Exceso de mortalidad durante la pandemia de COVID-19 en Ecuador. Análisis espacio temporal del exceso de mortalidad durante la pandemia de COVID-19 en Ecuador / Excess Mortality during the COVID- 19 Pandemic in Ecuador. Spatiotemporal Analysis of Excess Mortality During the Covid-19 Pandemic in Ecuador

Introducción: La pandemia de COVID-19 causó una elevada mortalidad en el mundo y en el Ecuador. Esta investigación se propuso analizar el exceso de mortalidad debido a la pandemia de COVID-19 en Ecuador. Método: Estudio observacional, longitudinal, cuantitativo y descriptivo. Clasificado como estudio ecológico en el campo de la epidemiología. Este estudio se centra en la medición del exceso de mortalidad durante los años 2020, 2021 y 2022, tomando como período base el promedio de defunciones ocurridas en el intervalo de 2015 a 2019. Resultados: Ecuador, en el período de enero 2020 a octubre 2022, acumuló un exceso total de muertes de 98.915. En el año 2020, el exceso de mortalidad fue mayor a 46.374, siendo el mes de abril el valor más alto de 15.484. En el año 2021, el exceso de muertes fue de 35.859, siendo abril el mes con mayor exceso de 7.330. Y el año 2022 el exceso de mortalidad fue de 16.682, el mes con mayor exceso fue enero con 4.204. Conclusión: Se evidenció un subregistro de defunciones, así como variaciones temporales y geográficas en el exceso de mortalidad. La provincia con mayor número de fallecidos y exceso de mortalidad fue Guayas seguida de Pichincha. Los resultados proporcionan un análisis del panorama durante la emergencia sanitaria, destacando la importancia de evaluar la capacidad de respuesta de los sistemas de salud en momentos de crisis y la necesidad imperativa de implementar medidas correctivas para el futuro.

Introduction: The COVID-19 pandemic caused a significant mortality in the world and in Ecuador. This research aimed to analyze the excess mortality due to the COVID-19 pandemic in Ecuador. Method: An observational, longitudinal, quantitative and descriptive study, classified as an ecological study in the field of epidemiology. This study focuses on measuring excess mortality during the years 2020, 2021 and 2022, using the average number of deaths that occurred in the period from 2015 to 2019 as the baseline. Results: From January 2020 to October 2022, Ecuador accumulated a total excess of deaths of 98,915. In 2020, the excess mortality was higher at 46,374, with the highest value occurring in April at 15,484. In 2021, the excess deaths amounted to 35,859, with April having the highest excess of 7,330. In 2022, the excess mortality was 16,682, with January recording the highest excess at 4,204. Conclusion: Evidence of underreporting of deaths, as well as temporal and geographi-cal variations in excess mortality, was observed. The province with the highest number of deaths and excess mortality was Guayas, followed by Pichincha. The results provide an analysis of the situation during the health emergency, emphasizing the importance of evaluating the healthcare system's capacity to respond during times of crisis and the imperative need to implement corrective measures for the future.

Organização dos sistemas de saúde no enfrentamento à covid-19: uma revisão de escopo / Organization of healthcare systems to confront COVID-19: a scoping review / Organización de los sistemas de salud para hacer frente a la COVID-19: revisión del alcance

RESUMO Objetivo. Identificar na literatura as evidências sobre a resposta dos gestores quanto à organização dos sistemas de saúde mundiais para enfrentar a pandemia do novo coronavírus. Método. Trata-se de uma revisão de escopo, com buscas realizadas em 11 bases de dados inseridas na Biblioteca Virtual em Saúde. A partir da pergunta norteadora "Como os gestores atuaram na organização dos sistemas de saúde para enfrentar a pandemia relacionada ao coronavírus?", foram selecionados 11 estudos, publicados de 2019 a 2020. Os resultados foram organizados a partir das categorias do Marco de Referência da Rede Integrada de Serviços de Saúde em resposta da covid-19 da Organização Pan-Americana da Saúde: governança da rede; modelo de atendimento; organização e gestão; financiamento/recursos. Resultados. Identificou-se que os gestores em países que investiram e articularam ações nas categorias do Marco de Referência, com coordenação de cuidados pela atenção primária à saúde, apresentaram melhores desfechos no enfrentamento à pandemia. Conclusões. Coordenar os sistemas de saúde ao nível dos cuidados primários, preparar os gestores e manter a alocação contínua de recursos financeiros para saúde são fatores importantes para garantir uma resposta satisfatória a crises como a da pandemia de covid-19.

ABSTRACT Objective. To identify evidence in the literature on the response of managers regarding the organization of global healthcare systems to face the COVID-19 pandemic. Method. For this scoping review, searches were performed in 11 databases accessible through the Virtual Health Library. Eleven studies, published in 2019 and 2020, were selected based on the following guiding question: "How did managers act to organize healthcare systems to face the coronavirus pandemic?". The results were organized in terms of the categories outlined in the Pan-American Health Organization's Framework for the response of Integrated Health Service Delivery Networks to COVID-19: governance; model of care; organizational and management; financial allocations. Results. Managers in countries that invested and articulated actions in the categories of the Reference Framework, with coordination of care at the primary healthcare level, achieved better outcomes in coping with the COVID-19 pandemic. Conclusions. Situating the coordination of healthcare systems at the primary care level, preparing managers and ensuring the continued allocation of financial resources to healthcare are important factors to secure a satisfactory response to crises such as the covid-19 pandemic.

RESUMEN Objetivo. Hacer una búsqueda bibliográfica de la evidencia de la respuesta de los gestores en lo referente a la organización de los sistemas mundiales de salud para hacer frente a la pandemia por el nuevo coronavirus. Método. Se trata de una revisión del alcance, con búsquedas realizadas en 11 bases de datos disponibles en la Biblioteca Virtual de Salud. A partir de la pregunta orientadora sobre "¿cómo actuaron los gestores en la organización de los sistemas de salud para enfrentar la pandemia relacionada con el coronavirus?", se seleccionaron 11 estudios publicados en el período 2019-2020. Los resultados se organizaron a partir de las categorías del Marco de referencia de la red integrada de servicios de salud para la respuesta a la pandemia de COVID-19 de la Organización Panamericana de la Salud, a saber, gobernanza de la red, modelo de atención, organización y gestión, y financiamiento o recursos. Resultados. Se observó que los gestores de los países que invirtieron recursos y organizaron acciones en las categorías del marco de referencia, con la coordinación de los cuidados por medio del sistema de atención primaria de salud, obtuvieron mejores resultados en el abordaje de la pandemia. Conclusiones. La coordinación de los sistemas de salud en el nivel de atención primaria, la preparación de los gestores y el mantenimiento de la asignación continua de recursos financieros al sector de la salud son factores importantes para garantizar una respuesta satisfactoria a crisis como la causada por la pandemia de COVID-19.

The ancient Tuberculosis in the novel COVID-19 scenario

Abstract Recently, the world has coped with the challenge of the novel SARS-CoV-2 rapid spreading, causing COVID-19. This scenario has overburdened health systems, forced social isolation, and interrupted some services, changing the way how health assistance is provided. The management of chronic infectious diseases such as tuberculosis is a sensitive matter in times when the control strategies are at risk. In this sense, how could a high burden disease such as tuberculosis affect or be affected when combined with the COVID-19 pandemic? Patients with tuberculosis have a social background and lung impairment that represent risks in the pandemic scenario of another widely transmitted respiratory disease. Thus, even with several questions remaining unanswered, research and public policies should be addressed to control the effects of the current highly contagious COVID-19 without forgetting how it will affect the natural progression of patients suffering from tuberculosis.

The regulation of artificial intelligence for health in Brazil begins with the General Personal Data Protection Law / A regulação da inteligência artificial na saúde no Brasil começa com a Lei Geral de Proteção de Dados Pessoais

ABSTRACT Artificial intelligence develops rapidly and health is one of the areas where new technologies in this field are most promising. The use of artificial intelligence can modify the way health care and self-care are provided, besides influencing the organization of health systems. Therefore, the regulation of artificial intelligence in healthcare is an emerging and essential topic. Specific laws and regulations are being developed around the world. In Brazil, the starting point of this regulation is the Lei Geral de Proteção de Dados Pessoais (LGPD - General Personal Data Protection Law), which recognizes the right to explanation and review of automated decisions. Discussing the scope of this right is needed, considering the necessary instrumentalization of transparency in the use of artificial intelligence for health and the currently existing limits, such as the black-box system inherent to algorithms and the trade-off between explainability and accuracy of automated systems.

RESUMO A inteligência artificial se desenvolve rapidamente e a saúde é uma das áreas em que as novas tecnologias desse campo são mais promissoras. O uso de inteligência artificial tem potencial para modificar a forma de prestação da assistência à saúde e do autocuidado, além de influenciar a organização dos sistemas de saúde. Por isso, a regulação da inteligência artificial na saúde é um tema emergente e essencial. Leis e normas específicas são elaboradas em todo o mundo. No Brasil, o marco inicial dessa regulação é a Lei Geral de Proteção de Dados Pessoais, a partir do reconhecimento do direito à explicação e à revisão de decisões automatizadas. É preciso debater a abrangência desse direito, considerando a necessária instrumentalização da transparência no uso da inteligência artificial na saúde e os limites atualmente existentes, como a dimensão caixa-preta inerente aos algoritmos e o trade-off existente entre explicabilidade e precisão dos sistemas automatizados.

Minitaller sobre la aceptación y el uso de las vacunas en el contexto de la seguridad de las mismas

Entender cómo piensa, se posiciona y actúa la gente sobre la vacunación es fundamental para informar el desarrollo de estrategias para la aceptación y el uso de las vacunas. La generación y el uso de datos sobre los factores sociales y de comportamiento implicados requiere un conjunto de herramientas -encuestas, guías de entrevistas, herramientas y marcos relacionados- para apoyar la recopilación y el uso de datos de calidad sobre los factores y las barreras para la aceptación de la vacunación contra el COVID-19. Los programas de inmunización se enfrentan a una serie de retos en el contexto actual de la vacunación contra la COVID-19, incluyendo la preocupación por la seguridad de la vacuna, los retos relacionados con la politización, la equidad y la aplicación de la vacuna, así como la desinformación. La situación es especialmente crítica en lo que respecta a la seguridad de las vacunas, ya que muchos países de América Latina y el Caribe informan de la preocupación del público por la seguridad y la eficacia de las vacunas durante las fases iniciales de su implantación. La escucha social y la recopilación de datos sociales y de comportamiento relacionados con estas preocupaciones reforzarán el diseño, la aplicación y la evaluación por parte de los países de estrategias específicas para generar y mantener la demanda de vacunas, y contribuirán así a aumentar la aceptación de la vacunación contra la COVID-19.

Sesión informativa COVID-19 en las Américas - 21/04/2021

Coletiva de Imprensa OPAS COVID-19 - 04/22/2021 audio Español.

PAHO press briefing on COVID-19 in the Americas - 21/04/2021

PAHO Press Briefing on COVID-19 in the Americas - 04/22/2021 audio English.

Conferencia de prensa de la OPS sobre COVID-19 - 21/04/2021

Conferencia de prensa de la OPS sobre COVID-19/PAHO’s virtual press briefing on COVID-19 audio original.

Press briefing PAHO COVID-19 - 04/21/2021

Press briefing PAHO COVID-19 - 04/22/2021- 04/21/2021 audio French

Coletiva de Imprensa OPAS COVID-19 - 21/04/2021

Coletiva de Imprensa OPAS COVID-19 - 04/22/2021 áudio Português.

Media briefing on COVID-19 and climate change with Dr Tedros and Greta Thunberg - 19/04/2021

0:00:34 CL Hello, good day and welcome to... wherever you are listening to us today from [sic]. It's Monday 19th April 2021. My name is Christian Lindmeier and I'm welcoming you to today's global COVID-19 press conference. The press conference today is on COVID updates with a special focus on the linkages between the climate and the COVID-19 crisis and the role of youth in the response ahead of Earth Day, which is 22nd April, and the first Global Youth Summit organised as part of the global youth mobilisation, which is 23rd to 25th April. Today's press conference will include three special guests and I'm happy to welcome Greta Thunberg, Climate and Environmental Activist, Elahi Rawshan from Bangladesh, volunteer in the International Federation of the Red Cross and Red Crescent Society, supporting young people in Bangladesh, and Daisy Moran from the USA, Global Youth Mobilisation Youth Board Member and World YMCA Representative. Welcome to the three of you. We will have simultaneous interpretation as usual provided in the six official UN languages, Arabic, Chinese, French, English, Spanish and Russian, plus Portuguese and Hindi. Now let me introduce the participants here in the room. Present in the room are Dr Tedros Adhanom Ghebreyesus, WHO Director-General, Dr Maria Van Kerkhove, Technical Lead on COVID-19, Dr Bruce Aylward, Special Advisor to the Director-General and the Lead on the ACT Accelerator. We have Mr Anil Suni, Chief Executive Officer from the WHO Foundation and we have Dr Maria Nera, Director for Health and Environment. We also have joining us remotely today Dr Mike Ryan, Executive Director for the Health Emergencies Programme of WHO, and Dr Mariangela Simao, Assistant Director-General for Access to Medicines and Health Products. With this let me hand over to the Director-General for the introductory remarks. Dr Tedros, the floor is yours. Thank you. Thank you, Christian. Good morning, good afternoon and good evening. Last week new cases of COVID-19 increased for the eighth week in a row with more than 5.2 million cases reported, the most in a single week so far. Deaths rose for the fifth straight week and more than three million deaths have now been reported to WHO. It took nine months to reach one million deaths, four months to reach two million and three months to reach three million deaths. Big numbers can make us numb but each one of these deaths is a tragedy for families, communities and nations. Infections and hospitalisations among people aged 25 to 59 are increasing at an alarming rate, possibly as a result of highly transmissible variants and increased social mixing among younger adults. 00:04:28 Today the emergency committee gave me its advice on vaccines, variants, international travel and other issues. Its full statement is available on our website. We have the tools to bring this pandemic under control in a matter of months if we apply them consistently and equitably. On Friday WHO issued an expression of interest for establishing a COVID-19 technology transfer hub for MRNA vaccines to increase production of those vaccines in low and middle-income countries. We're calling for the original manufacturers of MRNA vaccines to contribute their technology and know-how and for manufacturers in low and middle-income countries to express interest in receiving that technology. We have seen incredible innovation in science. Now we need innovation to ensure as many people as possible benefit from that science. The pandemic will recede but we will still be left with all the other challenges that we had before including the climate crisis. 00:05:58 This week marks Earth Day on 22nd April, a reminder that human health depends on the health of the planet that sustains us. COVID-19 has now killed more than three million people. Air pollution kills more than double that number, seven million people every single year. Despite temporary improvements in air quality last year as a result of so-called lock-downs by September air pollution had returned to pre-pandemic levels. Globally CO2 emissions only decreased by less than 6% last year but by December they had rebounded to their previous levels. The health argument for climate action is crystal-clear. The same unsustainable choices that are killing our planet are killing people. There is no vaccine for climate change but we do have solutions. Last year WHO published our manifesto for a healthy and green recovery, calling on all governments to protect nature, support clean energy sources, develop sustainable food systems and healthier cities and reduce polluting activities. 00:07:36 Together the six prescriptions of the WHO manifesto can not only restore resilient economies; they are a linchpin and essential prerequisite for healthy societies. At the COP26 climate conference in Glasgow this year WHO will deliver a special report with recommendations on how to maximise the health benefits of tackling climate change while avoiding the worst health impacts of the climate crisis. WHO is also spearheading an initiative on promoting climate-resistant health systems in collaboration with the Government of the United Kingdom. Today it's my honour to welcome someone who needs no introduction. Over the past few years Greta Thunberg has become the powerful voice of a young generation demanding climate action. Greta's mobilisation of communities, particularly young people, has been truly inspirational and has brought into sharp focus the impact of the climate crisis on people's lives and the urgent need for transformative action. The awareness she has raised on the links between climate, the environment and health has supported WHO's agenda in these areas, demonstrated the threats all of us face and the role young people can play in building a more sustainable, safer, healthier world. 00:09:33 More recently she has become a powerful advocate for vaccine equity. Tack så mycket, Greta. Today Greta has announced a donation of €100,000 from the Greta Thunberg Foundation to the WHO Foundation in support of COVAX to provide vaccines to people in need. Greta, thank you, tack så mycket for your superb advocacy for climate action and now for vaccine equity. Your contribution makes you the youngest person to contribute to COVAX. Welcome and you have the floor. GT Thank you so much for having me. It is an honour to participate in this event and I will talk briefly now. Science shows that in the future we will most likely experience more frequent and more devastating pandemics unless we drastically change our ways and the way we treat nature. Today up to 75% of all emerging diseases come from animals and as we are cutting down forests and destroying habitats we are creating the ideal conditions for diseases to spill over from one animal to another and then to us. 00:11:08 We can no longer separate the health crisis from the ecological crisis and we cannot separate the ecological crisis from the climate crisis. It's all interlinked in many ways. During this pandemic we have seen what we can achieve when we put resources into science. Vaccines were developed in record time but so far on average one in four people in high-income countries have received a coronavirus vaccine compared with just one in over 500 in low and middle-income countries. The international community, governments and vaccine developers must step up their game and address the tragedy that is vaccine inequity. We have the tools we need to correct this great imbalance that exists around the world today in the fight against COVID-19. Just as with the climate crisis those who are the most vulnerable need to be prioritised and global problems require global solutions. It is completely unethical that high-income countries are now vaccinating young and healthy people if that happens at the expense of people in risk groups and on the front lines in low and middle-income countries. This is a moral test. We talk today about showing solidarity and yet vaccine nationalism is what's running the vaccine distribution. It is only when it really comes down to it that we show our true face and that is why I and many others are supporting WHO, GAVI and all involved in the COVAX initiative, which I believe offers the best path forward to ensure a more equitable global vaccine distribution and a way out of this pandemic. Thank you. 00:13:04 TAG Thank you. Thank you so much, Greta, and thank you for your generosity in donating to the WHO Foundation in support of COVAX. These funds will help us save lives. Around the world young people have been affected by the pandemic in many ways from disruptions in education, loss of employment opportunities, mental health challenges and increased domestic and gender-based violence. WHO is committed to ensuring that the global recovery from COVID-19 includes the voices, energy and ideas of young people. To do that we have partnered with an alliance of the six largest youth development organisations in the world to form the Global Youth Mobilisation, to empower young people to respond to the challenges created by the pandemic in their local communities. 00:14:08 The Global Youth Mobilisation has established a grant mechanism with funds from the Solidarity Response Fund to support innovative local solutions to address the impact of the COVID-19 pandemic. From today young people around the world will be able to apply for grants of between 500 and US$5,000 through the Global Youth Mobilisation. These local solutions will be judged and decided on by young people for young people. To mark the starting point for young people to get involved in the Global Youth Mobilisation a Global Youth Summit will be held virtually from this Friday to Sunday, 23rd to 25th April. Over three days thousands of young people, leaders, policymakers and change-makers will come together in one space to discuss the issues facing young people across the world. On behalf of the Big Six youth organisations, the United Nations Foundation and WHO I invite everyone to join us at the Global Youth Summit. Today I'm delighted to be joined by representatives from two of the Big Six organisations. First it's my honour to welcome Elahi Rawshan, a volunteer with the International Federation of the Red Cross and Red Crescent Societies in Bangladesh. Elahi, thank you for joining us today. You have the floor. 00:16:05 ER Thank you, Dr Tedros, for inviting me here today. I'm really honoured to be here. My name is Elahi Rawshan. I'm a Red Cross/Red Crescent youth volunteer living in Bangladesh. There are about three million young people around the world how have been taking action to respond to the COVID-19 pandemic, driving the response efforts and supporting their local communities. I'd like to share with you my story to help explain why recognising, championing and investing in young people through the Global Youth Mobilisation is important. I led the very first disinfection team of Bangladesh Red Crescent Society in different hospitals for two consecutive months. At the beginning of the pandemic here the hospitals needed more supporting hands and we wanted to make sure the hospital environment was safe for everyone and we did to a great extent. One day when the very first COVID patient died in a hospital and everyone was so frightened to go near him, even his own son was reluctant to take his father's body. We went in, we disinfected the room and made sure the body was safe for carrying. 00:17:31 Another day I carried a critical COVID patient on a wheelchair and put an oxygen mask on her when there was no-one around for the support of that person. But I was not the only one; there are thousands of young people in Bangladesh fighting this battle in many different forms. About 4,500 young volunteers of the Red Crescent Society are supporting the vaccination programme every day in Bangladesh. It's mostly the young people here who are making a difference and again it's the young people here who are mostly infected by the pandemic. Many of my friends, colleagues from the different youth organisations and networks have lost their jobs. Almost everyone here is suffering from mental health issues. The data shows that from March 2020 to February 2021 more than 14,000 have committed suicide, which is 45% higher than the previous year and the majority of them are young people. 00:18:44 My dear friends, I have seen localised action making a positive impact on people's lives during this pandemic. I have been trying to collaborate with the Red Crescent Society with my workplace [unclear] who have been offering an online skills programme for the young people. Now as both parties have agreed the Red Crescent youth volunteers will receive a three-month online skills training on different trades like graphics designing, web development, etc. I believe drives like this will help young people individually and at the same time will contribute to the national economy. There are plenty of organisations and individuals out there who are making many more new initiatives to combat this COVID crisis and I would like to invite them all to collaborate with the Global Youth Mobilisation and it will support, promote and invest in your initiatives for improving more lives and communities. Thank you. TAG Thank you. Thank you so much, Elahi. Next it's my pleasure to introduce Daisy Moran, a representative of the World YMCA and a board member of the Global Youth Mobilisation. Daisy, thank you for joining us and you have the floor. 00:20:16 DM Thank you for giving me this opportunity, Dr Tedros, and greetings to you all. I'm Daisy Moran, proud to be with the YMCA in Illinois, USA and proud to be one of the six youth board representatives of the Global Youth Mobilisation. Here's what youth mobilisation has meant for me as the COVID pandemic has significantly increased the inequities in all of our societies. As a young leader I saw a need in my community to offer relief to essential workers who are undocumented immigrants. Through collaboration with fellow young change-makers and organisations we were able to disburse almost $17,000 in relief funds for 38 families. This is just one of thousands of stories that illustrate the simple and powerful fact; when given access and opportunities young people can make a significant difference. In the YMCA and right across the Big Six youth organisations young people have stepped up during the pandemic by delivering supplies to vulnerable people, looking after each other's mental health, making masks, helping share vital public information and now actively facilitating the COVID vaccine campaign. 00:21:35 As the global pandemic enters the recovery and relief period it is crystal-clear that young people are disproportionately impacted by the immediate and long-term implications of disruption in education, employment opportunities, physical and mental health/well-being, to name a few. These two reasons - young people bearing the brunt of the impact of COVID and young people offering so many of the solutions - are what has inspired the Big Six organisations, the World Health Organization and the United Nations Foundation to support young people around the would in delivering and developing youth-led community solutions through the Global Youth mobilisation. I am so excited and I want young people all over the world to be excited and get involved. They can start by attending the Global Youth Summit, which will be held virtually from 23rd to 25th April. At the summit they will hear about the role of young people in the immediate and long-term COVID recovery. It's a great forum where we can share our thoughts, passions, ideas that will influence policies and decisions that impact all of our lives. 00:22:47 This is a critical time for my generation, for our generation to bring policymakers, change-makers, advocate together to address the major challenges confronting young people by solutions and put them into action in our communities. No matter how big or how small I encourage you to have the confidence to apply for funding. If you have an idea to a challenge created by the pandemic you can apply for funding from $500 to $5,000. It is young people like you and me who will evaluate and agree who gets support for these local solutions. So please visit our website, www.globalyouthmobilisation.org We are the movement by youth, for youth and young people really are the answer. We are not the challenge. We are truly being the change that we want to see in the world. Thank you. TAG Thank you. Thank you so much, Daisy - by youth, for youth - and thank you to both of you for your leadership and vision. I look forward to joining both of you at the World Youth Summit and I look forward to seeing what ideas we can help take forward through the Global Youth Mobilisation. This is a reminder that although we're all living through a dark time there are also many reasons for hope and optimism about the future. Christian, back to you. 00:24:24 CL Thank you very much, all, and thank you very much, Dr Tedros. We will start the round of questions and answers. To remind you, if you want to get into the queue for questions please press the raise your hand icon on your screen. We'll start with the first question from Carlos from El Mundo. Carlos, please unmute yourself. CA Hi. CL Go ahead, please. CA It's a question specifically for Greta. Isn't there a risk that the COP26 will lose its momentum? What should we change in the next three months for example to turn the tide and to put the two goals of climate change and vaccination equality on the same level? CL Thank you very much, Carlos. Yes, Greta Thunberg, please. 00:25:27 GT Of course there's a risk that COP will lose momentum but the most important thing is that everyone is safe and of course safety and health come first in these kinds of situations. Of course there's not just one thing that needs to change in order to break this trend that we are seeing now, there's not just one single thing that we can do to - so-called - solve the climate crisis and the vaccine inequity crisis. Of course it's a bit more complicated than that and I think I may not be the best person to answer that. I think there are lots of experts who are more suited for that question but we do need to change our mindsets, we do need to think globally and not only think about ourselves. That's what these crises come down to, that we only think about ourselves, that we don't think about others. They come down to the way we treat others, the way we treat other human beings, the way we treat other animals and nature itself so we need to change our mindsets, if you want one single thing; it's more complicated than but just one thing. CL Thank you very much, Greta. I'll ask Dr Maria Neira from WHO to add, possibly. 00:26:56 MN Thank you, Christian, and thank you very much, Greta. It's really a pleasure to have you with us. You are an inspiration. You have been driving an incredible movement and many people are behind so certainly the COP26 has to be something very successful. In response to your question, Carlos - hola - I think what will change the mindset and what might have an incredible impact is what the Director-General was saying at the beginning, the health argument of climate change. If we are able to explain to people that climate change is about our health, it is affecting our health and if we stop burning fossil fuels the benefits will be enormous in terms of reducing the process of climate change but as well on reducing air pollution. Air pollution, as mentioned again by the Director-General, is responsible for more than seven million premature deaths every year due to exposure to air pollution and in addition to that it creates an environment that makes our health more vulnerable and creates the perfect conditions for more emerging infectious diseases to occur. 00:28:12 So I think we have a perfect case here for creating more action at the COP26, giving the health benefits that can be obtained in an incredible way. If we tackle the causes of air pollution, if we tackle the causes of climate change that will be an enormous health agenda and talking about health is what can make this change that we all need in terms of ambition to go for more at [?] the COP and in convincing people. If we tell people that this is connected to human health I think this will be the final argument that will create much more motivation and engagement and probably a stronger movement to put political pressure on those who will take decisions and hopefully going for much more. Thank you. CL Thank you very much. This was Dr Maria Neira, Director for Environment, Climate Change and Health. The next question goes to Shoko Koyama from NHK. Shoko, please unmute yourself. SH Hello. Can you hear me? CL Go ahead, please. SH Thank you for taking my question. Regarding COVAX, UNICEF is trying to buy one billion syringes by the end of this year in order to distribute to countries together with vaccines. 00:29:37 One billion syringes in addition to the six to 800 million syringes they procure annually seems to be a large quantity. Is COVAX able to procure this huge number of syringes by the end of this year and what challenges are there regarding the procurement of syringes? Thank you. CL Thank you very much, Shoko. I'll give it to Dr Bruce Aylward. BA Thank you very much, Shoko, for the question and thanks for highlighting that it takes more to get the world vaccinated than simply to make and procure the vaccines because there are all the additional pieces that have to go into this including additional supplies like not just syringes, which you mentioned, but also the vaccination cold chains and other supplies that are necessary to keep them in the right conditions before we get them to the actual people who need to be vaccinated. 00:30:38 In terms of the syringes, just like the cold chain equipment the COVAX facility began working with countries way back in October or even earlier last year to look at what numbers of syringes would be required and to start working with manufactures to ensure that pipeline would be there. You might remember some months ago the Director-General invited Henrietta Fore, who is the Executive Director of UNICEF, to join one of these press conferences and at that time she explained what they were already doing to try and make sure that the necessary syringes would be in place. This will continue to be a challenge, just like all of the supplies necessary to get the world vaccinated, these extraordinary numbers but for the moment the pipelines are there and the producers are doing their part. But it all comes back again also to the COVAX facility having the resources it needs so that it can put the contracts in place up-front to make sure the supplies are there, not just the supplies in terms of the vaccines but, exactly as you highlight, the syringes and the other supplies including, as I mentioned, the cold chain equipment and sometimes very specialised cold chain equipment to get these products to people. 00:31:57 CL Thank you very much, Dr Aylward. We'll move on to Robin Mia from AFP. Robin, please unmute yourself. RO Thank you. A question for Greta, if I may. If vaccine inequity carries on and young people start being offered a vaccine in wealthy countries whilst at the same time elderly and wealthy people remain completely unprotected in poor countries, would you advocate a vaccine strike amongst younger people in rich countries until their governments start sharing more vaccines? Thank you. CL Thank you very much, Robin. Of course, Greta, the floor is yours. GT We must not forget that this is not a problem that is caused by individuals. This is a problem that needs to be addressed by the international community, governments and the vaccine developers. It is wrong; if we should start focusing on individuals and urging individuals not to take the vaccine that would send a very wrong message. 00:33:00 Of course everyone who is offered a vaccine should take it but we need to see the bigger picture here and be able to focus on several things at once. So no, I would not advocate for people not to take the vaccine. CL Thank you so much for that. We'll move to Jamil Chad from O Estado de Sao Paulo. Jamil, please unmute yourself. Jamil, do you hear us? Please unmute yourself. JA Can you hear me, Christian? CL Please go ahead. JA Can you hear me? CL Yes. JA Thank you. This is Jamil Chad, a journalist from Brazil. Ms Greta Thunberg, my question is about vaccines but also on climate change. What is your message to President Bolsonaro at this time when both the pandemic is hitting Brazil hard but also climate change is an issue? You'll note very well what is the position of President Bolsonaro. What is the message you can send him today? Thank you. CL Thank you so much, Jamil. Over to Greta. 00:34:24 GT Of course I don't think we should be focusing on talking about individuals since this is a much larger problem but of course Jair Bolsonaro has a huge responsibility both when it comes to the climate, environment and of course we can see the response that Brazil has had during the corona pandemic. I can only speak for myself but I can safely say that he has failed to take the responsibility that is necessary in order to safeguard present and future living conditions for humanity. CL Thank you very much, Greta. We'll move on to Navas Shah from Xinhua. Navas, please unmute yourself. Navas Shah, do you hear us? Please unmute yourself. It looks as if we're not getting to you so we will continue with Gunila Van Hal from Svenska Dagbladet. Gunila, please unmute yourself. GU Can you hear me? CL Wonderful. Go ahead. GU Thanks for taking my question. It is to Greta Thunberg and I'd like to know your view on the proposal from WHO and many governments, among those your own, the Swedish Government, that richer countries should donate remaining vaccine doses to poorer countries once their own risk groups have been vaccinated and before they vaccinate the rest of the population. 00:36:06 What do you think about this and what do you respond to people questioning this, saying, why should we sacrifice our own populations in order to save the world? Thank you. CL Thank you, Gunila. Over to Greta, please. GT I think that is a very reasonable thing to do. We need to protect and prioritise the most vulnerable people in risk groups and working on the front lines, no matter which countries they come from; at least that's my opinion. Of course I understand that people will be frustrated by that. Of course I also want to return to everyday life and everyone I know wants to do that as well but we need to act in solidarity and we need to use common sense when it comes to these issues. As I said, the only sensible thing to do, the only morally right thing to do is to prioritise the people who are the most vulnerable no matter whether they live in a high-income country or a low-income country. 00:37:23 CL Thank you very much, Ms Thunberg. We'll move ahead to Jamie Keaton from AP. Jamie, please unmute yourself. JM Thank you, Christian. My question is both for Ms Thunberg and Ms Moran. What is your message to young people who have become a major driver of COVID-19 infection? We heard the Director-General, Dr Tedros, just mention that increased social mixing among younger adults is possibly one of the reasons for the increase in infections and hospitalisations among people aged 25 to 59. If I could just sneak in a another question to Ms Thunberg, ahead of President Biden's climate summit what do you hope it will achieve? Thank you. CL No small questions today. Thank you very much, Jamie. Let's move to Greta Thunberg first and then on. Thank you. GT Yes, of course it's absolutely crucial that everyone takes our personal responsibility in this crisis. We young people may be the ones who are in general least affected by the virus in a direct way but of course, as I said, we need to act in solidarity with the people in risk groups. 00:38:57 Of course many young people fail to draw that connection maybe; of course not everyone but of course there will always be some. My message to those is that during crises like these we need to take a few steps back and act for the greater good of society and in order to protect our fellow citizens and of course especially people in risk groups because that is the thing you do during crises; you step up for one another. My hopes for the Biden summit; I hope that we will soon in one way or another start treating this crisis like a crisis - the climate crisis, that is - because if we are to be blunt, we can have as many summits as we want, we can have as many meetings and conferences as we want and make nice speeches and nice pledges like next year or 2050 and so on. But as long as those things contain so many loopholes as they do and as long as we are not actually treating the crisis as a crisis of course we won't be able to achieve any major changes. As I mentioned earlier, we need to change our mindsets and we need to change or view of the world. We cannot try to solve this crisis with the same approach that got us into it in the first place so we need to start treating the crisis like a crisis. 00:40:40 Without an increased level of awareness among people in general of course there will be no pressure on world leaders to actually start making the changes that are necessary to safeguard humanity so my hope is that we will start treating the crisis like a crisis. CL Thank you so much, Greta. Let me first give the floor to Daisy Moran from the global youth organisation [unclear]. Daisy. DM Thank you and thank you for your question. I believe my generation, our generation that we are representing is a generation of allyship because we understand our privilege and how to use our privileges to uplift those in the most vulnerable situations. The Global Youth Summit is a platform and a forum for all of youth and stakeholders and supporters to come together to really listen to what are the policy changes that need to be made so that we can have more equitable societies and systems in place. So I hope that you can join us this weekend while we discuss the important issues and challenges facing our generation and how our youth leaders are in a position to create the most innovative solutions to tackle these big issues. Thank you. 00:41:59 CL Thanks so much, Daisy. Now we'll move to Dr Maria Van Kerkhove. MK Thanks, Christian. Those were excellent answers but I did want to clarify something here with regard to increased transmission. We are seeing increased rates of infection across all age groups. Last week there were 5.2 million cases reported to WHO globally, the largest in a single week since this pandemic began, 16 months into the pandemic. That is the largest increase in a week that we have seen to date. We've seen an increase across all age groups. We need to take the blame away and in the question it was meant to blame and we can't do that. Everyone has a role to play in this pandemic. We all have a role to play in keeping ourselves and our loved ones safe. What we are seeing is a slight age shift in some countries driven by social mixing and social mixing doesn't necessarily mean going out and having a party. It means individuals who have to leave their home to go to work, it means individuals have to feed their families and if you increase social mixing for a variety of reasons, whether this is for work or for religious reasons or indeed socialising itself the virus will take advantage of that. 00:43:18 If you add on top of it these variants of concern, variants that are circulating around the world, particularly the B117 variant which is circulating in a large number of countries across the globe that have increased transmissibility; if you add variants that have increased transmissibility with increased mixing this virus will take off and case numbers will increase. In a number of countries we've seen a very, very steep incline due to this. In addition to that we are seeing some countries not able to implement the public health and social measures that are needed to allow for physical distancing and in many parts of the world physical distancing is really not possible but in other parts of the world it is. So we need to do what we can to avoid those crowded settings, avoid those settings where social mixing - particularly indoor, crowded settings where there's poor ventilation, where the virus really likes to spread efficiently between individuals. 00:44:18 We need governments to enable people to carry out those measures; very easy for us to say stay home if you can but we need governments to support individuals to work from home, to stay home if necessary so that we can reduce the possibility for the virus to spread. All of us really have a role to play. Youth, young people, children, young adults are showing us ways in which to be innovative, to remain socially connected yet physically distant. I think what we are seeing with the youth and this youth mobilisation is really energetic. There's a spirit, there's an energy here that is holding leaders accountable and saying, help us help the situation and I'm really inspired to see that. I was really happy to hear the by youth, for youth as you pointed out and showing us that young people, young adults, children can make a significant difference every day. So please let's stop the blame in terms of who is spreading. All of us have a role to play, all of us need to be supported in taking those individual-level measures as well as measures at the family, at the community, at the sub-national, at the international level. 00:45:30 CL Thanks so much, Dr Van Kerkhove. We have Dr Mike Ryan, WHO Health Emergencies Executive Director, to add. MR Thanks, Christian. I just want to reflect on one thing that Daisy said. She said youths are not the problem, youths are the solution and I fundamentally believe in that and thank you, Daisy, for saying that and the energy from everyone today is fantastic. Reflecting on something that Greta said, she spoke about mindset and mindset is everything and Tedros reminds of that every day, I think; it's one of his most common pronouncements about mindset and it doesn't matter what problem you're trying to solve. There's no amount of announcement, there's no amount of recommendations, there's no amount of anything that changes anything until we change our mindset and that can be the mindset about protecting ourselves and our families from COVID and taking precautions. It can be the mindset on government's response to COVID. It can be the mindset driving climate action and reducing climate change. 00:46:37 So I think really we all need to reflect on that. It is our mindsets that drive our behaviour, both positive and negative and they're having a huge impact on the planet and obviously our behaviour's having a huge impact on the trajectory of this pandemic. Thank you. CL Thank you very much, Dr Ryan. The next question in line comes from Isabel Sacco from EFE. Isabel, please unmute yourself. IS Good afternoon, thank you, Christian. I would like to know if you can give us an overview of the proportion of the people under 40 years old who are in ICUs globally or by region. Connected to that, what do we know about mortality among babies? I saw figures from Brazil that indicate that 1,300 babies have died there from COVID. Thank you. CL Thank you very much, Isabel; very detailed questions. Let me give to Dr Maria Van Kerkhove first. MK Thanks for these very important questions. I cannot give you a specific answer of the proportion of those under 40 in ICU but what I can say is that there is an increasing number of hospitalisations among younger individuals and this is driven by what I answered in the last part of the question. 00:48:01 When you have increased transmissibility across all age groups you will see increased rates of hospitalisation, you will see an increased proportion of ICU and you will see increases in death. We are seeing unfortunately a little bit of a shift in the age structure in terms of the median age of individuals who are infected but that is driven by changes in social mixing patterns. If you remember, last spring, in the northern hemisphere's spring we saw a similar situation where as societies were opening up across Europe for example there was an age shift in the median age; it went from an older age group to a slightly younger age group. Again this is driven by people who are leaving their homes to go back to work and if there is the virus that is spreading, if you have virus variants this is a dangerous combination. We are seeing increases in hospitalisation among younger age groups and increased ICU and increased deaths. 00:48:55 With regard to children I did see that report that you mentioned about Brazil. Overall if we look at infection among children, if we look at severity among children still around the world there is a lower proportion of children that experience disease, that experience severe disease and some children do die. If there is a lot of virus that is circulating, if you have millions of cases being reported - and you know so far we've had 140 million cases reported worldwide - we will see deaths in all age groups. With regard to the youngest children, overall they tend to be more mild but again this is not universal. We do see that children, particularly children with underlying conditions but children in general, have died from COVID. So everyone is at risk from this virus. People are at risk of getting infected, at risk of getting severe disease so we do need to do what we can where we can as much as we can to first and foremost prevent infections but also making sure that we use the systems that are in place to get tested, to be able to carry out the public health actions that do prevent the spread from an adult to a child, from a child to an adult; everything that we can to really prevent that level of infection and care for as many people as we can, getting them early into that clinical care pathway to receive the care based on the symptoms that they have. 00:50:28 CL Thank you so much. The next question goes to Akwazi Sarpong from BBC News Africa. Akwazi, please unmute yourself. Akwazi, do you hear us? Yes, please go ahead. AK [Inaudible]. CL Akwazi, the sound is really bad. Please try one more time. AK Yes, [inaudible] in Ghana so [inaudible]. I have two questions. I would like [sound slip] many young people living with disability, particularly visual impairment, have been affected by this virus in Africa and at the global level. The second question is, what programmes are in place to support families with children and young persons with disability and special needs to help us combat this? Thank you. CL Thank you very much, Akwazi; very important questions. I'll hand to Dr Van Kerkhove for a start. 00:51:35 MK I can start. In fact we have departments that are working particularly on persons with disabilities to ensure that persons with disabilities, who are disproportionately affected by COVID-19 in a variety of ways, whether this is about getting the right care, receiving information appropriately so that they know how to keep themselves safe, making sure that they have the ability to receive the materials they need, testing, etc. We have some guidance that is coming out, I hope, today - it was approved yesterday - looking specifically at the more than one billion people worldwide who are living with disabilities, making sure that they have access to vaccination for example. We have seen some innovation in terms of personal protective equipment; if you've noticed, some of the masks for example will have a clear panel so that you can see lips moving for people who have a hearing impairment so there are a number of innovations that are coming online to support individuals with disabilities but also families with disabilities as well because even individuals with disabilities; their caretakers have to be able to care for them. So we need to make sure that those caregivers are protected against the virus as well so there're a number of activities that are underway to ensure those living with disabilities as well as those caring for those with disabilities have the appropriate care and information that they need. 00:53:05 CL Thank you very much, Dr Van Kerkhove. The next question goes to Priti Padnaik from Geneva Health Files. Priti, please unmute yourself. No, Priti lowered her hand apparently in the meantime or we don't find you any more. The next question goes to John Zaracostas from The Lancet. John, please unmute yourself. JO Good afternoon. Can you hear me there? CL Very well. Go ahead. JO I was wondering if you could give me up-to-date estimates on how many vaccine facilities worldwide with excess capacity could be enabled to produce vaccines and secondly, if possible, if Dr Tedros could give us his perspective on what's going on in his homeland where right now they're facing an existential threat. CL Thank you very much. We'll take the first question and I guess we'll see if Mariangela Simao is online... or then... SS I could start. CL Dr Swaminathan; exactly. Please go ahead. SS Thank you. Thank you very much, John, for that question. This is exactly the work that we've started now as part of the COVID vaccine manufacturing taskforce with our COVAX partners, CEPI, GAVI, UNICEF as well as the private sector and regional bodies like the African Union but also other regional organisations. The idea really is to take a short-to-medium-term and a longer-term approach. The short-term and the immediate need is to increase vaccine supplies within the next weeks and months and that can be done by unblocking roadblocks and obstacles that have been identified by the manufacturers and by working with suppliers of those critical ingredients and raw materials so that we can link suppliers and manufacturers as well as work with member states to make sure that export bans and things like that don't interfere with the process of vaccine manufacturing. That's our immediate short-term priority which hopefully will be able to put more doses for COVAX in the coming weeks. The second, more medium-term, is to look at fill and finish capacity to link... 00:55:43 We know that there's a lot of unused fill and finish capacity globally and therefore we need manufacturers who have the capacity to make bulk product and link them with these existing fill and finish capacities in facilities around the world. CEPI already has done a mapping of that and it exists. Then the third, more medium to longer-term, is really to develop new facilities that would build on existing facilities, particularly in low and middle-income countries and get technology transfer, encourage companies. As the DG mentioned, the WHO put out a call on Friday both for owners of technology, particularly MRNA technology to begin with, to come forward to work with us to share that technology, share the know-how and experience with recipient companies that will be selected according to a set of criteria that we are developing. 00:56:40 This will ensure not only supplies for this pandemic - though it may take a few months to get up and running if we start with existing facilities with some expertise - but also will help the future regional health security of regions which currently do not have any manufacturing capacity. This obviously can be extended to vaccines for many other infectious diseases. So that's what the taskforce is looking at and over the coming days we will provide much more detail. Thank you. CL Thank you so much, Dr Swaminathan. I'm calling on Dr Mike Ryan to take the other part. MR Thank you, John; important question. The situation in Tigray in Ethiopia remains very, very dire at the moment. The situation is not improving. We have unpredictable access, increasing humanitarian needs, increasing sexual violence. The response has been hindered by armed clashes throughout the region and many areas are still not receiving food or other assistance. We've got 4.5 million people affected by this crisis. 2.5 million of them have no access to services whatsoever. Half a million people have no access to food. We have a million internally displaced people in 178 sites scattered across the region being served by IOM and UNHCR. 00:58:18 We've had over 800 cases of sexual and gender-based violence reported from just five hospitals alone; that many cases. We've over 62,000 refugees who have crossed into Sudan. That safety valve is very, very difficult to manage and very difficult for us to have access from that side and to support people in the affected area. So, as I said, unpredictable access, displacement, tremendous humanitarian needs but we have 20 health partners working with us who are operational on the ground but they're only accessing about half of the... where aid is concerned. When we look at health facilities, we've done a health facilities survey throughout the region in 264 health facilities. As of now only 72 of those facilities are operational and 40 of those are only partially accessible. 19 hospitals have been completely damaged or destroyed; 15 more with major damage. There're inadequate supply chains across the board. 00:59:23 So the situation in Tigray could not be more dire, the people there could not be in more need of support and help. The situation is deteriorating. The situation is very much a massive concern on a purely humanitarian basis here. There is a health crisis on top of a humanitarian crisis. We're very concerned about malnutrition, about malaria, about cholera, measles, COVID-19 - positivity rates have been rising - and other diseases like meningitis and other diseases that will exploit malnutrition, they will exploit stress and they will exploit all of what's happening in that population. We have resumed surveillance activities but only covering about 30% of the population and again severe, acute malnutrition is a major, major issue. It is very hard to overstate the extent of the humanitarian crisis and the health crisis currently unfolding in Tigray and the WHO and the other UN agencies and NGOs are calling for unfettered humanitarian access and for military conflict and those perpetrating the conflict to remove themselves from civilian areas and those who should not be there should not be there. Thank you. CL Thank you very much. This was Dr Mike Ryan, Executive Director for WHO's Health Emergencies Programme and Dr Bruce Aylward wanted to come in too. 01:00:51 BA Thanks, Christian. I just want to come back to the important point you raised, John, about how much capacity is unused around the world right now because there was huge attention last week at the conference of the African Union on the consultation that was called by the World Trade Organization to try to expand vaccine production globally. But we need to remember that the challenge is how we're actually using the doses that are being made because last week while those conferences were taking place 100 million more doses of vaccine were administered around the world. The issue, John, is where they're being administered because 1% of that 100 million went to low-income countries so 99 million doses of vaccine last week went into high, upper-middle-income and some low-middle-income countries but only 1% of that went to the lowest-income countries. 01:01:48 So every time we bring new capacities online, when we bring new deals online, etc, that you're hearing about we need to ask the question of where those doses are going because those doses are not going to the places that have got the least vaccine today. So we need to be careful in thinking that we can simply build additional capacity because that capacity is still going to the wrong places, quite frankly. While we are giving great attention to how we expand capacity it's going to take weeks and months for that to come online and in the meantime we've got to take some urgent and important decisions about how we are going to use the vaccines that exist today because if we have a lot more weeks where 100, 99% of the vaccine goes to a set of countries that already have most of the vaccine we are not going to get out of this crisis as rapidly and efficiently and with the least lives lost possible. CL Thank you very much for all your answers. With this we're coming to the end of our question-and-answer session. I was very glad to have you all online today and our special guests and I will ask our special guests to start the closing round and we'll go in reverse order. We'll start with Daisy Moran, the Global Youth Mobilisation, Youth [Unclear] and Worldwide YMCA representative. Daisy, please go ahead. 01:03:20 DM Thank you for the opportunity once again and as a reminder, please join us this weekend on April 23rd to 25th to have your voice heard. You have the solutions; please come to the table. We want you to be involved in your local communities and we have the funds to support you. With any questions please visit our website at www.youthglobalmobilisation.org Thank you. CL Fantastic. Thanks so much. Now we go to Elahi Rawshan, volunteer from the International Federation of the Red Cross and Red Crescent Societies, supporting young people in Bangladesh. Elahi, please go ahead. ER Thank you. I would like to thank everyone for inviting me here and I would like to echo the last voice; young people are the solution and I would like to invite all the localised solutions to collaborate with the Global Youth Mobilisation, who have been supporting these local actions and promoting them. 01:04:22 So I would also like to invite everyone to join the Global Youth Summit coming up this week from 23rd to 25th. Thank you once again. CL Thank you so much, Elahi, to you. Last but not least we go to Greta Thunberg, Climate and Environmental Activist. Greta, the floor is yours. GT To be honest I don't really have anything more to add. Just take care, everyone. But also while we have media here, I really urge you to really bring awareness to this issue of vaccine inequity because you have the power to raise awareness about this. When we talk about countries like, for example, the UK and the US - just as a few examples - that they are mass-vaccinating large groups of their populations, even healthier young people, we see it from a different perspective, that we don't always see it from our Western, privileged point of view but rather that we think globally and we need to prioritise those most vulnerable first. Thank you. Take care, everyone. CL Thank you so much, Greta, for these words. Yes, there's hardly anything to add; I agree. From my side let me thank everyone and remind you that the sound files of this press briefing will be shared right afterwards today and the transcript will be available as of tomorrow. Dr Tedros. TAG Thank you. Thank you, Christian. I would like to thank our guests today, Greta, Elahi and Daisy. You have been wonderful. Thank you so much indeed. I would also like to join you in inviting everybody to join on the 23rd to 25th the Global Youth Summit, from Friday to Sunday so I look forward to seeing you there. I would also like to thank our media colleagues who have joined and see you in our upcoming presser. That will be on Friday. Thank you so much. 01:06:54

Sesión informativa COVID-19 en las Américas - 14/04/2021

Sesión informativa COVID-19 en las Américas - audio Español

Press briefing PAHO COVID-19 - 04/14/2021

Press briefing PAHO COVID-19 - audio English

Conferencia de prensa de la OPS sobre COVID-19 - 14/04/2021

Conferencia de prensa de la OPS sobre COVID-19 / PAHO’s virtual press briefing on COVID-19 - audio original

Press briefing PAHO COVID-19 - 04/14/2021

Press briefing PAHO COVID-19- audio French

Coletiva de imprensa OPAS sobre COVID-19​ nas Américas - 14/04/2021

Coletiva de imprensa OPAS sobre COVID-19​ nas Américas - áudio Português

Revisión intra-acción (IAR) de COVID-19

Este video de 3 minutos presenta la Revisión intra-acción (IAR) de COVID-19 del país promovida por la OMS, incluida la metodología y los recursos disponibles para los países. Más información: https://www.who.int/publications/i/it...

Sharing COVID-19 experiences: the El Salvador response

El Salvador responded rapidly and effectively to the emergence of the SARS-CoV-2 virus in the country. In line with WHO advice, El Salvador stepped up preparedness of its health system in mid-January and announced a national emergency on 30 January, the same day that WHO declared COVID-19 a public health emergency of international concern. El Salvador’s strong response has been built on equipping hospitals, community level care and training health workers, plus preparing for vaccine rollout, which commenced 17 February 2021.

Media briefing on COVID-19 - 08/01/2021

00:00:54 FC Hello, all. I think our technical problems are being solved now. I am Fadela Chaib, speaking to you from WHO headquarters in Geneva and I welcome you to our global COVID-19 press conference today, Friday 8th January. Present in the room are WHO Director-General, Dr Tedros, Dr Mike Ryan, Executive Director, Health Emergencies, Dr Maria Van Kerkhove, Technical Lead for COVID-19, Dr Bruce Aylward, Special Advisor to DG and lead on the ACT Accelerator, Dr Mariangela Simao, Assistant Director-General, Access to Medicines and Health Products. Joining us remotely are Dr Kate O'Brien, Director, Immunisation, Vaccine and Biologicals, and Dr Ed Kelley, Director, Integrated Health Services. Welcome, all. We have simultaneous interpretation in the six UN languages plus Portuguese and Hindi. Now without further delay I would like to invite Dr Tedros for his opening remarks. DG, you have the floor. TAG Thank you. Thank you, Fadela, shukran. Good morning, good afternoon and good evening. COVAX, set up by GAVI, CEPI and WHO in April last year, has now secured contracts of two billion doses of safe and effective COVID-19 vaccines, which we're ready to roll out as soon as the vaccines are delivered. 00:02:31 We also have the right of first refusal on an additional one billion doses. However this is where the current challenge is. At present 42 countries are rolling out safe and effective COVID-19 vaccines. 36 of these are high-income countries and six are middle-income countries. So there is a clear problem that low and most middle-income countries are not receiving the vaccine yet. This is a problem we can and we must solve together through COVAX and the ACT Accelerator. At the outset rich countries have bought up the majority of the supply of multiple vaccines. Now we're also seeing both high and middle-income countries that are part of COVAX making additional bilateral deals. This potentially bumps up the price for everyone and means high-risk people in the poorest and most marginalised countries don't get the vaccine. 00:03:42 Some companies and countries have not submitted critical data which we need to issue emergency use listings, which blocks the whole system of procurement and delivery. Vaccine nationalism hurts us all and is self-defeating. But on the flip side vaccinating equitably saves lives, stabilises health systems and would lead to a truly global economic recovery that stimulates job creation. Importantly it would also help us limit the virus' opportunity to mutate. The current variants show that the virus is doing its best to make itself more suitable to ongoing circulation within the human population. This is normal of every virus but at present we're helping it thrive if we don't reduce transmission and vaccinate equitably. Going forward I want to see manufacturers prioritise supply and roll-out through COVAX. I urge countries that have contracted more vaccines than they will need and are controlling the global supply to also donate and release them to COVAX immediately, which is ready today to roll them out quickly. And I urge countries and manufacturers to stop making bilateral deals at the expense of COVAX. No country is exceptional and should cut the queue and vaccinate all their population while some remain with no supply of the vaccine. 00:05:33 Science has delivered. Let's not waste the opportunity to protect the lives of those most at risk and ensure all economies have a fair shot at recovery. It is a massive undertaking to ensure health system planning, co-ordination, training and logistics are set and able to roll out vaccines in the midst of a COVID-19 surge. The 100/100 initiative driven by WHO, UNICEF and the World Bank is supporting over 100 countries to conduct rapid readiness assessments and develop country-specific plans for vaccines' deployment. We have hit our target; 100 countries have now completed this critical process and the governments and health systems are on stand-by for global vaccine roll-out. We're ready, COVAX is ready, countries are ready. The time to deliver vaccines equitably is now. This is a very dangerous time in the course to the pandemic and I do not want to see people become complacent as vaccines are starting to roll out. Over the past few days we have seen some of the highest numbers of deaths recorded at any point in the pandemic. 00:07:03 This is happening because over previous weeks there has been a lack of compliance with what health authorities are advising in several countries. The virus has taken advantage of this and is spreading at alarming rates in some countries. You might think that it won't happen to you and that you don't need to comply with the measures. The problem is that before you know it not complying a bit becomes a habit, people you know mimic the behaviour and the whole system breaks down. Not complying with recommended measures gives the virus opportunities to spread, putting you and your loved ones at risk of infection and for more people to develop severe disease and for more pressure to be put on health workers. People need to know that they can personally stop the virus and they need to know that the virus can stop with them. If I said one thing to people in areas where there are high numbers of cases it would be to do all you can to avoid mixing with people from other households, especially inside, because the virus thrives when people gather in groups, especially inside where people are less inclined to physically distance. 00:08:44 Wear masks and hand wash where windows aren't open and there is not adequate ventilation, which means everyone is sharing the same air. In this difficult period it's best to meet virtually but if you have to meet others do it carefully and with the right precautions; meet outside wherever possible. None of us are exceptional and the more we can break the chains of transmission and stop the virus ourselves the more we will avoid severe cases and tragic deaths. This year is the year of the health and care worker. Let's show our respect and appreciation for health workers and care workers by protecting each other and vaccinating all health workers everywhere now. Remember, ending this pandemic is one of humanity's great races and whether we like it or not we will win or lose this race together. I thank you. Fadela, back to you. FC Thank you, Dr Tedros. I will now open the floor to questions from journalists. I remind you that you will need to raise your hand using the raise your hand icon to get in the queue. I would like now to invite our first journalist, Jeremy Launch from RFI, Radio Internationale. Jeremy, can you hear me? 00:10:33 JE Yes, Fadela. Can you hear me? FC Yes. JE Thank you so much. Good evening. A quick question on the new study that suggests that the Pfizer vaccine protects against the new variants of COVID. I would like to know if WHO has more details on that and what about the other vaccine, probably AstraZeneca and Moderna? Do you have info that they too protect against the new variants? Thank you so much. FC Thank you, Jeremie from Radio France Internationale. I would like to invite Dr O'Brien to take this question. Dr O'Brien. KOB Thank you for this question. We're looking into this very recent information and I think the important thing is this is going to be a dynamic situation and the evidence is going to continue to accrue so this is welcome information. It's also what has been expected, understanding where the modifications are that are part of these variants so this is certainly a dynamic space and there will continue to be work going on to look at the relationship between these variants and the vaccines, a number of vaccines coming out. 00:12:05 In particular I think what is also anticipated is evidence from efficacy trials that re being conducted in areas where the variants are circulating and that of course will be some of the most powerful information that will come out about these vaccines. FC Thank you, Dr O'Brien. I would like now to invite Jamil Chad from EOL to ask the next question. Jamil. JA Yes, can you hear me? FC Yes, very well. Go ahead, Jamil. JA Thank you for the question, Fadela. My question is probably to Dr Mike Ryan. It's a question about Brazil. Could you tell us what is, in your view, the current situation in Brazil, especially in the state of Sao Paulo, whether you think it is time, as WHO already asked for others in terms of Europe and other regions of the world, to make restrictions more solid or increase restrictions at this point in time? 00:13:12 Where are we now, at what point are we in Brazil today and can you comment on the specific situation of regions? Thank you very much. MS Hi, Jamil. This is Mariangela. I will come in there. I think we are observing the data from Brazil very carefully and it's actually evolving differently in the different regions of Brazil. It's welcome news that the Brazilian producer, Butanta, has made public the news about the efficacy of the Sinovac vaccine so we're watching the situation in Brazil as it evolves. Of course, as I said, being a big country, the different regions are showing different signs either of stabilising the epidemic, the number of cases or increasing in some regions, especially the south-east and the south of Brazil. I don't know if Mike wants to come in. MR Just to add that, like many other countries, the latest surge in cases has been pretty much country-wide. We've seen again the healthcare system impacted but the number of available ICU beds remains adequate in most regions although some areas have now over 70, 75% of ICU occupancy. Remember in previous surges that went up to nearly 90 or over 90% in some cases so the health system continues to cope. Brazil is essentially in the same situation that many, many other countries are, dealing with a third surge, second surge, whatever you call that and keeping the health system online is extremely important. 00:15:09 The DG has spoken to what we all need to do to reduce the force of transmission within our communities. The same advice goes to everybody in Brazil and again we're all struggling with this virus at this moment in time in different countries for different reasons. FC Thank you. Maria. MK Yes, thanks. Just to supplement this to say, it's not Brazil-specific but I think it's a good opportunity to remind everyone that the epidemiology needs to drive the response so regardless of where you are and what is happening the data that is captured from the systems that countries have put in place which are being implemented through the surveillance activities and active case finding, through your testing, through your cluster investigations; that data should drive what you do next. 00:16:01 So while we see now strong national plans with strong strategies the implementation of the public health and social measures, as those are applied, as those are lifted need to be guided by the epidemiology of the local situation so taking decisions at the most local level possible. What we are seeing is what countries are doing is looking at agile and tailored approaches based on the need, based on the capacities and adjusting as necessary. These are strengths of the responses that we are seeing at subnational levels; course-correcting, making those adjustments to what is needed, using your workforce as best you can, the tired and overworked and exhausted workforce, through contact tracers, through those that are doing lab tests, through those community health workers that are going door-to-door, to your front-line medical workers. Use your workforce as best you can where they are needed but base it on the data that's driven and that is something that I think is worthwhile reminding because as we see case numbers go up and down in many different locations the response has to be guided by the epidemiology. 00:17:10 Whether this is a virus variant or not it needs to be based on the local epidemiology that you're seeing and use the tools that you have on hand and use the vaccines and vaccinations as the come online but use everything at your disposal to reduce the spread. As much as we can limit the number of infections this will have a positive impact on reducing the burden on the health system, it will reduce the number of people that will develop severe disease, the number of people that will need hospitalisation and ultimately the number of people that will die. FC Thank you. I would like now to invite Nina Larson from AFP to ask the next question. Nina, are you with us? NI Yes, hi. Can you hear me? FC Very well. Go ahead, please. NI Thanks. I was hoping you could provide us with an update on the international mission to China, if the Chinese officials have provided you with an explanation for why visas were not provided earlier this week and when you think they'll be expected and also where the two experts who set off on Tuesday are now. Are they still waiting? Thank you. FC Dr Tedros. 00:18:25 TAG Yes, thank you very much. We're in touch with Chinese officials and they agreed to share with us the specific dates for the travel in the next few days and we will share with you the specific dates next week. We're also advised that the visa and other needs are on their way so we will give you more details next week but we expect to fix travel dates next week. Thank you. MR I'd just supplement to say that the two experts who had begun travel have returned to their home stations and we, including the Director-General, spoke with them at the weekend but also today we had a meeting of the international team. We continue to remain fully committed to the detailed planning for the mission on the scientific basis. We had a very good meeting today to discuss that and we will reach out once again to continue that scientific collaboration with the colleagues on the science side in China so we fully expect to continue that planning in terms of the terms of reference and the objectives of the mission, the specific scientific investigations and enquiries that need to move ahead. 00:19:44 As the DG said, the other arrangements around the logistics are in hand and we stand ready and are on stand-by to move as quickly as those issues are resolved. FC Thank you. I would like now to invite Michael Buzietkiv from CNN Opinion to ask the next question. Michael, can you hear me? MI Yes, I can hear you. Can you hear me? FC Very well. Go ahead, please. MI Super. Thank you for taking my question. I recently had the chance to interview Dr Michael Osterholm. He is a member of President-Elect Joe Biden's COVID-19 advisory board. He said quite grimly the following; the coronavirus is like a series of forest fires looking for human wood to burn. Likely well over 65 to 75% of the world's population has yet to be infected and indeed just today LA County said they're observing a test positivity rate of 20 to 25%. So my question is the following; given the slow pace of the vaccine roll-out, new spikes in regions that had earlier crushed the curve [?], vaccine hesitancy and given the faster spread of the virus from the newer strain, what is your best estimate on what percentage of the world's population will become infected at the end of the day after all is said and done? Thank you. 00:21:15 MR Hi. Thanks. Mike has said many very, very wise things right the way through this pandemic and continues to do so. The reality is you lay out some very tough realities as part of your question. The DG has said it before; we are in the fight of our lives. We're at a moment when the virus transmission is intensifying because of our behaviours. It's intensifying because of variant strains and we're continuing to track the movement of the virus as it finds susceptible individuals and continues to infect them. Mike is correct in that it is like a series of forest fires where there are large numbers of susceptible people and the virus enters that group, it spreads very quickly and then makes those people who are vulnerable very sick and many die. The reasons for that are the way in which we're mixing and allowing the virus the opportunity to transmit further. The virus is not stopping in each generation with each individual. The virus is continuing to find ways to move to the next generation of infection and causing havoc as it does so. 00:22:38 The measures the DG has outlined and that Maria emphasised are still the same measures. We can still stop this virus. We can still interrupt its transmission. We have to double down and recommit ourselves to that process. Mike is correct; the vast majority of the population of this planet still remains susceptible to infection with this virus. It's very, very difficult to come up with an actual, accurate figure for how many people have actually been infected. Many of the seroprevalence studies have occurred over the past year; many are six months old at this point so we're dealing with older data. Maria can speak to how we're trying to address that number but Mike is correct when he says up to three-quarters of the population and potentially more are still susceptible to infection with this virus. So this fire, to use his analogy, will continue to burn. It will continue to burn until we put the fire out. We can and need to put this fire out. We need to dampen the intensity of the flames. 00:23:37 We can only do that right now through the measures we take individually and collectively and at government level to do that. We need to use all the tools, as Maria has said many times, in that toolkit. We have the tools, we have the means to do that. The vaccine is rolling out, it will continue to roll out and it will provide a huge opportunity to save lives and it will ultimately provide an opportunity to dampen and shut down transmission. But that day has not come yet and we need to buy time, we need to buy time and save lives until that happens. If we cannot get vaccines - and the DG has spoken to this as well - we do not want to see a prospect where we see large proportions of people vaccinated in some countries and no-one vaccinated in other countries. The people likely to die from this infection are not everybody in every country. It's very particular risk groups by age and by vulnerability who are likely to get very sick and likely to die. It is front-line health workers who are exposed to this virus every day. This is whom we need to protect first. It's not about the overall percentage of the population that's susceptible. It's not about the overall percentage of the population that will ultimately be infected. It is, are we going to allow those people who are vulnerable and those people who are most at risk to get sick and die from this virus. 00:25:02 That is what the DG has spoken to, the need for us now to take a step back and ensure that we distribute this vaccine to those who need it, to those who are most vulnerable and those who are going to benefit most. But again Maria may speak to the issues of how we're trying to get to a better number in terms of those who are susceptible and Bruce may want to comment on the issues of vaccine distribution. MK Thanks, Mike. Yes, indeed, I think the forest fire analogy is really a good one and if you've heard us speak before many times about the idea when we think of transmission as cases, sporadic cases, those sporadic cases could be embers, these could be little tiny sparks that could potentially turn into small fires which are clusters of cases and those clusters of cases could turn into wildfires which are community transmission. 00:25:56 All of the measures that we have outlined through this comprehensive, all-of-government, all-of-society approach are working towards making sure that those embers, those sporadic cases do not become little fires or clusters and that those little fires or clusters do not become community transmission and those wildfires. That is what countries are showing us they can do so I think that fire analogy works really, really well because we have tools in our toolkit that put out those fires. Those tools that we have break those chains of transmission and prevent the sporadic cases from becoming clusters and those clusters from becoming community transmission. Those same tools help us move from community transmission to clusters and from clusters to sporadic cases and we've seen that in many, many countries across the world, in all regions of the world, in different types of societies, high-income, low-income, urban, rural over and over again and that will be done again and vaccines and vaccinations will be one more powerful tool to help us put out those fires. But with regard to the serology, indeed there are hundreds of studies that have been done that have looked at specific populations and amongst those populations how many of those individuals have had evidence of infection. 00:27:14 They look at a point in time and most of those studies have been done up through the spring and into the summer in the northern hemisphere so April, May, June, July, August and they have given us almost a point estimate. In that population between three, five, maybe 10% of that population has evidence of infection. What we are working towards through our Unity studies - and this is a programme that we have begun in January where we with our partners have developed protocols, research templates which we have shared now with more than 100 countries, we are working with them to adapt these research protocols for the countries themselves. We're providing technical support, operational support. We're even providing the serologic assays that they can use to follow populations over time so that we can get estimates of the populations that have this evidence of infection. 00:28:11 Our goal in doing so using a standardised approach is to be able to pool that data either regionally or globally so that we can come up with estimates to answer the question that you asked in your question to us today. But we're also looking at the immune response over time. There are some recent studies that have come out even today or yesterday that suggest that the immune response may be six months or longer and that's very good news to show that somebody that was infected, even if they had mild disease, develops a robust immune response and that immune response lasts for six months or longer so that's good. We're still studying this so while there are hundreds of studies underway we don't have all of the answers yet but the results that come to us, that are shared with us in real time almost tell us that the majority of the world remains susceptible to infection and therefore we have to do everything that we can to prevent as many infections as we can. We will emphasise that every time we have an opportunity to do so because this matters. Every step that you take that reduces your exposure reduces the opportunity for this virus to infect you and it reduces the opportunity for you to pass it on to someone else who may be of a vulnerable group, who may be of an older group, that would develop severe disease, need hospitalisation and potentially die. 00:29:38 While we have got better at treatment there are still a large number of people who are dying from this virus so it's up to us; as the DG said today, the virus can stop with us. We need to do what we can to make sure that we break those chains of transmission; first of all not let you get infected but if you are infected let the virus stop with you. FC Thank you so much. I would like now to call on Jason Bobien from public national radio, NPR, to ask the next question. Jason, can you hear me? JA Yes, thank you very much. I want to ask about the variant, the B117 which originated in the UK. There is a lot of concern about how transmissible it actually is. What do you have in terms of clarity on exactly how much more transmissible this is and is there adequate monitoring globally to actually detect these changes and report these variants? Thanks. 00:30:49 MK Thank you for the question. The virus variant identified in the United Kingdom is B117. We are working with our colleagues in the UK and in fact as we sit here just now they've just released their third technical briefing online. That has just come out from Public Health England. We meet with our colleagues regularly there and they're looking at a variety of factors related to this virus variant. One of the issues they're looking at is transmission and the way that they're evaluating transmission is looking at the data captured through their surveillance system, through the molecular testing, the PCR testing, the antigen base testing but also the amount of cases that are sequenced. They've done some modelling studies, they've done some phylogenetic analysis which is analysis of the full genome sequences that have been made available across the country and they're doing some studies in the lab looking at the viral loads of individuals infected with this variant compared to other SARS-CoV2 viruses. What we understand from their studies that are ongoing - and again these are ongoing studies and they're constantly updated with more information - is that the virus variant, this B117, is more transmissible than the wild-type SARS-CoV2 virus is. 00:32:07 They have estimated through their modelling studies that the increase in transmissibility as measured by the reproduction number, which is the number of cases an infected individual would infect, has increased from about 1.1 to about 1.5 or 1.7. That's also been analysed through the phylogenetic data. They've seen increases in transmission across all age groups and that's a reflection of the mixing patterns and the transmission that has happened in south-east England, in London and across other parts of the UK. They've also measured viral load, which is the amount of virus detected through the testing systems that they have and they have found that people who have been infected with the virus variant, the B117 have a higher viral load compared to others with the wild-type virus. But we did specifically speak today about the way that the virus transmits or the modes of transmission and there is no difference in the way that this virus transmits and that's important because we need to constantly look at the measures that are in place, the personal protective equipment that is being advised. 00:33:17 They are discussing that with their expert groups in the UK and they have not changed their recommendations on PPE but it does mean if you have a virus that is more easily transmitted you have to work that much harder in breaking those chains of transmission. It is important to note that the tools that we have against normal SARS-CoV2 virus - which is dangerous enough - work against the virus variant that was identified in the United Kingdom and separately also against the virus variant that was identified in South Africa as well. So they are continuing to do studies. We're very grateful for all of the collaboration across Public Health England and the many different academic groups and modelling groups and the front-line workers and the studies that are ongoing and quite literally are sharing these results with us in real time. So thanks for that question but an increase in transmissibility, no change in disease presentation or severity, which I don't think I mentioned, but that has been confirmed through the cohort study that they have ongoing looking at rates of hospitalisation -so no change in hospitalisation of people infected with the virus variant compared to the other SARS-CoV2 viruses - or in mortality. 00:34:34 MR Just to add that WHO and partners; we're fully activated on monitoring the emergence of variants and the evolution of this virus and have been for months with the virus evolution working group which involves scientists and labs from all over the world. We are issuing guidance to countries today - thank you, Maria - on specific epidemiologic and laboratory surveillance for these variants, which is supplementary to previous advice put out there. Our global epi team is working on an epidemiologic analysis right now looking at signals for unusual epidemiological events that may be occurring in relation to variants around the world. 00:35:17 It's important that our work is epidemiologically driven and that we're using epidemiology to drive our lab investigations and, as I said, the virus evolution working group continues to work. The vaccines group is also working very hard and next week there will be a specific programme on research and development for RUPE [?] and for epidemics. We'll be hosting two meetings next week, one specifically to look at the emergence of viral variants and one looking specifically at the research needed around vaccines in relation to the same issues and beyond; the vaccines meeting is broader but it will consider the variant issues as well. Much work is underway as well looking at the long-term effectiveness or functioning or performance of diagnostic tests, looking at the lab assays, also looking at continued effectiveness of monoclonals and polyclonal antibodies and then with vaccines so that work is underway. All of that needs to be further brought together, different, very important strands on this but Maria is correct; we're not seeing a clinical signal that this disease is more severe. The evolutionary pressure on the virus is - and this is what viruses do; they tend to become fitter. They become better adapted to transmission in humans and with higher viral loads they're more likely to cause transmission. That is in the interest of the virus; that's a positive evolutionary outcome for the virus, not for us. 00:36:48 In that regard there is no signal at this point of any change in clinical severity and that's very important to recognise. We've also had meetings today with our strategic and technical advisory group on infectious hazard, which is chaired by David Hayman from the London School. We've considered these issues as well. Next week we will have our meeting of the Emergency Committee on the IHR, which will consider these issues as well. In addition we've been working with the Global Influenza Surveillance and Response System. The GISRS system has been providing vital monitoring of COVID-19 around the world through severe acute respiratory illness and ILI surveillance and we've been able to track the overall impact and presence of COVID around the world over the last number of months. We're currently working with them to see how we can adapt that and enhance that to do more of the genetic monitoring as well and in addition working on expanding genetic sequencing capacity around the world, particularly in low and middle-income countries. I know there are some excellent projects out there led by the Wellcome Trust and others looking at how we can rapidly further expand the capacity to do genetic sequencing and genetic surveillance as such on this virus. 00:38:04 So many, many strands of activity from the vaccines to the labs to the epidemiology to the transfer of knowledge and technology and capacity and we will continue to do so and keep you informed of progress. Again though I think it's important to recognise that we've had variants before emerge - the D614G and others - and these variants will continue to emerge as the virus evolves. We're in a race against the virus in that sense but we should also remember, as Maria said, that the way in which this virus is transmitting has not changed. We still have the capacity to suppress that transmission if we do the right things and we will continue obviously to study the long-term impact of any of these variations on diagnosis, on therapies and on vaccines. But rest assured, this is in hand and we are looking very, very closely at this. We take these developments very seriously but we also need to remain focused on the job at hand which is breaking chains of transmission and getting vaccines out to those who need them. Thank you. 00:39:09 FC I think Dr Van Kerkhove would like to add something. MK Just to say we can share the guidance that was issued today. There were two pieces of guidance issued today related to sequencing. We've had a lot of people ask us questions about how much we need to sequence and how we do that. So we've issued in our disease outbreak news which was on 31st December some preliminary recommendations on who to sequence, which cases to sequence, recognising that sequence capacity is not at the level that we need it around the world and also that you don't need to sequence every single case that's out there. But as Mike has said, leveraging the systems around we have really worked very hard with our flu network to be able to build diagnostic capacity as well as use the sequencing to do that. We've issued two guidance today. One is interim guidance which is a recommendation on who to test, who to sequence. 00:39:59 What we want to focus on is sequencing a subset of cases that are in your country based on capacity but also especially focusing on any cases that are part of clusters that may be different than what you would expect. For example in the United Kingdom they noticed that there was an increase in transmission in late November/early December when they didn't expect there to be increased transmission because there were some interventions in place. They were in tier-two and tier-three lock-down. So they went back and looked there and did some sequencing. But also if you see any change in disease profile, difference or severity those would be good cases to sequence. That's a good place to start but we've issued some guidance with more specificity in there for the lab programmes in each country to look at. Also we have a much larger implementation guide on how to set up sequencing which is a much bigger project because it's very labour-intensive and quite expensive but we're working with countries to be able to increase that capacity with the public health labs in country but also leveraging academic labs and private labs that can do sequencing as well. 00:41:03 Because, as you pointed out in your question, we need to be able to detect and detection of these mutations and detection of these variants comes from the full genome sequencing so being able to do that helps us have eyes on these viruses and how the viruses change but also sharing those viruses, sharing those sequences with public databases like GISAID for example. That allows scientists all over the world to do these beautiful trees and phylogenetic analysis of actually tracking it over time. As Mike has outlined and as you've heard us say, there's a comprehensive risk monitoring framework around mutations and variants so that we can have a robust process to determine which ones are important and why and what is the public health impact of any of these that are identified. 00:41:54 MR I just wanted to add one thing; sorry for taking the floor again. As the UK have assigned the value to this, calling it a variant of concern, I think it's important to reflect on that. There are lots and lots of different variations in the virus. Every virus you sequence will be slightly different. What UK have identified through epidemiologic investigation first and then identifying a variant was associating that variant with a change in the epidemiology and then labelling that a variant of concern. I think that's what we're after; we're after being able to detect not just variations in the virus but being specifically able to identify variations of the virus that are of concern for public health, for transmission, for severity. That's the job; picking out of the noise, picking the needle in the haystack, picking out the signal for the virus as it evolves, whether new versions of the virus evolve that are of more concern for us in terms of our ability to control it or in terms of its severity. Again just to say, the Governments of the United Kingdom and of South Africa and Nigeria and other countries are doing a fantastic job in stepping up on this issue of genetic surveillance and monitoring this at a much more enhanced level and therefore it's really important that when people call this a UK variant or a South Africa variant we're not assigning values to these countries. 00:43:13 These countries are not the cause of this problem. They're actually defining solutions by giving us the information that we need and they should be commended and lauded for having invested in the kinds of systems that allow us to do this kind of monitoring. We should be following their example rather than looking at these as problems generated by or in South Africa or in the United Kingdom. The Government, the public health, the labs, the clinicians and others in those countries should be... I think South Africa is a beacon in terms of the comprehensiveness... and the way South Africa has been able to pull together data from many, many different sources again shows that this old idea of the north/south divide, that countries in the south can't do as well as countries in the north when it comes to doing this hardcore epidemiology in the lab; this is about access to technology. 00:44:01 Other countries in the south can do this as well. They don't necessarily have access to the technology and the training and the resources to do it but South Africa has clearly shown, Nigeria has clearly shown that if they have those resources, if they have access to these technologies they will get on and do exactly the same job as is done in the north. FC Thank you. I would like now to invite Catrine Fionco Bokonga to ask the next question. Catrine, can you hear me? CA Yes, thank you, Fadela. Thank you for giving me the floor. My question is regarding the types of vaccines. Africa, which has problems getting access to the vaccines for the moment, is turning to the Chinese Sinopharm vaccine and Guinea started vaccination with Sputnik 5. Could you give us more information about those vaccines and also maybe the price? If I understood, vaccines like Pfizer and Moderna that are using new technology are ten times more expensive than AstraZeneca, Oxford or the ones that are using a more traditional method of vaccination. Thank you very much for your answers. FC Merci, Catrine. I would like to invite maybe Dr Aylward to start. 00:45:41 BA Sure. Thank you, Catrine. You've asked about the types of vaccines. Dr Tedros in his opening comments highlighted that there're 42 countries around the world that we know are now vaccinating with COVID-19 vaccines, the majority of these of course in the industrialised world - sorry, in high-income countries and a small number in the upper middle-income countries, about six. There's very limited if any vaccination... A lot of what you've referred to are actually plans, not actually the roll-out of products yet and sometimes just exploratory discussions. But in the places that have started vaccinating there've been six vaccines that are in use right now, among them the ones that you mentioned. These are a range of vaccines from MRNA vaccines, as you said, all the way to inactivated vaccine products. At this point we're aware of two of those vaccines that have gone through stringent regulatory authorities in multiple countries, one approved by a stringent regulatory authority in one country. One has been, let's say, emergency use listed by WHO and that is the Pfizer product that we've seen. 00:46:59 Others are in the pipeline now for evaluation very, very rapidly. We are aware that some countries have made decisions to proceed with vaccines that have been approved through other mechanisms. We recognise that and we are continuing to work with both the countries to support the decision-making that they may make in that regard and understanding the issues around that. But we're also working very hard with the companies that are producing these products to make sure that they can be assessed by WHO through its regulatory support processes so in the process of looking at those products. As you know, we are not in a position to provide a perspective on vaccines that are in use that we've not seen the data on and at this point, as I say, the vaccine that we have seen is the Pfizer vaccine. We have all of the data on that. We also recognise of course in this exceptional circumstance vaccines that have been approved through stringent regulatory authorities and now those are the Pfizer vaccine and the Moderna vaccine and then one country having approved one other vaccine at this point through a stringent regulatory authority. I think Mariangela wanted to add. 00:48:22 MS Can I just complement from the regulatory side. First of all countries have the autonomy, according to their legislation, to issue emergency use authorisation for health products according to their own legislation. But WHO does have a process which most of you are aware of which is the pre-qualification process and in the case of new vaccines like the COVID vaccines we do an emergency use listing assessment. We have issued an expression of interest, received 13 valid proposals since October and besides the Pfizer vaccine which was already listed by WHO we do have other products that are at an advanced stage. Specifically in the products that you have cited we have received already - and this information is public, it's published on WHO's website. We have received for example the full dossier from Sinopharm, which has finalised its phase three trial and has been authorised in some countries. We are in the process of receiving the complete data from AstraZeneca, from the Serum Institute and we expect to receive additional data from the Gamaliya, which is the Russian producer, before the end of January. 00:49:51 This is just to say that these products are currently being assessed by WHO. This is important not only because many countries rely on WHO's assessment for authorising the use of the product in their own country but also because it helps the international procurers like UNICEF and others to procure the vaccines that have been assessed by WHO. Thank you. FC Thank you. I think Dr Aylward would like to add something. BA Yes, I also want to come back in on the point that when people ask our opinion on the products - I'm sure the journalists with us today will appreciate, for us to provide an opinion on a product that we've actually not seen and seen the data behind would be inappropriate and unfair to those asking the opinion. We also have to be very clear though; a neutral perspective. Some of these products may turn out to be great products and extremely important in the battle against COVID-19. This comes back to a point that the Director-General made in his opening comments. We've put together a fantastic facility to help make sure vaccines get rolled out equitably around the world. The fundamentals are completely sound. That mechanism can only work if vaccines come into it and go through it as well as money. We don't print money and we don't make vaccines. This is where we need the manufacturers working with us and we need the donor countries and others working with us and working together. 00:51:24 If a company does not submit the data that we need it is slowing equitable access to vaccines around the world. If a company doesn't sign and work the deals through with us and if we don't have the financing to do it they are slowing equitable access. The Director-General, I think, was very frank about that today and what we're calling for in this frank call to action in the Director-General's speech is access to the data on all of these products in real time as it's coming out so that we can ensure that we can provide a perspective on these products as rapidly as possible and get them out equitably around the world. Michael asked an excellent question earlier and then Maria was responding to it, talking about the tools. The problem we have is the tools aren't equitably distributed. Look at the map of the world. There's a huge part of the world that's not vaccinating yet. 50% of the high-income countries in the world are vaccinating today. 0% of the low-income countries are vaccinating. 00:52:27 That is not equitable access, especially when we know - and Mike made this point - that the people at risk of dying are older people. There're older people everywhere in the world. The people at most risk of exposure to this are those front-line workers. These people are working around the world but they're not being protected at the same rates. That's why we've created COVAX. It is there, it works but it needs the vaccines and financing. We have part of the financing in place. We are ready to go, ready to get started. We need the manufacturers working with us and we need the countries working with us. We have to change the colours of those maps this month. FC Thank you, Dr Aylward. I think Dr O'Brien also has something to add. Dr O'Brien. KOB Yes, just two things to add to what has already been said by Bruce and by Mariangela. The two additional points I want to add have to do with transparency and with policy. In addition to the procurement, the money that Bruce has spoken about and the need for the data on regulatory issues, in addition countries do rely on WHO for recommendations on how to use the vaccines especially because these vaccines are in limited supply in the initial phase of roll-out - we know that - all over the world. 00:53:56 Choices do need to be made about how best to use them to their best impact, the maximum impact especially in these very early phases. We do need to see the data on these products in order to establish policies, as SAGE did at the beginning of this week. The second thing is transparency on information. Our understanding of which countries, where they're using vaccines, what deals are being done is extremely important in order to help with this whole process of equitable allocation and equitable access to vaccines. We're also calling on countries and manufacturers to be clear and transparent about where vaccine deals are being done, the doses that are being arranged for use in various countries and then their actual roll-out. Having this information over time is really important for WHO and for the world to respond to this crisis in a way that will have its maximum impact. I think those are the two other points to make here. Thank you. 00:55:12 FC Thank you all. I would like now to invite Christopher Hamill-Stewart from Arab News to ask the next question. Christopher. CH Hi, can you hear me? FC Yes, very well. Go ahead, please. CH Great, thank you. I wondered if the WHO had a response to Iran's announcement today that it would ban the import of US and UK vaccines. FC Thank you, Christopher. Dr O'Brien, do you want to respond to this question, please? KOB As Bruce has just indicated, there are a number of vaccines on the market that are available around the world and especially in the COVAX facility the importance of having a portfolio of vaccines that serve the different needs of different countries and especially serving the different needs of delivery situations. We know of the different products that we have some require an ultra-cold chain, some require a frozen temperature that's not ultra-cold and some require refrigeration. 00:56:20 So we have a lot of variability of the products in terms of a range of their characteristics. I think the other important thing to say in relation to this is that there is manufacturing going one of these products in different places around the world and that provides greater or lesser access to different vaccines. So I think the range of needs of countries and choices of countries is served by having this portfolio of vaccines where there can be matching of vaccines to the delivery needs and the characteristics that countries have for the access to those vaccines. FC Thank you. I think Dr Aylward wanted to complement. BA Yes, thank you, Fadela, and thanks, Kate. Super-important questions about vaccines and vaccine access that we keep coming back to and we're going to come back to them more and more as we go forward over the coming months. 00:57:20 The important thing to recognise is that every country in the world is making decisions about what products it does and doesn't want to use and prioritises and doesn't prioritise for different reasons. One of the things that we've been doing as part of the COVAX facility is going out and talking to the 90-plus countries that are what we call our AMC countries and our other participants; we have 190 participants. We get back a wide range of preferences on what kind of products they want to use, whether they want to use more than one product, two products, which particular products they may want to use and for a whole wide range of reasons. I come back to that perspective that the Director-General comes back to again and again about the importance of not singling out individual countries or issues and really focusing on how we get these products to as many countries as necessary. One of the beauties of the COVAX facility the way we've set it up is we've got a very broad portfolio of products, we know we have a broad range of clients that we're working with through that, participants and what we're going to do is work with them to get that right balance of products. Again it's one of the reasons that this facility is such an important part of the global solution to equitable access and roll-out. Every country needs these products, every economy needs these products right now and it's really time to put any kind of politic aside and make sure that vaccines get to the people that need them. 00:58:50 MR I think Bruce said it. The DG has said many times in the past, let us not politicise this virus. Please let us not politicise this vaccine either. FC Thank you. I would like now to invite EFE, Antonio Broto, to ask the next question. Antonio, can you hear me? AN Yes. Can you hear me? FC Yes, very well. Go ahead, please. AN Thank you, Fadela, for taking my question. Global figures for daily cases of COVID in the first days of this year are not higher than in December despite the virtual [?] spike in transmissions after the Christmas and New Year holidays. Do you think that this is a good sign, maybe a sign that the vaccines are already working or is it too soon to be that optimistic? Thank you. 00:59:43 MR I think it's way too soon to be that optimistic. The reality is for the third week in a row we've had over four million cases reported each week in this pandemic. There's been a very slight decrease in the last week but again the transmissions that would have occurred over the holiday period will only be pushing through into the numbers that we're seeing this week, next week and beyond. So no, it is way too early to interpret that. What we do know is certainly in the northern hemisphere there's been a tremendous amount of mixing of people over the last number of weeks and, as has been previously stated, we're dealing with the complications of variant strains and potential increases and transmission. So no, there's nothing to suggest that. The numbers of vaccines that have currently been distributed will have had zero impact on transmission by now at country level. They maybe are saving lives as we speak and we're very grateful for that but they're not going to affect transmission dynamics for a very long time. Bruce. 01:00:50 BA Just to the point that Mike made, the last point was so important, the last part of that question about whether or not we're seeing the impact of the vaccines already and the answer is no. These vaccines and the way we're rolling them out have two really specific goals. Our first; save lives, get them to the people at highest risk of dying of this disease. We know those populations; they're the older people in our societies; so important that they get protected early. We know the people who are getting exposed at a disproportionate rate and especially those front-line workers who unfortunately have been giving their lives to try and save lives during this crisis. We've got to protect those people first so that's what our initial goals are. We do not have the volumes, they don't exist yet and we also don't know all the mechanisms of these vaccines to be having an impact on these curves; much, much too early. As we look into our crystal balls we're not going to see that in the coming six months. As we scale up these vaccines over time - it comes back again and again to what Mike has been saying; the Director-General. This is not going to work if people are mixing at high rates, if they're not using masks, if they're not doing all those things that are so important. 01:02:07 Vaccines have a lot of promise but what we need to do now is identify the cases rapidly, the mild cases, the moderate cases that are driving this crisis, get them isolated, identify the contacts, get them quarantined. That plus the roll-out of these vaccine is what is going to see those curves change. But it's not going to change just by those drops of vaccines that are going out at the current rates and they're only going to go out... We've seen all the challenges to getting the numbers up even in highly advanced environments so it's absolutely imperative that the other parts of this response work and we start applying the knowledge we've learned in the 12 months that we've known this virus. FC Thank you. Maria. MK Yes, thank you. I have to come in on the aspects of the consequences of our action and the Director-General said it in his speech tonight. The results of our actions over the last five, six weeks are what is resulting in increased case numbers, in increased hospitalisations and in increased numbers of deaths and that will continue for the coming weeks and the coming months if we do not change our behaviour. 01:03:21 You have to follow the local advice that being advised in the areas where you live. Governments need to enable populations to be able to do so. If you are asked to stay home we understand that that is challenging in many different respects of our daily lives and our social lives and many situations. People need to work to put food on the table so we need people to be supported in the actions that are advised by governments but we also need individuals to think about what they do every single day. The decisions that you make every single day about what you want to do versus what you need to do matter. They can have consequences of increasing transmission and they can have consequences of decreasing transmission. Please help be part of the solution of decreasing transmission. There are actions that you can take right now that limit the exposure to yourself and to your loved ones. Maybe you don't think that COVID-19 is a big deal for you but it can be because we know that this virus is dangerous, this virus can cause severe disease and it can kill you and maybe not you, maybe someone that you love that has an underlying condition or is of older age. 01:04:33 This is serious and at the present time in many countries we're seeing increased transmission where we can turn the corner by putting in the measures at home, staying home if you're unwell, staying home and not mixing with other families, postponing that trip that all of us want to take, making sure that all of the actions that are put in place... If you are asked to be in quarantine please stay in quarantine. You are adding to the solution here. If you are a case - and we hope there are no more case but if you are a case staying in isolation, making sure that you receive the adequate care that you need in medical facilities, allowing the community workers to do contact tracing and cluster investigation and the technicians to do lab tests and get those test results back quicker. But all of those actions can reduce transmission and we are pleading with everyone to do everything that they can to be part of the solution to break those chains of transmission. It is within our hands. Vaccines and vaccination are another powerful tool but it will take time. In the meantime there is much that you can do every single day so please help be part of the solution. 01:05:46 FC Thank you, Maria. I think Dr O'Brien wanted to say a few words. Dr O'Brien, you have the floor. KOB Yes, really important things that everybody has said about this, Maria in particular just now but we've been saying about the vaccines, even anticipating that they were coming even before they came, that it was not going to be a flip of the switch and even as they roll out we actually don't have the information right now about the magnitude, the degree to which they actually interrupt transmission. So although we do have evidence now about the degree to which they can protect against disease and especially severe disease that does not necessarily imply that the same magnitude of impact will be on the protection against transmitting from one person to the next person. So I just want to reinforce that even for people who have been vaccinated - and there will be an ever-increasing number of those people - that does not mean that people who have been vaccinated are now fully protected from getting infected in their nose. 01:06:53 They are very substantially protected against themselves becoming ill but we have evidence from a very new study that a 59% estimate from a model of the transmission is coming from people who are not symptomatic at that point in time. So we really do need as we roll out the vaccines to remember, as Maria has said, this is just one tool, a new tool and a very powerful tool in the toolkit but it doesn't mean that we should step back. In fact we should be escalating and improving our use of all the other tools that we already have. Thank you. FC Thank you, Dr O'Brien. Antonio's question was the last one for today. Over to you, Dr Tedros, for final words. Thank you. TAG Thank you. Thank you so much, Fadela. Thank you, all colleagues from the media, for joining and look forward to seeing you in our upcoming presser. Have a nice weekend and Happy New Year. FC Thank you, DG. Just to remind journalists, we will be sending the audio file and the DG's speech right after this press conference. The full transcript will be posted soon on the WHO website. As usual do not hesitate to contact the media team if you wish to ask any follow-up questions. Thank you and have a nice weekend. 01:08:19

Media briefing on COVID-19 - 01/04/2021

00:00:49 CL Good day. Hello and welcome, wherever you are listening to us today. It is Thursday 1st April 2021. My name is Christian Lindmeier and I'm welcoming you to today's global COVID-19 press conference with a special focus on the impact of COVID-19, the success of the ACT Accelerator and the work needed to support equity, especially for the health workforce. For this we welcome two special guest today; first Dr Fahrettin Koca, Minister of Health from the Republic of Turkey, who is actively supporting the International Year of Health and Care Workers; and Carl Bildt, former Prime Minister of Sweden and recently named WHO Special Envoy for the ACT Accelerator. Simultaneous translation is provided in the six official languages, Arabic, Chinese, French, English, Spanish and Russian as well as Portuguese and Hindi. When we get to hear from Ankara we will have Turkish and then English consecutive translation. Now let me introduce the panel in the room. Present are Dr Tedros Adhanom Ghebreyesus, WHO Director-General, Dr Mike Ryan, Executive Director of the Health Emergencies Programme of WHO, Dr Maria Van Kerkhove, the Technical Lead on COVID-19, Dr Mariangela Simao, Assistant Director-General, Access to Medicines and Health Products, Dr Bruce Aylward, Special Advisor to the Director-General and the Lead on the ACT Accelerator, Dr Kate O'Brien, the Director for Immunisation, Vaccines and Biologicals and last but not least, Dr Jim Kempel, the Director for Health Workforce. 00:02:38 With this let me hand over to the Director-General for the opening remarks and to welcome our guest. Director-General, the floor is yours. TAG Thank you. Thank you, Christian. Good morning, good afternoon and good evening. This week more than 25 leaders from the G20, G7 and from every region united behind the idea of a pandemic treaty. There is an acknowledgement and humility from those leaders that collectively the world was not prepared for the first coronavirus pandemic ever seen and that going forward we must collectively do better in future outbreaks. There has been a great deal of momentum since the President of the European Council, Charles Michel, and I spoke about this at yesterday's press conference. I am pleased that more leaders are now joining the call for a pandemic treaty which would be a generational commitment to keeping the world safe. 00:03:46 There will always be new pathogens with pandemic potential. It's not a matter of if but when. One key aspect that could be enshrined in the treaty is to... a stronger health workforce which is the very essence of health systems' resilience. An effective health workforce is the key element to pandemic-proofing our health systems. Health and care workers are at the forefront of the response to the COVID-19 pandemic and they play the critical role in protecting us all. Far too many health and care workers have died in the pandemic. Millions have been infected and the pandemic has taken a huge toll on their physical and mental health with devastating effects on their families and communities. Anxiety, depression, insomnia and stress have all increased. Exhaustion is commonplace and there have been cases of stigma and even abuse. I give thanks to those that have stood up in one of humanity's toughest periods. This is the year of the health and care worker and we know that even before the pandemic there was a shortfall of at least 18 million health workers and we work to end the pandemic and recover together. Health and care workers must come first. We must make sure that they're trained, protected and supported to do their job safely and effectively. 00:05:40 As recognised in last week's UN financing for sustainable development report a true recovery from the pandemic requires additional investment in health and in people. These two priorities can be achieved if we invest in the health workforce. Investing in the health workforce is an investment in women and youth. Almost 70% of the global health workforce are women. In particular we must support countries with fewer resources to expand their workforce capacity and pay decent salaries and we must ensure that they are at the front of the line for COVID-19 vaccines. I would now like to turn to Health Minister of Turkey, Dr Fahrettin Koca. Turkey has been a strong champion of 2021 being the year of the health and care workforce. Dr Koca, the floor is yours. FK [Turkish language]. TR Distinguished Director-General, Mr Prime Minister and distinguished participants, COVID-19, which has been a part of our lives for over a year, is the biggest pandemic that the entire world has fought against within the past 100 years. This disease has not only been a health threat but it has also affected our lives in many ways. 00:08:32 Since day one of the pandemic each and every country has been putting up a fight against it within the bounds of their healthcare capacities. Although the methods adopted by countries vary the whole world has become more aware of an idea about the importance of healthcare workers in our lives. This powerful idea has led to the birth of a new set of ethics for healthcare workers. To elaborate,i would like to refer to a principle from the fourth century BC from the Hippocratic Oath which reads, primum non nocere. In Turkey and in other countries people have witnessed one thing; healthcare workers whose main principle is not to harm the patient, embrace the possibility that they can be harmed themselves. It is this testimony that is the foundation of the new set of ethics that is beginning to develop and this is the very testimony that has improved the status of healthcare workers and societies. The heroes of these times when people seek trust in fear are healthcare workers. 00:11:41 There is another factor in the background for this newly emerging ethics. Before the pandemic healthcare was between the individual and the healthcare worker. However with the pandemic this relationship morphed into a broader and more encompassing one. In line with all of this we are aware of the fact that societies are willing to take healthcare workers to a higher position. What decision-makers will do for healthcare workers is what societies demand. Distinguished participants, Turkey's response to the pandemic is well-known both to our people and the world and we have been taking strength from our well-trained, equipped, dedicated and selfless healthcare workforce. We all know that when the need arises healthcare workers rush to the fronts by the very nature of their profession. This pandemic has been the proof of this. While they perform their work various roles and duties fall upon the rest of society and on the decision-makers. 00:13:59 Societies that can adopt necessary policies bearing in mind this responsibility will be able to offer great support to boost the morale and motivation of healthcare workers and to relieve their burden. As a demonstration of this understanding we have introduced and implemented timely and effective policies in a variety of issues such as supplying high-quality and sufficient protective equipment, offering timely and science-based information about current developments and providing socio-economic and moral support. Alleviating the burden on healthcare workers by employing new people has been a priority for us. Another priority has been to take measures to improve the productivity of healthcare workers such as redefining and redistributing roles and responsibilities and delaying non-urgent procedures. Of course none of these steps can make up for the selfless efforts of our healthcare workers. Their selfless efforts should definitely go down in history. Societies are aware of the need to honour such work. This is the very motivation behind the idea of declaring 2021 the international year of health and care workers, for which we have been a strong advocate since day one. 00:17:59 Esteemed participants, Mr Director-General has posted about a very important issue recently, noting that healthcare workers had saved the world and it was now the world's responsibility to protect them. He underlined that health and care workers around the world should have access to a COVID-19 vaccine as soon as possible. I support this call wholeheartedly. With this understanding I have to note that we have completed vaccinating one million healthcare workers in our country in only 45 days. Even though we have yet to produce our own vaccine I would like to note that we have shared a portion of the vaccines we have supplied with other countries to be delivered to healthcare workers. We have another responsibility which is to ardently advocate for the access of healthcare workers to vaccines. As Turkey we have taken on a facilitating role by building diplomatic bridges between vaccine-producing countries and those having problems accessing them. 00:20:11 I am glad to say that we have achieved concrete results out of these initiatives. Distinguished Director-General, I would like to also highlight that our own vaccine production efforts are still ongoing at full speed. We believe that we will soon be producing our own vaccine and when that happens rest assured that your call on vaccine-producing countries will be met with a clear response in Turkey. Distinguished participants, not only one single day but the whole year of 2021 has been dedicated to health and care workers. Many activities will be held on this occasion throughout the year. We are committed to making the most active contribution to these events. We will continue to advocate for the process through ideas, projects and events on international platforms, especially the platforms of the United Nations. Together we will mobilise the sense of duty and gratitude of the whole world. We will try to further improve the status of healthcare workers, the status of their professions as required by our ethical responsibilities. Stories of heroism are being told from large cities to the most remote corners of the world in hundreds of different languages. These stories are now needed to be told in the common language of humanity. 00:23:29 The battle against the pandemic is also fought in uniforms. These uniforms bring out compassion in people and right now is the time when we should write down history. For this purpose as a first step we are working on creating a digital platform with WHO to serve as a memorial dedicated to health and care workers. Tedros, my dear friend, I expect your personal support for this platform. As I conclude I would like to give the following message to all healthcare workers around the world. The whole of humanity is grateful to you right now and humanity will find the best way to express this gratitude. Thank you. TAG Thank you. Thank you so much, Your Excellency, Dr Koca. I'm glad that vaccines are rolling out to health workers in this difficult period in the pandemic and look forward to working with you closely. Thank you so much. Teşekkür. 00:25:28 The clock is still ticking on vaccine equity. We have nine days left until we reach the 100th day of the year and the target of starting vaccine roll-out to health workers and those at risk in all countries remains in our grasp. COVAX has already delivered 35 million doses to more than 78 countries but there is still a serious challenge on vaccine equity and availability. Last week I made an urgent request to countries with doses of vaccines that have WHO emergency listing to share ten million doses immediately with COVAX. The extra ten million doses will be an urgent stopgap measure so that 20 countries which are ready but haven't got the supply needed to start vaccinating their health workers and older people could begin before the 100th day, 10th April. I also requested manufacturers help ensure that the countries that step up can rapidly donate those doses. This challenge has been heard but we've yet to receive commitments for these doses. I'm still hopeful that some forward-looking and enlightened leaders will step up. I know this is a challenging time for many countries as cases and hospitalisations are spiking but conversely it's when cases are spiking that it's the most important time to share vaccines equitably and protect health workers and at-risk communities. The race is on to get vaccines to those places and groups where they can have the greatest impact. We're not in a race against each other. We are in a race against the virus and over the last year the ACT Accelerator has been critical for ensuring that new vaccines, life-saving oxygen, corticosteroids for severe disease and rapid tests are being shared more equitably. Today I'm happy to welcome former Prime Minister of Sweden, Carl Bildt, who I appointed as WHO Special Envoy to the Access to COVID-19 Tools Accelerator. Carl will help lead the collective advocacy for the ACT Accelerator, mobilising support and critical resources so it can deliver against its strategy for 2021. My friend, Carl, the floor is yours. Tack så mycket for joining us. CB Thank you, Director-General. I have to start by saying I'm honoured and I'm humbled by the fact you have appointed me Special Envoy to start working with the ACT Accelerator. I am thoroughly impressed with what has been achieved in an absolutely unique situation where we have a global challenge of a magnitude that we haven't seen in living memory anyhow if we look at how things are. 00:29:02 I think the ACT Accelerator has been a critical instrument in mobilising resources and in co-ordinating the activities of a very diverse set of actors. Without that co-ordination mechanism I doubt that what has been achieved would have been possible to achieve. Then of course we're all in a situation where we would like everything to be done by now in terms of vaccines, [unclear], treatments, and whatever but we are in a phase where efforts are in a phase of acceleration all over the world. I'm convinced that everyone is doing their very best to make this as fast and as secure and as safe as is possible. I hope that I can make my contribution to this work as well. I'm certainly not a medical expert; no-one expects me to have any firm views on that but I have a fair amount of experience on working in politics and working in the international community, trying to get the different parts of that wide community to work towards the same goal. 00:30:11 I think that is of course more important now than on perhaps any other of the global challenges that we have been seeing during the last few decades. Lots on the agenda; mobilising resources, distributing vaccines, as the Director-General mentioned; COVAX, the ramping-up of production and all of that but also mobilising resources. We still have a funding gap with the ACT Accelerator different efforts [?] in the order of $22 billion. That's a fair amount of money but if you compare it with the amount of money that the government are spending - rightly so - in order to sustain their economies it's less than 1% of that money. We know of course that if we don't get the pandemic under control that money's not going to be enough so I hope it will be possible to mobilise that money. It's an effort with the co-chairs of the facilitation council, Norway and South Africa being very active but I hope I can make my contribution to that as well. I leave the Director-General with that; much ahead; I look forward to it. It's a task that is, mildly speaking, urgent and all efforts by everyone are welcome. 00:31:38 CL Thank you. Thank you so much indeed and thank you for your inspiring words and look forward to working with you very closely. I couldn't agree more and believe that with your support we can take the ACT Accelerator to the next level, overcome vaccine nationalism so that we defeat this pandemic and recover together. Tack så myckete again. Christian, back to you. CL Thank you very much, Dr Tedros. Let me now open the floor to questions from the media. We have a long list already and therefore I ask you to only ask one question at a time. We'll start with Bayram Ayturk from Anadolu agency. Bayram, in case you want to ask in Turkish I would ask you to please also immediately after ask your question in English to make it easier for us here. Thank you very much. Bayram, please unmute yourself. BA Can you hear me? Hello, Christian. CL Yes. Go ahead, please. BA Thank you for taking my question. I'll ask my question in English. My question is for the Minister of Health of the Republic of Turkey. Mr Koca, Director-General Dr Tedros has spoken man times of the importance of having solidarity across the world in using resources to fight the COVID pandemic. How do you assess Turkey's contribution to this process and what has its contribution been to the world? 00:33:15 Also Turkey is a leading country giving priority to vaccinating health workers so can you comment on where Turkey is regarding the production of vaccines and supply of vaccines? Thank you. CL Thank you very much. Your Excellency, Dr Koca, please. Your Excellency, Dr Koca, could I ask you to reply. TR [Turkish language]. FK [Turkish language]. TR Thank you for the question. Yes, as you have mentioned, Mr Director-General has stressed many, many times since the start of the pandemic the importance of solidarity and international co-operation. 00:37:50 In that regard I would like to say that Turkey has supported 158 countries with personal protective equipment, diagnostic kits and ventilators. Also we have cooperated very closely with 14 international organisations including the WHO and I myself personally held meetings with the Ministers of Health of 20 countries throughout this period. Also we have a COVID-19 scientific board here in Turkey and they have shared their experiences with experts of 13 countries. So in terms of your question about the vaccine, we have 18 vaccines right now that are in WHO's list and one of these vaccines is in phase two right now and we will proceed to phase three in about a month. This is an inactive vaccine, by the way. Also we have four vaccines that are currently in phase one and we believe that by August or September we will have the first vaccine complete and ready. Our President has also sent a clear message. He said that more than 1,000 countries have yet to have access to a COVID-19 vaccine. That's why he said that when Turkey is able to produce its own vaccine that vaccine will definitely be offered for the use of the whole of humanity. Right now 100 countries do not have access to a COVID-19 vaccine, which is why the vaccine to be produced in Turkey will be offered for the whole of humanity. By the way, we will also work on not only the inactive vaccine but also MRNA vaccines, virus particulate-based vaccine and also we are working on an intranasal vaccine which will be in phase two in two to three weeks. Thank you. 00:40:15 CL Thank you very much, Your Excellency. Let me move to the next question from Gunila Van Hal, Svenska Dagblad. Gunila, please unmute yourself. GU Can you hear me? CL Very well. Go ahead. GU Thank you. Thanks for taking my question. It is to Carl Bildt and it is about access to vaccine. WHO is urging governments to share excess vaccine doses with low-income countries in need once their own risk groups have been vaccinated. How do you think this could be perceived as reasonable and motivated in countries like Sweden and others that have waited for a long time to get vaccines at all and where many people below 65 are waiting to be vaccinated? 00:41:03 If I may just squeeze in one short question to you, how are you going to convince countries to contribute more to the ACT Accelerator? Thanks. CL Mr Bildt, can I invite you. CB Yes, two questions. Certainly first the money, as I said, a huge amount of money but if you compare it with the money that is now spent on sustaining economic recovery it's really a very limited amount; it's less than 1% of the stimulus money that is available, be that in the US or in the EU, to take those two big ones. Of course most of this money, although we would like everyone to contribute, will have to come the major rich countries. So lots of money but if you compare it with the other money that we were forced to spend as a result of the pandemic not very much. Second question, yes; I don't need to tell this to you, I've been in politics for some time and I can see the pressures that every political leader, every prime minister; every health minister is under pressure in every country because everyone wants to have the vaccine and wants to have the vaccine yesterday. 00:42:19 But I think it's very important also that they all are ready to take the broader perspective, that they really understand that no-one is really safe until everyone is safe and we have a self-interest, be that in Sweden or the United States or India or Portugal or South Korea, that the pandemic is brought under control because the risk is, as we know, that otherwise we might get new mutations, new variations which might even undo what we have already done. If I look at the figures of course the EU has been exporting quite a lot during the past few months, which I think has been positive if I take it only from the EU perspective that you ask about. CL Thank you very much, Mr Bildt. We'll now move to the next and that's Nina Larson from AFP. Nina, please unmute yourself. NI Hi, can you hear me? CL Very well. NI Great. Thank you for taking my question. I have question for Dr Tedros. In your briefing to member states about the origins report earlier this week you said it was a very important beginning but not the end. Has it been agreed that the next phase in this process also must involve investigations in China and when do you think this phase two could get underway? Have you had talks with Beijing about a fresh international expert mission to the country? Thank you. CL Dr Tedros, please. TAG Thank you very much for that question. Of course there are many recommendations made by the team from the report - I hope you have read the report so there will be follow-up assessments - so that's what we expect but we haven't yet discussed because the report was just released last Tuesday. We will start engagements as soon as possible. Thank you. CL Thank you very much, Director-General. Now we'll move to Sara Teofilo from Cabreo Brasiliense. Sara, please unmute yourself. SA Hi. Thank you for taking my question. In Brazil we're seeing our worst moment in the epidemic. Yesterday we had more than 3,800 people killed by COVID, which was a record. States and cities have implemented some restrictive measures in recent weeks, which were widely criticised by our President but many have already backed down and as we all know, we are the second country in total number of victims of COVID. Knowing that we have a slow pace of vaccinations because we don't have enough vaccines, what results should we expect if aggressive measures are not taken? 00:45:19 Are we going to have more people killed by COVID than the US and how could international organisations and governments help Brazil with vaccines and medicines? Thank you. CL Dr Van Kerkhove, please. MK Yes, I will start and then I'm sure others will come in. There was a very important live Q&A that occurred earlier this week with Dr Mariangela Simao and others in Portuguese so I do encourage you to look at that if you haven't had a chance to talk about the situation. Indeed there's a very serious situation going on in Brazil right now where we have a number of states that are in critical condition. I understand that the Brazilian Ministry of Health has stated that six states are in critical condition and nationwide the hospitals are overwhelmed with most ICUs are over 90% capacity. 00:46:14 We're aware of a recent survey that was carried out by the National Council of Health Secretaries finding that more than 6,000 people were waiting for an ICU bed, 6,000 people with COVID-19 waiting for an ICU bed so indeed there is a critical situation there. The challenges are many in terms of increased transmissibility with this P1 variant that has been detected, that is circulating in the country. If you have increased transmission or a more transmissible virus you'll have more cases, which can overwhelm a health system that is already overwhelmed. Our regional office in PAHO with our country office are working with the states, working with the country to make sure that they have the right provisions in place to be able to care for patients, to get oxygen in, to provide the support that is necessary but indeed it is a critical situation. We do know that with this P1 variant that it is predominant in about 13 states, I think it's about 13 states as of right now and we do see that hospitalisations and ICU are increasing across all age groups, including younger age groups between 20 and 60 years old requiring hospitalisation and also ICU so there's a lot underway. 00:47:32 I do know that vaccination is increasing so someone else may want to comment on the proportion of the population that is receiving vaccination because I don't have those latest numbers there. I'll pass to Mariangela but it is important that the measures that are in place include vaccination. We still need to make sure that the public health and social measures, the distancing, the mask-wearing, the hand hygiene and making sure when you do wear a mask that you wear a mask with clan hands, that you touch the mask, you put it on, you take it off, you wash it, you dispose of it if it's a single-use mask appropriately, that you avoid crowded spaces, you limit the number of contacts that you have, try to just mix with the individuals within your household. All of those measures, I know, are incredibly difficult to still adhere to 16 months into a pandemic when everybody is exhausted but those measures are still in place in addition to vaccination. Mariangela, maybe you want to comment on the vaccination. 00:48:33 MS Thank you. I'm going to speak in Portuguese. TR Thank you very much for the questions and of course the WHO is very concerned with what is going on in Brazil. On the one hand the local production of vaccines is very important right now in Brazil. Despite the fact that Brazil is receiving vaccines through the COVAX facility Brazil can actually create its own vaccines and produce them via Butanta and Fia Cruz [?]. This is essential right now considering the pressure that is being put on supplies of vaccine. I wanted to just support what was said by Dr Maria Van Kerkhove. We need to not just be placing all our bets on the availability of vaccines. Even when there is greater vaccine coverage it is also very important that the authorities say that it is necessary to still stick to prevention measures such as avoiding crowded spaces, using masks, hand washing. That means that it is very important that we do not fall into a false sense of security regarding the quantity of vaccines. I think right now healthcare professionals and those over the age of 68 have now started being vaccinated. 00:50:18 Nonetheless it is right now when there is high transmission that we need to continue to be very vigilant, especially in urban centres. Thank you. CL Thank you very much both. Let me move to Mariella Skukta from [Unclear] TV, Albania. Mariella, please unmute yourself. MA Hello, everyone. CL Please go ahead. MA First of all I want to start by saying thank you for always being so professional and answering all of our concerns. I know this might sound a bit bizarre but on 5th April Albania will be going into the parliamentary elections and our Prime Minister, Edi Rama, has often stated that if the opposition wins the election the Albanian citizens will no longer have access to vaccine. As I said, it sounds bizarre but the general public might be concerned about this statement being true so my question is, is the statement true or false? Will or will not the Albanian citizens have access to vaccines in the case of the opposition winning the election? Thank you very much. 00:51:42 CL Thank you very much, Mariella. I don't think we can give a political answer here but I could ask Dr Aylward if there's anything about vaccine supply in general through COVAX. BA Thank you, Christian. The question just reinforces the importance of ensuring all peoples everywhere have access to vaccination, especially healthcare workers, as we heard from His Excellency, the Minister from Turkey today and others, the Director-General, and then of course the older population and then onward through the high-risk populations. The goal of the COVAX facility of which Albania and others are members is to ensure that all countries and all populations have access. That is the key to getting out of this irrespective of the situation or circumstances of an individual country or economy. CL Thank you very much, Dr Aylward. We move to Catherine Fiancon of France 24. Catherine, please unmute yourself. 00:52:47 CA Thank you, Christian. Good afternoon to all of you. I have a question about treatments. At the beginning of the pandemic we spoke a lot about treatments and vaccines but during the conferences we don't talk a lot about treatments so I would like to know a bit about that, particularly about preventive nasal treatments. There are some products that have been manufactured by Israel and Canada. What is your opinion about that, is it useful? Thank you. CL Thank you very much, Catherine. I have Dr Van Kerkhove to start. MK I can give a general answer to that and in fact Mike and I did a live yesterday where we were asked quite a lot about treatments because there is much more work that needs to be done on treatments for COVID-19. We do have the dexamethasone for patients who are severe and critical. This saves lives and we know that there are other measures that can be put in place that save lives so first of all it's prevention. 00:53:52 Secondly if people are ill that they enter the clinical care pathway early so that they receive the appropriate care depending on the severity of their illness, that they have their oxygen saturation checked, that they receive oxygen. Oxygen saves lives and WHO with partners has been working around the world to ensure that oxygen reaches countries around the world so that patients can receive this life-saving care. There are a number of therapeutics that are in developing looking at early-stage treatment. More work needs to be done in this area, there's no question about that. Our clinical teams are evaluating the studies that are coming out through these clinical trials and as the data come out they will be able to make recommendations as the data allow in terms of enough numbers and results so that they can activate the system to start to pool together the data from all of the clinical trials so that we have enough cases to be able to assess their efficacy. So that is something that is underway. CL Dr Aylward, please, to add. BA Thank you, Chris, and further to the point that was just made by Maria, the question is so valuable because the reality is we don't talk enough about treatments and what can be done for people suffering with COVID and particularly severe COVID-19. 00:55:19 Because, as Maria highlighted, dexamethasone is now available, saves lives combined with oxygen can have a tremendous impact and these simple interventions, we're learning more and more, are not available in enough places to be able to ensure the maximum impact. So as we talked about a couple of weeks ago with the launch of the new strategy for the ACT Accelerator for 2021, a huge part of the emphasis will be on not only ensuring that the vaccines are getting out there and getting to all populations but that we're also getting the rapid diagnostic tests out there to guide treatments and of course we're getting the oxygen and the dexamethasone. So just a thank you for the question because the reality is we do not talk enough about some very simple, relatively inexpensive and certainly unaffordable interventions that could make a huge difference for people suffering severe disease. 00:56:14 CL Thank you very much both. With this we've come to the end of our question-and-answer session. I would like to invite our special guests to give their closing remarks and we of course would like to start with His Excellency, Dr Fahrettin Koca, Minister of Health of the Republic of Turkey. The floor is yours, sir. FK [Turkish language]. TR Thank you very much. I believe that in terms of access to vaccines the world is faced with a very difficult condition and an obstacle so I think we should be able to produce vaccines everywhere, all over the world without intellectual property rights being a problem. That's why I think we need to be taking concrete steps about this issue. Thank you very much for your attention. CL Thank you very much for these remarks. I'll ask Carl Bildt, the former Prime Minister of Sweden and now WHO Special Envoy for the ACT Accelerator, for his comments. CB Yes, I can only say related to the question that was coming in from Albania related to the election campaign that is underway there that I think we all recognise that this is a race; humanity versus the virus. 00:58:16 We live in a world where there are a lot of political tensions between different countries and certainly within countries between different political parties, be there elections or not. But this is a time when these things should be put aside and the fight against COVID should be above all of this and should not be used for political purposes, be that a political purpose of an external nature, foreign policy or be that of a domestic nature, one way or the other. This is all of us, humanity versus the virus and it's important that it's seen in that context. CL Thank you so much, Carl Bildt, for these words. Before I hand to Dr Tedros for the final remarks thank you all for the participation. We will be sending the audio file and the remarks of our special guests and Dr Tedros right after the press conference. The full transcript will be posted on the WHO website tomorrow morning. Any further questions, please don't hesitate to contact mediaenquiries@who.int With this, Dr Tedros, the floor is yours. 00:59:27 TAG Thank you. Thank you so much. I fully agree with what former Prime Minister Carl Bildt said on this virus; the most important weapon is national unity and global solidarity. We have been saying this for a long time and I fully agree with him that this fight is humanity against the virus, directly quoting him of course. So any country should actually unite around the fight against this virus. Any divisions or cracks between us will only give opportunity to the virus. Then to what the Minister said I fully agree; local production is very, very important and WHO is ready to help countries. I think going forward the vaccine equity could be addressed by increasing local and regional capacity in production and we have been calling also for intellectual property waivers to help expand the production capacity significantly. With that, thank you so much to our guests, thank you for joining us today and also thank you to the media members for joining us. I look forward to seeing you next week. Happy Easter and also have a nice weekend. Thank you so much.