The World Health Organization’s new action plan to speed up universal access to safe blood and blood products pulls together existing recommendations and recommends new improved ways of working. It’s the start of a four-year collaborative effort to improve blood transfusion and blood-based therapies in all countries.

Safe blood saves lives in all sorts of circumstances, not least in emergency and epidemic settings. Blood transfusion and blood products are critical for birth delivery for both the mother and baby; the survival and quality of life of patients suffering from life-threatening conditions such as haemophilia, thalassemia, immune deficiency and cancer; treating severe injuries and carrying out medical and surgical procedures.  

But progress in blood safety and availability has been slow in many parts of the world, placing patients’ safety at risk and putting undue pressure on health workers. Progress is also mostly restricted to developed countries. Out of the approximate 118 million blood donations collected globally, 42% are collected in high-income countries, home to 16 % of the world’s population. And one out of four low-income countries do not test all donated blood, while 54% of countries do not have surveillance systems to securitise the supply chain from blood donor to patient. 

Challenges include: slow implementation of national blood policies and weak blood regulatory systems; insufficient number of voluntary blood donors (who are considered the safest donors); poor quality management of screening tests, blood grouping and compatibility testing; inappropriate clinical use of blood; insufficient national funding for blood safety.

To address these, WHO has set out six key objectives for all countries and in particular those with weak blood systems:

• appropriately structured, well-coordinated and sustainably resourced national blood systems;
• regulatory capacity to ensure the quality and safety of blood;
• functioning and efficiently managed blood services;
• effective implementation of patient blood management to optimize transfusion practices;
• effective surveillance, haemovigilance and pharmacovigilance, supported by comprehensive and accurate data collection systems;
• partnerships, collaboration and information exchange to achieve key priorities and jointly address challenges and emerging threats at global, regional and national levels.

The Organization looks forward to working with partners worldwide to implement the plan, improve blood supply particularly in the low and middle-income countries where this is so urgently needed, and save lives. The plan will run from 2020-2024.

As the current outbreak of the Coronavirus Disease (COVID-19) continues to develop, the World Health Organization (WHO) and the World Tourism Organization (UNWTO) are committed to working together in guiding the travel and tourism sectors’ response to COVID-19.

On 30 January 2020, the Director-General of the World Health Organization (WHO) declared the outbreak of COVID-19 to be a Public Health Emergency of International Concern and issued a set of Temporary Recommendations. WHO did not recommend any travel or trade restriction based on the current information available. WHO is working closely with global experts, governments and partners to rapidly expand scientific knowledge on this new virus, to track the spread and virulence of the virus, and to provide advice to countries and the global community on measures to protect health and prevent the spread of this outbreak.

Cooperation is key

The tourism sector is fully committed to putting people and their well-being first. International cooperation is vital for ensuring the sector can effectively contribute to the containment of COVID-19. UNWTO and WHO are working in close consultation and with other partners to assist States in ensuring that health measures be implemented in ways that minimize unnecessary interference with international traffic and trade.

Tourism’s response needs to be measured and consistent, proportionate to the public health threat and based on local risk assessment, involving every part of the tourism value chain – public bodies, private companies and tourists, in line with WHO’s overall guidance and recommendations.

UNWTO and WHO stand ready to work closely with all those communities and countries affected by the current health emergency, to build for a better and more resilient future. Travel restrictions going beyond these may cause unnecessary interference with international traffic, including negative repercussions on the tourism sector.

At this challenging time, UNWTO and WHO join the international community in standing in solidarity with affected countries.

Geneva: France’s Minister for Europe and Foreign Affairs, Mr Jean-Yves Le Drian, and Dr Tedros Adhanom Ghebreyesus,  Director-General of WHO today met at the Permanent Mission of France to the United Nations in Geneva to discuss the WHO Academy, which will be the world’s largest and most innovative lifelong learning platform in global health.

The WHO Academy aims to reach millions of people worldwide, offering high-tech learning environments at a “hub” in Lyon with “spokes” in the six WHO regions. The Academy will provide learning opportunities for leaders, educators, researchers, health workers, WHO staff and the broader public, and will deliver high quality, multilingual learning, both online and in-person, alongside a cutting-edge simulation centre for health emergencies.

The discussion today follows a Declaration of Intent signed by Emmanuel Macron, President of the French Republic and Dr Tedros on 11 June 2019, and a pledge by France in the amount of US$ 100 million (€ 90 million) to WHO to support the creation of the WHO Academy, which will be established as an internal division within WHO.

“Technology and innovation in learning are creating exciting new opportunities to accelerate progress towards health for all in every country,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “The WHO Academy will support millions of learners to maximize health impacts with the best evidence, adult learning approaches and state-of-the-art technologies.”

By propelling and strengthening digital innovations and lifelong learning opportunities around the world, the WHO Academy will play an instrumental role towards achieving WHO’s triple billion goal by 2023 and the health Sustainable Development Goals: 1 billion more people will benefit from universal health coverage; 1 billion more will be better protected in health emergencies, and 1 billion more will enjoy improved health and wellbeing.

The funding from France represents a commitment to accelerate the development of the WHO Academy, and confirms the engagement of France — a longstanding partner of WHO and a key actor in global health – and its strong support to the ambitions of 13^th WHO General Programme of Work to ensure healthy lives and well-being for all ages. 

WHO has declared 2020 as the International Year of the Nurse and the Midwife to mark the bicentenary of the birth of the founder of modern nursing, Florence Nightingale and to recognize the critical contribution both professions make to global health. May is a key moment to catalyse high-level dialogue and collaborative engagements for moving forward the findings of The State of the World’s Nursing Report, which will be launched on World Health Day, 7 April 2020, as part of the activities of the International Year of the Nurse and the Midwife.

Key dates for May 2020

Ninth WHO Global Forum for Government Chief Nursing and Midwifery Officers (GCNMOs) and the Eighth Triad Meeting, 13–15 May, Geneva– organized jointly by WHO, the International Confederation of Midwives and the International Council of Nurses. The meetings will be held at the Centre International de Conférence (CICG), immediately prior to the Seventy-third World Health Assembly. (by invitation only)

The GCNMO Forum and the ICM-ICN-WHO Triad Meeting have heightened importance during the International Year of the Nurse and the Midwife.  Occurring at almost the mid-point of 2020, the meetings will focus on pivoting from advocacy to action.  Participants will learn how to leverage the findings from The State of the World’s Nursing 2020 and anticipated reports on midwifery to make evidence-based arguments for national policy reforms and investment in nursing and midwifery to improve primary healthcare, strengthen emergency response and resilience, and achieve UHC.  

Health for All, Film Festival, 16 May (PM), Geneva – special focus on nursing and midwifery film submission

Walk the Talk, 17 May (AM), Geneva – special focus will be given to nurses and midwives in celebration of the International Year of the Nurse and Midwife. We encourage you to register at https://www.who.int/news-room/events/detail/2020/05/17/default-calendar/walk-the-talk-the-health-for-all-challenge

World Health Assembly 17- 20 May, Geneva

In response to calls for action, WHO has provided guidelines, physical standards, training and technical support to improve blood product quality, safety and availability in WHO regions and in countries. Despite these actions, progress in blood availability and safety under effective regulation has been slow in many parts of the world.

For that reason, the WHO Action framework for blood products 2020-2023, proposes a renewed effort to scale up programme implementation to improve global adequacy of blood donation, and universal access to quality and safe blood and blood components for transfusion, and plasma derived medicinal products.

The Action Framework provides strategic direction to WHO’s work for the years 2020-2023. It identifies six strategic objectives: appropriately structured, well-coordinated and sustainably resourced national blood systems; regulatory capacity to ensure the quality and safety of blood; functioning and efficiently managed blood services; effective implementation of patient blood management to optimize transfusion practices, effective surveillance, haemovigilance and pharmacovigilance, supported by comprehensive and accurate data collection systems; and partnerships, collaboration and information exchange to achieve key priorities and jointly address challenges and emerging threats at global, regional and national levels.

The Action Framework will improve coordination and collaboration at all levels of WHO. The document will promote and strengthen new and existing partnerships, as areas for collaborative action are clearly identified. Moreover, it demonstrates the need for support to WHO (including sustainable funding) to coordinate the implementation of this ambitious plan. As a result, the Action Framework for blood products will allow WHO to more effectively carry out its mandate on blood, and to increase the impact of WHO activities to strengthen blood systems and blood regulation in countries and regions and eventually to ensure universal access to blood products worldwide.

In a new position paper, published in the Weekly
Epidemiological Record today, WHO recommends vaccination against
tick-borne encephalitis in people of all ages where the disease is
highly endemic. Where the prevaccination incidence of the disease is
moderate or low or is limited to particular geographical locations or
certain outdoor activities, immunization should target individuals in
the most severely affected groups. People travelling from non-endemic
areas to endemic areas should be offered vaccination if their visits
will include extensive outdoor activities.

Since the incidence of tick-borne encephalitis may vary
considerably between and even within geographical regions, public
immunization strategies should be based on risk assessments conducted at
country, regional or district level, and should be appropriate to the
local endemic situation.

Immunization offers the most effective protection against
tick-borne encephalitis. Currently, there are four widely used vaccines
of assured quality: FSME-Immun and Encepur, manufactured in Austria and
Germany respectively, and TBE-Moscow and EnceVir, manufactured in the
Russian Federation. The four vaccines are considered to be safe and
efficacious.

Tick-borne encephalitis virus is an important cause of viral
infections of the central nervous system in eastern, central and
northern European countries, and in northern China, Mongolia, and the
Russian Federation.

Approximately 10 000–12 000 clinical cases of tick-borne
encephalitis are reported each year, but this figure is believed to be
significantly lower than the actual total. Most infections with the
virus result from tick bites acquired during outdoor activities in
forested areas.

As climate and commercial threats intensify, WHO-UNICEF-Lancet Commission presses for radical rethink on child health

No single country is adequately protecting children’s health, their environment and their futures, finds a landmark report released today by a Commission of over 40 child and adolescent health experts from around the world. The Commission was convened by the World Health Organization (WHO), UNICEF and The Lancet. 

The report, A Future for the World’s Children?, finds that the health and future of every child and adolescent worldwide is under immediate threat from ecological degradation, climate change and exploitative marketing practices that push heavily processed fast food, sugary drinks, alcohol and tobacco at children. 

“Despite improvements in child and adolescent health over the past 20 years, progress has stalled, and is set to reverse,” said former Prime Minister of New Zealand and Co-Chair of the Commission, Helen Clark. “It has been estimated that around 250 million children under five years old in low- and middle-income countries are at risk of not reaching their developmental potential, based on proxy measures of stunting and poverty. But of even greater concern, every child worldwide now faces existential threats from climate change and commercial pressures.

“Countries need to overhaul their approach to child and adolescent health, to ensure that we not only look after our children today but protect the world they will inherit in the future,” she added.

Intensifying climate change threatens every child’s future

The report includes a new global index of 180 countries, comparing performance on child flourishing, including measures of child survival and well-being, such as health, education, and nutrition; sustainability, with a proxy for greenhouse gas emissions, and equity, or income gaps. [Top & Bottom 10 countries; Full Global Index on pp. 35-38] [1]

According to the report, while the poorest countries need to do more to support their children’s ability to live healthy lives, excessive carbon emissions – disproportionately from wealthier countries –  threaten the future of all children. If global warming exceeds 4°C by the year 2100 in line with current projections, this would lead to devastating health consequences for children, due to rising ocean levels, heatwaves, proliferation of diseases like malaria and dengue, and malnutrition. 

The index shows that children in Norway, the Republic of Korea, and the Netherlands have the best chance at survival and well-being, while children in Central African Republic, Chad, Somalia, Niger and Mali face the worst odds. However, when authors took per capita CO2 emissions into account, the top countries trail behind: Norway ranked 156, the Republic of Korea 166, and the Netherlands 160. Each of the three emits 210% more CO2 per capita than their 2030 target. The United States of America (USA), Australia, and Saudi Arabia are among the ten worst emitters.  

“More than 2 billion people live in countries where development is hampered by humanitarian crises, conflicts, and natural disasters, problems increasingly linked with climate change,” said Minister Awa Coll-Seck from Senegal, Co-Chair of the Commission. “While some of the poorest countries have among the lowest CO2 emissions, many are exposed to the harshest impacts of a rapidly changing climate. Promoting better conditions today for children to survive and thrive nationally does not have to come at the cost of eroding children’s futures globally.”    

The only countries on track to beat CO2 emission per capita targets by 2030, while also performing fairly (within the top 70) on child flourishing measures are: Albania, Armenia, Grenada, Jordan, Moldova, Sri Lanka, Tunisia, Uruguay and Viet Nam.

Harmful commercial marketing preys on children – with childhood obesity increasing 11-fold

The report also highlights the distinct threat posed to children from harmful marketing. Evidence suggests that children in some countries see as many as 30,000 advertisements on television alone in a single year, while youth exposure to vaping (e-cigarettes) advertisements increased by more than 250% in the USA over two years, reaching more than 24 million young people. 

Professor Anthony Costello, one of the Commission’s authors, said: “Industry self-regulation has failed. Studies in Australia, Canada, Mexico, New Zealand and the USA – among many others – have shown that self-regulation has not hampered commercial ability to advertise to children. For example, despite industry signing up to self-regulation in Australia, children and adolescent viewers were still exposed to 51 million alcohol ads during just one year of televised football, cricket and rugby. And the reality could be much worse still: we have few facts and figures about the huge expansion of social media advertising and algorithms aimed at our children.”

Children’s exposure to commercial marketing of junk food and sugary beverages is associated with purchase of unhealthy foods and overweight and obesity, linking predatory marketing to the alarming rise in childhood obesity. The number of obese children and adolescents increased from 11 million in 1975 to 124 million in 2016 – an 11-fold increase, with dire individual and societal costs.

A manifesto for immediate action on child and adolescent health 

To protect children, the independent Commission authors call for a new global movement driven by and for children. Specific recommendations include:

1. Stop CO2 emissions with the utmost urgency, to ensure children have a future on this planet;
2. Place children and adolescents at the centre of our efforts to achieve sustainable development;
3. New policies and investment in all sectors to work towards child health and rights;
4. Incorporate children’s voices into policy decisions;
5. Tighten national regulation of harmful commercial marketing, supported by a new Optional Protocol to the UN Convention on the Rights of the Child.

Dr. Richard Horton, Editor-in-Chief of The Lancet family of journals, said: “The opportunity is great. The evidence is available. The tools are at hand. From heads-of-state to local government, from UN leaders to children themselves, this Commission
calls for the birth of a new era for child and adolescent health. It will take courage and commitment to deliver. It is the supreme test of our generation.” 

“From the climate crisis to obesity and harmful commercial marketing, children around the world are having to contend with threats that were unimaginable just a few generations ago,” said Henrietta Fore, UNICEF Executive Director. “It
is time for a rethink on child health, one which places children at the top of every government’s development agenda and puts their well-being above all considerations.” 

“This report shows that the world’s decision makers are, too often, failing today’s children and youth: failing to protect their health, failing to protect their rights, and failing to protect their planet,” Dr Tedros Adhanom Ghebreyesus,
Director-General of the World Health Organization said. “This must be a wakeup call for countries to invest in child health and development, ensure their voices are heard, protect their rights, and build a future that is fit for children.”

Notes to editors

[1] About the index; please see pp. 35-38 of the report, with technical details in the Annex, pp. 19-72

[2] This Commission was funded by the Bill & Melinda Gates Foundation.

For more information or to set up interviews with report authors, please contact any of the listed media contacts.

The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) to review the current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) took place on Wednesday, 12 February 2020, from 14:00 to 16:45 Geneva time (CEST).

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference.

The Secretariat welcomed the Committee and thanked them for their support. The meeting was turned over to the Chair, Dr Robert Steffen.

Dr Steffen also welcomed the Committee and gave the floor back to the Secretariat.

Representatives of WHO’s legal department and the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting.

The Chair then reviewed the agenda for the meeting and introduced the presenters.

Presentations were made by representatives of the Ministry of Health of the Democratic Republic of the Congo (DRC), the WHO Secretariat, and the UN Ebola Emergency Response Coordinator.

The current situation in the DRC was reviewed. As of 10 February 2020, there were a total of 3431 cases, of which 3308 were confirmed and 123 were probable. 2253 persons have died (66%). Between 3 and 9 February 2020, three new confirmed cases were reported in Beni Health Zone, North Kivu. These three cases were already registered as contacts and two were under surveillance at the time of detection. More than 2000 contacts are being followed. There has been an increase in the number of security incidents in recent months.

Challenges that remain include: strengthening of community acceptance for full commitment to response measures; protection of personnel at strategic health checkpoints; improvement of infection prevention and control practices in health facilities; strengthening of the local health system; and comprehensive treatment and support for patients in recovery.

The WHO Secretariat gave an overview of the epidemiological situation, which shows an overall encouraging trend in case incidence and geographic spread. It was noted that sustaining this progress depends on the security situation and control of the well-known drivers of transmission, particularly in traditional health facilities, and on continued trust and communication with the community.

A risk communication and community engagement programme has been developed, as has an EVD survivors programme. It is critical to ensure the long-term sustainability of these two initiatives.   

The situation in countries neighbouring DRC was reviewed, as was preparedness in nonaffected areas of DRC. An EVD operational readiness standardized approach has been implemented in 9 priority countries. More than 2400 alerts have been investigated, and more than 14,600 health workers have been vaccinated.

The UN Ebola Emergency Response Coordinator gave a brief report on operational support, focused on security challenges and preparations for any resurgence of disease.

Context and Discussion

The Committee noted a great deal of progress in the situation since its last meeting and commended the response, under the leadership of the DRC Ministry of Health and the multisectoral coordination commission established in July 2019. Support provided by WHO, UN agencies, nongovernmental organizations and other partners has also contributed to limiting the spread and impact of this virus in a difficult context. An increase in the number of alerts was attributed to strong and proactive community surveillance.

Conclusions and Advice

It was the unanimous view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC) under the IHR (2005).

The Committee acknowledged the revised risk assessment, which puts the risk now as high at national and regional levels, and low at the global level.

The Committee was concerned that withdrawing the PHEIC now might have adverse consequences for the response efforts through diminishing focus. Additionally, although the primary concern of the Committee is EVD, there are serious ongoing outbreaks of other diseases, including measles and cholera, in DRC. The country continues to need support to combat infectious diseases as well as to strengthen its health system. Further, there remains an urgent need to maintain international solidarity for the response.

The Committee noted the ongoing discussions about the interpretation in the text of the IHR (2005) of the terms international and regional spread, and about creating an intermediate level of response between the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations on the Regulations. The Committee supports these discussions, as an intermediate level would be as useful for gradually ending a PHEIC and for signaling the potential for one to be declared.

The Committee provided the following advice to the Director-General for his issuance as revised Temporary Recommendations under the IHR (2005).

For DRC:

• Sustain the political commitment and multisectoral coordination approach to the response.
• Continue to engage and build trust with associations of survivors to facilitate rapid detection of any cases arising from exposure to infected bodily fluids of survivors.
• Continue to strengthen capacity, implementation, and coordination for community awareness and engagement, including a focus on hotspots, preventing resurgence where cases have declined, and to support survivors in their communities.
• Further enhance the acceptance of response measures and address access and security issues by engaging influencers and decision makers for all interventions.
• Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision, including in private-sector and traditional health facilities.
• Continue cross-border screening and step up monitoring at checkpoints around hotspots and at main roads.
• Continue to implement and share real-time full-genome genetic sequencing of all new confirmed cases.
• Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision.
• Strengthen preparedness in non-affected provinces of DRC, and more generally strengthen the health system across the country to respond to concurrent health emergencies.
• Continue to implement optimal vaccine strategies that have proven maximum impact on curtailing the outbreak, as recommended by WHO’s Strategic Advisory Group of Experts (SAGE).

For countries at risk:

• At-risk countries should maintain their work with partners to improve their preparedness for detecting and managing imported or locally acquired cases, including the transparent sharing of detailed information on suspect cases, as required by the International Health Regulations (2005), and sharing laboratory samples of suspect cases for confirmatory testing in accordance with WHO norms and guidance.
• Countries should continue to map population movements and sociological patterns that can predict risk of disease spread.
• Risk communications and community engagement, especially at points of entry, should be maintained.

For all countries:

• As recommended previously, no country should close its borders or place any restrictions on travel and trade.
• The Committee does not consider entry screening at airports or other ports of entry outside the region to be necessary.

The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.

Based on this advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 12 February 2020 maintained the Ebola outbreak in the Democratic Republic of the Congo as a Public Health Emergency of International Concern (PHEIC).

The Director-General endorsed the Committee’s advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of Ebola, effective 12 February 2020. The Director-General thanked the Committee Members and Advisors for their advice and requested their reassessment of this situation within two months or earlier if the situation requires.