Unlike China’s President Xi Jinping, United States President Donald Trump didn’t appear on camera yesterday at the opening of the first-ever virtual World Health Assembly.

Instead he used Twitter to get his message across about China’s alledged coverup of early news about the novel coronavirus and WHO’s failure to act assertively vis a vis Beijing.

In a letter to WHO Director General Dr Tedros Adhanom Ghebreyesus, released early Tuesday morning on his personal Twitter account, @realDonaldTrump, the US President said he would permanently halt funding to the Organization and reconsider US membership if WHO does not commit to “substantive improvements within 30 days.”

“My Administration has already started discussions with you on how to reform the organization. But action is needed quickly. We do not have time to waste. That is why it is my duty, as President of the United States, to inform you that, if the World Health Organization  does not commit to major substantive improvements within the next 30 days, I will make my temporary freeze of United States funding to the World Health Organization permanent and reconsider our  membership in the organization.   I cannot allow American taxpayer dollars to continue to finance an organization that, in its present state, is so clearly not serving America’s interests.”

Annual 73d World Health Assembly – Votes on COVID-19 Resolution in Virtual Format

Hours after Trump’s letter was published, the World Health Assembly approved a European Union-led resolution that responded, at least initially, to two of the most key US demands. The resolution mandates an independent, “stepwise” review of the WHO’s performance in the  pandemic response, as well as a scientific investigation into the origins of the virus emergence in China.

However, Trump’s blunt, in-your-face message, was dramatically different in tone and style from the statements being made by most of the WHO’s other 193 member states during the two-day assembly – showing solidarity with WHO in the face of the challenges posed by COVID-19, and saying the organization’s independence needs to be strengthened, not undermined.

While other member states have oft criticized WHO, even bitterly, such remarks are usually made behind closed doors, while public discourse is softened by the language of diplomatic nuance.

Style May Detract From Substance

The US delivery style may, in fact, deflect attention away from a more serious examination of allegations about China’s missteps, including the represssion of free information flow and reprisals against Chinese and Wuhan whistle-blowers in the pandemic debacle, observers said.

“President Trump is behaving like a schoolyard bully,” Suerie Moon, co-director of the Global Health Centre, Geneva Graduate Institute, told Health Policy Watch.

“One of the weaknesses of the WHO is that it is not easily able to criticize any of its Member States, neither China nor the US. Trump appears to continue using WHO as a scapegoat to distract from what continues to be a highly-concerning epidemiological situation in the US. While the US can land a punch on WHO, there’s not much WHO can do to fight back. The US has a beef with China, but instead of raising these openly in the WHA yesterday, it went after a softer target.

“The thing is, nobody likes a bully. Although the US has raised concerns that are shared by other countries regarding the origins of the virus, how it was initially handled by the Chinese authorities, and the degree to which the authorities shared information with WHO or internationally, this letter weakens the US ability to get other countries to support its desire to get answers to these questions.”

Critics also point to the White House’s own repeated statements in late January and early February that praised China’s response and played down the impacts of the virus, both in terms of its infectious capacity and its impact on human health.  These were shortcomings that Trump critics quickly replayed on his own Twitter feed just after the letter was issued, recalling statements that the President had made in late January saying “We have it totally under control,” as well as another tweet stating “China has been working very hard to contain the Coronavirus.”

The other problem, others point out, is that reducing funding to WHO also weaken’s its range of independent action in times of crisis.

“The WHO is not perfect, but it is structurally starved of core funding, leaving this unique institution, that has the potential to be the agency we all want it to be, and deliver so much, weakened, undermined and destabilized, by the very people who it serves – its member states,” said Tim Reed, executive director of the advocacy organization Health Action International.

Letter Chronicles Alleged Chinese Delays and Concealment of Early Virus Reports

The Trump chronicle of charges is roughly based on a report published by the US Congressional Research Services last week: COVID-19 and China: A Chronology of Events (December 2019-January 2020).  The Congressional record cites a 30 December “urgent notice” by the Wuhan Health Commission about cases of atypical pneumonia that leaked online in China.  By the next day thre was a flurry of Chinese media reports. Taiwan sent a warning to WHO on 31 December about an unusual cluster of cases, in isolation. And WHO sent a query to its China office for clarifications. WHO finally issued its first public alert on January 4, 2020.

Based on that, the Trump letter charges that: “By no later than December 30 2019, the World Health Organization office in Beijing new there was a ‘major public health concern’ in Wuhan, including from Chinese media reports about “evidence of a new virus emerging from Wuhan, based on patient data sent to multiple Chinese genomics companies” and reports by a Hubei Province doctor, “that a new coronavirus was causing a novel disease that was, at the time, afflicting approximately 180 patients.”

Despite the fact that “International Health Regulations require countries to report the risk of a health emergency within 24 hours, “China did not inform the World Health Organization of Wuhan’s several cases of pneumonia, of unknown origin, until December 31, 2019, even though it likely had knowledge of these cases days or weeks earlier,” the letter states.

Lancet Study Published 24 January 2020 – Refers to 1 December Coronavirus Case
Graphic shows 1 December 2019 symptom onset date for first of 41 Wuhan coronavirus patients studied, The Lancet 24 January 2020,

Trump further claims: that WHO “consistently ignored credible reports of the virus spreading in Wuhan in early December 2019 or even earlier, including reports by the Lancet medical journal.”

That was immediately rebutted by Lancet editor Richard Horton. He later told Health Policy Watch: “The first reports the journal published were on January 24, 2020. In a paper by Chaolin Huang and colleagues, the first 41 patients from Wuhan with COVID-19 were described.”

The statement added, “The allegations levelled against WHO in President Trump’s letter are serious and damaging to efforts to strengthen international cooperation to control this pandemic. It is essential that any review of the global response is based on a factually accurate account of what took place in December and January.”

In fact, a Health Policy Watch review of the study 24 January 2020 Lancet study, in question found that it refers back to 1 December – as the earliest symptom onset date for the patients studied. It notes that: “The symptom onset date of the first patient identified was Dec 1, 2019”.  Patients were hospitalized between Dec 16, 2019, and Jan 2, 2020, the study authors further noted.

WHO Policies on Travel Restrictions Faulty – Statements Pandered to Beijing – Says Trump

The Trump letter further cites a litany of alleged “grossly inaccurate” or “misleading” claims by WHO about the virus and it’s praise for China’s response.  These include reference to WHO’s tweets on 14 January that there was “no clear evidence of human-to-human transmission of the novel coronavirus (2019-nCov) identified in Wuhan China.”

The letter also alleges Chinese pressure on WHO to defer a declaration of the outbreak as an international public health emergency. And it slams WHO praise for the Chinese government’s  “transparency” with respect to its reporting on the coronavirus. Other key points mentioned include:

Reprisals against Chinese scientists and health professionals –

The letter describes how the Chinese medical expert who first sequenced the genome of the virus and posted it online 11 January, had his lab closed by the authorities the next day for “rectification” – even as the WHO praised China for its transparency in posting the genome sequence.

Travel restrictions – The letter also criticizes WHO’s reluctance to recommend international travel restrictions to contain the virus, including statements in early February that spread of the virus ouside of China was “minimal to slow” and travel restrictions caused “more harm than good,” while millions of people leaving the Wuhan epicentre spread the virus around the world: “You also strongly praised China’s strict domestic travel restrictions, but were inexplicably against my closing of the United States border, or the ban, with respect to people coming from China… Incredibly, on February 3, 2020, you reinforced your position, opining that because China was doing such a great job protecting the world from the virus, travel restrictions were “causing more harm than good.” Yet by then the world knew that, before locking down Wuhan, Chinese authorities had allowed more than five million people to leave the city and that many of these people were bound for international destinations all over the world.

WHO-led Fact-finding mission to China: The “Even after you belatedly declared the outbreak a Public Health Emergency of International Concern on January 30, 2020, you failed to press China for the timely admittance of a World Health Organization team of international medical experts. As a result, this critical team did not arrive in China until two weeks later, on February 16, 2020. And even then, the team was not allowed to visit Wuhan until the final days of their visit. Remarkably, the World Health Organization was silent when China denied the two American members of the team access to Wuhan entirely.

Virus Spread by Asymptomatic Carriers: Trump cites WHO statements in early January about the absence of proof of human-to-human transmission and from early March downplaying the risk of asymptomatic virus, saying “It is now clear that China’s assertions, repeated to the world by the World Health Organization, were wildly inaccurate.”

Discrimination Against African Migrants: And it notes that WHO failed to comment on China’s “racially discriminatory actions” against Africans migrants that were evicted or refused services – which was the subject of a complaint by several African ambassadors to China on 11 April.

Praise for China: Throughout this crisis, the World Health Organization has been curiously insistent on praising China for its alleged “transparency.” You have consistently joined in these tributes, notwithstanding that China has been anything but transparent. In early January, for example, China ordered samples of the virus to be destroyed, depriving the world of critical information. Even now, China continues to undermine the International Health Regulations by refusing to share accurate and timely data, viral samples and isolates, and by withholding vital information about the virus and its origins. And, to this day, China continues to deny international access to their scientists and relevant facilities, all while casting blame widely and recklessly and censoring its own experts.

WHO Performance In SARS Era Praised – Including Including Its Recommendations For Travel Restrictions
WHO Director General Dr Tedros speaks at World Health Assembly

The letter concludes by sharply contrasting the COVID-19 policies of Dr. Tedros Adhanom Ghebreyesus with decisions taken by former Director General Gro Harlem Brundtland, during the 2003 outbreak of Severe  Acute Respiratory Syndrome (SARS) in China, and other parts of Asia:

“Perhaps worse than all these failings is that we know that the World Health Organization could have done so much better,” he states.

“Just a few years ago, under the direction of a different Director­ General, the World Health Organization showed the world how much it has to offer. In 2003, in response to the outbreak of the Severe Acute Respiratory Syndrome (SARS) in China, Director­ General Harlem Brundtland boldly declared the World Health Organization’s first emergency travel advisory in 55 years, recommending against travel to and from the disease epicenter in southern China.

“She also did not hesitate to criticize China for endangering global health by attempting to cover up the outbreak through its usual playbook of arresting whistleblowers and censoring media. Many lives could have been saved had you followed Dr. Brundtland’s example.

Investigations Mandated by European Union-led Resolution at the WHA – Key to Way Forward

The letter concludes with reference to the European Union-led resolution that should pave the way for an indepdent investigation of the origins of the virus and a review of WHO’s performance, stating that the resolution will fill the gap in areas where WHO has failed to act firmly:

“The World Health Organization has failed to publicly call on China to allow for an independent investigation into the origins of the virus, despite the recent endorsement for doing so by its own Emergency Committee.

“The World Health  Organization’s failure to do so has prompted World Health Organization member states to adopt the “COVID-19 Response ” Resolution at this year’s World Health Assembly, which echoes the call by the United States and so many others for an impartial,  independent, and comprehensive review of how the World Health Organization  handled  the crisis.  The resolution also calls for an investigation into the origins of the virus, which is necessary for the world to understand how best to counter the disease.”

“….It is clear the repeated missteps by you and your organization in responding  to the pandemic have been extremely costly for the world,” Trump states in the letter’s concluding paragraph. “The only way forward for the World Health Organization is if it can actually demonstrate independence from China.”

 

Image Credits: Donald Trump, WHO.

Grammy Award Winner Ricky Key (left) with Lonnie Park (right) singing for Walk The Talk

This weekend, over 16 million people from all over the globe came together for the WHO’s third Walk the Talk: The Health for All Challenge. The two-day virtual event began Saturday in the Philippines and concluded on Sunday, with a 5-hour jam-packed virtual programme broadcast from Geneva – and boasting a vibrant range of physical activities and live chats with health experts to get people moving for their own health and that of others.

“It’s time to get moving. Exercise is so good for you. It’s good to walk, it’s good to breathe deeply, and you can do it in your house, but stay healthy. I’m going to get up, I’m going outside. I’m going to do my walk and walk the talk,” said US-based rhythm & blues artist Kim Sledge in support of WHO’s event.

On Sunday, Walk The Talk offered about 30 interactive events for all ages, ranging from a refreshingly positive concert with Grammy Award winner Ricky Kej, as well as art therapy; cooking classes; and dance, cycling and fitness workshops.

International Basketball Federation presents ‘paper-ball at home’ activity

The event featured some 50 guests and organizations, including leading personalities from groups as diverse as the Fédération Internationale de Football Association (FIFA), the International Olympic Committee, the International Basketball Association, the World Food Programme, the European Commission, and more.

As We Adapt To New Realities, Looking After Our Health Is Ever More Important 

As we adapt to new realities of working from home, unemployment, or homeschooling, it is ever more important that we look after our physical and mental health, said WHO’s director of Mental Health and Substance Use Devora Kestel.

Physical inactivity is already the fourth largest driver of global mortality – and may increase given stay-at-home measures. Accounting for 6% of deaths globally, physical inactivity is responsible for 1 in 4 breast and color cancers, as well as almost 30% of diabetes and 30% of ischaemic heart disease.

However, regular and adequate levels of physical activity can help improve quality of life and reduce the risk of non-infectious diseases like hypertension, coronary heart disease, stroke, diabetes, breast and colon cancer, depression and the risk of falls.

Interactive field hockey drills organized by Geneva-based Servette Field Hockey group.

Looking after our mental health is equally important as times change. Having a routine and not being too hard on oneself is important, emphasized Kestel:

“Try to keep an eye on daily routines, as much as possible. Eat healthy meals, do some exercise, even if at home, and keep in touch with people you care about. Make sure that you make time for yourself to do things you enjoy doing. Don’t be too hard on yourself, keep informed, keep yourself and your loved ones safe. More importantly, take care of yourself and be kind to one another.”

Artist Ann Tracy presented interactive activity on Sunday

One daily coping strategy could include art therapy, as art has positive effects on people’s physical and mental health, said artist Ann Tracy during her interactive art workshop on Sunday. According to research, art therapy reduces blood pressure, heart rate, anxiety, and can also help with depression.

Achieving Universal Health Coverage: Solidarity, Cooperation And Healthcare Workers

To effectively fight COVID-19 while achieving universal health coverage, the world needs to tick together in solidarity, agreed panelists:

“Leaving just one person behind can be catastrophic for all of us. There is no more time to waste on the talk. Let’s start walking now, once and for all, towards universal health coverage. Everyone safety depends on it,” said António Vitorino, Director-General of the International Organization for Migration.

To achieve universal health coverage, international cooperation and multilateralism will be crucial, added Ambassador Walter Stevens, head of the European Union delegation to the UN.

“This is a time of solidarity. This is a time of international cooperation and multilateral response. And the WHO is crucial in those efforts to improve global health.”

Acknowledging the importance of healthcare workers will be crucial in fighting COVID-19 as well as attaining universal health coverage, said Elizabet Iro, WHO Chief Nursing Officer.

“We need to invest in nurses and midwives…The COVID-19 pandemic is a stark reminder of the vital role nurses, midwives and other health workers play without them. We will not win the battle against outbreaks. We will not achieve the Sustainable Development Goals, or universal health coverage [without healthcare workers]. They need our support and respect.” 

Stay-At-Home Notices Have Had Some Good Repercussions: Healthier Cities

Lockdowns have improved air quality and healthy cities

Though the raging pandemic has wreaked economic havoc around the globe, some good things have come out of it, suggested WHO’s Director of Social Determinants of Health Etienne Krug.  Air quality in cities is better, and people have begun cycling and walking to get around, while avoiding crowded public transport:

“For the last few months, our air has been cleaner and people walk and cycle safely [in cities]. We have to make sure that we continue to walk and cycle as much as possible] to guarantee cleaner air” and good health, said Krug. “I encourage all cities to think about more cycling and walking.”

Stay At Home; Get Tested; Implement Physical Distancing; Wash Your Hands;

Walk The Talk also reinforced key messages to better confront the pandemic, including stay-at-home measures, physical distancing and copious handwashing.

“Stay home, walk the talk. Join WHO in this fantastic virtual event. Stay home, keep social distancing and clean your hands. And if you feel symptoms, go and get tested. It’s so important,” said Didier Pittet, director of Geneva University’s Infection Control Programme.

As he closed the 5-hour event on Sunday, WHO director Dr. Tedros Adhanom Ghebreyesus, said that the Walk The Talk even provides a positive Launchpad for Monday’s 73rd virtual World Health Assembly, where the world will come together in attempts to “protect the most precious gift of health.” 

Dr Tedros personally presided over the first major, Geneva-wide Walk the Talk event just prior to the 2018 World Health Assembly – and ever since WHO has sponsored similar events before the WHA. At the last UN General Assembly in September 2019, WHO sponsored an event featuring music, culture and athletics in Central Park.  

“Welcome to the third edition of the who walk the talk, house for all challenge, live from Geneva, Switzerland. Unlike past years, when thousands of people gathered in Geneva us to dance, walk and move for health, today we are coming together and connecting in new ways to celebrate. 

“Today’s virtual Walk the Talk is the culmination of a two day global event,” Dr. Tedros said, referring to the fact that along with the events in Geneva, WHO regions have been hosting their own virtual Walk the Talk events, each in their own time zone.  “Yesterday, people from Manila to Washington DC showed that achieving our goal of promoting health for all has never been more important than today.”

Hopefully, the kind of cooperation that was evidenced in Sunday´s event also will help bring the world out of this crisis, said Valentin Zellweger, the Swiss ambassador to the Permanent Mission of Switzerland to the UN.

“Let’s now celebrate Walk The Talk today and hope that we will find a good outcome of the World Health Assembly [on Monday]…common action and cooperation [will] bring us out of this crisis as quickly as possible. So please join us in discussing these issues,” said Zellweger to participants.

“There is one thing we can learn from coronavirus. To get to the end of the tunnel, we all have to stay strong. We have to stay active, and we have to stay healthy. So, please, come on, get active right now,” said Thomas Back, President of the International Olympic Committee, which is based in Lausanne, Switzerland.

Image Credits: WHO.

Carlos Alvarado Quesada announces the launch of a COVID-19 intellectual property pool

Costa Rica and the World Health Organization today announced that a voluntary intellectual property pool for COVID-19 related technologies will be officially launched on May 29, following the World Health Assembly on May 18 to 19.

The official launch comes more than two months after the Costa Rican president and health minister first published an open letter to WHO calling on the agency to establish a COVID-19 intellectual property pool in order to promote access to new and existing technologies.

Dr Tedros Adhanom Ghebreyesus

“At the beginning of the pandemic, President Alvarado asked me to set up a health technology repository for vaccines, medicines, diagnostics and any other tool that may work against COVID-19,” said WHO Director General Dr Tedros Adhanom Ghebreysus in a prepared statement Friday. “WHO has accepted this visionary proposal from his excellency President Alvarado and will, in the next few weeks, launch a platform for open, collaborative sharing of knowledge, data and intellectual property on existing and new health tools to combat COVID-19.”

When pressed about whether US President Donald Trump would be likely to support the initiative, Dr Tedros said, “I mean, I cannot answer that question, I think you better ask the president.”  

The United States had just two days ago attempted to disassociate itself from language referring to countries rights to override patent protections during global emergencies in a European Union draft resolution to be discussed next week. In a modest victory for access advocates, the US objections were overridden.

Dr Mariangela Simao

Chile has joined on to support the Costa-Rica initiative, but other Member States are still finalizing negotiations with Costa Rica. However, “Member States from all [WHO] regions” are expected to sign on to support the initiative by the official launch date on 29 May, said WHO assistant director-general for Access to Medicines, Vaccines and Pharmaceuticals Dr Mariangela Simao, in response to a query from Health Policy Watch.

“This is a call for Member States. It’s a call also for academia, for the private sector and companies, for research institutions, and for cooperation agencies, all around the world,”  said Costa Rica President Carlos Alvarado Quesada. “We want to see these innovations and technologies as global public goods to protect humanity against this threat.”

“We’re also calling for this to be a repository created on a voluntary basis, because now we need solidarity,” added Alvarado Quesada.

Sebastián Piñera

“We recognize that WHO is the main mechanism for health matters and… health policy. Pandemics affect all people, whatever their age, gender or race, and particularly have a disproportionate effect in developing countries,” said a Chilean delegate, reading an official statement from Chile’s President Sebastián Piñera. “And that’s why we are very glad to join Costa Rica’s initiative.”

The pool will be built off of the Medicines Patent Pool, an existing UN mechanism funded by Unitaid that pools voluntarily released patents for essential medicines, and then licenses the patents to generics manufacturers. Both the MPP and Unitaid’s Boards have released open letters supporting the Costa Rica initiative, endorsing a temporary expansion of MPP’s mandate to include all COVID-19 related vaccines, diagnostics, drugs, and other technologies.

Image Credits: Government of Chile.

Kawasaki disease is a severe inflammatory disease in children

Children are 30 times more likely to experience Kawasaki-like disease in Bergamo, Italy’s epicentre of infections and deaths, reported a Lancet study of 29 children on Wednesday. The SARS-CoV-2 virus could trigger symptoms similar to those of a severe cardiovascular illness called Kawasaki disease.

While there were 19 cases of Kawasaki disease in the past five years between January 2015 and February 2020, there were 10 cases of Kawasaki-like disease between February-April 2020.

Initial calculations suggested that the rate of Kawasaki disease shot up by a factor of ‘at least’ 30 between February-April 2020, in comparison to the pre-pandemic period between January 2015 and February 2020. However, the initial calculation is an underestimate, said researchers, as emergency referrals in Bergamo’s hospital were 6 times higher in the pre-pandemic period compared to the months leading up to COVID-19.

After correcting for the 6-fold difference in emergency referral before and after the pandemic,  the total incidence of Kawasaki disease shot up to 3.5% in February-April 2020 compared to 0.019% between January 2015 and February 2020, or a 184-fold increase.

Kawasaki disease incidence has surged since COVID-19

The Italian retrospective cohort study of 29 children, which compared the number of patients with Kawasaki-like disease before and after the pandemic began, provides the most convincing evidence yet that the SARS-CoV-2 virus can trigger Kawasaki-like disease.

In the group of 10 children that developed Kawasaki-like disease between February-April 2020, 8 of them developed IgG antibodies for COVID-19:

“These results and considerations support the hypothesis that the immune response to SARS-CoV-2 is responsible for a Kawasaki-like disease in susceptible patients.

“Kawasaki-like disease….has a clear starting point after the first case of COVID-19 was diagnosed [in Bergamo],” said researchers from Hospital Papa Giovanni XXIII in Bergamo, Italy.

While all the children diagnosed with Kawasaki-like disease during the COVID-19 pandemic survived, they had more severe symptoms than those in the last 5 years, with 6 of 10 patients having heart complications, compared with only 2 of 19 (11%) of those diagnosed before.

5 of the 10 children diagnosed during the pandemic had signs of toxic shock syndrome, compared with none of the children diagnosed previously. Toxic shock syndrome is a rare, life-threatening illness with symptoms including a high fever, low blood pressure, and rash.

While the Lancet study acknowledged some limitations, such as the need for a larger sample size to confirm the strong link between COVID-19 and Kawasaki-like disease, they warned that “a similar outbreak of Kawasaki-like disease is expected in countries affected by the SARS-CoV-2 pandemic.” 

Kawasaki disease has been spotted all over the map since COVID-19 arose, with 125 cases in France, 100 cases in New York, 10 cases in London and 3 in Switzerland.

These findings have important implications for policy-makers as they begin lifting their lockdowns, said researchers:

“The association between SARS-CoV-2 and Kawasaki-like disease should be taken into account when it comes to considering social reintegration policies for the paediatric population.”

Although the cause of Kawasaki disease remains unknown, the Lancet study builds on an existing body of evidence that coronaviruses like SARS-CoV-2 can trigger the disease.  

In developed countries, Kawasaki disease is the most frequently acquired heart disease, affecting “no more than one in 1000 children exposed to SARS-CoV-2”, said the researchers. 

A Third Of Patients With COVID-19 Have Acute Kidney Failure, Reports New York Study

In a parallel development, it is becoming more apparent that severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19, is more than a respiratory disease – Of some 5 500 hospitalized COVID-19 patients in New York, a third had acute kidney injuries and nearly 15% required dialysis, reported a study on Thursday published in Kidney International.

“Acute kidney failure occurs frequently among patients with COVID-19 disease..It occurs early [in the disease] and is associated with poor prognosis,” said researchers.

Mechanical ventilators can help patients with severe COVID-19 breathe.

In the study, almost 40% of patients with COVID-19 entered the hospital with kidney failure, suggesting that kidney failure occurs early in the disease.

Once patients were placed on a ventilator, kidney failure was even more likely, as 90% of patients on ventilators developed kidney failure. 

Individuals most at risk of acute kidney failure included those with diabetes type II, heart disease, hypertension, older people and people of black ethnicity.

Image Credits: BruceBlaus, The Lancet, Agência Brasília .

Worldwide distribution of people that are undernourished

An additional 135 million people globally will be unable to feed themselves if measures are not put in place to ensure food security, said World Food Programme Regional Director for West and Central Africa Chris Nikoi, in a regular press briefing on Thursday. In the WHO African region, an extra 22 million people will be undernourished as a result of the economic fallout from COVID-19 lockdowns on top of the 200 million Africans that are already undernourished.

The majority of Africa’s population lives hand-to-mouth, and lack of income opportunities under the lockdowns have left many hungry and unable to afford food. The cost of basic foodstuffs has increased, and essential food supplies have been delayed due to trade restrictions imposed since the lockdown – with major repercussions on older populations, which are more vulnerable to COVID-19:

Chris Nikoi, UN World Food Programme (WFP) Regional Director for Southern Africa

“If this aging population is beginning to be affected by the pandemic, then it will have serious implications for food production going forward. West and Central Africa is now going to enter planting season and just imagine if most of rural Africa with older people who farm are falling ill,” said Nikoi.

Africa’s population is already vulnerable to COVID-19 given its high burden of pre-existing diseases like HIV/AIDS, malaria or tuberculosis – and undernourishment weakens the immune system even more. 

“Undernourished people have weaker immune systems, which may make any infection worse,” said WHO Regional Director for Africa Matshidiso Moeti, who also spoke at the press conference.

Governments should allow supply chains and trade to function. Production, distribution and consumption must be maintained, Nikoi said – or there will be serious malnutrition across the continent. 

In a parallel development, a new United Nations report projects that the world economy will shrink by 3.2% in 2020. The United Nations Department of Economic and Social Affairs forecasts a prolonged economic slump and a slow recovery, with global poverty rising for the first time since 1998. 

Image Credits: World Food Programme , Our World In Data.

Celebration of Older Adult Mental Health Awareness Day in the USA

The raging pandemic has highlighted an urgent need to incorporate mental health into COVID-19 recovery plans and to ‘substantially’ improve mental health funding – Or the world will face a ‘massive’ mental health crisis in upcoming months, reported a United Nations policy brief on Thursday. 

“The impact of the pandemic on people’s mental health is already extremely concerning,” said WHO Director-General Dr Tedros in a statement on Thursday. “Social isolation, fear of contagion, and loss of family members is compounded by the distress caused by loss of income and often employment.”

COVID-19 has increased psychological distress worldwide, report national 2020 surveys

All over the globe, mental health difficulties have worsened due to COVID-19, leaving vulnerable populations like healthcare workers, children, women and older people at particular risk. In Ethiopia, the number of people with symptoms of depression has tripled. Meanwhile in China, almost half of healthcare workers have reported depression and anxiety, and 34% have insomnia, according to a study published in JAMA from late March. 

As well as healthcare workers being disproportionately affected by COVID-19, children have faced COVID-related psychological distress, with parents reporting difficulties concentrating, as well irritability, restlessness and nervousness in children – and lockdowns have increased the risk of domestic violence and abuse.

Parents’ reports of children’s difficulties during COVID-19 confinment (Italy and Spain)

COVID-19 lockdowns have strained mental health services that were already fragile. Community services like self-help groups for alcohol and drug dependence have not met for months, and mental health facilities in hospitals have been converted to care for people with the coronavirus, leaving mental health needs unmet.

Adapting Policy: Incorporating Mental Health In Recovery Packages & Improving Funding 

It is critical that people living with mental health conditions have continued access to treatment, said a WHO statement from Thursday – and some countries have begun adapting policy, with some signs of success. 

To ensure continuity of care, teams from Egypt, Kenya, Nepal, Malaysia and New Zealand, among others, have ramped up mental health capacity through emergency telephone lines for mental health to reach people in need.  

Some countries have even considered mental health as an ‘essential’ component of the national response to COVID-19.

In Madrid, local-policy makers have deemed emergency psychiatry services as ‘essential services’, enabling mental health-care workers to continue outpatient services over the phone and through home visits. While Madrid has converted over 60% of mental health beds to provide COVID-19 care, people with severe mental health conditions have not been left behind – They have received care in private clinics.

As well as incorporating mental healthcare in ‘any COVID-19 recovery plan’, countries need to cover essential mental health needs in health care benefit packages and insurance schemes, said the UN Policy Brief.

Prior to COVID-19, only 2% of national health budgets were invested in mental health, and over three quarters of people with mental health conditions in low- and middle- income countries received no treatment for their condition.

The global economy loses more than US$ 1 trillion every year due to depression and anxiety, according to UN estimates.

Image Credits: National Center for Equitable Care for Elders, UN.

Nurses are on the frontline of the COVID-19 response

On the 200th anniversary of the birth of Florence Nightingale on Tuesday, we marked International Nurses Day, a day for the world to focus on the invaluable role that nurses play in our society. They not only have a tremendous role in health settings but are also crucial for the economic wellbeing and national security of the world.

Among the issues confronting our health care professionals every day on the front lines, is the issue of fake medicines and treatments, which has become all of the more pervasive in the COVID-19 era.

The International Council of Nurses has drawn up a position statement on sub-standard and falsified (SF) medicines which calls for a concerted, collaborative effort by health professionals, industry, governments, law enforcement bodies, customs, and other stakeholders.

Among other things, it urges governments to recognise the risk that SF medical products pose to public health and develop national action plans that include comprehensive legal frameworks, robust reporting systems, and strong national regulatory mechanisms linked to the global regulatory network as well as greater pharmacovigilance capacity.

Busting the Myths

The COVID-19 pandemic has created ideal conditions for criminals to exploit people’s fears of contracting the disease by advertising falsified treatments and vaccines, promoting fake tests and spreading unsubstantiated rumours of potential cures. In Iran, at least 44 people died in early March from drinking toxic alcohol after a coronavirus cure rumour.  An American man died and his wife went into critical care after they took chloroquine phosphate in an apparent attempt to self-medicate for the novel coronavirus. As the Alliance of Safe Online Pharmacies (ASOP) has warned: ” While the nation struggles to deal with the public health implications of the COVID-19 pandemic, criminals are exploiting fear and confusion for profit by peddling fake preventions, treatments and cures online. At best, these phony products are ineffective, at worst, they are deadly.”

The World Health Organization (WHO), like the US Food & Drug Administration (FDA), has warned against other mythical cures for COVID-19, and emphasized that, to date, there is no specific medicine recommended to prevent or treat COVID-19.

In March, Interpol’s Operation Pangea found 2,000 online links advertising counterfeit items related to COVID-19, and seized more than 34,000 counterfeit and substandard masks, “corona spray”, “coronavirus packages” or “coronavirus medicine”.

Many countries already crippled by infectious diseases and weak health systems could go under in the COVID-19 outbreak and increase the spread of misinformation and fake cures.

“COVID-19 is on the rise in Africa, and we are already facing shortages of critical protective equipment and a plethora of misinformation,” says Thembeka Gwagwa, ICN’s second Vice-President, and a nurse from South Africa. “Lack of access to care will mean many people will seek cheap, fake medicines which will have devastating consequences.”

Fake medicines as a whole are unsafe and ineffective, failing to treat or prevent the intended disease; they may have little or no effect – or cause disastrous patient outcomes, such as poisoning, disability and death.

 The Role of Healthcare Professionals

Nurse and midwife immunizes baby in Nigeria

Healthcare professionals, such as nurses, are in the front line of treating patients with COVID-19 and are vital in the fight against substandard and falsified (SF) medicines and misinformation. They administer, monitor and, in some countries, prescribe treatment and are therefore well-positioned to detect SF medical products. However, identifying SF medicines can be difficult as they are often visually identical to the original, genuine product. It may be only through monitoring a patient that either a side effect is identified or there is no effect at all, and this raises a red flag that the medication is a fake.

Nurses also play an important role in educating the public on safety concerns related to the use of SF medical products and dispelling false rumours about potential cures. They actively promote health literacy to support properly informed preventative measures and discourage self-diagnosis and self-prescribing. While nurses’ workloads are under severe pressure during this pandemic, the work of educating and informing patients and their families should not be seen as an additional burden but rather as part of safeguarding the health of the public – a vital role that nurses play throughout the year.

The Fight the Fakes campaign aims to raise awareness of fake medicines and gives a voice to their victims, is now warning of an ever-growing “infodemic” alongside the coronavirus pandemic.

The Solution

Without including nurses and other healthcare professionals in developing and implementing national action plans to combat SF medical products, we will not succeed in the fight against SF medicines. Nurses are often the principal and sometimes the only health professionals providing primary healthcare in often tough settings such as hospitals and clinics at risk of being overrun by COVID-19.

2020 is the International Year of the Nurse and Midwife. Never before has the value of what nurses do been clearer to the world. As we watch nurses and other health professionals give all they have and more to fight this pandemic, the WHO has released the first ever State of the World Nursing Report. This provides compelling evidence of the value of the nursing workforce globally and calls for governments to invest in the nursing workforce.

The fight against the COVID-19 pandemic, future pandemics and fake medicines highlights the urgent need to strengthen health systems, educate more nurses and better support the ones we have. If we are to be prepared for the next health crisis – and, undoubtedly, there will be one –the health workforce requires urgent investment.

 

Howard Catton is the CEO of the International Council of Nurses (ICN).

Image Credits: Acumen Public Affairs, WHO.

Some cautious shoppers in Geneva’s Train Station wear face masks after Switzerland enters the second phase of reopening

Countries that reopen while COVID-19 is still circulating widely will likely face strong waves of virus resurgence, and then have to reinstate severe lockdown measures. However, the cyclical relaxation and reinstatement of some public health measures, such as bans on mass gatherings or school closures, may also be normal as countries learn how to track and control the virus.

At a WHO briefing on Wednesday, Mike Ryan, WHO Health Emergencies Executive Director warned that “this virus may become just another endemic virus in our communities.  This virus may never go away,”  he added, comparing to other new infections that have emerged only in recent decades, notably HIV. “HIV has never gone away… but we have found drugs and therapies that … can allow people to live long and healthy lives.”

After a sharp spike in cases, Lebanon on Wednesday reinstated stay-at-home orders, re-shuttered restaurants, and closed temples after easing restrictions in April. That followed patterns in a number of other countries including Algeria and the Japanese island of Hokkaido – which had reopened businesses and schools, only to see a spike in cases that forced further closures.

A new cluster of coronavirus cases also was reported in Wuhan China, the original epicenter of the outbreak, on Sunday – the first since the city reopened in late April. City health officials announced an ambitious plan to test all 11.5 million city residents in the next ten days on Tuesday. Mass gatherings were banned, and travel restrictions were reinstated in Jilin, another city in China, this week after a cluster of cases was identified. 

The South Korean capital of Seoul also delayed reopening schools and shut down bars and clubs, following a spike in cases last week that was linked back to just one man. At least 85 confirmed cases were linked to the man who had visited a series of nightclubs last week.

“Some [of these cases] are cautionary tales and some represent actually, the kind of things we expect. It’s all about scale and it’s all about how much you understand the problem,” said WHO Executive Director of Health Emergencies Mike Ryan in a Wednesday press briefing. “What we all fear is a vicious cycle of public health disaster followed by an economic disaster followed by a public health disaster followed by economic disaster.”

“If you reopen in the presence of a high degree of virus transmission, then that transmission may accelerate. If that virus transmission accelerates, and you don’t have the systems to detect it, it will be days or weeks before you know something’s gone wrong. And by the time that happens, you’re back into a situation where your only response is another lockdown,” said Ryan.

The purpose of lockdowns, Ryan explained, was to keep people from coming into contact with each other frequently, therefore curbing the spread of the virus. 

“If you can get the day to day case numbers to the lowest possible level, and get as much virus out of the community as possible, when you open, you will tend to have less transmission, or, much less risk,” said Ryan.

Switzerland Mobilizes Money To Address ‘Unimaginable Levels of Poverty’ During Phased Reopening

Meanwhile, Switzerland was grappling with the fallout of a COVID-19 economic crisis, including what one journalist described as “unimaginable levels of poverty” as one of Europe’s most affluent countries reopened for business again.

Many Swiss cafes and restaurants, which had been anticipating seeing regulars again, were stunned to have barely any customers. Almost one-third of Geneva’s cafes will be unable to reopen due to poor business prospects.

On the other hand, more than 1600 packets of free food were distributed in one central Geneva location in just six hours, mostly to undocumented migrants and those who had lost their jobs due to coronavirus. Queues were over 200 metres long, albeit with proper social distancing measures between the waiting customers. 

New cases in Switzerland have continued to drop or stabilize as the country entered the second phase of its deconfinement plan on Monday. The country of about 9 million people has so far reported 30,433 confirmed cases with 1,564 deaths, one of the highest per capita case rates in Europe. Geneva, the nearby canton of Vaud, Zurich as well as Valais and Ticino, which abut the border with Italy are the most affected cantons.  

Less-affected cities, however, have seen anti-lockdown protests demanding faster relaxation of anti-coronavirus measures. Police broke up protests in Bern, Zurich, St. Gallen and Basel, which disregarded the ban on gatherings of more than five people. This move was criticised by the Swiss branch of Amnesty international, which called it a violation of freedom of expression. 

In light of the economic need, Swiss Federal Council sanctioned 57 billion CHF to be released in urgent credits — the largest amount ever to be released in such a format. Additionally, around 8 billion CHF is expected to be spent on short-term workers compensation, bringing the total financial package to more than 65 billion CHF. 

In addition, the Swiss Solidarity Fund has raised over CHF 37 million to help those most in need, including socioeconomically strained groups, older people, people with disabilities and the homeless. 

“It is a priority to provide assistance to individuals and families who are not or insufficiently covered by the Federal Council’s assistance measures,” stated Fabienne Vermeulen, the Head Of Swiss Programmes. The money has been distributed in the form of food aid, financial assistance, care services and community engagement through over 80 already-existing Swiss agencies, ranging from the Swiss Red Cross and Caritas.

Nevertheless, the long queues for food might be a new reality for Switzerland, warns journalist Grègoire Barbey, as the country faces “unimaginable levels of poverty.”

KTX trains undergo disinfection for COVID-19 at Seoul Station, Seoul
New Cases Spur Fears Of A Second Wave in China and South Korea 

Wuhan, China which had not recorded a single new case since April 3, has instituted a 10-day testing plan in response to a cluster of new cases, and will be testing all of its 11 million inhabitants for coronavirus. The reemergence of the virus has already had ramifications for the local government. State media reported Monday that Zhang Yuxin, chief official of Changqing, the area in Wuhan where the new cases had been detected, was removed from his post “for failures in epidemic prevention and control work.”

China recorded 17 new coronavirus cases on Sunday, 5 of which were in Wuhan, the country’s coronavirus epicentre, triggering fears of a second wave. Seven others were ‘imported’, coming in on a flight that stopped at Inner Mongolia for testing. 

The remaining cases were detected in Jilin, close to the borders with Russia and North Korea. The city has been put under partial lockdown, sealing borders and cutting off transport links, as well as closing cinemas, indoor gyms, internet cafes and other enclosed entertainment venues. Pharmacies have also been asked to report sales of antiviral and fever medication to authorities. The city’s four million inhabitants can leave the city only if they have tested negative for COVID-19 in the past 48 hours and complete an unspecified period of ‘strict self-isolation’.

In South Korea, Seoul officials are trying to track down about 5,000 people who had visited clubs and bars in Itaewon, a popular nightlife district during the same period when the COVID-19 infected bar-hopper had been in the area. The outbreak triggered South Korea’s steepest daily increase in new coronavirus infections in more than a month, threatening a broader easing of the country’s social distancing measures. The country has enjoyed widespread international praise for its efficient mass testing, high-tech contact tracing and social distancing measures. This new incident puts those measures to a test, yet again. 

 

Image Credits: Republic of Korea (Kim Sun-joo), HP-Watch/Svet Lustig Vijay.

The World Health Assembly in Geneva, Switzerland.

World Health Organization member states were close to an agreement Wednesday evening on a European Union-led draft resolution on global COVID-19 response to the upcoming World Health Assembly. If approved, it would pave the way for coordinated planning by the global health community to ensure wide and equitable access by people worldwide to COVID-19 medicines and vaccines, according the latest draft obtained by Health Policy Watch.

But a “silence period” in which any of the 194 member states can raise formal objections – before the final draft is officially published – was extended at the last minute until noon Thursday – indicating that the bargaining was by no means over yet – with objections from the United States as a key obstacle.

The latest iteration of text submitted by the EU and 9 other co-sponsors including Australia, the United Kingdom, and Zambia, includes pointed references to a voluntary global “patent pool” for new COVID-19 treatments.  It also refers explicitly to countries’ rights to entirely upend international patent rules, and purchase or produce generic versions of treatments, when there is an overriding public health need.

The so called flexibilities in “Trade Related Aspects of Intellectual Property Rights (TRIPS),” are enshrined in a number of World Trade Organization agreements. They allow countries to legally issue  licenses to import or produce generic versions of patented pharma products, when urgent health needs arise. But in reality, countries rarely resort to their use.

But it remains to be seen if any of the references to so-called “TRIPS flexibilities” – or even voluntary patent pooling – will remain intact in the final draft.

Member states continued negotiating late this evening and Thursday morning. Countries have been meeting daily in private, virtual sessions, for several weeks, since the EU first announced its initiative to bring the world together around a potentially far-reaching resolution entitled “COVID-19 Response.”

The response so far has been anything but simple.

The United States has opposed many principals of the plan, observers say, even including calls for “universal, timely and equitable access and fair distribution” of COVID-19 remedies, as per a paragraph that asks member states and WHO to work towards:

“… the universal, timely and equitable access to and fair distribution  of all quality, safe, efficacious and affordable essential health technologies and products including their components and precursors required in the response to the COVID-19 pandemic as a global priority, and the urgent removal of unjustified obstacles thereto; consistent with the provisions of relevant international treaties including the provisions of the TRIPS agreement and the flexibilities as confirmed by the Doha Declaration on the TRIPS Agreement and Public Health (OP4);”

As one source, who asked to remain anonymous, cautioned: “This is the text as put forward by the countries that are listed as the co-sponsors. The US has not signed off on this.. Equitable access and fair distribution is not something that the US is a great fan of…The US has proposed alternative text.”

TRIPS References Peppered Throughout Draft Proposal
A researcher tests the efficacy of a generic drug in the United States.

Other, softer references to the global pooling of patents, along with TRIPS provisions for overriding them, are also peppered throughout the proposed draft, which was submitted on Wednesday by the EU chair of negotiations. These include a call to countries to:

“Work collaboratively at all levels to develop, test, and scale-up production of safe, effective, quality, affordable diagnostics, therapeutics, medicines and vaccines for the COVID-19 response, including, existing mechanisms for voluntary pooling and licensing of patents to facilitate timely, equitable and affordable access to them, consistent with the provisions of relevant international treaties including the provisions of the TRIPS agreement and the flexibilities as confirmed by the Doha Declaration on the TRIPS Agreement and Public Health (OP 8.2).

However, US wants to delete language on the “voluntary pooling of patents,” other sources further told Health Policy Watch late Wednesday night. That is despite the fact that voluntary pooling of innovations is the foundational idea upon which the EU resolution was first initiated.

“This is one of those moments when having a clear message from the World Health Organization and its members could have made a difference,” said James Love, head of the access advocacy group, Knowledge Ecology International, bemoaning the direction in which negotiations seemed to be leading.

“But, instead, some countries, the US, the UK and Swiss in particular, want to protect drug and vaccine manufacturers, as if there is no real crisis, so we have text that a few experts can argue over, to figure out what it even means.

“The big issue will be when a really good drug or a vaccine that works is available, and of course, there will be capacity constraints, and unfair and unequal access, not to mention concerns over pricing.  Just acting as if that can be addressed better later, when reality begins to hit you in the face, is hardly what we want from public health leaders.”

The proposed EU draft also assigns a central role to the WHO, calling on the WHO Director General to identify options for scaling up access to COVID-19 diagnostics, drugs and [future] vaccines:

“… in consultation with Member States, and with inputs from relevant international organizations  civil society,  and the private sector, as appropriate, identify and provide options that respect the provisions of relevant international treaties, including the provisions of the TRIPS agreement and the flexibilities as confirmed by the Doha Declaration on the TRIPS Agreement and Public Health to be used in scaling up development, manufacturing and distribution capacities needed for transparent equitable and timely access to quality, safe, affordable and efficacious diagnostics, therapeutics, medicines, and vaccines for the COVID-19 response taking into account existing mechanisms, tools, and initiatives, such as the Access to COVID-19 Tools (ACT) accelerator, and relevant pledging appeals, such as “The Coronavirus Global Response” pledging campaign, for the consideration of the Governing Bodies; (OP 9.8).  The (ACT) accelerator, announced just last month by European Commission President Ursula Von Leyen, dozens of other countries, WHO, and major global health donors has raised nearly €7.4 billion for a pool of COVID-19 technologies to date.

Another observer, who asked not to be named, described the [EU proposed] text as “tortured and badly written, but not a disaster,” despite nods to industry interests and consultations with the private sector.

However, whether that text can now even gain acceptance over US and other objections remains up in the air.  And if not, EU and other Member State sponsors face two choices.

They can barter away over the weekend at the language of the EU draft, until the US and its allies hopefully agree to a drastically pared-down deal. Or they can submit the EU-sponsored draft to a public vote next week at the full Assembly, presuming that the vast majority of low- and middle-income member states will readily sign onto the deal. But that vote, in and of itself, is likely to be a confusing and chaotic affair due to the fact that the WHA’s 194 members are meeting virtually for the first time ever, on untested and potentially unstable internet platforms.

And ever if a large majority of countries see the current text through to approval, opposition by one powerful state such as the US, would thwart the multi-lateral spirit of the agreement.

Others Thorny Issues – Reproductive Health Rights and WHO Funding
A nurse consults her patient with family planning needs. Sexual and reproductive health has been a controversial issue past UN debates over Universal Health Coverage (UHC).
Photo: Dominic Chavez/World Bank

A number of other thorny issues also exist in the draft proposal, whose other co-sponsors currently include New Zealand, Monaco, Montenegro, North Macedonia and San Marino, which could stall agreement at the last minute.

They include a reference to the importance of maintaining “the continued functioning of the health system in all relevant aspects.. including  by undisrupted vaccination programmes, neglected tropical diseases, noncommunicable diseases, mental health, mother and child health  and sexual and reproductive health and promote improved nutrition for women and children…” (OP 7.5)

References to sexual and reproductive health have often been red-penciled for deletion from international documents by the Administration of US President Donald Trump, which has regarded them as coded references to abortion rights.

The text also makes numerous references to ensuring funding flows to WHO, calling on member states to: “provide sustainable funding to the WHO to ensure that can fully respond to public health needs in the global response to COVID-19, leaving no one behind. OP 7.15)”.  Such references, if accepted by the United States, might also hint at a softening of earlier positions by the Trump administration whch had said it was temporarily suspending funding to the organization.  Then again, maybe those will disappear as well.

However, the text also clearly includes some clauses that Washington should be keen to see survive. These include demands that member states “provide WHO timely, accurate and sufficiently detailed public health information related to the COVID-19 pandemic as required by the IHR [International Health Regulations] (OP 7.10).”

Another clause calls on the WHO to work with the World Organization for Animal Health (OIE) and the Food and Agriculture Organization (FAO) to identify the elusive source of the virus, and how it lept from animals to humans, “including through efforts such as scientific and collaborative field missions, which will enable targeted interventions and a research agenda to reduce the risk of similar events as well as to provide guidance on how to prevent SARS-COV2 infection in animals and humans and prevent the establishment of new zoonotic reservoirs,  as well as to reduce further risks of emergence and transmission of zoonotic diseases. (OP 9.6)”

The research would presumably attempt to answer critics, including, but not limited to the White House, who have questioned the Chinese narrative that SARS-COV-2 first reached humans via contact with infected animals at a live market in Wuhan, China.  Some have also suggested that the virus may have somehow escaped from a nearby virology laboratory which was studying coronaviruses.

Evaluation of the COVID-19 Response by WHO – A Stepwise Process

Finally, the draft text contains a proposal, for an “impartial, independent and comprehensive evaluation” of the “WHO-coordinated international health response to COVID-19, including (i) the effectiveness of the mechanisms at WHO’s disposal; (ii) the functioning of the IHR and the status of implementation of the relevant recommendations of the previous IHR Review Committees; (iii) WHO’s contribution to United Nations-wide efforts;…(OP 9.10).”

Such an investigation is politically important to the United States – and also to other countries worldwide that have paid a significant price, both human and economic, as a result of the current pandemic. However, one key refinement is a conditional clause that suggests the investigation should be initiated “at the earliest appropriate moment, and “in consultation with Member States,” as part of a “stepwise process.”

Those small, diplomatic flourishes of “at the appropriate moment, and “stepwise”, in fact, give the global community a diplomatic breathing space to fight the pandemic first – and review the lessons learned once the fires of immediate danger have subsided a little bit more.

If ever the WHA resolution for “COVID-19 Response”, can at least be approved.

–Updated 14 May 2020

 

 

Image Credits: FDA/Michael Ermarth, WHO, Dominic Chavez/World Bank, World Health Organization .

Health Policy Watch is the media partner for the Geneva Graduate Institute – Global Health Centre series of World Health Assembly events, running Thursday 14 May to Wednesday 27 May.

The series of events is built around themes relevant to the 73rd session of the WHA, 18-19 May, the first ever Assembly to bring together the World Health Organization’s 194 member states in a virtual session, and focusing largely on a response to the COVID-19 pandemic.

The two-week series of virtual events will feature discussions on a range of critical global health issues such as the COVID-19 response, the role of civil society in global health governance, access to medicines and price transparency; women in the health workforce, as well as the political and commercial determinants of health.  The series, co-sponsored by the WHO, UN Foundation, the civil society movement UHC 2030, and others, brings together panels of scientists, public health professionals and policymakers from WHO, other UN agencies, and civil society.

See the full schedule and links for plugging in online below. Click the event titles for more information.

WORLD HEALTH ASSEMBLY OPEN BRIEFING

14 May, 15:00 | The Global Health Centre and UN Foundation announce the annual World Health Assembly (WHA) Open Briefing for delegates, non-state actors, and the general public. This virtual event will introduce how the 73rd Assembly, the first ever to convene online, will work this year, with an update from WHO on the COVID-19 response. A diverse panel of experts will explore key issues emerging in the global response to the pandemic, including resource mobilization and financing, human rights and gender equality, and international cooperation for innovation and access to health technologies.

WALK THE TALK: THE HEALTH FOR ALL CHALLENGE 

17 May, 12:00 CEST | The third edition of the Walk the Talk will offer a global platform to promote well-being for people all over the world. This WHO virtual event will support ongoing efforts to promote ways for people to be healthy at home, and engage in activities that promote good physical and mental health, including healthy diets, hand washing and mental health awareness. People are invited to join in from their homes for a range of online activities (yoga, zumba, meditation and more) presented by athletes. All activities are meant to be enjoyed by all ages, all abilities, alone or with your families.  See More here.

IS SPACE CLOSING FOR CIVIL SOCIETY IN GLOBAL HEALTH?

19 May, 16:00 | With restrictions in many countries on nongovernmental organisations, and sweeping new laws coming into play in response to COVID-19, is space closing for civil society, journalists and other whistleblowers in global health? Who will speak for civil society in the COVID-19 response, and what role –if any– will they play in oversight of the billions to be spent? Do civil society activists on the boards of global health agencies act as a force for accountability, or does being at the table with powerful donors, governments and UN agencies limit what they say? Leading activists  will debate these questions.

EL SUSTO (THE SHOCK): THE POLITICAL AND COMMERCIAL DETERMINANTS OF TYPE 2 DIABETES

20 May, 15:00 | The online screening of El Susto, followed by a discussion with the film director and leading experts, will shed light on the factors that shape the epidemiology of type 2 diabetes. Mexico’s number one killer is not cartels, but type 2 diabetes. Medical textbooks speak of genetics, diet, obesity, lack of physical exercise as the causes, but what are the political and commercial determinants that shape mass lifestyle choices? We will share an online screening of this 75-minute film in advance of this webinar, jointly organised by the Global Health Centre and Saluteglobale.it.

TRANSPARENCY AND ACCESS TO MEDICINES: ONE YEAR AFTER THE WHA RESOLUTION

21 May, 15:00 | In May 2019, a milestone resolution on transparency in pharmaceutical markets was adopted by the 72nd World Health Assembly. One year later, this event will reflect on efforts to implement it at national level, challenges that have arisen and ongoing debates. How does transparency shape innovation and access to medicines and diagnostics? What is the relevance of transparency to the ongoing COVID-19 crisis? Panelists will address these questions from government, civil society, academic and industry perspectives, looking at both national and global levels.

MASKED HEROINES? BUILDING RESILIENCE BEGINS WITH A GENDER-EQUITABLE HEALTH WORKFORCE

Cropped shot of a group of surgeons performing a medical procedure in an operating room

22 May, 15:00 | The COVID-19 pandemic is exposing the deep inequities that undermine global health, especially gender inequities impacting women front line health and care workers. In the Year of the Nurse and Midwife, few health and care workers (many of whom are women) have safe and decent working conditions, appropriate protection and equal and timely pay. How many decision makers in health systems are women? Do we collect sufficient data and evidence to understand the implications of COVID-19 on female health workers? Speakers in this session will share the perspectives of female health workers during this pandemic, and review lessons learnt from previous outbreaks.

TIME TO GET OUR ACT TOGETHER ON HEALTH SECURITY AND UHC

27 May, 14:00 | UHC2030 will launch its updated vision document for health systems strengthening, building on the recent statement from UHC2030 co-chairs which called on world leaders to remember their UHC commitments as they respond to COVID-19. This event proposes to stimulate discussion with stakeholders from across the UHC movement and beyond, immediately after the World Health Assembly, in order to leverage the momentum around the discussions among ministers of health.