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A lack of progress on reforms such as international health regulations means the world is as vulnerable as ever

The world is no better prepared for a new pandemic than it was when coronavirus emerged in 2019 and may actually be in a worse place given the economic toll, according to a panel set up by the World Health Organisation (WHO) to evaluate the global response.

A lack of progress on reforms such as international health regulations means the world is as vulnerable as ever, the Independent Panel for Pandemic Preparedness and Response said in its report.

The authors, led by former New Zealand prime minister Helen Clark and former president of Liberia Ellen Johnson Sirleaf, acknowledged some progress, including on more robust funding for the WHO, but said the process was going far too slowly. 

“We have right now the very same tools and the same system that existed in December 2019 to respond to a pandemic threat. And those tools just weren’t good enough,” Clark told reporters.

“If there were a new pandemic threat this year, next year, or the year after at least, we will be largely in the same place … maybe worse, given the tight fiscal space of many, if not most, countries right now.”

Wednesday’s report comes ahead of next week’s World Health Assembly in Geneva, the WHO’s annual decision-making forum, which is expected to address some of the issues raised.

While the body welcomed some steps forward, including moves to establish a separate global health security fund within the World Bank, it warned that global interest was waning and the years it will take to set up other instruments – including a potential pandemic treaty, an international agreement to improve preparedness – were too long.

The panel called for a high-level meeting at the U.N. General Assembly and independent health threats council led by heads-of-state to galvanise action.

“Only the highest-level political leadership has the legitimacy to bring multiple sectors together in this way,” Sirleaf said in a statement.

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The first-ever global report on Infection Prevention and Control, IPC, released today by the World Health Organisation, WHO has shown that where good hand hygiene and other cost-effective practices are followed, 70 per cent of those infections can be prevented.

The COVID-19 pandemic and other recent large disease outbreaks had highlighted the extent to which health care settings can contribute to the spread of infections, harming patients, health workers and visitors, if insufficient attention is paid to IPC.

The report showed that out of every 100 patients in acute-care hospitals, seven patients in high-income countries and 15 patients in low- and middle-income countries will acquire at least one healthcare-associated infection (HAI) during their hospital stay.

The report further noted that on average, 1 in every 10 affected patients will die from their HAI.

“People in intensive care and newborns are particularly at risk. And the report reveals that approximately one in four hospital-treated sepsis cases and almost half of all cases of sepsis with organ dysfunction treated in adult intensive-care units are healthcare-associated.

WHO’s  Global Report on Infection Prevention and Control brought together evidence from scientific literature and various reports, and new data from WHO studies.

Speaking on the report, WHO Director-General, Dr Tedros Adhanom Ghebreyesus said: “The COVID-19 pandemic has exposed many challenges and gaps in IPC in all regions and countries, including those which had the most advanced IPC programmes.

 “It has also provided an unprecedented opportunity to take stock of the situation and rapidly scale up outbreak readiness and response through IPC practices, as well as strengthening IPC programmes across the health system. Our challenge now is to ensure that all countries are able to allocate the human resources, supplies and infrastructures this requires.”

He noted that the new WHO report provides the first-ever global situation analysis of how IPC programmes are being implemented in countries around the world, including regional and country focuses. While highlighting the harm to patients and healthcare workers caused by HAIs and antimicrobial resistance, the report also addresses the impact and cost-effectiveness of infection prevention and control programmes and the strategies and resources available to countries to improve them.

The impact of healthcare-associated infections and antimicrobial resistance on people’s lives is incalculable.

“Over 24 per cent of patients affected by healthcare-associated sepsis and 52.3 per cent of those patients treated in an intensive care unit die each year. Deaths are increased two to threefold when infections are resistant to antimicrobials.

In the last five years, WHO has conducted global surveys and country joint evaluations to assess the implementation status of national IPC programmes.

Comparing data from the 2017-18 and the 2021-22 surveys, the percentage of countries having a national IPC programme did not improve; furthermore, in 2021-22 only four out of 106 assessed countries (3.8 per cent) had all minimum requirements for IPC in place at the national level.

This is reflected in the inadequate implementation of IPC practices at the point of care, with only 15.2 per cent of health care facilities meeting all of the IPC minimum requirements, according to a WHO survey in 2019.

The report further noted that encouraging progress has been made in some areas, with a significant increase being seen in the percentage of countries having an appointed IPC focal point, a dedicated budget for IPC and curriculum for front-line health care workers’ training; developing national IPC guidelines and a national programme or plan for HAI surveillance; using multimodal strategies for IPC interventions; and establishing hand hygiene compliance as a key national indicator.

“Many countries are demonstrating strong engagement and progress in scaling-up actions to put in place minimum requirements and core components of IPC programmes. Progress is being strongly supported by WHO and other key players. Sustaining and further expanding this progress in the long-term is a critical need that requires urgent attention and investments.”

The report revealed that high-income countries are more likely to progress their IPC work, and are eight times more likely to have a more advanced IPC implementation status than low-income countries. Indeed, little improvement was seen between 2018 and 2021 in the implementation of IPC national programmes in low-income countries, despite increased attention being paid generally to IPC due to the COVID-19 pandemic. WHO will continue to support countries to ensure IPC programmes can be improved in every region.

Who further called on all countries around the globe to increase their investment in IPC programmes to ensure the quality of care and patient and health workers’ safety as it will not only protect their populations, and increase investment in IPC but has also demonstrated to improve health outcomes and reduce health-care costs and out-of-pocket expenses.
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Almost three times as many people have died as a result of Covid-19 as official data show, according to a new World Health Organisation (WHO) report, the most comprehensive look at the true global toll of the pandemic so far.

There were 14.9 million excess deaths associated with Covid-19 by the end of 2021, the UN body said on Thursday.

The official count of deaths directly attributable to Covid-19 and reported to WHO in that period, from January 2020 to the end of December 2021, is slightly more than 5.4 million.

The WHO’s excess mortality figures reflect people who died of Covid-19 as well as those who died as an indirect result of the outbreak, including people who could not access healthcare for other conditions when systems were overwhelmed during huge waves of infection.

It also accounts for deaths averted during the pandemic, for example because of the lower risk of traffic accidents during lockdowns.

But the numbers are also far higher than the official tally because of deaths that were missed in countries without adequate reporting. Even pre-pandemic, around six in 10 deaths around the world were not registered, WHO said.

The WHO report said that almost half of the deaths that until now had not been counted were in India. The report suggests that 4.7 million people died there as a result of the pandemic, mainly during a huge surge in May and June 2021.

The Indian government, however, puts its death toll for the January 2020-December 2021 period far lower: about 480,000.

WHO said it had not yet fully examined new data provided this week by India, which has pushed back against the WHO estimates and issued its own mortality figures for all causes of death in 2020 on Tuesday. WHO said it may add a disclaimer to the report highlighting the ongoing conversation with India.

In a statement issued after the numbers were published, the Indian government said WHO had released the report “without adequately addressing India’s concerns” over what it called “questionable” methods.

The WHO panel, made up of international experts who have been working on the data for months, used a combination of national and local information, as well as statistical models, to estimate totals where the data is incomplete – a methodology that India has criticised.

However, other independent assessments have also put the death toll in India far higher than the official government tally, including a report published in Science which suggested 3 million people may have died of COVID in the country.

Other models have also reached similar conclusions about the global death toll being far higher than the recorded statistics. For comparison, around 50 million people are thought to have died in the 1918 Spanish Flu pandemic, and 36 million have died of HIV since the epidemic began in the 1980s.

Samira Asma, WHO assistant director general for data, analytics and delivery for impact, who co-led the calculation process, said data was the “lifeblood of public health” needed to assess and learn from what happened during the pandemic.

She called for more support for countries to improve reporting.

“Too much is unknown,” she told reporters in a press briefing.

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(Photo by Yasuyoshi CHIBA / AFP)

At least 228 probable cases of hepatitis of unknown origin in children have now been reported to the World Health Organization from 20 countries, the UN health agency said Tuesday.

“As of May 1, at least 228 probable cases were reported to WHO from 20 countries, with over 50 additional cases under investigation,” WHO spokesman Tarik Jasarevic told reporters in Geneva.

Most of the cases are from Europe but there are others in the Americas, the Western Pacific and Southeast Asia, he said.

The WHO was first informed on April 5 of 10 cases in Scotland detected in children under the age of 10. More than 100 cases have now been recorded in Britain.

Some cases have caused liver failure and required transplants. At least one child is known to have died.

Many cases reported jaundice, and gastrointestinal symptoms including abdominal pain, diarrhoea and vomiting.

The WHO refers to the outbreak of severe liver inflammations as acute hepatitis of unknown origin among young children.

“It is not yet clear if there has been an increase in hepatitis cases, or an increase in awareness of hepatitis cases that occur at the expected rate but go undetected,” it says on its website.

“While adenovirus is a possible hypothesis, investigations are ongoing for the causative agent,” it added.

Adenoviruses are generally known to cause respiratory symptoms, conjunctivitis or even digestive disorders.

After the discovery of the first 169 cases, the WHO said common viruses that cause acute viral hepatitis (hepatitis viruses A, B, C, D and E) were not detected in any of them.
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An obese man walks past the New York Stock Exchange after trading hours in New York on Aug.17, 2009. PHOTO: Lucas Jackson / Reuters

The WHO said Tuesday that “epidemic” overweight and obesity rates are linked to over 1.2 million deaths annually across Europe, calling for swift policy changes to reverse the dangerous trend.

Obesity rates in the region have ballooned by 138 percent in the past five decades, the World Health Organization said in a new report, and are linked to a series of cancers and cardiovascular diseases.

Nearly a quarter of adults are now obese in Europe, higher than in any other region except the Americas, the WHO said.

“Overweight and obesity rates have reached epidemic proportions across the region and are still escalating,” the health body’s European office said.

“Raised body mass index is a major risk factor for non-communicable diseases, including cancers and cardiovascular diseases,” WHO regional director Hans Kluge was quoted saying in the report.

Obesity causes at least 13 different types of cancer and is likely responsible for at least 200,000 new cases of cancer per year, it said.

“This figure set to rise further in the coming years,” the organisation said in the new report.

Excess weight and obesity are estimated to cause more than 1.2 million deaths per year, accounting for more than 13 percent of deaths in the region, it added.

– Pandemic pounds –

The latest comprehensive data available, from 2016, shows that 59 percent of adults and nearly one in three children — 29 percent of boys and 27 percent of girls — are overweight in Europe.

In 1975, 40 percent of European adults were overweight.

The prevalence of obesity among adults has risen by 138 percent since then, with a 21-percent increase between 2006 and 2016.

The Covid-19 pandemic is also linked to growing waistlines, especially as lockdowns promoted “an unhealthy diet or sedentary lifestyle”, the report found.

It also revealed further health risks associated with excess weight.

“People living with obesity were more likely to experience severe outcomes of the Covid-19 disease spectrum, including intensive care unit admissions and death,” Kluge said.

The authors also noted that the causes of obesity “are much more complex than the mere combination of unhealthy diet and physical inactivity”.

Environmental factors unique to “modern Europe’s highly digitalised societies are also drivers of obesity”, it said, including the marketing of unhealthy foods and online gaming — especially among children.

The WHO called for policy changes to prevent obesity and promote healthy lifestyles, such as taxing sugary drinks and subsidising healthy foods while limiting the marketing of unhealthy foods to children.

“Policy interventions that target environmental and commercial determinants of poor diet at the entire population level are likely to be most effective at reversing the obesity epidemic,” it stated.

The WHO’s European region comprises 53 countries, including several in central Asia.
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In this file photo taken on February 25, 2021 the United Nations logo is seen inside the United Nations in New York City. Angela Weiss / AFP

Measles cases have surged by nearly 80 percent worldwide this year, the UN said Wednesday, warning that the rise of the “canary in a coal mine” illness indicates that outbreaks of other diseases are likely on the way.

The coronavirus pandemic has interrupted vaccination campaigns for non-Covid diseases around the world, creating a “perfect storm” that could put millions of children’s lives at risk, the UN’s children’s agency UNICEF and the World Health Organization said in a statement.

More than 17,300 measles cases were reported globally in January and February, compared to around 9,600 during those months last year, according to new data from the UN agencies.

There have been 21 large and disruptive measles outbreaks in the last 12 months to April, most of them in Africa and the eastern Mediterranean, the data showed.

Christopher Gregory, senior health adviser in UNICEF’s immunisation section, told AFP that because measles is the “most contagious vaccine-preventable disease” it often serves as a warning sign.

“Measles is what we call the tracer, or the canary in the coal mine, that really shows us where those weaknesses in the immunisation system are,” he said.

He said yellow fever was among the diseases that could surge next, after rising cases were reported in West Africa.

“We’re particularly worried about those countries that are most fragile, where the healthcare systems are already really struggling, where they’re still trying to deal with the impacts of Covid on top of these outbreaks,” he said.

Somalia recorded by far the most measles cases in the last 12 months with more than 9,000, the UN data showed, followed by Yemen, Afghanistan, Nigeria and Ethiopia — all countries battling some form of conflict.

There are also fears that the war in Ukraine could spark a resurgence in the country after it recorded Europe’s highest rate of measles between 2017-2019.

Gregory said that it had been very difficult to keep track of any disease in Ukraine since the war began, adding that the biggest concern was “what we could be missing”.

– Impact ‘felt for decades’ –

More than 23 million children missed out on routine vaccinations in 2020 as the Covid pandemic descended, the largest number in more than a decade.

The UN agencies said that 57 vaccination campaigns in 43 countries postponed at the start of the pandemic had still not been completed, affecting 203 million people — most of them children.

Covid also continues to pile pressure on healthcare facilities and drag staffing and attention away from vaccination for long-standing deadly diseases.

“The impact of these disruptions to immunisation services will be felt for decades to come,” WHO chief Tedros Adhanom Ghebreyesus said in the statement.

“Now is the moment to get essential immunisation back on track and launch catch-up campaigns so that everybody can have access to these life-saving vaccines.”

Gregory said it was time to put childhood immunisation on “at least the same level of priority as finishing Covid vaccination”.

Measles is a disease caused by a virus that attacks mainly children. The most serious complications include blindness, brain swelling, diarrhoea, and severe respiratory infections.

Vaccination uptake of at least 95 percent is the best way to avoid it spreading, though many countries fall far short of that goal — Somalia is at just 46 percent, according to the UN data.

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Fresh Covid-19 surges are likely as the virus is expected to continue mutating, and tcountries should have in place plans to shift back into emergency mode

The European Commission said that between 60% and 80% of the EU population was estimated to have been infected with COVID-19, as the bloc enters a post-emergency phase in which mass reporting of cases was no longer necessary.

In preparing for this less acute phase, European Union governments should ramp up COVID-19 immunisations of children, the bloc’s executive body said, signallingit was considering plans to develop antivirals.

“It is estimated that between 60% to 80% of the EU population has by now had COVID,” EU health commissioner Stella Kyriakides told a news conference.

The EU public health agency said reported cases had covered about 30% of the European population so far, but if unreported infections were added, cases could be as high as 350 million, about 77% of the European population.

With a recent drop in infections and deaths linked to COVID-19, the EU is now shifting away from mass testing and reporting of cases, Kyriakides said, confirming what Reuters reported on Tuesday. Read full story

But fresh COVID-19 surges are likely as the virus is expected to continue mutating, and therefore countries should have in place plans to shift back into emergency mode, and should ramp up vaccinations, the commission said.

In a document outlining the strategy for the post-emergency phase of the pandemic, Brussels urged governments to continue pushing for the immunisation of the unvaccinated, especially children before the start of the new school term in the autumn.

Immunisation rates are below 15% among children aged between 5 and 9, the youngest age group for which COVID-19 vaccines have been authorised in Europe. That compares to over 70% of teens aged 15 to 17, the document says.

The Commission also said it could back the development of new drugs against COVID-19, especially antivirals that are easier to store and administer.

The EU “will explore possibilities to support projects targeting the development of antivirals,” it said.

Antiviral pills against COVID-19 developed by Pfizer PFE.N and Merck & Co MRK.N have been approved for use in the EU. But their uptake has so far been limited, due to a range of reasons including the slowing of the pandemic, high prices and complicated national procedures to prescribe them.

The EU executive also said it would work to support the development of the next generation of COVID-19 vaccines which it expects will offer more robust and longer-lasting protection against infection or transmission.

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Several members of the 1966 England World Cup squad, including Jack Charlton and Nobby Stiles, have died after suffering from brain functioning diseases believed to be linked to heading footballs

Researchers are looking to recruit 120 former professional footballers to help with a new study to investigate possible ways to reduce the risk of dementia.

The £1.3million BrainHOPE study aims to build on the 2019 FIELD study, which found the risk of dementia and related disorders was three and a half times higher among former professional footballers than the general population.

The new project, jointly funded by the Football Association and FIFA, will use a range of tests to compare brain health in former footballers between the ages of 40 and 59 compared to the general population, and explore whether there are ways to reduce the risk.

Professor Willie Stewart, consultant neuropathologist and honorary professor at the University of Glasgow and leader of the FIELD study, said: “This is an incredibly important study, and we are grateful to the FA and FIFA for their support to allow it to proceed.

“Our findings from the Field study show there is reason to worry about lifelong brain health in former footballers. BrainHOPE is designed to identify tests that might detect problems early on and, more importantly, possible ways to try and reduce dementia risk for former footballers.”

Led by the University of Glasgow, the project will be undertaken in collaboration with the University of Edinburgh, Imperial College London and the wider Prevent Dementia research collaborators.

Stewart’s FIELD study compared the health records of 7,676 former Scottish male professional footballers born between 1900 and 1976 with 23,000 individuals from the general population.

The study was launched after claims that former West Brom striker Jeff Astle died as a result of repeated head trauma.

Several members of the 1966 England World Cup squad, including Jack Charlton and Nobby Stiles, have died after suffering from brain functioning diseases believed to be linked to heading footballs.

Following the FIELD study, the FA, Premier League, English Football League, Professional Footballers’ Association and League Managers Association last summer jointly introduced guidance saying that footballers should engage in a maximum of 10 “higher force” headers during training in any one week.

Charlotte Cowie, head of performance medicine at the FA, said: “The launch of the BrainHope study is another important step in building our understanding of the long-term health of former professional footballers.

“Forming part of the wider Prevent Dementia study, this research will help us further understand the links between the game and neurodegenerative diseases and also potential early interventions which could help reduce risk or speed of developing dementia.”

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President Buhari attends APC National Executive Committee (NEC) Meeting in State House on 20th April 2022

President Muhammadu Buhari on Wednesday in Abuja directed the Minister of Health, Dr Osagie Ehanire, to submit a progress report by the end of May 2022 on the indigenous production of vaccines in the country.

The President gave the directive while receiving the leadership of the Nigeria Integrated Biopharmaceuticals Industries Consortium (NIBI), led by Mr Vilarugel Cuyas, Chairman/Chief Executive Officer of Fredlab.

The President commended the NIBI consortium made up of European biotechnology companies Merck, Unizima, Rommelag, and Fredlab, who are collaborating with the Nigerian start-up PIA BioPharma to establish a world-class Bio-Pharma Industrial Complex for the manufacture of vaccines and essential therapeutics in Nigeria.

Stressing that this administration considers food and medicine sufficiency as national security issues, the President asked the health minister and his team to work closely with the consortium on the Federal Government support required for the actualization of the NIBI project within the next few months.

‘‘While the Ministry of Health continues to drive collaboration with investors for vaccines, pharmaceuticals, and medical devices, in a move towards self-sufficiency, I welcome the NIBI consortium's desire to partner with the Federal Government in support of our agenda and look forward to the implementation of the NIBI project as it takes shape,’’ the President said.

Recounting the impact of COVID-19 pandemic on Nigeria’s economy and health systems and how some nations with comparative advantages in being centres of bio-pharmaceutical productions adopted a “me-first” attitude towards securing their citizens, President Buhari said:

‘‘I want Nigeria to make a bold statement in this field not just for reasons mentioned earlier, but because of its knock-on effects on our economy at large.’’

The President told his audience that Nigeria has learnt key lessons from the pandemic, including that countries must look inward for sustenance in food and medical supplies.  

‘‘Having witnessed the impact of the COVID-19 pandemic on our health system, our communal life and national economy, from which we are yet to fully recover, we are reminded that the wealth of a nation is dependent on the health and wellbeing of its citizens.

‘‘ At the advent of the COVID-19 pandemic, Nigeria was quick to respond to what seemed an existential threat, by strengthening the health system’s capacity to handle the pandemic - an initiative that continues till today in collaboration with the state government, private sector, and international partners.

‘‘Key lessons of the pandemic are that nations can be brought to their knees by disease outbreaks that cripple national and international trade, and that countries must be able to look inwards for sustenance in food and medical supplies.   The benefit of this Administration's early investment in agriculture came to light during this global turbulence.

‘‘However, we cannot say the same for essential medicines, health supplies and most importantly vaccines to protect our citizens.   Increasing the capacity for in-country production of vaccines and medical supplies has therefore become a matter of not just urgency, but of national security.

‘‘As we saw, many nations who had developed comparative advantages in being centres of bio-pharmaceutical productions adopted a “me-first” attitude towards securing their citizens. These actions placed developing nations, particularly those in Africa at severe disadvantage.’’

The President noted that as part of the fallout and lessons learned from the crises, under his directive, the Minister of Health has been conducting local and international high-level consultations to seek access to the know-how and finance to revive domestic manufacturing of vaccines.  

He added that the consultations had become more important as Nigeria prepares to fully transition from the Global Alliance for Vaccines and Immunization (GAVI) support for the supply of vaccines by 2028.

‘‘Since we consider food and medicine sufficiency as national security issues, technical and financial investments and partnerships are priorities in our policy planning, with the assurance that Nigeria has the market and a pool of expert scientists to draw upon, from within and outside the country,’’ he said.

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The Nigerian government has received 3.2 million doses of the Johnson and Johnson COVID-19 vaccines, from the Italian government in Abuja.

Speaking during a press conference on Monday in Abuja, the Executive Director of the National Primary Health Care Development Agency, Dr. Faisal Shuaib, said Nigeria has fully vaccinated a little above 13.5 million people with the first dose of COVID-19 vaccine, representing 12.2 percent of the eligible population in the country.

He said over 23 million people who have received their first doses are yet to take their second jab, a situation the Nigerian government hopes to improve with the rollout of the Johnson and Johnson vaccine, which is a single shot.

“As of today, we have fully vaccinated 13.5 million persons; this represents approximately 12.2 percent of our total eligible population. Meanwhile, 23 million have taken the first dose of the vaccine,” he stated.

The NPHCDA boss further thanked the Italian government for the donation, assuring that the Nigerian government would ensure that other Nigerians are vaccinated against the covid disease.

“This represents 18 percent of the total eligible population. You will recall that in January, the Federal Government formally rolled out the administration of the Johnson and Johnson vaccine across the country. I must say that this has rapidly improved our coverage.

“I want to appreciate the government of Italy for this donation which is in line with the global call for for equitable access to Covid vaccines. Let me assure you that these vaccines, like all other vaccines, will be judiciously utilised.”