While a face mask could provide some protection against COVID-19, the lives of many women in Africa, and elsewhere, are at the mercy of their abusers. (Photo Credit: Paul Adepoju)

Ibadan, Nigeria – Twenty-two year-old Uwaila Vera Omozuwa, freshly admitted to university, had retreated to study in a church in the city of Benin, Nigeria during lockdown, when she was raped and killed on May 30. 

The following day, 18-year-old Barakat Bello was reportedly raped and killed in Oyo state. 29-year-old Azeezat Shomuyiwa and 21-year-old Grace Oshiagwu also suffered similar fates just days and few streets apart. In late March 2020, a video from Ghana surfaced on social media showing a boyfriend assaulting his girlfriend. 

As the COVID-19 pandemic continues to expand globally, African countries as well as other nations worldwide are also dealing with another related pandemic – that of gender-based violence. 

The stress triggered by COVID-19 lockdowns and economic uncertainty is exacerbating violent assaults, according to experts speaking at a panel last week hosted by the WHO Regional Office for Africa. Effectively, the pandemic has forced many women who are in abusive relationships to remain shut up at home with their abusers, further escalating their risks, they said. 

Social media responses condemning the gruesome murder and rape of Vera Uwaila Omozuwa. (Photo Credit: Youth Alive Foundation )
A “Shadow Pandemic”

Gender-based violence is a “shadow pandemic” to COVID-19 said UN Women’s Executive Director, Phumzile Mlambo-Ngcuka. She noted that in Africa as well as elsewhere in the world, domestic violence hotlines and shelters are reporting rising calls for help.

“Confinement is fostering the tension and strain created by security, health, and money worries. And it is increasing isolation for women with violent partners, separating them from the people and resources that can best help them,” Mlambo-Ngcuka said in a statement on violence against women and girls. 

“It’s a perfect storm for controlling, violent behaviour behind closed doors. And in parallel, as health systems are stretching to breaking point, domestic violence shelters are also reaching capacity, a service deficit made worse when centres are repurposed for additional COVID-response.” 

Africa has struggled with social attitudes sanctioning violent attacks on women, well before the pandemic began. For instance, in 2017, researchers at the University of Ghana reported that men who were in consensual unions or customary marriages remained in favour of wife beating.

Police attitudes are often lax as well. Following Uwaila’s rape and murder in Benin, Nigeria, for instance, the local police initially demanded a “mobilization money” from the family to open an investigation, according to  the victim’s sister, who finally led a protest to the Edo State police headquarters to trigger action – which she videotaped on Instagram.   

Now, in the period of COVID-19, for every 3 months lockdowns are imposed or continue, an additional 15 million extra cases of gender-based violence could be recorded worldwide, states a new report, COVID-19: A Gender Lens, by the UN Population Fund (UNFPA). And six months of lockdown could result in additional 31 million cases of gender-based violence in the world.   

Photo Credit: UN Women

While the most extreme outcome, gender-based violence is not the only way women are suffering from  lockdown restrictions, noted Dr. Natalia Kanem, UNFPA Executive Director while unveiling a new analysis by UNFPA and partners. 

“Millions more women and girls now risk losing the ability to plan their families and protect their bodies and their health,” she said, noting that women often cannot get to health services for basic care. “Women’s reproductive health and rights must be safeguarded at all costs. The services must continue; the supplies must be delivered; and the vulnerable must be protected and supported.”

Fighting the Shadow Pandemic 

In Africa, political leaders have generally been reluctant to make themselves the face of campaigns against gender-based violence, the panel participants observed, recommending that Africa’s political leaders need to start speaking up now. 

“African leaders need to declare this situation as another pandemic and appeal to people, men, society, and those who set norms. African leaders need to speak up and recognise this is happening,” said Dr Matshidiso Moeti, WHO African Regional Director while speaking on the panel.

Governments also need to make gender-violence prevention initiatives integral to economic and healthcare programmes dealing with COVID-19, she said. 

Matshidiso Moeti

Specifically, she mentioned that police officers and health workers in African countries need to be made aware of the roles they are supposed to play in prevention of gender-based violence.

For countries that are still in the dark over what to do, she noted that the government can work with men and women groups to improve the level of public education, provision of call numbers to report cases of abuse, and establishment of shelters to provide help and services to victims.

“These can be part of the socio-economic response to the pandemic,” Moeti added.

While most African countries now have legislation against gender-based violence, political leadership is still missing, agreed Winnie Byanyima, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

“I so rarely hear a male African leader speaking and leading on this issue. Most African leaders leave it to others, yet it is a pandemic – a silent one too,” Byanyima said.

For Africa to advance in tackling gender-based violence, African leaders must be saddled with the responsibility of providing political leadership, she said. 

One leader that has spoken up recently was South African President Cyril Ramaphosa, a political powerful voice, as he is also the head of the African Union. Speaking to the media last week, he blamed the reopening of liquor stores as lockdown measures eased for a spate of attacks on women in that country. Those included pregnant, Tshegofatso Pule who was found hanging from a tree, Naledi Phangindawo, who was stabbed, and Sanele Mfaba whose body was later found in a Soweto township.  

South African campaigners note that in fact violence against women shot up from the moment the lockdowns began. The police force’s gender-based violence hotline received 2,300 calls in the first five days – nearly three times the rate prior to lockdown. 

Even so, Ramaphosa’s remarks were significant as this represented one of the few instances when an African Head of State has spoken out forcefully on the issue. 

Community-based Prevention and Education Are Key    

While some actions are being taken to improve Africa’s response to gender-based violence including building police and judiciary systems that understand their roles and can prosecute cases of gender-based violence, more needs to be done about awareness-raising and education that can prevent crimes from ever occurring, stressed Byanyima.

“In my view, we are weakest on prevention. You need aggressive campaigns discouraging violent behaviors of boys and men, especially the way they see their masculinity and how they exercise it. That discouragement still needs to happen,” Byanyima said.

Presently, this duty is largely left to civil societies and women organisations, but Byanyima noted that it is the business of the government to invest in continual campaigning in communities to change how relationships can be managed without violence.  

Winnie Byanyima

“This is about men’s behavior – the way men are raised and see themselves as men. Tackling toxic masculinity is something that is not well invested in,” she said.

Another necessary action to tackle the silent pandemic is to empower girls and women in African societies. Citing data from HIV, the UNAIDS Executive Director noted that an African girl’s vulnerability to HIV, sexual violence, unintended pregnancy and early marriage reduce by up to 50% if she is able to complete high school.

But while African leaders have ratified universal basic education requiring every child to get at least primary education, two-thirds of children in Africa do not have access to secondary education.

“The time for secondary education has come. We fought for universal primary education in Beijing and within ten years we have achieved it. Now we need to draw the line and say every government worth its name must put its kids, boys and girls, through high school. Not only for the knowledge economy but also for the safety and empowerment of girls and fighting gender-based violence,” Byanyima said.

Story of Success: Experts Laud Rwanda’s One Stop Center For Sexual Violence 

Bineta Diop, African Union’s Special Envoy on Women Peace & Security, recommended African governments adopting Rwanda’s one-stop center for sexual violence. 

Located within the Kacyiru Police Hospital, the Isange One Stop Centre, the Isange One Stop Center has become a hub for gender-based violence survivors. At the center, survivors can access all the required services in one place and for free. The center is operated by the country’s Gender and Family Promotion, of Health, and Justice ministries in addition to the Rwanda National Police.

Bineta Diop

The initiative that started in 2009 as a pilot has since been expanded across the country. Rwanda now has a One Stop Centre in every district. Every day, up to 12 survivors are received at the center. 

“28% are survivors of intimate partner violence and 78 percent are survivors of sexual violence. Of the 78% of survivors who have been sexually assaulted, 16% are younger than 5 years,” said Daniel Nyamwasa, Commissioner of Police and Chief Infectologist Consultant at the hospital.

Diop also encouraged African governments to acquire DNA testing capabilities to provide evidence that could be used to prosecute cases of rape and other gender-based violence against women and girls.

Enlisting More Women in Police and Judiciary 

Another solution is the enlistment of more women in the police and judiciary systems across the continent which Diop said will encourage more women to approach the legal system to file complaints. She also called for the engagement of Africa’s traditional leaders.

“If you want to break the patriarchal system, you have to engage the traditional system,” Diop said.

However, as the number of confirmed cases of COVID-19 in Africa is increasing, African governments are also focusing on how to quickly and safely reopen their economies to minimize the impact of the pandemic. 

This current reality threatens the materialization of recommendations giving more attention to combating gender-based violence. 

But Ramaphosa, for one, has said this does not have to be the case. In his comments last week, he stressed that action can and should be taken to combat violence, despite the numerous familiar and peculiar challenges that countries across the continent are facing:

“For public faith in the criminal justice system to be maintained, gender-based violence needs to be treated with the urgency it deserves by our communities working together with our police.”

Cyril Ramaphosa, President of South Africa

Image Credits: Paul Adepoju, Twitter: Youth Alive Foundation, UN Women.

Central Laboratory at the Academician Nikoloz Kipshidze University Clinic, Tbilisi, Georgia, receives laboratory equipment for COVID-19 diagnosis.

The World Health Organization aims to raise a whopping US $31.3 billion to fund the ambitious goals of the Access to COVID-19 Tools (ACT) Accelerator; a multi-stakeholder initiative that aims to develop and deploy diagnostics, drugs, and vaccines to control the virus.

But so far, only $US 3.4 billion has been pledged towards the initial goals. And US $13.7 billion is ‘urgently needed’ in order to cover immediate needs, according to an investment case released by WHO on Friday.

“Though these numbers sound big, they are not. If we spend billions now, we will avoid spending trillions later. The time to act is now, and the way to act is together,” said Gavi Board Chair Ngozi Okonjo-Iweala.

The funding will go toward:

  • Scaling up development and delivery of 500 million diagnostic tests to low- and middle-income countries (LMICS) by mid-2021
  • Delivering 245 million courses of treatments to LMICs by mid-2021,
  • Delivering 2 billion vaccine doses, of which 50% will go to LMICs by the end of 2021.

“It’s clear that because all people are at risk of COVID-19, all people should have access to all the tools to prevent, detect and treated, not only those who can afford to pay for them,” said World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus at a Friday press briefing. “We have made the principle of equitable access a simple thing to say, but a complicated thing to implement.”

Dr Tedros at the 26 June press briefing

More than 9 million people have been infected, and nearly half a million have so far lost their lives to the virus. The investment required in the Accelerator is less than a tenth of the loss the global economy is facing every month due to the pandemic, according to International Monetary Fund estimates.

“The cost of inaction now is quite important to take into consideration,” said Philippe Duneton, executive director of UNITAID, working with the Wellcome Trust on the therapeutics pillar of the project.

A good portion of the immediate investments will go towards preparing markets to absorb new COVID-19 technologies, setting up demand, manufacturing, and country capacity to roll out any new diagnostics, vaccines, or drugs.

Four Investment Pillars Require Urgent Funding

The ACT Accelerator operates under four main pillars – diagnostics, therapeutics, vaccines, and the health systems connector.

The diagnostics pillar, co-led by FIND and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, aims to avoid 1.6 billion further infections by scaling up access to diagnostics. The pillar requires US $6 billion in the next year, but US $2 billion is urgently needed to begin deploying tests now. Ultimately, 10,000 healthcare workers will be needed.

“The real strategy towards containing the epidemic is through testing, tracing, isolation; and the starting point for that is a very rapid rollout of very large numbers of tests,” said Peter Sands, executive director of the Global Fund. “To underscore the urgency for many lower middle income countries, lockdown is not sustainable. Households don’t have the wherewithal to continue without working, and governments don’t have the ability to compensate for lost income, coupled with the fact that clinical care facilities are extremely limited.”

The therapeutics pillar will focus on accelerating the development and deployment of effective treatments. While no drugs have yet been tapped, the pillar aims to provide 250 million courses of treatment to LMICS in the next 12 months. Some US$11.6 billion is needed in the next year, while US $3.8 billion is needed immediately.

“Of course, as soon as we have a medicine, the situation at the country level will also be a challenge,” said Duneton. “The access to oxygen, for example, is not the same in all countries.”

But “the only way to prevent further transmission [of the virus] and to break that cycle, would be to have an effective and safe vaccine available to people,” said WHO Chief Scientist Soumya Swaminathan. 

Soumya Swaminathan speaks at the 26 June ACT Accelerator press briefing

The vaccines pillar has an ambitious goal of delivering 2 billion doses by the end of 2021. Seven candidates are currently in clinical trials, but none have yet received regulatory approval. So far, the fastest vaccine to move from lab bench to approval for human use was the Ebola vaccine – which took five years to develop.

“In general, it takes 8 to 10 years for a vaccine to move from when the research begins to when it gets into people. We want to shorten that timeline as short as possible – 12 months, 18 months maximum,” said Swaminathan. “That would be unprecedented, and can only happen through global collaboration.”

The Coalition for Epidemic Preparedness Innovation (CEPI), and Gavi, the Vaccine Alliance, will lead the vaccines pillar alongside WHO, which will provide oversight of regulation, policy and allocation. Some US $18.1 billion is required to safely deliver the vaccine to people in need.

Gavi, through an advanced market agreement under its COVAX Facility, aims to pool purchasing power from nations of all income levels to secure low vaccine prices. Some 950 million doses must be procured by self-financing, upper-middle and high income countries, in addition to the 2 billion doses set aside for lower income countries.

A final pillar, the health systems connector, aims to strengthen the infrastructure and community networks required to deliver tools to people in need. Led by the World Bank, and the Global Fund, the pillar aims to build lab capacity, train staff to safely manage COVID-19, and to use new tools as they are deployed.

Image Credits: Flickr: IAEA Imagebank/Natalia Khurtsidze, PR Manager of the Clinic.

The online WHO Academy delivers health training around the world based on WHO guidance

A slew of new and repurposed public health technology has been rapidly developed in the wake of the COVID-19 pandemic. But in the whirlwind of contact tracing apps, artificial intelligence, and location tracking being used for public health surveillance, old ethical dilemmas have resurfaced around who is actually benefiting from these technologies. 

“The question remains; will digital technologies save us from the pandemic?” asked Katerini Storeng, associate professor and deputy director of the Independent Panel on Global Governance for Health, Centre for Development and Environment, University of Oslo.

The answer is a resounding, “no” according to a panel of global health policy, governance, and anthropology experts from The New School, University College London, the Center for International Governance Innovation (CIGI), and Simon Fraser University. The panelists were speaking at the third webinar in the Global Pandemics in an Unequal World series, co-hosted by Health Policy Watch, The New School, and The Independent Panel on Global Governance.

“I would argue rather than something new, it’s an intensification of what was already there,” said Stephen Roberts, assistant professor at the University College London. 

German contact tracing app alerts user if any contacts have tested positive for COVID-19

Sean McDonald, senior fellow at the Center for International Governance Innovation (CIGI), even declared the debate around public health technologies a “digital governance emergency” months before COVID-19 was declared a pandemic, saying “hard learned” lessons from previous epidemics such as those learned from the recently quashed Ebola outbreak in the eastern Democratic Republic of the Congo. The nearly two-year long ordeal was declared officially over by DRC officials just hours before the panel.

“A lot of what we saw in the Ebola epidemic was a sort of similar push to big data analytics, doing sort of analysis in public health care without the public,” said McDonald. He pointed to the use of ‘technology theatre’ – or the use of expert debates about the technical features of a tool, rather than the equities or power relationships that tool might affect – to make decisions regarding the use of new technologies.  

There is a concerning lack of oversight for how digital technologies are screened, according to the experts. And there is evidence that some technologies aren’t very useful for public health means, and could be weaponized against vulnerable populations.

Unlike new vaccines or drugs, digital technologies don’t often go through an extensive vetting process including debates around equity and inclusion, said Manjari Mahajan, co-director of the India China Institute at The New School.

“What kind of data and knowledge is going to be produced [by these technologies] to know populations and know the problem? How will this affect minorities, marginalized groups, free speech issues?” poised Mahajan. “And another issue, which has not really been discussed explicitly enough, is how is this really reconfiguring citizenship, and the geography of placemaking rights… and the relationship of citizens to states?”

New apps for reporting social distancing violations as states reopen can result in racialized or discriminatory enforcement of distancing policies, just as one example, said Susan Erikson, professor at Simon Fraser University.

“So here’s a technology that is assumed to be unbiased and objective and apolitical, and yet the enforcement of social or physical distancing is, in fact, done by  public servants who are well known now for discriminatory practices against racialized groups,” said Erikson, referring to recent reports from New York City of police officers doling out more punitive treatment of Black people violating social distancing policies. 

Panelists at the third webinar in the Global Pandemics in an Unequal World series
Other Key Quotes From The Panelists:

Katerini Storeng, Associate Professor and Deputy Director of Independent Panel on Global Governance for Health, Centre for Development and Environment, University of Oslo. 

Over the past few months we’ve seen an explosion of new digital technologies such as contact tracing apps and mobile phone localization data, which is being used to model and monitor and control the pandemic. The use of such technologies that can invoke images that are quite dystopian of ‘Big Brother-type’ digital surveillance, but also invoke utopian hopes that technology will help curb the pandemic and allow us to somehow return to normal.

Of course these developments raised a number of crucial questions: can digital tech really replace old school public health measures? At what cost will new digital surveillance technologies benefit public health, or deepen existing inequalities and will they enable social control of vulnerable groups, or political opponents? Finally, what are some of the implications of the increasing role of Big Tech companies assisting governments with managing emergencies like COVID-19?

Manjari Mahajan, Associate Professor of International Affairs & Starr Professor and Co-Director of the India China Institute, The New School

The discussion of digital technologies in India in the context of COVID, is revealing the fragility of the health, regulatory and public statistical systems. And at the same time, it’s diverting attention away from these institutional weaknesses. A lot of these digital apps and the data that they produce has become so attractive, especially in poorer countries, because they operate in the context of highly depleted public statistical systems. So you see that app-produced data is replacing statistics, because the alternatives has been historically sidelined.

Legally, India’s contact tracing app is voluntary, though there are constraints which compel people like public sector employees to download it in involuntary context. 

But the domination of the discussion by contact tracing apps is distracting from other digital technologies which in some ways are shaping the response. In the context of India, platforms like WhatsApp are crafting entire new public spheres for disseminating information, misinformation, deliberation, dissent. And then there are a whole menu of technologies for service delivery – telemedicine portals or discrete apps funded by philanthropies for maternal health, hygiene, etc.

Stephen Roberts, Assistant Professor, University College London, United Kingdom

The digitization of infectious disease surveillance is not novel. We can trace things back as far as 25 years ago with techniques like Promail that essentially was an online listserv that sends alerts to policymakers about potential outbreaks. We are seeing a real intensification of techniques like facial recognition programs, artificial intelligence, and big data analytics, being rolled out in the context of this pandemic in a way that we haven’t seen previously. And we’re seeing Big Tech increasingly partnering with states to provide the infrastructures to track progress. 

In most previous contexts in which algorithmic decision making has been applied, the defining feature that we continually see is that the data collected by these opaque processing systems are inherently biased, and they increasingly and consistently have impact on overly surveilled communities – marginalized communities and communities of color. And we see the Black Lives Matter movement around the world which is telling us that much of the data collected from societies is inherently biased and racist. We need to look out for these same tendencies and dangers within health surveillance during COVID as well.

Susan Erikson, Professor, Simon Fraser University, Canada

There’s this question of whether or not these apps actually work to both reduce human suffering and meet public health needs. And there’s a lot of evidence to suggest that they’re not, so then what are they actually doing? I think a political economy analysis is really essential to the conversations that we’re having. 

The fact is that for the last four decades, we haven’t worked very effectively at keeping businesses in check, and now there’s a knowledge divide between the policymakers making decisions and the tech folks that know how these things work. And that knowledge divide is pretty detrimental to rolling out technology that can help us achieve the equity goals that governments are here to defend, and businesses have very little interest in preserving.

One of the problems with algorithms, is the assumption for people who really aren’t looking too closely at them, that they are unbiased and objective. But because algorithms are written by humans, they are inherently biased. And how far can humans get away from subjectivities? At this historical moment the work is really about just getting people to acknowledge that data itself is biased and the algorithms are opinions embedded in code. 

Sean McDonald, Senior Fellow, Centre for International Governance Innovation (CIGI), Waterloo, Canada, and co-founder of Digital Public

‘Technology theatre’ is a term about the use of expert debates about the technical features of a new tool, instead of a meaningful conversation about the equities and power relationships they may affect. You know, Norway and Lithuania both shut down their contact tracing apps as being not necessary. The heads of almost every major contact tracing program that has achieved any legitimacy has said that the benefits of the technology are marginal at best, if not actively harmful as in Israel. 

And another issue: you can’t ‘technologize’ trust. So for example when I worked on the Ebola response, people were sending more than 300 separate SMS based interventions during the Ebola response. The question became; how many text messages from a stranger would it take to convince you to change the way that you buried someone? Because that would help stop and slow transmission, since burial rituals involved a lot of touching. No number of text messages will do that. And the value of human contact tracing is that it connects you to an institutional care setting, whereas digital tracing does not do that as directly. 

 

Image Credits: WHO, Flickr: Marco Verch.

Emer Cooke, new Executive Director of the European Medical Agency

High-level WHO official Emer Cooke has been nominated as the head of the European Medicines Agency (EMA), the critical regulatory body for European health product approvals.

Cooke, an Irish national with 30 years’ experience in international regulatory affairs, is currently the Director of the WHO’s Regulation and Prequalification Department since 2016. In this role, she leads WHO’s programme on prequalification approval for health products being procured and sold to low- and middle-income countries at concessionary prices, in close collaboration with Member States and international partners.

Cooke’s work also involves quality assurance to ensure that health technologies perform to high standards, and in accordance with safety norms. she holds a degree in pharmacy and a Masters degrees in Science and in Business Administration, from Trinity College in Dublin, Ireland.

At an extraordinary virtual session on 25 June, the Board selected Emer Cooke from a shortlist of candidates created by the European Commission.

On 13 July, Cooke will give a statement to the European Parliament’s Committee on Environment, Public Health and Food Safety (ENVI). The appointment of the new Executive Director will only be finalized after that meeting.

See the EMA’s press release for more details.

Image Credits: EMA.

Health worker prepares an Ebola vaccine

The deadliest and longest Ebola outbreak in the history of the Democratic Republic of the Congo has finally ended, the Health Minister Longondo Eteni jubilantly announced on Thursday. The outbreak, concentrated in Ituri and North Kivu provinces in the northeastern DRC, infected 3470 people, and caused 2287 deaths. 

The end of the nearly two-year long fight, was celebrated by the World Health Organization, and welcomed by other organizations such as the Wellcome Trust.

But officials are cautiously optimistic, and emphasize that vigilance must be maintained in order to support survivors and prevent potential resurgences.

“This is the time for celebration, but we must resist the temptation to be self-satisfied. Viruses don’t take a break. Ultimately, the best defense against any outbreak is to invest in a stronger health system that provides the foundation for universal health coverage,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus in a press release.

Some 1170 survivors will need support to manage the potential long term effects of infection, which include memory loss and kidney failure. And ongoing outbreaks of measles, COVID-19, and another cluster of Ebola cases in Western DRC present new challenges.

The announcement of the outbreak’s end was made 42 days after the last Ebola patient was discharged from a treatment center in Beni, North Kivu. No new cases have been reported in the 42 days since the patient’s release, well beyond the virus’ three-week incubation period.

The success of the Ebola response was largely due to the advent of new tools against the virus – two working vaccines and two effective Ebola treatments.

More than 303,000 people received Merck’s rVSV-ZEBOV-GP Ebola vaccine over the course of the outbreak, through a partnership between Merck and Gavi, the Vaccine Alliance. After the Merck vaccine received regulatory approval from WHO in November 2019, Gavi made moves to establish a stockpile of the vaccine in preparation for future outbreaks.

 

Epidemic Response Teams Face Challenges In Conflict-Ridden Zones

But in conflict-affected zones, affected communities’ participation was key to finding and treating patients, and vaccinating contacts. Survivors often returned to their communities to serve as health educators after beating the virus.

In Ituri and North Kivu province, insecurity and community distrust have presented significant challenges to quashing the outbreak, which has simmered in the background of the coronavirus pandemic since January. 

Earlier this year in April, a new cluster of Ebola cases emerged just days before WHO was poised to declare the Eastern DRC outbreak over. One patient escaped from a treatment center and has still not been accounted for, according to the New Humanitarian. 

An attack on an Ebola treatment centre in late November 2019 left at least four dead and six injured, and one Congolese journalist involved raising awareness about the Ebola response was killed earlier that month. A WHO epidemiologist was killed in April 2019, highlighting the dangers and difficulties of working in insecure regions.

Still, the significant Ebola response has helped build up infrastructure to respond to other pandemic threats, such as a contact tracing workforce. 

“The DRC is now better, smarter and faster at responding to Ebola and this is an enduring legacy which is supporting the response to COVID-19 and other outbreaks,” said Matishidiso Moeti, WHO Regional Director for Africa in a press release.

But the same challenges have resurfaced and amplified in the wake of the coronavirus pandemic, which has swept the globe, unlike Ebola’s confinement to poor countries. And also unlike Ebola, there are no vaccines or treatments for COVID-19. 

And COVID-19 is hitting the country in the context of another Ebola flare-up in more peaceful Équator province in western DRC and an ongoing measles epidemic that has killed more than 6000 people, mostly young children. So far, some 24 people in Équator province have been infected by Ebola and 13 have died since 1 June.

“With the worrying increase in cases linked to an Ebola outbreak in Mbandaka in western DRC, along with cases of COVID-19 rising in the region, it is vital we continue to support the DRC and other countries all around the world with fragile health systems,” said Josie Golding, epidemics lead at the Wellcome Trust.

“It is only through science and collaboration that we will be able to end the COVID-19 pandemic. We must continue to unite an international effort, to ensure that all advances, including vaccines and treatments, are equally available to all, with no country left behind.”

Image Credits: WHO.

Left: Germany’s Jens Spahn; Middle: Dr. Tedros Adhanom Ghebreyesus; Right: France’s Olivier Veran

Germany has pledged an unprecedented € 500 million to the World Health Organization for 2020, making this the “highest amount” ever provided by the country, said Jens Spahn, German Minister of Health at an impromptu WHO press briefing on Thursday. 

The German contribution, equal to about 20% of WHO’s annual budget, plugs the major funding gap left by United States, following President Donald Trump’s announcement last month that it would halt funding and withdraw over alleged “pro-China” biases in management of the COVID-19 pandemic.   

“Due to the still remaining major funding gap to implement the [COVID-19] Strategic Preparedness Response plan until the end of this year, the German government has decided to provide an additional €200 million to WHO on top of the € 110 million which we have already pledged…in May”, Spahn said at the press conference.  

Of the promised €500 million, other German funds will go to supporting WHO core programmes as well as financing the purchase of masks, respirators and other medical equipment, with an eye to supporting countries bearing the heaviest brunt of the disease, Spahn said.    

“This is a clear sign of our dedication to the work of the WHO”, Spahn added. “With partners all around the world, isolated national answers to international problems are doomed to fail. We are convinced that in a pandemic, you have to react on a national level, but you have to coordinate the reaction internationally.”

Spahn made his remarks just after a meeting with WHO Director General Dr Tedros Adhanom Ghebreyesus and French Solidarity and Health Minister Olivier Veran. 

At the event, France’s Veran also announced a new commitment of an additional € 50 million to WHO as well as a € 90 million commitment to a new WHO Academy, dedicated to training health professionals worldwide, and based in Lyon, France. 

“We need a global response and only the WHO is capable of achieving it. The WHO can count on the EU and German-French unity,” Veran said. 

But it is the breathtaking German contribution, which equals about US$ 561 million, that will put WHO on a more solid financial footing for the second half of 2020, which will be a critical period in the pandemic battle and for the organization’s leadership of the global response effort. 

In fact, the German funding will provide in 2020 alone an amount comparable to what the United States had pledged for the entire 2020-2021 period – in which US contributions had already been sharply reduced by the Trump Administration over previous years.  

“We’re not sure what will happen to funding” from the US, said Spahn. “The US has always been a very big and very much appreciated contributor to the WHO. We still want to be in touch and discuss how we can go on together within the WHO.”

On May 29, Trump announced that the US would withdraw from the Organization due to its alleged failure to undertake “greatly needed” reforms. Trump has also criticized the WHO for its excessive appraisal of China’s “transparency” early on in the pandemic. 

Germany’s move was lauded by Director-General Dr. Tedros, who stated:  

“WHO is a Member State organization, a family of nations. WHO is what its Member States decide it should be, and works with the resources its Member States decide it should have.”

This unprecedented commitment will ensure full implementation of WHO’s Strategic Preparedness Response Plan for 2020 – which aims to halt COVID-19 transmission around the world and to cushion the battering effects of the pandemic. 

And although Germany’s new commitment needs to be approved by Parliament first, Spahn said he was  “very confident” that it will be endorsed by July 2020.

France Donates 100 Million Masks To WHO & Pledges € 90 Million To WHO Academy 

The WHO Academy will deliver health training around the world based on WHO guidance

With regards to the French commitments, the € 90 million French pledge to the new WHO Academy will help the Lyon-based institution, just two hours from Geneva, prepare for the  planned launch of courses by May 2021.

The WHO Academy, a vision of Dr Tedros first announced last year, is a new initiative to deliver health training around the world, based on WHO guidelines and recommendations.  

“The WHO Academy will train many future health professionals and contribute to fundamental research and international cooperation, which is more important than ever given the COVID-19 crisis,” said Veran.

Discussions “Ongoing”  Over Opening Schengen Zone To Outside Travelers  

Travelers attempt to fly home from Madrid-Baraja Airport, Spain’s largest international airport

Veran also confirmed that the doors of the so-called “Schengen Zone” countries will be opened “soon” to outsiders – although he indicated criteria for admission would be on a case-by-case basis. 

“We need to protect the security and health of Europe”, he added. ”This is why we will assess the situation on a case-by-case basis. It will also depend on how outbreaks evolve, and the measures put in place by countries to halt transmission.”

Most travel has already been restricted between countries that lie within the zone, which includes 22 of the 27 European Union member states as well as non-EU members:  Switzerland, Norway, Liechtenstein and Iceland.  

However, a vigorous debate is going on over the management of travel from countries that lie outside the zone, and particularly countries like the United States, Brazil and the Russian Federation, where COVID-19 infection rates remain very high. 

The European Commission recommends that Member States use a checklist to assess whether travel restrictions should be lifted for any given country outside the EU, and has also urged Member States to come up with a common list of non-EU countries for which travel restrictions can be lifted as of 1 July, to be reviewed on a regular basis. This decision “should be based” on ‘objective criteria’, like a country’s epidemiological situation:

“Restrictions should be lifted first with countries whose epidemiological situation is similar to the EU average and where sufficient capabilities to deal with the virus are in place”, said the European Commission in a press release. ”Restrictions should remain in place for countries whose situation is worse than in the EU.”

The European Commission also recommends to lift travel restrictions for Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia as of 1 July, given that their epidemiological situation is “similar or better” than that of the EU. 

However, while European health officials are clearly trying to make the criteria as evidence-based as possible, political pressures are also being wielded by Trump, who will see exclusion as a big blow to its prestige and economy. 

Although France does not want to ostracize travellers from outside the EU, it needs to guard against the importation of new cases of the novel coronavirus, which has infected over 9.5 million people and claimed almost 500,000 lives worldwide, Veran emphasized.

“We are not intending to ostracize or prevent anyone from entering France. France is a welcoming country, Europe is welcoming as well. However, precautions are important to take,” Veran said.

Added Spahn: “Regarding travelling to Europe and the European Union, there is an ongoing process of negotiating and consultation within the European Union and Member States, and since it is ongoing, I can’t tell you the results yet.”

Image Credits: Svĕt Lustig Vijay, WHO, Wikimedia Commons: Nemo.

One of the major medical supply limitations the Yekatit Hospital Medical College in Ethiopia faces is the shortage of oxygen tanks

As new coronavirus cases surge around the world, shortages of supplemental oxygen, a crucial treatment for people suffering drastically low blood oxygen levels due to COVID-19, have left patients in many low- and middle- income countries gasping for breath.

 “WHO estimates that at the current rate of about 1 million new cases a week, the world needs about 620,000 cubic metres of oxygen a day, which is about 88,000, large cylinders,”  World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus told reporters on Wednesday.

In wealthier countries in Europe and North America, oxygen flows free through hospitals, piped directly to a patients’ bed. But as the pandemic appears to wind down in Western Europe and gather steam in Latin America, South Asia, Eastern Europe, and Africa, a shortage of the lifesaving gas has already led to COVID-19 deaths in countries with weaker health systems, according to AP News.

Hospitals in many low-resourced countries do not have the capacity to produce oxygen – and heavy tanks of gas are often transported from factories miles away, or imported from other countries. Many low-income countries’ own oxygen factories’ tanks may also contain rust or chemicals that could damage coronavirus patients’ lungs, as these factories mainly produce the gas for use in construction or mining, WHO Chief of Operational Support and Logistics Paul Molinaro told the New York Times.

WHO has been concerned about distribution of oxygen since the early days of the pandemic. “We need also to focus on getting better distribution of medical oxygen,” WHO Emergencies Executive Director Mike Ryan said at a press briefing in late March, when much of the global attention at been focused on a shortage of ventilators.

Oxygen Concentrators Also in Low Supply
portable oxygen concentrator by Innogen

Hospitals can make their own oxygen using oxygen concentrators, which purify oxygen from the surrounding air and can be hooked up non-invasive continuous positive airway pressure machines (CPAP) to provide support. But even concentrators are in short supply.

“Many countries are now experiencing difficulties in obtaining oxygen concentrators. Some 80% of the market is owned by just a few companies; demand is currently outstripping supply,”  said Dr Tedros. 

WHO has procured 14,000 oxygen concentrators for use in 120 countries in recent weeks. Talks to buy some 170,000 more machines are in the works. The agency has also bought 9800 pulse oximeters, small monitors used to measure a patients’ blood oxygen level. Without access to such monitors, patients’ blood oxygen levels can drop precipitously low before telltale symptoms such as blue lips appear. 

However, COVID-19 patients in critical condition and put on ventilators require higher flow rates of oxygen than commercially available oxygen concentrators are able to supply, said Dr Tedros.

“WHO is supporting several countries to buy equipment that will enable them to generate their own concentrated oxygen in larger amounts,” he added. “This is a sustainable solution for COVID-19 and beyond, but requires technical expertise for maintenance. WHO has also published technical specifications for the design of this equipment, as well as guidance for countries on oxygen sources, and distribution.”  

Image Credits: UNICEF Ethiopia/2015/Mersha, Wikimedia Commons: Oxystore.

Africa must tackle both the climate and coronavirus crises at the same time, according to a new paper published by the UN Economic Commission for Africa (UNECA), joining other regional agencies such as the European Commission and the World Health Organization in calling for a “green recovery” from COVID-19.

The paper, Climate Change and Development in Africa Post COVID-19: Some Critical Reflections, came on the day temperatures potentially set a grim new record for the highest temperature recorded within the Arctic Circle, where a small town in Siberia surpassed 100.4 degrees Fahrenheit.

“Sustainability in a post COVID-19 world should be based on reducing greenhouse gas emissions and protecting the environment,” writes experts from UNECA’s Africa Climate Policy Centre. “Recovery plans must not reinvest in… polluting industries but promote meaningful employment, ensure just transitions, and be based on available science.” 

The coronavirus’ breach of the animal-human barrier shows that the pandemic and climate crises are intertwined, writes the authors. Solutions must therefore address both. 

“The origin of the novel coronavirus in wildlife points to the dangers of the disruption and destruction of natural ecosystems and biodiversity, which has brought us much closer to wild animals – and their viruses.

“This ecosystem destruction is brought about by growing global demand for crops and animal-based foods, combined with unsustainable production practices (particularly industrial agriculture), and has resulted in us breaching several planetary boundaries including land use, climate change and genetic diversity.” 

World Meteorological Organization Sends Team To Confirm Record High Arctic Temperature

While the Siberian town, Verkhoyansk, is located in an area of Eastern Siberia with extreme temperatures in both the winter and summer, passing 100 degrees Fahrenheit may still set a new record for the region.

The World Meteorological Organization’s atmospheric scientists are “formally reviewing” the reports, according to a press release. 

““It has been an unusually hot spring in Siberia, and the coinciding lack of underlying snow in the region combined with overall global temperature increases, undoubtedly helped play a critical role in causing this extreme temperature observation,” said Prof Cerveny, President’s Professor of Geographical Sciences, Arizona State University.

So far, the WMO has tentatively confirmed the reports, which they say are consistent with upper atmosphere measurements above Eastern Siberia. 

Image Credits: WHO/Mwebembezi.

A COVID-19 vaccine may be the only way to halt the coronavirus

24 June 2020 (Cape Town, South Africa) – From today, South Africans volunteers will join thousands of people in the UK, US and Brazil in testing a COVID-19 candidate vaccine developed by the Oxford Jenner Institute.

The South African Ox1Cov-19 Vaccine VIDA-Trial will involve 2,000 people, including 50 people living with HIV, in a collaboration between Wits University, the University of Oxford and the Oxford Jenner Institute.

The candidate vaccine is currently being tested for safety on 4,000 Britons, with another 10,000 people expected to join the trial by the end of July as it expands to test efficacy. Within the next few weeks, 7,000 Brazilians and 10,000 US citizens will also start testing the candidate vaccine.

“This is a landmark moment for South Africa and Africa at this stage of the COVID-19 pandemic. As we enter winter in South Africa and pressure increases on public hospitals, now more than ever we need a vaccine to prevent infection by COVID-19,” said trial leader Shabir Madhi, and Professor of Vaccinology at Wits University.

Madhi said that Johannesburg residents had responded with enthusiasm to the call for volunteers: “We sent messages out via community groups and within three days, over 1000 people had come to our clinics wanting to know more about how they could be involved.”

Shabir Madhi, Principal Investigator of the first Covid-19 vaccine trial in South Africa

The study is being undertaken in urban areas where the risk of SARS-CoV2 infection is high. South Africa accounts for over half of Africa’s COVID-19 cases and this week reached 100,000 cases.

The double-blinded randomised control trial is expected to last a year, but Madhi said that “once 42 people have tested positive for the virus, we will know whether it will work or not”, adding that the vaccine would need to show at least 60% efficacy to be viable.

Madhi added that genetic information, including blood type, would be collected from volunteers to see whether this had any impact on infection.

Participants will be given an E-diary to record any symptoms experienced for seven days after receiving the vaccine. They will also record if they feel unwell for the following three weeks.

Following vaccination, participants will attend a series of follow-up visits. During these visits, researchers will review the completed diaries and take blood samples to assess their immune response to the vaccine.

If participants develop COVID-19 symptoms during the study, a member of the clinical team will assess them for infection and, if they become particularly unwell, they will be helped to get hospital care.

The technical name of the vaccine is ChAdOx1 nCoV-19, as it is made from an adenovirus called ChAdOx1. The vaccine contains genetic material that codes for the spike glycoprotein expressed on the surface of the SARS-CoV-2 virus.

The virus that causes COVID-19 uses this spike protein to bind to ACE2 receptors on human cells. Researchers have already shown that antibodies produced against sections of the spike protein after natural infection are able to neutralize the virus when tested in the laboratory.

By vaccinating volunteers with ChAdOx1 nCoV-19, scientists hope to make the human body recognise and develop an immune response to the spike glycoprotein that will help stop the SARS-CoV-2 virus from entering human cells and causing COVID-19.

The South African study has been approved by the South African Health Products Regulatory Authority (SAHPRA) and the Human Research Ethics Committee of the University of the Witwatersrand.

Helen Rees, Chair of South African Health Products Regulatory Authority

“It is essential that vaccine studies are performed in southern hemisphere countries, including in the African region, concurrently with studies in northern hemisphere countries,” says Professor Helen Rees, Chair of SAHPRA.

“This allows evaluation of the efficacy and safety of candidate vaccines to be assessed in a global context to see whether they work across different populations.”

However, Rees warned that access to any vaccine would be highly competitive and a vaccine might have to be rationed initially with health workers possibly being the first to be vaccinated.

There are currently over 260 candidate COVID-19 vaccines in development around the world. The ChAdOx1-Cov19 vaccine is one of only five vaccines that are currently in the clinical development phase in humans, with the studies mainly being done in China, USA, UK, Australia and Europe.

Image Credits: Kerry Cullinan , University of the Witwatersrand, University of the Witwatersrand.

To mark Olympic Day, the International Olympic Committee (IOC) launched a partnership with the WHO and the UN to inspire healthy behavior around the world, announced a WHO statement on Tuesday.

As COVID-19 upends daily routines and lives around the world, we need to pay attention to our own mental and physical health and help others who may need extra support, said the statement.

In a global collaboration with athletes during the pandemic, the WHO will bring tailored health messages to people around the globe through digital platforms.

“We are pleased to partner with the International Olympic Committee to spread important health messages that will save lives”, said WHO’s Director-General Dr Tedros Adhanom Ghebreyesus. “Olympians will help us advocate for healthier populations to ensure that people are as resilient as our health systems must be to fight COVID-19.”

Said IOC President Thomas Bach: “Sport can save lives. We have seen over the last few months just how important sport and physical activity are for health and well-being. And working together with the WHO and the United Nations we can take another step together. We will ask our Olympic athletes to help share the information and best practice that the world needs now.”

Physical activity can boost physical and mental well-being

According to a WHO survey, people with chronic diseases (NCDs) like hypertension, diabetes or obesity are more likely to be critically ill with COVID-19.

In Italy, for instance, 98% of people that died from COVID-19 had pre-existing conditions, including cardiovascular issues (67%) and diabetes (31%). And diabetics are twice as likely to die from COVID-19 compared to people without diabetes.

Chronic diseases are triggered by unhealthy lifestyles like physical inactivity, tobacco use, unhealthy diets and harmful use of alcohol. 

Image Credits: Derek Jensen (Tysto), International Olympic Committee, WHO and United Nations.