Too Early to Decide on Annual COVID-19 Boosters as Virus Has No Seasonal Pattern Yet
Dr Tedros Adhanom Ghebreyesus

While the World Health Organization’s (WHO) emergency committee on COVID-19 will decide this week whether the virus still constitutes a global health emergency, the body’s Director-General, Dr Tedros Adhanom Ghebreyesus, is “very concerned” about the pandemic.

“While I will not pre-empt the advice of the emergency committee, I remain very concerned by the situation in many countries and the rising number of deaths,” Tedros told a media briefing on Tuesday.

He described the global COVID-19 response as being “under strain” with too few vulnerable people adequately vaccinated, too many people behind on their boosters, antivirals remaining too expensive, fragile health systems struggling with COVID-19 and other diseases, alongside a “torrent of pseudoscience and misinformation”.

“My message is clear. Do not underestimate this virus. It has and will continue to surprise us,” Tedros warned.

Dr Joachim Hombach, executive secretary of the WHO Strategic Advisory Group of Experts on Immunization (SAGE) agreed: “For the time being, COVID hasn’t really come down to the usual seasonal seasonality that we see for other viruses. The virus is still fairly unstable so it is a bit of anticipation if we end up in a seasonal pattern as we have it for instance for influenza.”

“It is conceivable that annual vaccination would be suitable. You basically have to find  the sweet spot between waning immunity and the benefit and the effort of providing an additional vaccination,” said Hombach.

Dr Joachim Hombach, executive secretary of the WHO Strategic Advisory Group of Experts on Immunization (SAGE).

Meanwhile, Dr Maria van Kerkhove, WHO’s lead on COVID-19, said that there were “a lot of uncertainties in terms of what is circulating in our ability to assess them”, given that surveillance of the virus had dropped substantially.

Funding appeal for emergencies

Tedros also appeal for an additional $2.5 billion to assist the WHO to address 54 health crises around the world, 11 of which are classified as Grade 3, WHO’s highest level of emergency.

“The number of people in need of humanitarian relief has increased by almost 25% compared with last year, to 339 million people, and 85% of humanitarian needs globally are driven by conflict.,” said Tedros.

“The world cannot look away and hope these crises resolve themselves.”

WHO Executive Board focus on resources

The key issues to be discussed at next week’s WHO’s executive board meeting, involve money and resources, according to Dr Tim Armstrong, WHO’s director of the department of governing bodies.

Armstrong’s top three issues from over 40 agenda items are the new programme budget for 2024/25, sustainable financing and an enhanced central role for the WHO in the global health architecture, particularly to support member states during health emergencies.

The board meeting starts next Monday, 30 January.

Better surveillance of contaminated medicines

Dr Hanan Balkhy

Tedros called on governments to ensure better surveillance of medicines following “incidents of contaminated cough syrups for children”. 

While the WHO had issued medical alerts focused on the Gambia (last October), Indonesia (last November) and Uzbekistan this month,  “at least seven countries have been affected”, said Tedros. 

“Most of the [over 300] deceased have been children under the age of five. These contaminants are toxic chemicals used as industrial solvents, and antifreeze agents that can be fatal even in small amounts,” he said.

This week, the WHO issued an “urgent call for countries manufacturers and suppliers to do more to prevent detect, and respond quickly to contaminated medicines,” said Tedros. 

“Governments must increase surveillance so they can detect and remove from circulation any substandard medicines identified in the WHO medical alerts. They must also enforce illegal measures to help stop the manufacture, distribution and use of substandard and falsified medicines. 

“Manufacturers must purchase pharmaceutical grade ingredients from qualified suppliers and conduct comprehensive testing before using them.”

Meanwhile, Assistant Director-General Dr Hanan Balkhy, said the WHO was appealing to governments and specifically the regulatory authorities to ensure that they “have proactive surveillance mechanisms to be able to detect the presence of these medications”.

Balkhy, who oversees Antimicrobial Resistance and is Acting interim Assistant Director-General for Medicines and Health Products, said that while contamination would always be an issue in the production of medicine, the WHO’s “ask” was that member states strengthen the capacity of their regulatory authorities’ oversight capacity.

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