Month: April 2020

WHO chief Tedros Adhanom Ghebreyesus explained that the Emergency Committee meeting will mark three months since members agreed that the new coronavirus disease was an international global health emergency.

“In the three months since the Emergency Committee last met, WHO has worked day in, day out to sound the alarm, support countries and save lives”, he said.

The Emergency Committee consists of 15 independent experts from across the world brought together under a treaty known as the International Health Regulations (IHR), which guides global health response.

COVID-19 first emerged in Wuhan, China, and at the time of its last meeting, there were just over 80 cases outside the country, and no deaths. The global caseload has now approached nearly three million, and nearly 205,000 deaths.

‘We sounded the alarm early’

Tedros outlined WHO’s actions starting from 31 December 2019, when it first learned about the “pneumonia of unknown cause”, through to his pronouncement of the global health emergency on 30 January, which was based on the Emergency Committee’s advice.

The rationale for providing the timeline was “to be clear about what WHO knew, and what we did”, he said.

“From the beginning, WHO has acted quickly and decisively to respond and to warn the world. We sounded the alarm early, and we sounded it often”, he told journalists.

“We said repeatedly that the world had a window of opportunity to prepare and to prevent widespread community transmission.”

After learning about the cluster of pneumonia cases, WHO sought more information from China on 1 January. A day later, it informed the Global Outbreak Alert and Response Network (GOARN), which includes more than 260 institutions in over 70 countries.

China came back to WHO through a face-to-face meeting in Beijing on 3 January, and the UN agency subsequently reported the unusual pneumonia cases on Twitter. Tedros added that no deaths were reported at that stage.

PAHO Barbados/Brenda Lashley

A training session on coronavirus testing takes place at the Best-dos Santos Public Health Laboratory in Barbados.

Sharing information and guidance

Two days later, WHO shared detailed technical information, including precautionary advice to its 194 Member States and IHR focal points, with guidance on the basis that there could be human-to-human transmission of the new virus.

Information was also published for use by the scientific and public health communities, as well as the global media.

Tedros detailed additional WHO actions taken over this period, such as guidance on how to detect, test and manage cases, and a checklist for countries to help assess their capacities for detection and response. WHO also published the first instructions for making diagnostic kits after China shared the genetic sequence of the virus.

Human-to-human transmission

Tedros said that on 14 January, WHO tweeted reports from China indicating that authorities there had found no clear evidence of human-to-human transmission of the virus.

“This is in line with our practice of reporting to the world, information that countries report to us. We post country reports as is”, he explained.

“However, earlier the same day, WHO held a press briefing at which we said that, based on our past experience with coronaviruses, human-to-human transmission was likely. Our senior experts participated in that press conference, and that news was carried by mainstream media.”

Additionally, WHO staff visited Wuhan on 20 and 21 January, and reported that evidence suggested human-to-human transmission was occurring.

Experts divided and Emergency Committee reconvened

Tedros convened the Emergency Committee over 22 and 23 January. As members were divided over whether WHO should declare a global public health emergency, they asked to meet again  within 10 days.

During this period, Tedros and other senior WHO staff travelled to Beijing where they met with President Xi Jinping and other Chinese leaders to learn more about the national response there, and to offer assistance.

It was agreed that an international team of scientists should travel to the country, consisting of experts from China, Germany, Japan, the Republic of Korea, Nigeria, the Russian Federation, Singapore and the United States of America.

Tedros reconvened the Emergency Committee on 30 January, following which he declared that the new coronavirus constituted a Public Health Emergency of International Concern.

The COVID-19 taskforce initiative follows a direct request to WHO from UN Secretary-General António Guterres to coordinate the Organization’s response to the new coronavirus.

Demand 200 times greater than normal

It comes amid unprecedented global shortages of critical supplies, skyrocketing prices and export bans, said Paul Molinaro, Chief, Operations Support and Logistics, WHO Health Emergencies Programme.

“The demand has obviously increased in those markets 100 or 200 times normal demand”, he told journalists via video conference. “On the supply side we saw a lot of shutdowns in manufacturing, we saw a lot of export controls, we saw the international air transport system on which we’re quite dependent for the movement of cargo, gradually shut down, so we’re at the point where we need to look for solutions to this.”

As part of the collective effort by the UN and public and private partners, a dedicated “COVID-19 Supply Portal” is set to launch within days, offering countries the opportunity to submit supply requests via a single platform.

This will enable the humanitarian supply chain system “to plan and coordinate allocation of critical supplies” to those 135 countries deemed to be most vulnerable, WHO said in a statement: “We need to streamline demand at country level to really look at the highest priority and to try and get the numbers to something manageable and coordinated,” Mr Molinaro said, highlighting the first of the initiative’s four priorities. 

“Step two is collaborative procurement amongst ourselves in the UN and some of our key partners in approaching the market together. This gives us a bigger voice, particularly in a constrained market with a lot of intense competition”, he added. 

“The third part is allocation process based on vulnerabilities and gaps and on critical needs. And then the fourth step – in light of difficulties with transportation – is to create a unified transport system, and this is something our partners are currently doing, particularly WFP.”

Focus moves to weaker health systems

Health workers in Guyana learn how to safely dress in personal protective equipment (PPE)., by PAHO/WHO Guyana

After raising the alarm earlier this year about the health threat posed by the new coronavirus that emerged in central China in December, the WHO announced that it was stepping up support to countries with beleaguered public health systems.

To date, it has distributed 1.1 million tests to 129 countries, and “we have another 1.5 million on the way”, Mr Molinaro said, noeting that the new supply chain initiative should secure a further nine million tests, which would be allocated as needed.

In addition, partner agency UNICEF (the UN Children’s Fund) has shipped supplies to 44 countries including 1.2 million surgical masks, more than 320,000 respirators, 6.4 million surgical gloves and over 250,000 gowns. UNICEF has also shipped oxygen concentrators, basic surgical equipment, stethoscopes, medication and nutrition to the Democratic Republic of the Congo (DRC), along with personal protective equipment to Iran and Venezuela, and a 50-bed COVID-19 isolation and treatment unit to Cox’s Bazar, Bangladesh.

According to WHO, the taskforce aims to procure 75 million face masks, 50 million respirators, 28 million surgical gloves, 10 million face shields and three million goggles for distribution. Discussions are also ongoing with the Jack Ma Foundation for 100 million surgical masks and one million respirators, WHO said in a statement.

Border closures affecting aid deliveries

ID verification at the Kakuma Camp in Kenya, by WFP/Florence Lanyero

The positive development comes amid concerns about border closures or delays which are already impacting aid deliveries, including at the border between Uganda and Kenya, WFP spokesperson Elisabeth Byrs said: “We are seeing long queues of trucks waiting, because…some governments like Uganda, Kenya and Rwanda are taking the temperature of the truck drivers; this slows the delivery of food in the country.”

There are also concerns that frontier delays and protective trade measures may hamper life-saving immunization work. “There’s enormous challenges and the longer we continue to face this situation, it’s clear there are going to be repercussions outside the COVID response,” said Mr Molinaro. “We already see UNICEF vaccine shipments which are highly dependent on commercial air cargo, we do see those having been disrupted in the month of May – in the month of April sorry- if this continues into May, there will be gaps in routine immunisation and also in campaigns against outbreaks of other diseases.”

Asked about distribution of supplies to Latin American countries, the WHO official replied that although there may have been some “difficulties…in the beginning” when the caseload wasn’t high, “the situation has changed and as mentioned, we’re in the process of now planning that the next acquisitions and batch volumes we get, at least in PPE, will be making their way in that direction, certainly.”

Moving forward, the COVID-19 taskforce’s strategy is to “speak up for those countries that don’t have the means to access life-saving supplies”, WHO said.
Its partners include UN agencies, The Global Fund, the World Bank, and other partners.

In a related development, the World Food Programme (WFP) issued an alert about a potentially massive spike in global food insecurity in East African nations and the Horn of Africa, as a direct result of the pandemic.

“WFP estimates that 20 million people are now food insecure in many countries in the region. Ethiopia, South Sudan, Kenya, Somalia, Uganda, Rwanda, Burundi, Djibouti and Eritrea,” said WFP spokesperson Elisabeth Byrs. “We have done projections about the situation there, about the number of food insecure people, and this number is likely to increase to 34 million up to 41 million during the next three months, due to the social-economic impact of COVID-19.”

In his latest update on the crisis, WHO chief Tedros Adhanom Ghebreyesus reported that the pandemic has put polio vaccination campaigns on hold, while some countries have scaled back or even shut down routine immunization services.

“Every year, more than 116 million infants are vaccinated, or 86% of all children born globally. But there are still more than 13 million children around the world who miss out on vaccination. We know that that number will increase because of COVID-19”, he told journalists.

Myths, misinformation and vaccine shortages

Tedros said even where services are operating, some parents are not taking their children to be vaccinated because of COVID-19 fears. Myths and misinformation about vaccines also “are adding fuel to the fire”, putting young lives at risk.

“When vaccination coverage goes down, more outbreaks will occur, including of life-threatening diseases like measles and polio”, he said.

Furthermore, border closures and travel disruptions have led to vaccine shortages in at least 21 low and middle-income countries, according to Gavi, the Vaccine Alliance.

“So far, 14 vaccination campaigns supported by Gavi against polio, measles, cholera, human papillomavirus, yellow fever and meningitis have been postponed, which would have immunized more than 13 million people,” Tedros said, adding “the tragic reality is that children will die as a result”.

Tedros urged countries to support Gavi’s “ambitious goal” of immunizing 300 million more children by 2025, which will require $7.4 billion in funding.

Solidarity flying high

As declining COVID-19 cases lead to an ease in lockdowns across Europe, the WHO chief urged countries to ensure the trend continues by finding and treating all cases, and conducting more extensive contact tracing.

However, Tedros expressed concern about increasing trends in Africa, Eastern Europe, Latin America and some Asian countries.

“As in all regions, cases and deaths are underreported in many countries in these regions because of low testing capacity”, he said.

Therefore, more “solidarity flights” carrying supplies of personal protective equipment (PPE) for health workers are getting ready for take-off.

More than 40 countries in Africa received shipments during the past week.

Overall, WHO has sent PPE items to 105 countries globally, and lab supplies to more than 127 nations.

“We will ship many millions more in the weeks ahead, and we’re preparing aggressively,” said Tedros.