Seventy-first World Health Assembly update, 26 May

The Director-General of WHO, Dr Tedros Adhanom Ghebreyesus, told delegates to the World Health Assembly today that they had charted a new course for the Organization.

Closing the Assembly, he said that everything WHO did going forward would be evaluated in the light of the "triple billion" targets which were approved this week in WHO's new five-year strategic plan. By 2023 the targets aim to achieve:

  • 1 billion more people benefitting from universal health coverage
  • 1 billion more people better protected from health emergencies
  • 1 billion more people enjoying better health and wellbeing.

On the final day of the Assembly, delegates also came to agreement on maternal, infant and young child nutrition and on poliovirus containment.

Nutrition

Delegates unanimously renewed their commitment to invest and scale up nutrition policies and programmes to improve infant and young child feeding.

Member States discussed efforts to achieve the World Health Assembly Global Nutrition Targets, concluding progress has been slow and uneven, but noted a small step forward in the reduction of stunting, with the number of stunted children under 5 years falling from 169 million in 2010 to 151 million in 2017. WHO is leading global action to improve nutrition, including a global initiative to make all hospitals baby friendly, scaling up prevention of anaemia in adolescent girls, and preventing overweight in children through counselling on complementary feeding. A new report was launched on the implementation of the Code of Marketing Breastmilk Substitutes, highlighting that 6 more countries had adopted or strengthened legislation in 2017 to regulate marketing of breastmilk substitutes.

Polio

With wild poliovirus transmission levels lower than ever before, and the world closer than ever to being polio-free, discussions focused on securing a lasting polio-free world. As at May 2018, only 9 cases due to wild poliovirus had been reported globally, from just 2 countries: Afghanistan and Pakistan. Delegates reviewed emergency plans to interrupt the last remaining strains of the virus.

To prepare for a polio-free world, global poliovirus containment activities continue to be intensified, and Member States adopted a landmark resolution on poliovirus containment. In a limited number of facilities, poliovirus will continue to be retained, post-eradication, to serve critical national and international functions such as the production of polio vaccine or research. It is crucial that poliovirus materials are appropriately contained under strict biosafety and biosecurity handling and storage conditions to ensure that the virus is not released into the environment, either accidentally or intentionally, to again cause outbreaks of the disease in susceptible populations.

Member States expressed overwhelming commitment to fully implement and finance all strategies to secure a lasting polio-free world in the very near term. Rotary International, speaking on behalf of the Global Polio Eradication Initiative (which consists of WHO, Rotary, CDC, UNICEF and the Bill & Melinda Gates Foundation) offered an impassioned plea to the global community to eradicate a human disease for only the second time in history, and ensure that no child will ever again be paralysed by any form of poliovirus anywhere.

Closing remarks

In his final speech to this year's Assembly, Dr Tedros said that everywhere he went, he had the same message: health as a bridge to peace. "Health has the power to transform an individual's life, but it also has the power to transform families, communities and nations," he told delegates.

The Organization's new 5-year strategic plan, he said, called on WHO to measure its success not by its outputs, but by outcomes - by the measurable impact it delivers where it matters most - in countries.

"Ultimately, the people we serve are not the people with power; they're the people with no power," the Director-General said. He told delegates the true test of whether the discussions held in the Assembly this week were successful would be whether they resulted in real change on the ground and he urged them to go back to their countries with renewed determination to work every day for the health of their people.

"The commitment I have witnessed this week gives me great hope and confidence that together we can promote health, keep the world safe, and serve the vulnerable," he concluded.

http://www.who.int/news-room/detail/26-05-2018-seventy-first-world-health-assembly-update-26-may

 

World Briefs: Ebola outbreak in Congo may spread, says WHO

EBOLA OUTBREAK IN CONGO MAY SPREAD, SAYS WHO

GENEVA • A deadly Ebola outbreak in the Democratic Republic of Congo has a clear "potential to expand", the World Health Organisation warned yesterday, as it reported seven more cases of the disease.

"We are on the epidemiological knife edge," Dr Peter Salama, in charge of emergency response at the WHO, told a special meeting on the outbreak that has killed 27 people.

The agency issued a new toll, saying there had been 58 cases since the outbreak was declared on May 8 - an increase of seven over figures issued on Tuesday - and said it was actively following more than 600 contacts.

AGENCE FRANCE-PRESSE

METHOD FOUND TO CRIPPLE BREAST CANCER CELLS

PARIS • Scientists have identified the mechanism that allows breast cancer cells to lie dormant in other parts of the body only to re-emerge years later with lethal force, according to a new study.

In experiments with human cells and live mice, researchers showed that disabling the mechanism - with drugs or gene manipulation - crippled the cancer cells and inhibited their capacity to spread.

The discovery, reported in the journal Nature Communications on Tuesday, provides a promising target for the development of breast cancer therapies, the study said.

AGENCE FRANCE-PRESSE

104 PEOPLE JAILED FOR LIFE OVER FAILED TURKISH COUP

ISTANBUL • A court in Turkey has sentenced 104 people to life in prison for involvement in the failed military coup of 2016, handing down the heaviest penalties possible in the country.

The defendants were part of a group trial of 280 people, mostly military personnel, accused of participating in an attempt to overthrow President Recep Tayyip Erdogan.

Scuffles broke out at the sentencing on Monday as some of the defendants tried to attack two witnesses who had turned state's evidence and given details of the plan during the trial, according to Turkish news reports.

https://www.straitstimes.com/world/world-briefs-ebola-outbreak-in-congo-may-spread-says-who

 

At global health forum, UN officials call for strong, people-focused health systems

Everyone, everywhere must have equal access to quality health care, said top United Nations officials on Monday, urging greater focus on comprehensive health and well-being.

In a video message to the opening of the seventy-first session of the World Health Assembly in Geneva, Secretary-General António Guterres reiterated that the enjoyment of the highest attainable standard of health is a fundamental human right.

The World Health Assembly is the highest decision-making body of the World Health Organization, WHO. It determines the agency’s polices, supervises financial policies, and reviews and approves the proposed programme budget.

“We need strong resilient systems that place people at the centre,” said Mr. Guterres.

“Universal health coverage provides the foundation to help us overcome the inequities that continue to leave so many behind.”

Ensuring that everyone, everywhere has access to quality health care and services, is also vital for the achievement of the Sustainable Development Goals (SDGs), stressed the UN chief.

In particular, Sustainable Development Goal 3 (SDG 3), which has specific targets to ensure healthy lives and promote well-being at all stages in life. In addition, health improvements feature prominently in many of the other ambitious Goals.

Tedros Adhanom Ghebreyesus, WHO’s Director-General, also addressed the Assembly, emphasizing the importance of universal health coverage, as illustrated by the ongoing Ebola outbreak in the Democratic Republic of the Congo (DRC).

The WHO chief outlined a number of initiatives at the UN health agency to advance universal coverage and urged greater political commitment: “It’s clear that the twin messages of health security and universal health coverage resonate loudly with world leaders,” he said.

Mr. Tedros also highlighted critical upcoming events focussed on global health, including two high-level meetings; on non-communicable diseases and on tuberculosis at the upcoming session of the UN General Assembly which begins in September.

“The people who suffer from these diseases all over the world are relying on us: the people who cannot get the care they need; the people who cannot afford the care they need; the people who aren’t even aware they are infected with a potentially deadly pathogen,” he said.

“We owe it to them to ensure that we do not waste the opportunities.”

DRC Ebola outbreak: Vaccination of health workers commences

Separately on Monday, WHO announced that the vaccination of health workers in areas of the DRC effected by the Ebola virus, has begun.

Together with the Government and partner organizations, WHO is also preparing to start a so-called ring vaccination programme, whereby the contacts of confirmed cases and the contacts of those contacts will be offered immunization, using the experimental drug.

“We need to act fast to stop the spread of Ebola by protecting people at risk of being infected with the Ebola virus, identifying and ending all transmission chains and ensuring that all patients have rapid access to safe, high-quality care,” said Peter Salama, the WHO Deputy Director-General for Emergency Preparedness and Response.

While the rVSV-ZEBOV Ebola vaccine is yet to be licensed, it was highly protective against Ebola in a major trial in 2015 in Guinea, said WHO.

Earlier results have been promising with the agency reporting that among the 5,837 people who received the vaccine, no positive cases were recorded nine days or more after vaccination.

https://news.un.org/en/story/2018/05/1010272

 

The World Health Organization Just Declared War on Trans Fats

The World Health Organization has announced a comprehensive plan to eliminate industrially produced trans-fatty acids from the global food supply by 2023. It’s a good idea—but the five-year plan may be overly ambitious.

The plan, called REPLACE, urges global governments to eliminate the use of industrially produced trans fats, also known as partially hydrogenated oils (PHOs), within the next five years. It’s a logical next step given that many jurisdictions, particularly those in wealthier countries, have already taken similar measures—but the challenge now will be in getting low- and middle-income countries to follow suit, a more difficult task owing to weaker food and safety controls.

Trans fats, which are produced when vegetable oil hardens in a process called hydrogenation, can be found in margarine, ghee, and shortening products like Crisco. Margarine was super popular in the 1970s, as it was touted as a healthier alternative to butter back when saturated fats were, perhaps unfairly, linked to heart disease. Trans fats are also used in some deep frying, and can often be found in baked and processed snack foods.

The consumption of trans fats increases a person’s risk of heart disease by 21 percent and premature death by 28 percent, according to the WHO. Partially hydrogenated oils also lead to increased inflammation and endothelial dysfunction, a condition that precedes atherosclerosis and clogging of arteries. Globally, around 500,000 people die each year due to trans fat-induced cardiovascular disease. The CDC says a reduction of trans fat consumption would prevent between 10,000 to 20,000 heart attacks each year, and 3,000 to 7,000 coronary heart disease deaths annually, in the United States.

Manufacturers say PHOs extend the shelf life of foods, and that they are cheaper than the alternatives, but the WHO contests both of these claims.

“WHO calls on governments to use the REPLACE action package to eliminate industrially-produced trans-fatty acids from the food supply,” said WHO Director-General Tedros Adhanom Ghebreyesus in a statement. “Implementing the six strategic actions in the REPLACE package will help achieve the elimination of trans fat, and represent a major victory in the global fight against cardiovascular disease.”

These six strategic actions are designed to ensure the “prompt, complete, and sustained elimination” of industrially produced trans fats from the global food supply:

REview dietary sources of industrially-produced trans fats and the landscape for required policy change.

Promote the replacement of industrially-produced trans fats with healthier fats and oils.

Legislate or enact regulatory actions to eliminate industrially-produced trans fats.

Assess and monitor trans fats content in the food supply and changes in trans fat consumption in the population.

Create awareness of the negative health impact of trans fats among policy makers, producers, suppliers, and the public.

Enforce compliance of policies and regulations.

Speaking to reporters, Ghebreyesus said today’s announcement marks the first time that WHO has called for the elimination of a significant lifestyle factor responsible for a non-communicable disease.

As noted, some countries have practically eliminated industrially produced trans-fatty acids by enforcing limits on the amount that can be added to packaged foods. Some countries and jurisdictions have even taken the step of imposing bans on PHOs—the main source of industrially produced trans-fatty acids. Denmark was the first country to impose restrictions on trans fat over a decade ago, and in 2015, the US Food and Drug Administration took steps to eliminate PHOs from the American food supply by this year. New York City enacted restrictions 10 years ago, and studies suggest the move is already paying dividends in the form of reduced rates of cardiovascular disease—a claim that remains controversial.

“Banning trans fats in New York City helped reduce the number of heart attacks without changing the taste or cost of food, and eliminating their use around the world can save millions of lives,” Michael R. Bloomberg, a three-term mayor and WHO Global Ambassador for Noncommunicable Diseases, said in a statement today. “A comprehensive approach to tobacco control allowed us to make more progress globally over the last decade than almost anyone thought possible—now, a similar approach to trans fat can help us make that kind of progress against cardiovascular disease, another of the world’s leading causes of preventable death.”

Trans fats seem to be unhealthy because they increase levels of low-density lipoprotein (LDL, or “bad”) cholesterol, which has been linked to cardiovascular disease, stroke, and type 2 diabetes. At the same time, trans fats decreases high-density lipoprotein (HDL, or “good”) cholesterol, which has the beneficial effect of transporting cholesterol from the arteries to the liver for processing. Meanwhile, eating unsaturated fatty acids lowers a person’s risk of heart disease by offsetting the negative effects of PHOs on blood lipids—the fatty substances found in the blood, including cholesterol and triglycerides.

In its guidelines, the WHO recommends that people reduce their total trans fat consumption to less than 1 percent of their total daily energy intake. So for a 2,000 calorie per day diet, that’s no more than 2.2 grams of trans fats a day.

The WHO’s recommendations are exactly that: recommendations. As Walter Willett, a professor of epidemiology and nutrition at Harvard T.H. Chan School of Public Health, told CNN, the WHO has no enforcement capacity, so national and local governments will have to do the heavy lifting in this regard.

“The food industry is not monolithic. Some parts of the industry eliminated trans fat proactively once the evidence became clear that this was harmful, but other parts of the industry are likely to resist unless they are legally forced to remove trans fat from their products,” Willett told CNN. “In the long run, I’m confident that industrial trans fat will be eliminated.”

Eliminating all industrial-manufactured trans fats from the global food supply by 2023 is an ambitious, perhaps unrealistic goal. It’s also important to point out that naturally occurring trans fats from cud-chewing mammals like cows and sheep will continue to appear in food products, such as milk, butter, and yogurt. But a deadline is good, as it imparts urgency. As the WHO rightly points out, there’s no excuse to keep using trans fats in products. The issue now is one of will.

source: https://gizmodo.com/the-world-health-organization-just-declared-war-on-tran-1826011682

 

 

'Serious Challenge': World Health Officials Rushing to Stop Another Ebola Outbreak After 18 Deaths

The World Health Organization said Friday they are working to prevent an outbreak of the Ebola in the Democratic Republic of the Congo.

In the past five weeks, at least 34 cases of the fatal hemorrhagic fever have been reported, with 18 deaths and 14 suspected cases, the WHO said. Three health workers have also been infected.

“WHO staff were in the team that first identified the outbreak. I myself am on my way to the DRC to assess the needs first-hand,” said WHO director-general Dr. Tedros Adhanom Ghebreyesus in a statement. “I’m in contact with the Minister of Health and have assured him that we’re ready to do all that’s needed to stop the spread of Ebola quickly. We are working with our partners to send more staff, equipment and supplies to the area.”

“It is too early to judge the extent of this outbreak,” added Dr. Peter Salama, WHO deputy director-general for Emergency Preparedness and Response. “However, early signs including the infection of three health workers, the geographical extent of the outbreak, the proximity to transport routes and population centres, and the number of suspected cases indicate that stopping this outbreak will be a serious challenge. This will be tough and it will be costly. We need to be prepared for all scenarios.”

This is the DRC’s ninth outbreak of Ebola.

The WHO is teaming with the government there on their response plan. Right now, that plan includes contact tracing, infection prevention, community engagement and the use of ring vaccinations and antivirals.

During the 2014-15 Ebola outbreak, 11,310 people died and 28,616 were infected across West Africa, the Centers for Disease Control and Prevention reported.

source; http://people.com/health/world-health-officials-ebola-outbreak-after-18-deaths-confirmed/ 

 

 

Taiwan accuses World Health Organisation of bowing to Beijing over invitation to top health meeting

Taipei again fails to gain entry to the WHO’s main international gathering of the year

Taiwan has accused the World Health Organisation of succumbing to political pressure from mainland China after the island failed to receive an invitation to a major international meeting.

Beijing sees self-governing democratic Taiwan as part of its territory awaiting reunification and has used its clout to diminish the island’s presence on the world stage since Beijing-sceptic President Tsai Ing-wen took power in May 2016.

Last year was the first time in eight years that Taiwan was not granted access to the World Health Assembly (WHA), the WHO’s main meeting.

This year’s assembly is to be held in Geneva from May 21-26 and the online registration deadline lapsed on Monday without Taipei receiving an invite.

“We believe the WHO is a non-political organisation pursuing the highest health standards for humanity and should not solely serve Beijing’s political will,” Taiwan’s Mainland Affairs Council said in a statement.

Taiwan’s foreign ministry said on Tuesday it “regretted” that it had not been invited to the assembly.

“Health is a basic human right, as well as a universal value regardless of differences in race, religion, political beliefs, economic or social situations,” the ministry said in a statement.

It added that under the WHO charter, Taiwan should be allowed “equal participation” in all WHO events.

The WHO did not immediately respond to a request for confirmation it would not invite Taipei to this year’s assembly.

In Beijing on Monday, foreign ministry spokesman Geng Shuang the island was only able to attend the assembly from 2009-2016 because the previous Taiwan government had a consensus with Beijing that there is only “one China”.

While the former administration touted the agreement as enabling cross-strait relations to flourish without compromising Taiwan’s sovereignty, Beijing saw it as meaning that Taiwan and the mainland are part of a single China.

Tsai and her independence-leaning Democratic Progressive Party have refused to acknowledge the principle which Beijing sees as the bedrock for relations.

“This damaged the political foundation for Taiwan’s participation,” Geng said.

Beijing has also been trying to exert pressure on international companies to list Taiwan as a Chinese province on their websites, rather than as a separate entity.

The White House said on Saturday that China’s aviation authorities had sent letters to 36 foreign airlines including US firms demanding they refer to Taiwan, Hong Kong, and Macau as Chinese territories.

“This is Orwellian nonsense and part of a growing trend by the Chinese Communist Party to impose its political views on American citizens and private companies,” the White House said.

source: http://www.scmp.com/

 

World Malaria Day 2018: We are ready to beat malaria

25 April 2018, Cairo - On World Malaria Day 2018, the World Health Organization (WHO) and its partners are calling on all concerned parties to be ready to end malaria - a disease which can be fatal and which affects millions of people, claiming many lives annually.

This year’s World Malaria Day coincides with activities to commemorate the 70th anniversary of WHO. Over the last 7 decades, WHO has been providing support to countries to fight malaria. “Ready to beat malaria” is the theme of this year’s day. The theme underscores the collective energy and commitment of the global malaria community in uniting around the common goal of achieving a malaria-free world.

Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is a preventable and curable disease and yet the global burden of this disease is very high. According to the latest “World Malaria Report”, released in November 2017, there were 216 million cases of malaria in 2016, up from 211 million cases in 2015. The estimated number of malaria deaths stood at 445 000 in 2016, a similar number to the previous year (446 000).

In areas with high transmission of malaria, children under 5 are particularly susceptible to infection, illness and death; more than two thirds (70%) of all malaria deaths occur in this age group. The number of under-5 malaria deaths has declined from 440 000 in 2010 to 285 000 in 2016. However, malaria remains a major killer of children under 5, taking the life of a child every 2 minutes.

In the Eastern Mediterranean Region, the number of malaria cases increased from 3.9 million in 2015 to 4.3 million in 2016with 8200 deaths.

Ninety-five percent (95%) of confirmed malaria cases are reported from 4 countries in the Region and 6 countries are at high risk of malaria but are at the stage of burden reduction.

On the occasion of World Malaria Day 2018, Dr Jaouad Mahjour, acting WHO Regional Director for the Eastern Mediterranean, said that, “Although coverage of main interventions in endemic countries is increasing it falls short of universal health coverage targets. Humanitarian emergencies taking place in some countries are decreasing the capacity of malaria programmes and insufficient resources in high-burden countries are among the main challenges.”

Over the past few years, the Region has made some achievements towards eliminating malaria. The Islamic Republic of Iran and Saudi Arabia are at the stage of malaria elimination.

Fourteen countries in the Region are free from indigenous malaria transmission and are at the stage of prevention of establishment of local malaria transmission.

Increasing insecticide resistance in many malaria-endemic countries of the Region is a threat for vector control as the main preventive measure for malaria.

Together with diagnosis and treatment, WHO recommends a package of proven prevention approaches, including insecticide treated nets, spraying indoor walls with insecticides, and preventive medicines for the most vulnerable groups: pregnant women, under 5s and infants.

Without urgent action, the major gains in the fight against malaria are under threat. On this World Malaria Day, WHO continues to call for greater investment from national resources and also donors from the Region and expanded coverage of proven tools to prevent, diagnose and treat malaria.

source: https://reliefweb.int/

 

Prescreening necessary before dengue vaccine use, says WHO expert advisory group

MANILA — The World Health Organization’s expert advisory group on immunization, or SAGE, is not halting the use of the dengue vaccine Dengvaxia. But they stress the need for prescreen tests before its administration for safety reasons.

The group made the new recommendations following their two-day meeting last week.

While the new recommendation by SAGE is meant to maximize the public health benefits of the vaccine while minimizing risks, it poses limitations in terms of the vaccine’s widespread use. There are currently no rapid diagnostic tests at point of care available to know whether patients have previously been infected with the dengue virus.

“There are tests available, but these are not point of care tests, so their implementation would be cumbersome, and require that the person returns,” Dr. Joachim Hombach, SAGE’s executive secretary, said in a press conference.

“We see indeed a significant obstacle in using this vaccine that way. On the other hand, we are confident that this also spurs the development of rapid diagnostic tests that then could be readily used.”

There are several rapid diagnostic tests available in the market, but none have been validated or licensed when it comes to determining an individual’s dengue serostatus.

“Various ELISA-based assays exist such as the dengue IgG ELISA, and many countries actually have access to these diagnostic tests. The disadvantage of such laboratory assays are that they cannot be used at the point of care as blood sample needs to be taken, then it takes 1-3 days to receive the results, sometimes even longer,” Hayatee Hasan, WHO technical officer for Immunization, Vaccines and Biologicals in Geneva, told Devex.

Asked whether the onerous recommendations could limit the vaccine’s long-term existence, the group said that’s something the manufacturer has to deal with.

“Whether this has repercussions on the manufacturer is something which is secondary. For us, it is very important that we signal in which way we think this vaccine could be used, even if ... the options for using it may not be available immediately. But maybe for the medium term. This is for the company to decide in terms of how they cope with this,” Hombach said.

Dengvaxia is currently the only vaccine licensed against dengue.

The vaccine came under scrutiny after Sanofi Pasteur, its manufacturer, revealed in late 2017 of the potential severe effects of the vaccine in seronegative individuals, or essentially those who’ve not been previously infected with the dengue virus.

The issue caused widespread uproar in the Philippines, in particular, where over 800,000 schoolchildren have already received the vaccine. A senate inquiry commenced after reports emerged that 14 children reportedly died from the vaccine. The Department of Health formed a panel of experts to probe this. Initial findings by the panel showed three of the cases have “causal association” to the vaccine, but they stressed the need for further tests before they can arrive to a final conclusion.

“The results of this evaluation are to be forwarded to the Pharmacovigilance Team of the DOH for further investigation and/or signal detection for possible new causal association. Only then can the investigation of these cases be completed and the results considered final,” it said in the report.

Following the controversies, the Philippine Department of Health has decided to suspend its dengue immunization program.

The WHO will be aligning its position on the use of the dengue vaccine with the SAGE recommendations, said Hasan. The U.N. body’s revised position paper on the subject will be published in September 2018.

source: https://www.devex.com/