to fight COVID-19 accessible to all.
The Pool was first proposed in March by President Carlos Alvarado of Costa Rica, who joined WHO Director-General Dr Tedros Adhanom Ghebreyesus today at the official launch of the initiative.
“The COVID-19 Technology Access Pool will ensure the latest and best science benefits all of humanity,” said President Alvarado of Costa Rica. “Vaccines, tests, diagnostics, treatments and other key tools in the coronavirus response must be made universally available as global public goods”.
“Global solidarity and collaboration are essential to overcoming COVID-19,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Based on strong science and open collaboration, this information-sharing platform will help provide equitable access to life-saving technologies around the world.”
The COVID-19 (Technology) Access Pool will be voluntary and based on social solidarity. It will provide a one-stop shop for scientific knowledge, data and intellectual property to be shared equitably by the global community.
The aim is to accelerate the discovery of vaccines, medicines and other technologies through open-science research, and to fast-track product development by mobilizing additional manufacturing capacity. This will help ensure faster and more equitable access to existing and new COVID-19 health products.
There are five key elements to the initiative:
- Public disclosure of gene sequences and data;
- Transparency around the publication of all clinical trial results;
- Governments and other funders are encouraged to include clauses in funding agreements with pharmaceutical companies and other innovators about equitable distribution, affordability and the publication of trial data;
- Licensing any potential treatment, diagnostic, vaccine or other health technology to the Medicines Patent Pool - a United Nations-backed public health body that works to increase access to, and facilitate the development of, life-saving medicines for low- and middle-income countries.
- Promotion of open innovation models and technology transfer that increase local manufacturing and supply capacity, including through joining the Open Covid Pledge and the Technology Access Partnership (TAP).
With supportive countries across the globe, C-TAP will serve as a sister initiative to the Access to COVID-19 Tools (ACT) Accelerator and other initiatives to support efforts to fight COVID-19 worldwide.
WHO, Costa Rica and all the co-sponsor countries have also issued a “Solidarity Call to Action” asking relevant stakeholders to join and support the initiative, with recommended actions for key groups, such as governments, research and development funders, researchers, industry and civil society.
WHO and Costa Rica co-hosted today’s launch event, which began with a high-level session addressed by the WHO Director-General and President Alvarado in addition to Prime Minister Mia Mottley of Barbados and Aksel Jacobsen, State Secretary, Norway. There were video statements by President Lenín Moreno of Ecuador; President Thomas Esang Remengesau Jr. of Palau; Michelle Bachelet United Nations High Commissioner for Human Rights; Jagan Chapagain Secretary General of the International Federation of Red Cross and Red Crescent Societies; and Retno Marsudi Minister for Foreign Affairs for Indonesia. Leaders from across the UN, academia, industry and civil society joined for a moderated discussion.
To date, the COVID-19 Technology Access Pool is now supported by the following countries: Argentina, Bangladesh, Barbados, Belgium, Belize, Bhutan, Brazil, Chile, Dominican Republic, Ecuador, Egypt, El Salvador, Honduras, Indonesia, Lebanon, Luxembourg, Malaysia, Maldives, Mexico, Mozambique, Norway, Oman, Pakistan, Palau, Panama, Peru, Portugal, Saint Vincent and Grenadines, South Africa, Sri Lanka,Sudan, The Netherlands, Timor-Leste, Uruguay, Zimbabwe
Other international organizations, partners and experts have also expressed support to the initiative and others can join them using the website.
Note to Editors:
The Solidarity Call to Action follows from numerous international commitments, including: Global Sustainable Development Goal 3, target 3b; The WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (GSPA- PHI) and the WHO Roadmap for access to medicines, vaccines and health products 2019-2023; the UN General Assembly Resolution on “International cooperation to ensure global access to medicines, vaccines and medical equipment to face COVID-19” (A/RES/74/274); and the 73rd World Health Assembly Resolution on the “COVID-19 response” (WHA73.1).
To access the event: https://who.zoom.us/j/99683467690 - Password: WHO%OMS27
New guidance from the World Health Organization will help countries keep essential health services running whilst taking measures to keep people safe in the COVID-19 pandemic. Most health systems are facing challenges of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. Countries must find ways to keep people safe and ensure the delivery of services such as emergency care for conditions like heart attacks and injury; immunization to prevent outbreaks; treatment for infectious diseases like HIV, malaria and tuberculosis; and screening and treatment for noncommunicable diseases like cancer and diabetes.
Maintaining essential health services: operational guidance for the COVID-19 context recommends practical actions that countries can take at national, sub regional and local levels to reorganize and safely maintain access to high-quality, essential health services. It also outlines sample indicators for monitoring the maintenance of essential health services and describes considerations about when to stop and restart services as COVID-19 transmission waxes and wanes.
The guide outlines a set of basic principles and makes some practical recommendations for countries. These include:
- Ensuring timely access to emergency care services 24 hours per day, 7 days per week
- Adjusting governance and coordination mechanisms to support timely action
- Ensuring infection prevention and control measures to guarantee safe service delivery.
- Prioritizing essential services - identifying what can be delayed and what cannot; assessing what can be relocated to areas that are less affected by COVID-19; working out the particular needs of marginalized populations including indigenous peoples, sex workers, migrants and refugees.
- Reassigning health workers from areas with low or zero COVID-19 transmission, or from places with excess capacity, to boost the workforce in hard-hit zones so that essential services can be maintained.
- Maintaining the availability of essential medications, equipment and supplies by mapping lists of essential services to resource and through weekly reporting from major distribution points, such as hospitals and district stores, on critical products that may be at risk of shortage or other problems.
- Removing financial barriers to access and fund public health by suspending payments or user fees at the point of care for essential health services for all patients, regardless of their insurance or citizenship status.
- Disseminating information in local languages to prepare the public for changes in service delivery platforms using information sources trusted by the public and ensuring these sources are kept up to date about changes in essential service delivery and about available resources, such as hotlines.
- Shifting the delivery of some routine services to digital platforms (telemedicine) and establishing a mechanism for implementing electronic prescriptions (e-prescriptions) among public and private pharmacies and suppliers
The guidance provides specific advice on ways to meet some common health needs. Examples include mechanisms to decrease the volume of people visiting health centres through bulk prescriptions of medications and nutritional supplements and delivering at home for from drop-off points.
Other approaches include monitoring and outreach to people with existing conditions to ensure that they seek care that cannot be safely delayed, such as emergency care for heart attacks, sepsis or complications of pregnancy; auxiliary services, such as basic diagnostic imaging, laboratory and blood bank services.
The guidance outlines specific recommendations on adapting the ways vaccines are administered to reduce the risk of COVID-19 transmission while preventing outbreaks of other deadly diseases.
It also highlights ways to protect people who are particularly vulnerable to the direct and indirect consequences of the pandemic. These include interventions to protect older people from infection and mitigate the effects of social isolation; or alternatives to school-based delivery of services, such as nutritional supplementation, and activities to protect children from violence and keep them healthy at home when schools are closed. It also offers guidance on how mental health services be enhanced and strengthened in the pandemic context.
This new guidance will help decision-makers and managers at the national and subnational levels to ensure the continuity of essential health services in the context of COVID-19.
This is an unprecedented coordinated effort within WHO across four divisions, 14 departments, and dozens of program units at WHO headquarters, all liaising with regional counterparts across the globe.
Geneva—A record number of countries are now monitoring and reporting on antibiotic resistance - marking a major step forward in the global fight against drug resistance. But the data they provide reveals that a worrying number of bacterial infections are increasingly resistant to the medicines at hand to treat them.
“As we gather more evidence, we see more clearly and more worryingly how fast we are losing critically important antimicrobial medicines all over the world,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO). “These data underscore the importance both of protecting the antimicrobials we have and developing new ones, to effectively treat infections, preserve health gains made in the last century and ensure a secure future.”
Since the WHO’s Global Antimicrobial Resistance and Use Surveillance System (GLASS) report in 2018, participation has grown exponentially. In only three years of existence, the system now aggregates data from more than 64 000 surveillance sites with more than 2 million patients enrolled from 66 countries across the world. In 2018 the number of surveillance sites was 729 across 22 countries.
More countries are also reporting on the recently approved indicator on antimicrobial resistance (AMR) as part of the Sustainable Development Goal monitoring. “The enormous expansion of countries, facilities and patients covered by the new AMR surveillance system allows us to better document the emerging public health threat of AMR,” said Hanan Balkhy, Assistant Director-General for antimicrobial resistance at WHO .
High rates of resistance among antimicrobials frequently used to treat common infections, such as urinary tract infections or some forms of diarrhoea, indicate that the world is running out of effective ways to tackle these diseases. For instance, the rate of resistance to ciprofloxacin, an antimicrobial frequently used to treat urinary tract infections, varied from 8.4% to 92.9% in 33 reporting countries.
WHO is concerned that the trend will further be fueled by the inappropriate use of antibiotics during the COVID-19 pandemic. Evidence shows that only small proportion of COVID-19 patients need antibiotics to treat subsequent bacterial infections and the Organization has issued guidance not to provide antibiotic therapy or prophylaxis to patients with mild COVID-19 or to patients with suspected or confirmed moderate COVID-19 illness unless there is a clinical indication to do so.
Dr Balkhy, said: “We believe this clear guidance on the use of antibiotics in the COVID-19 pandemic will both help countries tackle COVID-19 effectively and prevent the emergence and transmission of Antimicrobial Resistance (AMR) in the context of the pandemic.”
WHO remains concerned by declining investment (including in the private sector) and lack of innovation in the development of new antimicrobial treatments - factors that are undermining efforts to combat drug-resistant infections.
“We must bolster global cooperation and partnerships including between the public and private sectors to provide financial and non-financial incentives for the development of new and innovative antimicrobials, added Balkhy.
To support this effort, WHO has released two documents on target product profiles to guide development of new treatments for common resistant bacterial infections and an economic model that simulates the costs, risks, and possible return on investment of antibacterial drug development.
The World Health Organization is today launching a new kit for school students aged 13-17 to alert them to the tobacco industry tactics used to hook them to addictive products. Every year the tobacco industry invests more than USD 9 billion to advertise its products. Increasingly, it is targeting young people with nicotine and tobacco products in a bid to replace the 8 million people that its products kill every year.
This year’s WHO’s World No Tobacco Day campaign focuses on protecting children and young people from exploitation by the tobacco and related industry. The toolkit has a set of classroom activities including one that puts the students in the shoes of the tobacco industry to make them aware of how the industry tries to manipulate them into using deadly products. It also includes an educational video, myth-buster quiz, and homework assignments.
The toolkit exposes tactics such as parties and concerts hosted by the tobacco and related industries, e-cigarette flavours that attract youth like bubble-gum and candy, e-cigarette representatives presenting in schools, and product placement in popular youth streaming shows.
Even during a global pandemic, the tobacco and nicotine industry persist by pushing products that limit people’s ability to fight coronavirus and recover from the disease. The industry has offered free branded masks and delivery to your door during quarantine and has lobbied for their products to be listed as ‘essential’.
Smoking suffocates the lungs and other organs, starving them of the oxygen they need to develop and function properly. “Educating youth is vital because nearly 9 out of 10 smokers start before age 18. We want to provide young people with the knowledge to speak out against tobacco industry manipulation,” said Ruediger Krech, Director for Health Promotion at WHO.
Over 40 million young people aged 13-15 have already started to use tobacco. To reach Generation Z, WHO launched a TikTok challenge #TobaccoExposed and welcomed social media partners like Pinterest, Tinder, YouTube and TikTok to amplify messaging.
WHO calls on all sectors to help stop marketing tactics of tobacco and related industries that prey on children and young people:
- Schools refuse any form of sponsorship and prohibit representatives from nicotine and tobacco companies from speaking to students
- Celebrities and influencers reject all offers of sponsorship
- Television and streaming services stop showing tobacco or e-cigarette use on screen
- Social media platforms ban the marketing of tobacco and related products and prohibit influencer marketing
- Government and financial sector divest from tobacco and related industries
- Governments ban all forms of tobacco advertising, promotion and sponsorship
Countries can protect children from industry exploitation by putting in place strict tobacco control laws, including regulating products like e-cigarettes that have already begun to hook a new generation of young people.
The World Health Organization (WHO) welcomes the creation of the WHO Foundation, an independent grant-making entity, that will support the Organization’s efforts to address the most pressing global health challenges.
Headquartered in Geneva, the Foundation will support global public health needs by providing funds to WHO and trusted implementing partners to deliver on the Organization’s “triple billion” goals. Featured in WHO’s five-year strategic plan, these goals aim to: protect 1 billion people from health emergencies; extend universal health coverage to 1 billion people; and assure healthy lives and wellbeing to 1 billion people by 2023.
The Foundation which is legally separate from WHO, will facilitate contributions from the general public, individual major donors and corporate partners to WHO and trusted partners to deliver on high-impact programmes. Its goal is to help broaden WHO’s donor base and work towards more sustainable and predictable funding. The WHO Foundation will simplify the processing of philanthropic contributions in support of WHO and make such contributions possible on all aspects of health and WHO’s mission.
“An important part of WHO's future success is broadening its donor base and increasing both the quantity and quality of funds at its disposal," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "The creation of the WHO Foundation, as part of WHO's transformation, is an important step towards this goal, and towards achieving our mission to promote health, keep the world safe and serve the vulnerable.”
“Today’s announcement is the culmination of more than two years of preparation and hard work by countless individuals and partner organizations. I would like to thank Professor Thomas Zeltner for spearheading this incredible adventure and founding the organization.”
“The work of the WHO is vital for both safeguarding and promoting global health – a role that has become all the more crucial in light of the COVID-19 pandemic. WHO’s achievements and contributions to global health and the wellbeing of humanity are tremendous, but we cannot take those accomplishments for granted. The WHO deserves a strong, independent, external advocate who can support and strengthen its impact. I am proud to lead these efforts and to create this missing piece in global health by establishing the WHO Foundation,” said Professor Thomas Zeltner, Founder of the WHO Foundation and former Secretary of Health of Switzerland and Director-General of the Swiss National Health Authority.
Established under the laws of Switzerland, the Foundation has benefitted from the guidance of an Advisory Group that has included experts in global health, philanthropy, ethics, and finance. The Foundation’s Board will now assume all governance responsibilities and will review all strategic decisions and serve as the highest decision-making body of the Foundation. Founding Board Members are: Mr. Bob Carter, Ms. Clare Akamanzi and Professor Thomas Zeltner.
In view of the COVID-19 pandemic, the WHO Foundation will initially focus on emergencies and pandemic response, and it will also raise and disburse funds for all WHO global public health priorities in full alignment with the WHO Member State adopted General Programme of Work.
A Call to Action: Get Involved with the WHO Foundation
Global health matters for everyone, everywhere. The WHO Foundation is an exceptional opportunity to shape the future of global health together. Be part of this journey, donate now or engage in a long-term strategic partnership and contact the team at email@example.com. Online giving is active at www.whofoundationproject.org, and tailored donations can be received by contacting firstname.lastname@example.org. All donations made to the WHO Foundation are tax-deductible to the extent feasible by relevant national laws.
The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing.
About WHO Foundation
The WHO Foundation is an independent grant-making foundation focused on addressing the most pressing global health challenges of today and tomorrow. By funding high-impact initiatives and advancing strategies of innovation, effectiveness, and rapid response, it will support the global health ecosystem. Headquartered in Geneva and legally independent from the WHO, the Foundation will work responsibly with individual donors, the general public and corporate partners to strengthen health systems globally. Specifically, the WHO Foundation will support global public health needs, from prevention, mental health, and non-communicable diseases to emergency preparedness, outbreak response and health system strengthening.