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1.
Artículo en Inglés | MEDLINE | ID: mdl-36011610

RESUMEN

Global environmental governance is the fundamental way to solve the human environmental crisis. With China as the world's largest emitter of greenhouse gases, the development of China's environmental law is a key component of global environmental governance. In order to better realize the construction of an ecological civilization, the compilation of China's Environmental Code has been officially put on the work schedule of the legislature. The compilation of the code is a sincere action, showing that China has taken the initiative to assume its own responsibility for environmental governance. In the past 50 years, China's environmental legislation has achieved a great leap forward: from nothing to something, from something to something more comprehensive. Aside from this progress, defects such as the internal imbalance of the environmental law system, the backwardness of some environmental legislation ideas, and the inability of environmental legislation and its academic research to fully match China's national conditions also exist. With the helping hands of conditions and times, it is most appropriate for China to start the compilation of the Environmental Code now. Environmental Codes such as the Swedish Environmental Code, the French Environmental Code and the German Environmental Code (Draft of the Committee of Experts) provide many empirical references for the compilation of China's Environmental Code. China will make important an contribution to world environmental governance again-an Environmental Code in line with international standards while maintaining native characteristics.


Asunto(s)
Conservación de los Recursos Naturales , Política Ambiental , China , Civilización , Agencias Gubernamentales , Humanos
2.
Land (Basel) ; 10(7)2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34413981

RESUMEN

Many cities worldwide are using re-greening strategies to help reverse urbanization patterns that aggravate environmental issues. Green infrastructure (GI) has become a significant and effective strategy to address environmental problems. To better understand GI, this study uses CiteSpace to analyze 5420 published papers in the field of GI on the Web of Science database from 1990-2020. This bibliometric analysis will help new scholars and researchers to better understand the current status and trends in GI research, as well as identify further research needed in the field. This study evaluated research on GI trends according to publication amounts, keywords, journals, disciplines, countries, institutions, and authors. Results show that, first, GI research has experienced rapid growth since 2014. Second, GI, ecosystem services, and city are the top three keywords related to GI research, with green roof as the keyword with the strongest linkage. Third, Sustainability, Urban Forestry and Urban Greening, and Landscape and Urban Planning are the top three journals publishing GI research. Fourth, the top three disciplines researching GI are environmental science, engineering, and science and technology. Fifth, the USA is the top ranked country in terms of the number of published GI-related papers (1514 papers), followed by China (730 papers) and England (546 papers). Sixth, the US Environmental Protection Agency (84 papers) is the top institution in terms of publications, followed by the Chinese Academy of Science (83 papers) and the Swedish University of Agriculture (66 papers). Finally, D. Haase has the most published articles (29 papers), followed by S. Pauleit (28 papers) and P. Angelstam (26 papers). These findings indicate that GI has developed significantly in the last 30 years, with a high probability for increased growth in the future.

3.
Scand J Public Health ; : 14034948211024483, 2021 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-34187239

RESUMEN

AIM: This study examined the barriers and opportunities in Sweden for integrating One Health practices. Sweden's long tradition of working with One Health was used as a case to analyse persistent barriers as well as opportunities. METHOD: Thirteen semi-structured interviews with experts from the Swedish Veterinary Agency, Food Agency, Public Health Agency, and Environmental Protection Agency were carried out. A thematic content analysis was conducted on the interviews using inductive coding in NVivo. RESULTS: The study revealed that while collaboration is the general aspiration across the Swedish agencies, barriers persist regarding the understanding of One Health, the integration of the environment sector and awareness of the different terminologies employed within the disciplines. There are legislative challenges and barriers to science to policy translation. Disease outbreak was identified as an opportunity for One Health integration. CONCLUSIONS: A One Health strategy needs to be developed at agency level to define One Health and clarify the roles and responsibilities. To overcome practical challenges, experts need to be aware of different terminologies and practices when collaborating. Further prospects for One Health integration include employing policy entrepreneurs to push One Health onto the political agenda. Preparations for disease outbreaks need to focus on reducing barriers to effectively integrate One Health. Experiences of One Health projects must be disseminated, and to raise awareness, education programmes must integrate One Health into curricula.

4.
Molecules ; 27(1)2021 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-35011310

RESUMEN

In 2017, the Swedish Environmental Protection Agency published a report on advanced wastewater treatment for the removal of pharmaceutical residues and stated that advanced treatment should be implemented where it will make the largest difference from an environmental perspective. However, the report also concluded that this need cannot be specified with existing data, but consideration must be made of local conditions. Two considerations are (1) the discharged amount of pharmaceutical into receiving water bodies and (2) the turnover of water in the recipient, where the highest risks are related to recipients with a low water turnover and low dilution. The current project comprised eight different WWTPs distributed throughout the entire County Skåne (Scania) in Sweden, with a population of ca. 1,300,000 persons. In total, 21 of 22 pharmaceuticals were analyzed according to the list proposed by the Swedish Medical Products Agency 2015. The results show that large amounts of pharmaceuticals are released from the WWTPs yearly to Scanian recipients. The total discharge of pharmaceuticals from the eight treatment plants adds up to 71 kg of these 21 substances alone, mainly comprising metoprolol, which is a drug that lowers blood pressure, and the analgesic drug diclofenac. Additionally, carbamazepine, losartan, naproxen and oxazepam were present in significant concentrations. These represented three illnesses that are very common: high blood pressure, inflammation/pain and depression/anxiety. The concentrations were generally in line with previous national Swedish screenings. It was estimated that, when one million cubic meters (1,000,000 m3) of wastewater is discharged, almost 4 kg of the 21 pharmaceuticals is released. The total volume wastewater release by the >90 WWTPs in Scania was estimated to 152,887,000 m3, which corresponded to 590 kg/year. The investigated 21 drugs cover only a small part of many hundred pharmaceuticals that are in use in Sweden. Thus, most likely, one or several tons of pharmaceuticals leak out to the Scanian recipients annually. The analysis of river samples shows that the dilution of wastewater is a key parameter in reducing concentrations. However, some locations have remarkably high concentrations, which occur when the volume wastewater is large in relation to the flow in the river. These kinds of regional results are of importance when selecting where advanced treatment should be prioritized in a first instance, as requested by the Swedish EPA.


Asunto(s)
Preparaciones Farmacéuticas/análisis , Contaminantes Químicos del Agua/análisis , Purificación del Agua/legislación & jurisprudencia , Monitoreo del Ambiente/legislación & jurisprudencia , Monitoreo del Ambiente/métodos , Geografía , Humanos , Preparaciones Farmacéuticas/química , Investigación , Ríos/química , Suecia , Contaminantes Químicos del Agua/química , Purificación del Agua/métodos
5.
Multimedia | Recursos Multimedia | ID: multimedia-7843

RESUMEN

00:00:25 FC Hello, all. I am Fadela Chaib speaking to you from WHO headquarters in Geneva and welcoming you to our global COVID-19 press conference today, Monday 7th December. 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, and Dr Mariangela Simao, Assistant Director-General, Access to Medicines and Health Products. Joining us remotely are Dr Soumya Swaminathan, our Chief Scientist, Dr Kate O'Brien, Director, Immunisation, Vaccines and Biologicals, Steve Solomon, Principal Legal Officer. Welcome, all. As usual we have simultaneous interpretation in the six official UN languages plus Portuguese and Hindi. Now without further delay I would like to hand over to Dr Tedros for his opening remarks. Dr Tedros, the floor is yours. TAG Shukran, Fadela. Good morning, good afternoon and good evening. Last week I spoke about the importance of testing, which is vital for knowing where the virus is but it's also important to know where the virus has been and how many people might have been infected without showing symptoms or being diagnosed by testing. 00:02:02 To do that seroprevalence studies are important, which look for antibodies in the blood of individuals to evaluate the extent of infection in different populations. Hundreds of seroprevalence studies have been done around the world, which vary in quality, methods and the type of tests used. Some follow people or populations over time to show how an antibody response in the individual or seroprevalence in populations changes over time. Despite their limitations their results are fairly consistent. They tell us that most of the world's population remains susceptible to infection with the COVID-19 virus. We're still learning how strong immune responses are in different populations and for how long this immune response lasts. In January WHO launched the Unity studies, a global effort to standardise seroprevalence studies and the use of serological tests. 00:03:10 So far more than 60 countries including more than 40 low and middle-income countries are conducting one or more of these studies using WHO's protocols. We're providing technical, financial and operational support and building research capacities for these studies. We continue to work with our global networks to better understand the proportion of the world's population that has been exposed to this virus and how long immunity lasts in people who have been infected. Seroprevalence studies can help us to understand how long immunity from natural infection lasts, which could also help us to understand how long immunity from vaccination might last. As countries plan to roll out vaccines in the coming weeks and months we urge them to prioritise vaccinating those most in need based on the values framework and population prioritisation roadmap issued by WHO's strategic advisory group of experts on immunisation. This document provides recommendations on who should be considered for vaccination first and lays out the values that inform those recommendations. These are not easy decisions. Vaccinating health workers who are at high risk of infection will help to protect them and the health system. 00:04:45 People at highest risk of severe disease or death as a result of age are also a high-priority group because protecting them will reduce severe disease and death and protect the burden of health systems. As supply increases the next groups would include those who have higher risk of severe disease because of their underlying conditions and marginalised groups at higher risk. In the initial stages of roll-out with only a small proportion of a country's population immunised it's vital that governments, communities and individuals continue using proven public health tools. Shortly after my election as Director-General in 2017 we analysed WHO's funding situation and showed that the organisation was too reliant on a handful of major donors. In May of 2018 we announced our plans to establish a foundation to reduce that reliance by generating funding from new sources. In May of this year I announced the creation of the WHO Foundation, a new independent body to generate resources for the work of WHO from source we have not accessed before. 00:06:14 Today the WHO Foundation announced the appointment of Anil Soni as its first Chief Executive Officer from the beginning of next year. Anil is an experienced global health expert with experience in the public, private and non-profit sectors. His previous role was at Viatris, a pharmaceutical company, where he was head of global infectious diseases. He has also held senior leadership roles at the Clinton Health Access Initiative and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Anil will play a vital role at a vital time in supporting the WHO Foundation to achieve its goal of raising $1 billion for global health over the next three years. The Foundation will also become a key partner of the COVID-19 Solidarity Response Fund, which has so far raised US$238 million from more than 650,000 individuals, companies and philanthropies. I would like to thank the United Nations Foundation and the Swiss Philanthropy Foundation for their partnership in the success of the Solidarity Response Fund so far and I would like to congratulate Anil Soni and we look forward to this exciting new era and to implement the strategic solution that can bring better resources to WHO. I thank you. 00:07:55 FC Thank you, Dr Tedros. I will now open the floor to questions from journalists. I remind you that you will need to use the raise your hand function in order to get in the queue and please unmute yourself. I would like now to invite Carmen from Politico to ask the first question. Carmen, can you hear me? CA Yes, I can, Fadela. Thank you so much for giving me the question. I have a question about the WHO Foundation and I was wondering, does the WHO framework for engagement with non-state actors apply to the WHO Foundation and where is the money coming from for the initial set-up of the foundation, who has financed it so far so it can get on track? Thank you. FC Thank you, Carmen. I think we can also... Dr Tedros would like to say something. TAG Yes, thank you. Thank you so much. I think, as I said in my speech, maybe I can go back to how it all started. We did a diagnosis of the problems WHO has been facing, especially in 2017 and 2018, as part of our transformation. 00:09:39 We have concluded that from some of the problems many of the problems, especially the financing part, could challenge WHO's sustainability in terms of funding. As you know from the volunteers, most of the money, 80% comes as volunteer financing and it comes from few donors. During that analysis what we thought was, if any of these donors withdrew its funding WHO could get into shock which it cannot absorb. So the strategic solution we proposed at that time was for WHO to broaden its base of donors but at the same time find new areas of resources and that's why we developed the first ever investment case, the first resource mobilisation framework and also the first partners' forum, which was held in Sweden last year, and also we decided to have the establishment of the WHO Foundation. WHO Foundation was one of the solutions so based on the first three I think there are strategic areas that have been already covered and this will focus - the WHO focuses new areas of resources. So the money will come from areas where WHO cannot mobilise directly and where, like the principles we have in FENSA, there could be a conflict of interest. 00:11:42 So the WHO Foundation can mobilise resources without really direct involvement of WHO so the relationship between WHO and what the WHO Foundation makes is not direct. So one thing I would like to assure you is that we have done all the assessments and based on FENSA the foundation's establishment is clear so it's based on FENSA that the foundation itself was established. But I just wanted to use this opportunity to tell you that WHO Foundation is one of the strategic solutions among others. Thank you. FC Thank you, Dr Tedros. I would like now to invite Bianca Rothier from Globo to ask the next question. Bianca, can you hear me? BI Hi, Fadela. Yes, can you hear me? FC Yes, very well. Go ahead, please. 00:12:45 BI Thanks. My questions' to Globo. I'm a correspondent here in Switzerland for Globo. It's about schools because contrary to what we have seen in most European countries during the second wave some cities in Brazil - Hijadel [?] for example - are closing schools again while shipping centres can still be open 24 hours a day. What are the WHO recommendations for schools in countries facing a level of spread like Brazil is facing now again and what have the most recent studies shown, what is the role of children in transmission; how about the teachers and other staff, parents when they are going to pick them up? How important is this risk? Thanks a lot. FC Thank you, Bianca. Dr Van Kerkhove will take this question. MK Thanks, Bianca, for this question. WHO advises taking a risk-based approach as it relates to schools and considerations for schools and education systems, whether they remain open or closed. I think universally everyone understands the critical importance of schools and education for children and young adults, especially the youngest kids. 00:14:11 So in our guidance which we've jointly issued with UNICEF - we're grateful for our partners at UNICEF and our global network, our strategic advisory group that helps advise us on educational settings - is to take this risk-based approach and first and foremost schools operate in communities and if the virus is circulating in the communities and there's intense transmission in the communities it's possible that the virus will enter into the school because individuals who work at the school, who attend the school live in those communities where the virus is circulating. So the first thing that needs to be done is to focus on reducing transmission in the communities and there are a number of steps that you've heard us outline over time. But on the schools themselves we also outlined guidance on what type of plans schools need to have in place in terms of the policies and plans for identifying cases, if they were to have a case how they would carry out contact tracing, having certain environmental cleaning within the school, make sure there's disinfection that's happening, certain physical barriers and distancing of desks for example to ensure that children remain apart. 00:15:18 Age-appropriate use of marks, making sure that there's good ventilation and ensuring that there's good natural ventilation and fresh air coming into the schools and making sure that part of those plans include communication; good communication with not only the students themselves who want to know what's happening and who are very, very smart but also the parents of those schools and what role they can play in this. So we've outlined an approach to help schools in taking the decisions of when t open and when to close, if they need to move to a distance-based learning application or virtual-type schooling. So we've helped countries and decision-makers with taking those decisions at the most local level possible because the virus doesn't spread uniformly, there're different levels of intensity. So that is something that's been issued and that's what countries are following. There's a lot of research now that's happening and looking at children and COVID-19 and the infection among children and we do see some age differences in terms of the amount of infection identified in kids as measured by seroprevalence, as the Director-General was talking about earlier in his speech. There seem to be lower levels of seroprevalence in the youngest age groups as compared to older children and teenagers and we do also see differences in the rates of transmission amongst the youngest children, which seems to be lower compared to older children and teenagers who can spread more than the youngest kids. 00:16:50 But we still have quite a lot to learn. Still we do see overall that children when they are infected tend to have more mild disease and asymptomatic infection and that is something that has held true through the more and more research that is being published but it isn't universal so we do have some children who have developed severe disease and we have had some children die. So it is really important that we take a risk-based approach, we look at schools as part of communities because it's not only the children, it's the people who work there. But there are many places all over the world who have open schools and who have prioritised keeping schools open while keeping transmission low. FC Thank you very much. I would like now to invite Emma Farge from Reuters to ask the next question. Emma, can you hear me? 00:17:42 EM Yes, I can. Thank you for taking my question. It's regarding the Biden health team which is coming together now. I'm wondering if the WHO has had any discussions with the incoming administration and whether specifically you can update us on those discussions; did they lead to anything significant on funding or even a possible late inclusion of the US into the COVAX scheme? Thanks. FC Thank you, Emma. TAG As you know, they're in transition and the team is not formed in full so there cannot be formal or organised discussions when they're doing their transition. So we will let you know when we have contacts, when we have formal engagements but so far we haven't done any discussion with the group as a group. As you know, some of them were just announced a few hours ago. Thank you. FC Thank you, Dr Tedros. I'd like now to invite Bloomberg to ask the next question; Corinne Gretlet. Corinne, can you hear me? Corinne? I can't hear you, Corinne. Okay. If not I will go to the next journalist, Gunila Van Hal, Swedish journalist. Gunila, can you hear me? 00:19:43 GU Yes, I can hear you. Can you hear me? FC Yes, very well. Go ahead, please, Gunila. GU Thanks for taking my question. It concerns vaccine hesitancy now, when we have the vaccines here or very close. How worried are you, how concerned are you about this and the fact that maybe too few people will vaccinate themselves to have a real impact on stopping the virus? If I may ask a question concerning that connected to Sweden where we have experience through the swine flu and the vaccinations that led to the life-long disease of narcolepsy for hundreds of young people, how to address vaccine hesitancy that actually comes from a negative experience of mass vaccinations and also from a vaccine that was developed extremely fast and keeping in mind that the pharmaceuticals do not know anything about the long-term side-effects. Thanks. FC Thank you, Gunila. I'd like to invite Dr Kate O'Brien to take this question. Kate. 00:20:51 KOB Thank you. This is an extremely important issue and I'm really glad you raised it. The vaccines that are demonstrating efficacy and are reaching authorisation for use in countries - and we expect that we will see more of these - are not going to be useful unless people actually become vaccinated. The vaccine that sits on the shelf in a refrigerator or a freezer is going to confer no benefit to people. The issue of vaccine hesitancy and certainly the questions about the vaccine are really legitimate questions and we do want people to be informed about the science, we want people to be fully informed about the evidence that regulators and policy recommending bodies are reviewing in order to make the recommendations and the decisions that are being made. I think one of the things that really helps communities and people, individuals who have to make decisions about being vaccinated is the trust that they have in where the information is coming from. Information really does need to come from the most local level possible; from trusted providers, from people's physicians or the nurse that they go to or the voice of public health people in the community. 00:22:26 So sharing the information and the transparency that we have through the regulatory process and through the policy recommending process is really important so that there's accuracy in what people understand about the vaccines. Each individual will make a decision for themselves about the value that they place on the vaccine and especially in this time where so many people, millions of people have suffered and the deaths that have occurred. I think this assessment that people will make about their understanding of the benefits of the vaccine is going to be a critical mixed phase in the pathway towards having these vaccines be critical tools in the toolbox of the interventions that we have. As Mike and Maria have emphasised so often, having vaccines is not going to be a switch, it's not going to be just going from not having vaccines to having them. We're going to have to continue with the public health interventions for some time yet because of vaccine supply and because of the ramp-up of people getting vaccinated. 00:23:42 What I really want to emphasise here is that there's a very robust, a very strong safety monitoring system that is in place and that system is in place in countries that will be starting vaccines, in all countries around the world. As WHO - and perhaps Mariangela can speak to this a little bit more - that safety system is switched on fully for full co-ordination across all of the different groups - the regulators, the manufacturers, WHO - to be looking at the data in real time. But if there are any signals of concerns around the vaccine we have the ability to look at that, to investigate it and to really understand if there's any issue. But in the clinical trials - which have been very large in nature - the safety evidence is the critical piece of evidence that is being assessed by regulators looking very carefully at the safety profile. As you've seen in the trials that have been reported - in the press releases at least - there are tends of thousands of people who have been enrolled in the trials and each of them is randomised so approximately half of them have received the vaccine. 00:25:09 So I think we have standards around safety, we have large clinical trials that have been done, we have a system in place to monitor for rare or unusual potential outcomes from the vaccine and assess whether they were related to the vaccine or not. I think where people really need to spend their time and their energy is on really being sure that the information that they're receiving is information that is based on the science. I wonder if Mariangela wants to say anything more about the safety part or anybody else to come in here. Thank you. FC Thank you, Dr O'Brien. I think that was a very comprehensive answer. I hope that Gunila was happy. I would like now to invite NPR, Jason Bobian from NPR, to ask the next question. Jason, can you hear me? JA Yes, I can, thank you. The CDC updated what they're calling a close contact and they're now adding anyone who had direct physical contact of a person; before it was anyone who's been within six feet of someone for 15 minutes, masked or unmasked. 00:26:35 I think there's still a little bit of confusion. What is your view of whether or not... They mentioned hugging, that if someone had hugged a person that person would then be considered a close contact and should quarantine. What would be your take on a short interaction like that, just a hug, would that be considered close contact? MK Thanks for the question. It's a good one because there are lots of different definitions out there for contacts. The reason we have the definition of contacts is because of the way the virus spreads. It's a respiratory pathogen and so the virus can be released from your mouth and your nose when you talk or cough or sing but it can also be passed if people have direct contact with one another. What we learn about through these studies is to really get much more detail around what that contact entails. What we know is that most transmission is happening among people who tend to spend a lot of time together. They happen in households, they happen in workplaces and so you have more than just a passing or a brief exchange between individuals. 00:27:50 So when you have a household contact you may hug that person, you may spend long periods of time in the same room together, you may sleep in the same bedroom together, you may share meals together. So when transmission happens in those households it's very difficult to disentangle how transmission actually occurred and the instant of transmission. But we know that long periods of time together, the intensity of that type of interaction, meaning the closeness of it, the direct contact, the direct nature of that contact and the type of setting in which that type of transmission takes place; if it happens in a closed setting with poor ventilation for example that is a situation where transmission can be facilitated more readily. So we define a contact; we use a time frame, we do give a 15-minute window in terms of that amount of time spent with someone. But countries and institutions and agencies need to take decisions about how they define contacts based on the experience that they're seeing in their countries, based on the studies that are being conducted, the details of those outbreak investigations. 00:28:54 This is why these outbreak investigations are so critical for us; because you get to that level of detail that really disentangles how transmission is happening because there are different ways in which transmission can take place. So it is important the time element, the type of contact; if you're hugging for someone, if you're kissing someone, if you're caring for someone, especially if they're sick. Those are really important to define contacts. Also, having said that, we try to outline what would be considered a higher-risk contact versus a lower-risk contact and that relates to the amount of exposure, the duration and the time of exposure because when you're carrying out contact tracing sometimes those numbers of contacts become very high and you do prioritise who you follow up so we recommend following up the highest-risk contacts, those who have the most exposure to someone who is a case. MR Thank you, Maria. I think Maria's spot-on with that. Also just for ordinary people out there, it's like looking at your skin in the sun. Some people can develop a cancerous growth. Nobody knows which specific event caused that. What we do know is if you spend longer in the sun there's more of a chance that you will but it's very difficult to associate a specific day or time at which that sun might cause that cell to change but we do know it's bad to be out in the sun with unprotected skin. 00:30:25 It doesn't mean that sunlight is bad; it means that overexposure to sunlight can lead to that outcome. In the same way we don't know what specific event causes the transfer of the virus to humans. It could be a hug but it's much more likely to occur in a situation where you're in the same space as somebody else for a long time because there are more opportunities during that period for the virus to jump. I think it's difficult right now for the likes of CDC in Atlanta; the US is accounting for a third of all world cases at the moment over the last number of weeks. The epidemic in the US is punishing, it's widespread. It's quite frankly shocking to see one to two persons a minute die in the US, a country with a wonderful, strong health system and amazing technological capacities. So I believe that the CDC are doing their job; they're trying to identify each and every possible significant contact, they're really reaching out to try and get people to stay the course and to use the hope of vaccines but just to remember, there are a number of months to go in which everyone is going to have to unfortunately avoid those hugs. 00:31:41 Maybe because we're here talking today about hugs and about how much we would like those hugs over the holiday period and just how getting that close to people in a situation with intense community transmission can be so tragically dangerous; that's, I think, the awful, brutal dilemma that we all face. It's a horrible thing to think that we would be here as the World Health Organization saying to people, don't hug each other. It's terrible but that is the brutal reality in places like the United States right now and I commend the CDC for doing everything they can. Definitions are definitions. At one level they're arbitrary; who is a contact, who is not. What CDC are trying to do is pick out as many of the significant contacts as they can so that people can protect themselves, get the diagnosis they need, get into treatment early. They're trying to make sure that people are detected and get access to care, they're trying to break the chains of transmission and I commend them as a strong federal agency and as an agency that sends light to the world through its science for doing what they're doing. 00:32:54 FC Thank you. I would like to call again Corinne Gretler from Bloomberg news, our second attempt. Corinne, can you hear me? CO Yes, I can. Can you hear me? FC Corinne? CO Hello, can you hear me? FC Yes, very well. Go ahead, please. CO I may have missed this in previous briefings but I was wondering whether the WHO is advising member states to make the vaccine mandatory. What's your general stance on that and if not countries would it maybe make sense for companies to make it mandatory for employees? FC Thank you, Corinne. Dr Simao. MS Let me start and colleagues can complement. Actually there are very few cases where vaccines are mandatory in countries because countries have different regulations and they usually refer to vaccination in children. 00:34:00 We don't have that experience with adults so far but we do believe that it's much better to work on information campaigns, on making the vaccine accessible to those priority groups who need to be vaccinated first as we don't have enough vaccine next year to vaccinate the entire population. So it will be up to countries to decide but the position is that the way it works better is to make sure that people who are in the priority populations should be vaccinated first, that they have the right information and that they can make an informed choice regarding getting the vaccine. FC Thank you, Dr Simao. I think Dr O'Brien would like also to comment. Dr O'Brien. KOB Yes, I also just wanted to add to what Mariangela has just said is that there is only one vaccine, the yellow fever vaccine, that has any requirement regarding international travel and obviously international travel is not a mandate to be vaccinated, it's an underpinning of that travel requirement. 00:35:20 Just on the issue of mandatory vaccination I fully agree with what Mariangela has had to say; there are some examples of countries for the purpose of paediatric vaccinations that have had success in ensuring that children have high coverage with vaccination in a setting where there are school-related requirements for attendance. But we do think that it is a much better position to actually encourage and facilitate the vaccination without those kinds of requirements. Really one of the limitations for vaccination is availability of vaccines and that doesn't just mean in a country itself but in a time and a place that is convenient for people to go and get vaccinated and with facilities that are of high quality, that provide a positive environment for people to come and be vaccinated. So there are many ways in which we can facilitate people coming to get the vaccines that they want to get and that they know are for their health and their safety. I think the other thing to say is that there may be some countries or some situations in countries where there are professional circumstances where it would be required to be vaccinated or where it would be highly recommended to be vaccinated. 00:36:55 One can imagine certain professional jobs in hospitals - respiratory technicians, intensive care unit physicians and nurses - where for the safety of the staff and the patients there would be a very strong recommendation to be vaccinated. So I don't think we envision any countries creating a mandate for vaccination but there certainly are situations where that strong recommendation - or perhaps on the part of an employer - would decide that that would be a requirement. FC Dr Ryan. MR Yes, I agree with very much of what Kate said. I think the issue and the discussion we need to have amongst ourselves, with ourselves is the issue of what is personal responsibility versus what is a requirement of law and what are you as an individual willing to do to protect yourself and those people around you. If I lived on a desert island would I necessarily want to have COVID vaccine? I don't know. But if I was going to visit my 80-year-old mother - she's not in the nursing home but if she was - if vaccine was available would I be responsible in going in there, visiting lots of older people without being vaccinated if a vaccine was available to me? 00:38:27 So I think we all have to ask ourselves those questions and when you ask yourself those questions you tend to come up with the right answers and then you avoid questions about law and mandatory nature of vaccines. I think the other thing that Maria reflected to me earlier was, the reality is most people want these vaccines. This is a massive potential breakthrough for global health. People are demanding these vaccines, people want these vaccines. They want these vaccines to be rolled out carefully and safely and Mariangela, Soumya, Kate and some of the others - Ana Maria - are working so hard here and around the world to ensure that process and give people the necessary reassurances. But the reality is the vaccine story is a good news story. It is the victory of human endeavour potentially over a microbial adversary, as the DG has called it many, many times and there's hope with that. Yes, we have to continue to bring people along on that journey but I don't think we should necessarily focus on the negative aspects here. 00:39:29 We need to convince people and we need to persuade and we need to dialogue on this issue. I'm not a great believer... I agree with Kate; there are specific circumstances in which governments may have to require a specific mandate for vaccination but I think all of us who work in public health would rather avoid that as a means of getting people vaccinated. I think we are much better served to present people with the data, to present people with the benefits and let people make up their own minds, obviously within reason because there are certain circumstances, as I've alluded to, where I would believe that the only responsible thing would be to be vaccinated, in future when the vaccine is fully available. FC Thank you. Kate, do you have something to add? KOB Yes, I just wanted to add on the comment that I made that there are some countries, a limited number of countries that do have requirements for school attendance for children to verify the vaccination status. 00:40:35 I'd like to also just comment that mandates have another side to them which is that they're also examples where when countries thought that this would be a means to improve the coverage of vaccination in the country it just went in the opposite direction. So just really reinforcing what I said before and what Mike said, that this is not a tool that has strong evidence behind it that it results in higher coverage. In each circumstance where it has been tried the evidence is that it actually goes in both directions. So especially in the circumstance that we're in - and as Mike has said and Maria has said - the substantial majority of people - and people are really eager to have these vaccines available and to move along with vaccination and access to vaccines so I don't think that mandates are the direction to go in here, especially for these vaccines. Thank you. FC Thank you all. I would like now to invite Kumar Bian, Indian media, to ask the next question. Kumar, can you hear me? KU Yes. Can you hear me? 00:42:00 FC Very well. Go ahead, please. KU From the beginning the WHO has been saying - the DG in particular - that the vaccine is very unpredictable, it behaves differently with different people. In this context I would like to ask whether the WHO is looking at different vaccines for different ages groups and geographies because elders have different symptoms, children have different symptoms. I myself have come out of COVID very recently. My age group will have different symptoms. What's your take on it, WHO? FC Thank you, Kumar. Dr O'Brien, can you take this question, please? KOB Sure. We have been emphasising that in the evaluation of the vaccines it is important that the trials are of large enough size and are of diverse enough populations that we can get some answers to questions about whether or not there is a difference in the efficacy of the vaccines according to different subgroups. Age is one particular attribute; that there is a high interest in knowing whether or not the vaccines perform in the same across different age groups. I want to emphasise that the data that has been made public at this point is from press releases. We're very eager to see the details of the data from these clinical trials. 00:43:37 Some of the clinical trials are large enough and enrolled in a a way that they are able to look at the efficacy of the vaccines according to some of the different age strata of interest, in particular older adults. But none of the trials enrolled people who were over 80 years of age so we don't have information among the very oldest in our communities. What is available from some of the press releases are statements in the press release that the efficacy in older age groups was very similar if not the same as among the groups in the younger age groups. So what we really need to wait for is to see the data go through the regulatory process and through the public processes where the data is provided. There are scientific reasons to ask a question about whether or not there could be differences of performance of vaccines in different age groups or underlying medical conditions. 00:44:45 There are a number of areas in which one might expect that there could be differences in the performance of the vaccine and as vaccines become used in communities there will be ongoing evaluations of those vaccines as people become vaccinated to identify whether one or more of the vaccines has better performance or less good performance in some subgroups of people. It's also the reason why we need to continue the research on vaccines, that the story isn't over with the first vaccines coming to authorisation and there are a large number of vaccines in the pipeline and it really is important that as we focus on ramping up both the manufacturing and the delivery as vaccines come through and are assessed for authorisation from a regulatory perspective that we don't stop with the research. Because for most vaccines there has been ongoing development of them and the ones that we started with at the beginning were improved upon over time. So as much as we want the vaccines that are coming through now I do want to emphasise the importance of the ongoing research. Thank you. FC Thank you, Dr O'Brien. I would like to invite Ana Maria Henao Restrepo, Dr Ana Maria, to respond also to this question. 00:46:19 AMR Yes, I just want to echo some of the points that Kate has highlighted. We have been discussing with chemical trialists and vaccine experts and, as Kate says, we are very pleased to have the third term information on the efficacy of these three vaccines but all the experts agreed that we require to have additional evidence. Placebo-controlled trials are the gold standard of obtaining information on the efficacy, the safety, the duration of the protection and the occurrence of serious adverse events. This is why we are communicating to all the researchers around the world who are doing the trials to continue the trials as per the protocols. Second, as he was saying, randomised evidence is the best opportunity we have to evaluate the additional vaccines and to know if these additional vaccines in the pipeline - we have almost 150 candidate vaccines all with different attributes. Some require one dose, some have different routes of administration, some are more suitable for certain contexts. 00:47:28 We want to test all of them because maybe there will be the solution for countries or for certain locations. Thirdly we of course understand that at some point we are going to move into observational data. The randomised placebo-controlled trials will not be possible any longer but we have to enter into this phase understanding that this kind of a study doesn't have the same attributes as the mass clinical trials, that even if they are very well conducted they are subject to bias and interpretation is going to be more complex. So we need to look at that; having close marketing surveillance, having case controlling studies, having cohort studies is a good idea but we need to deliver data. We are in the process of organising consultations to deliberate on what are the best contexts and the best approaches to conduct such studies so that we don't get the wrong answers. FC Thank you. I would like just to give you the title of Dr Ana Maria Henao Restrepo. She's Co-Lead, Research and Development Blueprint at WHO. Thank you so much for your answer. I would like now to invite the next journalist, NSK Shoko [?]. NSK, can you ask your question, please? 00:48:54 SH Hello, Fadela, can you hear me? Hello? FC Yes, I can hear you. Go ahead, please. SH Okay, thank you for taking my question. Tomorrow marks a year since the first patient was detected in Wuhan in China. Can you please give us an update on when WHO is planning to send the international experts to China? Does it take place by the end of this year or rather the beginning of next year or even later? Thank you. TAG Yes, thank you so much. We're planning and we're hoping to be to the ground as soon as possible. Thank you. FC Thank you. I would like now to invite Maya Klans from the UN Brief to ask the next question. Maya, can you hear me? MA Thank you very much, Fadela, for taking our question. My question is regarding the foundation. I know you have spoken already about it but I would like to know what's in the pipeline for the coming year, for its very first year. 00:50:17 FC Thank you so much. The board is established now and we have our CEO, as I have announced today, and we have already started and the foundation have already started taking the next steps, meaning raising the funding as operational cost for the foundation. While raising that funding of course it will trigger the ambitious three-year plan the foundation has. So while the immediate funding will be the US$40 million for the operation of the foundation then the plan is to mobilise US$1 billion in the next three years. Thank you. MR If I could just add - and this is more aspirational in terms of the foundation because I've had the great pleasure of working on behalf of Dr Tedros on the Solidarity Fund for COVID-19 which is the precursor in a way of some of the hopes that we have for the foundation. It's been very, very empowering this year to see how funding coming from sources other than traditional has funded so many amazing efforts in terms of the Solidarity Fund. It's invested in youth organisations for COVID-19 messaging, it's invested in oxygen solutions, in emergency medical team training and subregional centres in Ethiopia. 00:52:05 It's evolved funding our partners outside WHO more than our partners inside including UNICEF, the World Food Programme, UNROA, the UNHCR and others who are doing health-related activities in the field. So it is our hope, Dr Tedros, that the foundation will be, as you have laid out, a way in which WHO can leverage increased investment in health. I think Tedros always says that; that this isn't about necessarily just increased investment in WHO. It's about leveraging more funding into the global cycle for health and driving partnership and innovation throughout the world. I think we've started well with the Solidarity Fund and we hope that the foundation will have that same impact and I'm sure it will. TAG Thank you, Mike. You have reminded me of one thing. When we propose these strategic solutions for WHO it's not just to raise funding only. It could improve the amount of funding, it could improve the quality of funding; that's one. 00:53:15 But at the same broadening our base and moving into additional resources which doesn't have any strings attached means improving also WHO's independence. So it's not about funding only; it's also an independence issue. With long-term multi-tier [?], broad-based funding comes independence also so it's not just finance, it's also ensuring and securing the independence of the organisation and that's why I say this is a strategic solution that addresses some of the systemic problems that we have. Thank you. FC Thank you, Dr Tedros. I would like now to invite Kostas from ERT Greece to ask the next question. Kostas, can you hear me? KO Can you hear me? FC Very well. KO Thank you for taking my question. I would like to ask you about the origin of the coronavirus. Do you agree with the scientific opinion of several virologists in the last days who claim that the virus did come from China but mutated in Italy and then became more contagious and deadly than the original virus in Wuhan? Thank you. 00:54:51 FC Thank you, Kostas. Dr Ryan. MR We can pass to Maria for more specific comment but there are many, many hypotheses as to the origins, the evolution and the spread of COVID-19. They all make for great stories but at the moment there is no proof that any of the hypotheses for generation or for transmission are so. But it is important that we continue to create those hypotheses and then test those against the data that we know. That's part of the reason why Dr Tedros has pushed so hard to work with our Chinese colleagues on understanding the origins of the human disease in Wuhan. But we also have other data that we're looking at very closely for early transmission potentially in Europe and also we've seen the human-to-mink-to-human transmission. So what we see here is a very dynamic interface between animals and humans. We see evolution of the virus within human populations and potentially even faster evolution within small animal populations that are densely packed together. 00:56:01 So it is difficult to come up with a single hypothesis that explains transmission and there is no question that there was very explosive transmission in Wuhan in the early part of the epidemic and clearly in northern Italy a similar explosion of transmission at that time and Italy suffered greatly for that and then we saw the subsequent transmission in other countries. So it is an interesting observation around those effectively two epicentres and how they were related but there are no answers to those questions but we're really interested and we're working with both colleagues in Italy and other countries in Europe - and Denmark. We're working with our colleagues in China and we would hope to build up a much more definite picture on that so please keep sending us your hypotheses but every hypothesis needs to be tested against the data that we actually have. Maria. MK Thanks. Just to support what Mike has said, the studies that need to take place in Wuhan looking at the first cases that were detected are really, really critical in terms of those epidemiologic investigations and really understanding the time that the virus was detected. 00:57:11 Those need to take place and those are taking place and that's the main mission of the China international team and that's ongoing, as the Director-General has said and as Mike has said. But we are a scientific organisation, we are an evidence-based organisation, we follow the science, we follow all of the research that is ongoing globally and there are research groups that are looking at past serologic samples, sera from 2019 and for all of those examples we will follow up and we're following up a recent publication from Italy and those samples are being tested by a partner lab. All of the sequencing that has been made available and again it's incredible that more than 200,000 full genome sequences have been shared globally and these have been shared on publicly available platforms like GISAID. It's really incredible; we need more sequences to be shared so thank you to colleagues for doing that. 00:58:09 Looking at the most common ancestor, any evidence that points to a late November/early December most common ancestor. We're looking also at some countries that are looking at stored waste water samples and following up any indication of RNA testing and making sure that it's a real finding or it might be contamination. We're looking at countries that are going back into their labs and looking at stored clinical samples from 2019 and so all of these avenues are followed up but again - and the Director-General has made very clear and so has Mike and so have I - these studies will begin in Wuhan and it's really, really critical from the public health point of view to understand the events that took place because of the public health importance. What is really critical is that we understand the intermediate host or hosts because that is the important animal or animals that the virus can pass between and we want to make sure that that doesn't continue to happen or doesn't happen again. FC Thank you so much. I would like to invite Peter Kidi from Anadolu news agency to ask the last question. Peter, you have the floor. 00:59:28 PE Thank you for taking my question. Can you hear me? FC Yes, go ahead, please. PE Thank you. With all the growing optimism from vaccine development there's also quite a lot of talk about the thorny issue of intellectual property rights and sharing of knowledge and data. I know that South Africa and India have proposed to the WTO that they should choose whether to grant or enforce patents and other intellectual property related to COVID-19 and to share data. The industry says with all the innovation it's pushed forward such fast development of data. Can you say what the WHO has to say about this? Thank you. FC Thank you, Peter. Dr Simao. MS Thank you for the question; it has been coming up quite frequently lately because these discussions are ongoing in the Trips Council, which is managed by WTO, as you know well. WHO of course welcomes all measures that countries can make in order to address any barriers to access to safe and effective products. That's the spirit behind this process that's happening at the WHO. 01:00:59 On the other hand WHO's Director-General together with the President of Costa Rica has launched at the end of May the COVID Access Technology Pool which is aiming at increased sharing of knowledge and scientific information but also increased pooling of patents, pooling of licences through the medicines patent pool. We believe very much that for next year as we are facing a situation where we will have scarce products, scarce manufacturing capacity in countries and that short-term we need to deal with the affordable access, equitable access to these products that prove to be safe and effective. In the mid and long term we need to increase capacity for, for example, local production or technology transfer and that's where the CTAP, which is this platform, can play a very important role through a voluntary mechanism where manufacturers and researchers, academics and institutions in general can deposit and make available the pertinent licensing or scientific knowledge that can help us face the pandemic at the end of 2021, into 2022 and 23. 01:02:33 I'm saying this particularly because we have situations where we may have for example biotherapeutics that could be useful to fight COVID but they are also being developed for other disease but for which - for example monoclonal antibodies - there is a very, very limited manufacturing capacity concentrated in some multinational companies at the moment. We need to increase the willingness to do technology transfer and also to do the pooling of licensing so that we do not only address the COVID needs but we also address other conditions like oncological products and HIV products for example. Thank you. MR Thank you, Mariangela. I fully agree with your points but just from the perspective as we enter many holiday seasons - Mariangela's right - the technology transfer can take time and it can be done over many products but what we need now globally is not to enter the land of empty promises in terms of supporting the ACT Accelerator. 01:03:51 The structure is there, the partnership is there, the means to do this, allocation fairly and equitably is there. We've never had that in place previously but what's not in place is the financing to make that happen in 2021. I'm not directly and daily involved with the ACT so I'm speaking as an advocate for my colleagues who've given every ounce of their energy across multiple organisations on this project over months. Quite frankly right now there's too much of a gap between the rhetoric and the reality of what the Director-General and other leaders have at their disposal in order to make the ACT Accelerator deliver on a fair and equitable result for people around the world. Equity and fairness is still an aspiration, it's a dream, there's a plan. We have the architectural drawings for this moon shot but I think the DG will agree, we still don't have the financing to make that happen. So I do think as we approach the time of giving it's really important that countries that speak to the idea of fairness and equity, countries that want that to the a reality and have the financial power, the donors that have the power, be they philanthropic or be they government or other or private sector, that we actually make that happen. 01:05:19 Anyway, that for me is going to be the essence of creating equity. It's not just about the technology, it's about financing the ACT Accelerator, particularly the COVAX facility, in order to make this happen. FC Thank you so much. We have gone over one hour since we started this press conference. I would like to invite Dr Tedros for any final comments. Over to you, DG. TAG Thank you so much, Fadela, and thank you all for joining us. See you in our upcoming presser. Thank you. Have a nice week. FC Thank you, DG. I would like to remind journalists that we will be sending the DG's opening remarks and the audio file after this press conference. The full transcript will be available tomorrow on the WHO website and as usual don't hesitate to contact the media team for any follow-up questions. Thank you and see you on Friday. 01:06:22


Asunto(s)
Betacoronavirus/inmunología , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Pandemias/prevención & control , Monitoreo Epidemiológico , Estudios Seroepidemiológicos , Infecciones por Coronavirus/inmunología , Neumonía Viral/inmunología , Vacunas Virales/inmunología , Programas de Inmunización/organización & administración , Sistemas de Salud/organización & administración , Financiación de la Atención de la Salud , Donaciones , Instituciones Académicas/organización & administración , Aislamiento Social , Máscaras , 50207 , Portador Sano/transmisión , Cuarentena/organización & administración
6.
Multimedia | Recursos Multimedia | ID: multimedia-7702

RESUMEN

00:00:18 MH Hello, everybody. This is Margaret Harris at WHO headquarters, Geneva, welcoming you to our global press conference on COVID-19 today, Monday November 23rd. We have with us as always in the room the WHO Director-General, Dr Tedros, Dr Mike Ryan, Executive Director of our Emergencies Programme, and Dr Maria Van Kerkhove, our Technical Lead for COVID-19. We will also be joined remotely by a number of people including some special guests whom Dr Tedros will introduce. On the line to answer your questions will be Dr Mariangela Simao, our Assistant Director-General for Access to Medicines and Health Technologies, Dr Bruce Aylward, Senior Advisor to the Director-General, who leads on the ACT Accelerator, and Dr Soumya Swaminathan, our Chief Scientist. As usual we are translating this simultaneously into the six official UN languages plus Portuguese and Hindi. We will be posting the Director-General's remarks and an audio file of the press conference on the web as soon as possible and transcripts will also be available later. Now without further delay I will hand over to Dr Tedros to give us his opening remarks. Dr Tedros, you have the floor. 00:01:33 TAG Thank you. Thank you, Margareta, and welcome. I would also like to use this opportunity to thank Fadela, who has been moderating until today. Good morning, good afternoon and good evening. With the latest positive news from vaccine trials the light at the end of this long, dark tunnel is growing brighter. There is now real hope that vaccines in combination with other tried and tested public health measures will help to end the pandemic. The significance of this scientific achievement cannot be overstated. No vaccines in history have been developed as rapidly as this. The scientific community has set a new standard for vaccine development. Now the international community must set a new standard for access. The urgency with which vaccines have been developed must be matched by the same urgency to distribute them fairly. Every government rightly wants to do everything it can to protect its people but there is now a real risk that the poorest and most vulnerable people will be trampled in the stampede for vaccines. That's why in April with support from multiple partners WHO established the Access to COVID-19 Tools Accelerator. The ACT Accelerator has supported the fastest, most co-ordinated and successful global effort in history to develop vaccines, diagnostics and therapeutics. More than 50 diagnostic tests are being evaluated and new rapid antigen diagnostics are being made available for low and middle-income countries. Life-saving dexamethasone treatments are being rolled out and new medicines including monoclonal antibodies are being tested. 187 countries are now participating in the COVAX facility to collaborate on the procurement and roll-out of vaccines, ensuring the best possible prices, volumes and timing for all countries. Importantly COVAX is also analysing and supporting the systems for delivering vaccines and other COVID-19 tools which have been mapped in four regions and we're rolling out other tools like the WHO Academy's new augmented reality course for health workers on the correct use of personal protective equipment. However only a fundamental change in funding and approach will realise the full promise of the ACT Accelerator. US$4.3 billion is needed immediately to support the mass procurement and delivery of vaccines, tests and treatments. A further US$23.8 billion will be needed next year. 00:05:01 This isn't charity. It is the fastest and smartest way to end the pandemic and drive the global economic recovery. The International Monetary Fund estimates that if medical solutions can be made available faster and more widely it could lead to a cumulative increase in global income of almost US$9 trillion by the end of 2025. The real question is not whether the world can afford to share vaccines and other tools. It's whether it can afford not to. At the G20 leaders' summit on Saturday it was very encouraging to hear world leaders expressing their support for WHO and their commitment to the ACT Accelerator. Thank you. In September WHO established a facilitation council for the ACT Accelerator to leverage high-level political commitment to put the tools to defeat COVID-19 in the hands of the people who need them most. Today we're honoured to be joined by the two co-chairs of the ACT Accelerator facilitation council, His Excellency, Dag-Inge Ulstein, Minister of International Development of Norway - takk sa mye, takk skal du ha - and Dr Zweli Mkhize, Minister of Health of South Africa. 00:06:44 Minister Dag-Inge Ulstein, welcome and you have the floor. Takk skal du ha again. DIU Thank you so much and good evening, Dr Tedros. By the time I have presented my speech today many people will have received a positive COVID-19 test. Others will have been told that their loved ones did not make it. As of today there are more than 55.5 million confirmed cases, more than one million deaths. Every second matters. This pandemic is not going away if we sit still and do nothing. Moreover it is not going away if some countries are only taking a my-nation-first approach. Such vaccine nationalism is not only morally reprehensible, it is also a stupid thing to do because, as already heard many times, we are not safe until we are all safe. Our economies will continue to bleed money if countries with a large number of cases lack in obtaining the vaccine and other medicines. We are in this together and the solution is only achievable if we work as one team and, yes, time is running out. 00:08:06 This is not only a health crisis. It is an economic crisis, it is a nutrition crisis, it is a protection crisis, it is a humanitarian crisis. I could have gone on and on and on. The real-world ramifications of the pandemic are all too clear to see. Every day jobs are being lost. The ILO estimates that 495 million full-time jobs will be lost in the second half of 2020. Every day people are being pushed into extreme poverty. The World Bank estimates that this could be the case for an overwhelming 150 million people, 150. Every day children around the world are sitting at home as their schools are closed in an attempt to contain the global pandemic. This has taken 1.6 billion students out of classrooms around the globe. For millions of girls and young women, particularly those in the world's least-developed countries school shutdowns bring other risks such as domestic violence and sexual abuse. This pandemic affects us all but it does not affect us all equally. UN Chief Antonio Guterres warns that the impacts of the COVID-19 pandemic are falling disproportionately on the most vulnerable; people living in poverty, the working poor, women and children, persons with disabilities and other marginalised groups. 00:09:39 This is easy to forget as we are all faced with COVID fatigue. So now is not a time to feel sorry for movie time lost, parties not attended or dinner parties postponed. We owe the most vulnerable that we do whatever we can to end this pandemic. The human costs of not acting are obvious. So are the economic consequences. We heard some of the numbers. The IMF foresees $11 trillion will be lost in GDP in 2021. Behind these forecasts lie businesses, jobs, local communities, families and individuals. As economies bleed money futures are stolen and the occasional opportunities lost. Mental health issues are rising. The sooner we get the pandemic under control the sooner we can reopen societies and get the global economy back on track. To stop the pandemic we need to ensure that effective diagnostics, therapeutic drugs and vaccines are not only developed. To stop the pandemic we need to ensure these tools are distributed to people around the world. If we are to succeed in this we need to engage with civil society, humanitarian organisations and the private sector and, yes, there is hope. We have tests that provide results in less than 30 minutes now. 00:11:06 We have better knowledge of how to treat the disease. We have a wide portfolio of vaccine candidates on the cusp of finalising phase three trials. We need to make sure that we do not end up with having these tools but not the infrastructure to make them available to all. Fortunately there is a clear path forward and that is the Access to COVID-19 Tools Accelerator, ACT A. This initiative was set up to promote equitable global coverage of vaccines, tests and treatments and strengthen the health systems. In just six months ACT Accelerator partners have compiled the world's largest portfolio of these tools. To continue rolling out rapid testing, evaluating new treatments and ensuring access to vaccines as soon as they are licensed the ACT Accelerator urgently needs 4.3 billion and a further 23.9 billion in 2021. So we have a problem; we have a solution; now we only need to make it work. 00:12:19 I would argue that this is a no-brainer for the world leaders. $23.9 billion sounds a lot yet the total need is less than 0.1% of global GDP. In other words if G20 countries were to devote just 1% of their current stimulus spending on the efforts to alleviate the economic consequences of the pandemic globally they would actually more than cover the needs of the ACT Accelerator. I would argue that this is a small price to pay to get the world back on track. Once full travel and trade are restored that investment would be repaid in as little as 36 hours. I think we all know that the cost of inaction far outweighs the cost of action so this is the best business case ever and it is the only way. There is no plan B so each dollar, pound, euro, yuan and yen spent on the accelerator is underwriting future demands for goods and services so that global trade and growth can bounce back. In a letter sent last week from South Africa, Norway, the European Commission and WHO we called on the G20 countries to consider support to the global COVID-19 response as part of their domestic stimulus spending and to contribute substantial amounts to fully fund the ACT Accelerator. 00:13:50 As the G20 summit in Saudi Arabia closes I think we can say that we are being hurt. The 20 biggest economies vote [?] to spare no effort to supply COVID-19 drugs, tests and vaccines to all people. Yes, we still have a long way to go and the pledging marathon will continue. However I think the recent news about coronavirus vaccines and the strong support from the G20 meeting addressing the need for solidarity and multilateral co-operation makes me truly believe that we can allow optimism to fuel our next steps. Yet only a fundamental change in funding and approach will turn new hope of technological achievements into an effective weapon against the virus and allow us to change the course of the pandemic. I trust that every world leader will see that this problem is not solvable if we don't collaborate. The cost of inaction and the human consequences of prolonging this pandemic should be incentive enough. So to end, it's amazing what we have actually achieved so far. Despite many ongoing conflicts in the world, despite difficult topics all countries are somehow united in this. Yes, when it comes to the ACT Accelerator we are still sitting around the same table yet we come to the table with different perspectives and different needs. 00:15:21 But so far everyone has been willing to listen, to stretch to try to understand and meet each other because we understand how closely interwoven our countries and people actually are. The ultimate goal becomes so much more important than just launching the best and right solution for ourselves. With that said, back to you, Dr Tedros. Thank you. TAG Thank you. Thank you so much, Minister Ulstein, for your support and commitment. As you said, I fully agree; the best case ever and it has to be supported. Thank you so much again. It's now my great honour to introduce Dr Zweli Mkhize, Minister of Health of South Africa. Your Excellency, welcome and you have the floor. Thank you so much for your support also. Thank you. ZM Thank you very much, Dr Tedros, the Director-General of the WHO and all the members of the WHO team, my colleague, the Co-Chairperson, Minister Dag-Inge Ulstein. Thank you very much for the opportunity to be part of this very special occasion, this briefing. If there was ever a case for solidarity and global co-operation this COVID pandemic has demonstrated why. 00:16:48 The crisis is hitting the world hard and our most fragile regions harder, affecting income, health, education and other parts of our socio-economic lives. COVID-19 does not respect national boundaries and as long as it exists anywhere it is a threat everywhere. No-one is safe until everyone is safe. Global solidarity isn't just the right thing to do; it's the smartest thing to do. Ensuring that tools are allocated equitably, not based on income but based on universal protection against COVID-19 is the fastest and most effective way to defeat the pandemic and get our lives and our economies back to normal again. We must treat Access to COVID-19 Tools as a global public health initiative. Collective efforts to stamp out the virus now would also mean that future deadlier strains or mutations that are more difficult to treat could be avoided. It is clear that every country will need to play a part in financing an end to this crisis and every leader has a political choice to make. 00:18:04 But the lack of adequate financing for our global exit strategy, the ACT Accelerator, is an existential threat to the economic and health security of all countries and their citizens. Speaking from the perspective of the African continent it has now recorded over two million cases with 49,000 deaths, which accounts for 2.5% of the global caseload. There are signs of resurgence in 18 countries which is 38%. More than 20% increase is recorded in the numbers in the last seven days when compared to the previous seven days. It's also not certain how a resurgence on the African continent will evolve and therefore any equal access to vaccines and therapeutics will be critically mitigating the threat posed by the resurgence on the continent. As part of these preparations President Ramaphosa, His Excellency, Chair of the African Union established a COVID-19 African vaccine acquisition task team to lead this effort. In addition to equitable access to COVID-19 tools we also need to pay attention to the strengthening of health systems. The ACT Accelerator offers a clear way forward for ending the crisis through global co-operation that will deliver. All countries need to end the acute phase of the pandemic, restoring economic vitality and averting catastrophe. 00:19:43 Whilst the pace of scientific research and development into effective vaccine therapeutics and diagnostics is unprecedented its true value will only be realised if countries can access these tools and are prepared for their use. Every country has work to do to ensure that once ready these tools can be rapidly deployed. This includes ensuring that capacities and infrastructure that need to be rapidly scaled or upgraded to deploy COVID-19 tools are ready and working. Bottlenecks in key areas of health systems such as data, workforce, clinical care, supply chains as well as access to key commodities such as PPEs and oxygen remain limiting factors to effective deployment and use of COVID-19 tools in many countries. The health system connect, a pillar of the ACT Accelerator, is a critical mechanism to support countries to bolster and strengthen through a tailored approach that uses global knowledge to address local problems. 00:20:50 Countries' readiness is an absolute prerequisite to the equitable scale-up of the COVID-19 tools. It is a hurdle we must clear if we are to win this race and this is one time when we all need each other and every country matters and therefore we need to make sure that we focus on more and more partnership, solidarity and global co-operation. Thank you very much, Dr Tedros, for inviting us. Thank you. TAG Thank you. Thank you very much, Minister Mkhize, for your support and commitment and I look forward to working with both of you in this very critical period to realise the promise of the ACT Accelerator. Thank you so much again and I hope you will stay with us for a few more minutes to answer questions from the media if we have them. With that, back to you, Margaret. MH Thank you very much, Dr Tedros. Yes, we will now open the floor for questions. I probably don't need to remind you you need to use the raise your hand icon to get in the queue. We already have a large number of you in the queue so I ask that you restrict yourselves to one question. Remember we also have our experts on the line and in the room so indicate clearly what your question is. 00:22:22 We have limited time so please keep your questions short. I will stop talking now and give you a chance to ask your question. The first one goes to Corinne from Bloomberg. Corinne, could you unmute yourself and please ask your question. CO Hi, thanks for taking my question. It'd be great to get your take on the AstraZeneca vaccine results, especially since it said that they're going to try to get a quick recommendation from the WHO and it seems the results are not that straightforward. MH That question, I think, will go to Dr Soumya Swaminathan. Dr Soumya, are you on the line? SS Yes, I am, Margaret. Thank you for that question. First of all I'm sure the person who asked the question, like all of us, is very encouraged by the news that we got today with the preliminary results that have been released from the clinical trial of the AstraZeneca vaccine, following on from the encouraging results from the two earlier vaccine, the Pfizer and the Moderna, both of which are MRNA vaccines, the AstraZeneca vaccine being a viral vector vaccine. 00:23:42 So I think the good news is that vaccines for COVID-19 are possible to make and it's possible that we will have a number of different vaccine candidates that can be used in the fight against this disease. As we're discussing the ACT Accelerator today I think this I very relevant because we would like to provide access to as many efficacious and safe vaccines as possible so we can cover the population around the world. Remember we have to cover a huge number of people, billions and billions of people. This is unprecedented and we will need all the manufacturing capacity in the world to be able to do that. On the AstraZeneca results themselves we've heard only the preliminary results about the vaccine trials that were done in the UK and Brazil looking at two slightly different dosing schedules. The schedule that had the same dose given two times had a slightly lower efficacy but still it was about 62%, which is above the benchmark that we had set but the schedule which gave a smaller dose followed by a larger dose; the efficacy seems to have been higher, up to 90%. 00:25:01 But again this is based on rather small numbers and I think we need to wait to see the results both of the efficacy and the safety. The AstraZeneca vaccine is also being currently trialled in many other countries and eventually we should have data in about 60,000 patients or so. That will enable us to take a much more informed decision. So we await discussions with the company and they're already talking with our pre-qualification programme on how they will go about it and Dr Simao's available to answer more questions on that. Thanks. MH Thank you, Dr Swaminathan. Over to Dr Simao for some added points. MS Thank you very much, Margaret, and thank you, Corinne, for the question. Actually we have already had several discussions with AstraZeneca following the expression of interest WHO issued for the emergency use listing and pre-qualification of the vaccines so we are very hopeful and we are about to receive more clinical data in the next week. 00:26:13 We are also aware that AstraZeneca is also submitting the dossiers to the European Medicines Agency and we do have very close collaboration. There are actually eight sites; some of them are manufacturing sites so we will be analysing this data very carefully but very much welcome the results so far. We expect that we should finalise the assessment in the beginning of next year. Thank you. SS If I could just add, Margaret; I forgot to mention the advantage of this vaccine is that it can be stored at ordinary refrigerator temperatures of two to eight degrees and is stable at that temperature. That of course has huge logistical advantages for transporting and delivering this vaccine to cities, towns, villages and rural areas around the world. We hope there will be more vaccines like that which are more heat-stable and we have to also continue to encourage all the other developers who are doing clinical trials and who are in early phases of development because we do need a variety of vaccines out there that will target different groups better, that will have different storage conditions. Also the issue of affordability is important to keep in mind. Thanks. MH Thank you, Dr Swaminathan and Dr Simao. There do not seem to be any comments in the room so I will take the next question from Gunila, the Geneva correspondent for Swedish media. Gunila, please unmute yourself and go ahead. 00:28:05 GU Can you hear me? MH Yes. Please go ahead. GU Thanks for taking my question. It is very promising that a vaccine candidate is coming but first we have Christmas and Christmas is now about one month away. Countries have started to give advice; in the UK they said we can have an exception of three households celebrating Christmas together, which could be a lot of people. In Sweden meanwhile the Prime Minister yesterday said there should be one family staying inside for the time being. I'm wondering, would you be able to give advice, recommendations for how countries should deal with celebrations around Christmas, especially in Europe, which now still have a very high community transmission? 00:28:57 MR I can start. Maria will follow up. I think first of all it's important that we separate the science of COVID-19 from what are the policies that surround that science because governments have to make choices and they have to decide on the local epidemiology of the disease, they have to decide what the tolerance level of the population has been, how long people have been in lock-down or not in lock-down, what level of control they have, how strong their public health architecture has become over the last number of weeks, have they expanded their capacity to test, trace, quarantine and isolate those people who are actually sick or carrying the virus. are they able to protect vulnerable populations. So the decisions to ease restrictions coming towards a holiday period - and there are many countries heading towards holiday periods; we've seen the most recent holiday period in Canada, their Thanksgiving; they did see an increase in transmission after that period because people come together, they mix, they travel. It's inevitable that in the presence of community transmission if you further release the opportunity for the virus it will find opportunities to transmit. But there is the trade-off, the economic and social trade-off in that so I think it's really important that we're not trying to bend science in this. The science is straightforward. If there is significant community transmission in your country and you don't have the necessary public health architecture to track and trace and isolate and quarantine contacts then further opening up will result in increased transmission. 00:30:39 There's no question of that. The question is, have you got the disease under enough control to start with and can you in a sense allow people a little bit more freedom over the Christmas period, which generates a sense of confidence and a sense of joy in the community, which people need right now, without letting the virus let rip again within our communities? This is a very important trade-off and it's a trade-off between those two issues. The science is clear. The policy is what's not clear and each government will have to decide on its policy based on those trade-offs between the epidemiologic risk versus and economic and social risk of continuing to have people in a restricted situation over a holiday period, which will generate genuinely a lot of frustration, further fatigue and a lot of push-back. 00:31:34 Maria may comment on the technical aspects of this but I certainly hope that we're not going to enter into a period where we're trying to come up with a formula which says, this is how much you can open up and this is how many days of Christmas we have by some scientific formula that says, this is safe and this is not safe. There is no safe or unsafe decision. There is only higher and lower risk of the situation getting better or worse depending on what you do. MK Thanks, Mike. Yes, I think the point is that there's no zero risk here right now. We are in the middle of a pandemic and many countries unfortunately are in a very difficult situation with increasing case numbers, with hospitals full and with ICUs full. As Mike has said, there's lower risk or higher risk but there is risk. This virus needs us, it needs people to spread between and if we allow it to we could be that individual that brings that virus into someone's home. What we have outlined to support countries in making those policies is a risk-based approach in terms of what is the situation in the areas where you live, where people need to travel from, where they need to travel to. 00:32:46 You as individuals need to take decisions about, how will I celebrate these holidays that are coming up, that have happened, am I going to be visiting a family that has vulnerable individuals that live in that family and what is the possibility that I could potentially bring that virus into that home where someone who lives there has a higher risk of developing severe disease and a higher risk of dying. So there are a lot of things that we outlined; who will you be visiting, what will that situation look like, can you have that holiday indoors or outdoors, how crowded will it be? There are ways in which you can reduce the risk but there is no zero risk unfortunately in this situation. I do think I agree with Mike and all of you who understand that this is incredibly difficult because especially during holidays, especially during birthdays, especially during these family celebrations we really want to be with family. 00:33:43 But in some situations the difficult decision not to have that family gathering is the safest bet so everyone will need to take that decision based on your current situation, based on your family, based on where you need to travel. We hope everyone will have happy holidays and find ways to connect. Fortunately many people around the world have access to the ability to connect virtually and I think that that may be the way that many areas need to go. But I do want to say that even if you can't celebrate together this year you can find ways to celebrate when this is all over. We are doing that within our own family. We are going to have one heck of a celebration when this is all over regardless of when that is and that is something that helps personally myself and my family get through because we know that eventually we'll be able to celebrate with our loved ones. MH Thank you very much, Dr Van Kerkhove. The next question goes to Nina Larson of AFP. Nina, could you unmute yourself and please go ahead. NI Hi, can you hear me? MH Yes, Nina. Please go ahead. 00:34:56 NI Thank you for taking my question. I understand that you've held a briefing for diplomats on the progress on the independent international investigation into the origins of COVID-19 and that some concerns were raised about the lack of transparency in negotiating the terms of reference for the mission and also over the amount of time it's taking to send a team to China. I was hoping you could provide us with more information on the terms of the agreement with Beijing and also say when you expect them to go to China. It would be good to know who's on the list or how many people are on the list. Thank you. MK Thanks for the question. I can start and maybe Mike would like to supplement. We have actually released the terms of reference for the mission online. We have also released the names of those who are on the international mission online and so that is completely transparent for you to see. As you know, we sent a pre-team of WHO staff to China over the summer to discuss with counterparts the nature in which the studies needed to take place. We've outlined phase-one and phase-two studies. It's all in the terms of reference and you can see that; where those initial phase-one studies need to take place in Wuhan, looking at the earliest cases that were reported and identified in Wuhan, looking at the epidemiologic studies that were done. There're a number of studies that are underway that need to be conducted by Chinese counterparts. 00:36:30 The international team has met and is meeting with Chinese counterparts to see how that could be supported through global collaborations. This is very technical and very science-oriented and very research-oriented because there are many, many studies that need to be undertaken. The international team will travel to China. That is being discussed amongst the international team and the Chinese counterparts and that will be arranged in due time. MR Just to add, certainly with regard to the mission briefings - and remember, we have weekly briefings with our member states at mission briefings and are engaged in very open and transparent dialogue with our member states every single week and we discuss every issue from vaccines to the ACT Accelerator last week, to the animal/human origin studies all the way through to surveillance, to contact tracing. 00:37:33 We have the member states presenting on their own case studies, on their own experience. We exchange that information and the DG has led from the front in engaging directly with our member states on a weekly basis on all matters of importance. On the issues of the progress with the animal studies in fact quite the opposite; the member states who spoke - and there were many - all expressed appreciation for the progress that was being made, for the terms of reference and asked obviously for further progress to be made in the phase one and two. We explained to our member states the content of the phase-one studies and the hopes for phase-two. One member state did express some concerns regarding the phase-one studies and ensuring that they were completed as quickly as possible. We reassured that member state that that would happen and again we did release to the member states the names of the international team members. 00:38:33 Again the international team has been brought together. We were in the process of finalising the legal documentation to be members of this group and as soon as we have been able to confirm all of that we will put the names of the team up on the list. I must also express, the international team themselves have expressed their own concerns. There has been a level of attack and abuse to people involved in international science. It is not an easy space to be in right now; let me be plain about that. We have all received our fair share of hate mail and threats and everything else right through this process and it is important that we as an organisation protect the space of science and protect those scientists. We would like to thank them for their openness and transparency and for allowing us to release their names. That's not an easy choice when you're trying to do your best for your own system and for the international system so we thank them not only for their scientific leadership but for their courage in doing that and it's a strange thing to have to say in this world today that it takes courage to be a scientist. I used to think it only took brains but now you need to be brave and courageous as well to do science in the face of the anti-science movements that we see and the ideologic politics that has come into this process. 00:39:54 We're very, very pleased with the reaction of our member states. We're particularly encouraged by the way in which so many countries are supporting everything that we're trying to do. Imperfectly as we do it, our member states recognise the massive effort that this secretariat is making with our collaborating centres and scientific partners to fight this pandemic. We look forward to making progress on the animal/human origin studies and again I made it very clear at that briefing that we are pushing for co-operation from all countries and especially from our colleagues in China who have identified a very strong Chinese scientific team and we're working very closely with that. We expect openness and transparency from all our member states when it comes to scientific collaboration and we trust we will continue to receive that from our scientific colleagues in China. 00:40:49 MH Thank you very much, Dr Ryan and Dr Van Kerkhove. The next question will go to Michael from CNN. Michael, please unmute yourself and go ahead. MI Thank you for taking my question. Can you hear me? MH Yes. Please go ahead. MI As a follow-up to the last question, it's hard to believe but we're almost at a year from when case zero or the index case for coronavirus was identified. However all we seem to know according to state documents reported on by the South China Morning Post is that it was a 55-year-old male but he can't be identified or no-one can trace him. How important is it in your investigation to find the origins of the coronavirus who case zero or the index case was? Just quickly also the wet market where the virus is believed to have originated; that's been cleaned up and closed off. How will that be an impediment to your investigation? Thank you. MR We could end up in a lot of detail. Your questions are well asked. Identifying case zero is a very important aspect of all epidemic investigations. There may be more than one case zero in some situations because there may be more than one species breach. 00:42:15 We're increasingly seeing that SARS-CoV-like viruses have been identified in many different countries; in fact in horseshoe bats most recently in the last few days. We've seen other potential intermediate hosts identified in various settings so there's no question that this virus has an actual home, probably somewhere in the bat community; some intermediate hosts who we haven't fully identified yet. How that disease then breached that barrier into the human species may have been a single event, it may have been multiple events. Those events may have occurred in one particular time or over a range of different times because if the virus is present in the animal kingdom or in wild animals then the chances of multiple introductions - and we've seen that; for example if you look at the recent human-to-mink and mink-to-human. We've seen multiple reintroductions into the human population from the mink population; it wasn't just one exposure back. The natural history of these things is at least one case zero, probably more. 00:43:19 The DG has always said and was very, very strong on this from the very beginning; we need to start where we found the first cases and that is in Wuhan in China and then we need to follow the evidence after that wherever that leads. With regard to the Wuhan seafood market, in fact one of the interesting findings is while there was most certainly a temporal and geographic cluster associated with the market not all of the cases in that initial cluster can be linked directly to the market. So the market is likely to have been a point of amplification. As we've seen for example in the event in Shanghai [?], we had a similar event. We don't know whether it was a human that drove the amplification event at the Wuhan market; was it animal; was it environmental contamination; we don't know that. But certainly it's clear that there were cases that preceded that event at the Wuhan market so the real question is, the original species barrier breach; where did that occur? That is still unknown and it is extremely important and the terms of reference for the investigation clearly lay out in phase one the necessary epidemiologic and clinical and serologic and retrospective studies that need to be done to establish whether or not there's any evidence trail that will lead back. 00:44:43 It is remarkably difficult. It is like looking for a needle in a haystack sometimes for an individual event, to look for that single event. I've been doing that in Ebola for the last 25 years and we've never hit the mark except on one occasion where we could actually identify the actual event where the disease crossed the species barrier. So this is not easy to achieve. We will pursue those investigations over the next couple of months in phase one and hopefully move on to phase two. I think, Maria, there was a second part if you want to come in, on the markets. I think it's important. MK Yes, as Mike has said, there are a lot of studies that need to be underway to find the initial case wherever they may be and look at the conditions in which they were infected so this case zero that you mentioned may not be in fact case zero. There could have been other cases that existed that weren't detected because they weren't picked up through a current surveillance system. 00:45:45 That's not a criticism; that's just a possible fact, that we need to look back, we need to look retrospectively to see what happened. The amplification event at the market in Wuhan certainly is what triggered more transmission and the conditions by which that happened are the focus of some study as well, looking at the animals that were there, that were sourced at that market, where those animals came from, where those animals were sold onward, looking at environmental samples that were collected there. There were a number of environmental samples that were collected in that initial market from animals but also from surfaces around different parts of the market and those results the Chinese colleagues have presented to the international team so there are some results from there. But all of these are clues, if you will, that help lead to the next question. As far as any answers that we get from any studies, they lead to a number of additional studies so as Mike has just said and as the DG has outlined, we follow the science. We're also working with a large number of people across the world looking at retrospective analyses in different countries. 00:46:56 You've heard of studies of waste water, studies that have looked at samples from 2019. We're working with our seroepi networks on looking at stored clinical samples and sera from 2019 to see if any of those test positive but all of these really help us to piece together how this unfolded. Just to point out, for MERS coronavirus it took us almost a year to find the intermediate host for the MERS coronavirus which is the dromedary camel, the one-humped camels. Those came from detailed epidemiologic investigations at the animal/human interface with people who were caring for camels, testing the animals, testing the camels, looking at sequences and being able to match and see that there was transmission that had happened between the humans and the camels. It does take time and we know everyone is really anxious to get these answers and those studies are underway. We need the science to unfold, we need those studies to be done carefully and thoughtfully and thoroughly and we will be there across the world with our international partners to support that every step of the way. 00:48:03 MR Can I just add to be clear again on the journalist's question, we fully expect that we will have a team on the ground. We need to be able to have the international team join our Chinese colleagues and go onto the ground and look at the results and the outcomes of those phase-one studies and verify these data on the ground. This is extremely important and we are continuing to expect that that be the case and we would like to have that team deployed as soon as possible. So we're building the relationship between the Chinese counterparts and the international team. We have regular Zoom calls between the two groups and we fully expect and have reassurances from our Chinese Government colleagues that the trip to the field part of the mission will be facilitated and as soon as possible in order that the international community can be reassured of the quality of the science. Again the Chinese colleagues have done a tremendous amount of scientific investigation and in fact, I think, have published hundreds and hundreds of papers regarding the situation in China and the learnings they have done. 00:49:10 But clearly we all need to understand the origin of the virus, we all need to understand where it has come from, not least to understand where it may re-emerge in the future and I believe our Chinese colleagues are just as anxious to find those answers as we are. MH Thank you very much, Dr Ryan and Dr Van Kerkhove. The next question goes to Emilio Divinito from El Pais. Emilio, please unmute yourself and ask your question. EM Hello. Good afternoon. I'm going to make it a very short question but is it true? We've heard Dr Tedros and Mr Ulstein talking about how important it is to make sure that the poor countries are going to receive their share of the new developments; I'm thinking about the vaccines. I want to ask them how realistic it is to think that they are going to receive them on time or are they going to be the last ones in the queue. I'm thinking now that we know the plans for Spain or in Germany and in other countries, the plans that they have to vaccinate their own people where they have to prioritise amongst the populations. 00:50:32 So I don't know if it's realistic to think that these countries are going to give part of the vaccines... so how are you going to do it, make sure that the poor ones are going to receive their share? Thank you. MH Thank you. Our Minsters, our guests would like to respond to that question. DIU Thank you so much. Thank you for that question. I think this is the most important thing because it's not enough to develop vaccines. It's all about the last lap and that is why my colleague from South Africa and I have been so clear on our mission also. It's about creating equitable access for all and to make sure that vulnerable groups and critical health workers in all countries... I know that it's very much in Dr Tedros' heart and mind also because we really need to make sure that the logistics, that the infrastructure that we have, shared knowledge and trained enough healthcare workers in all countries to make sure that it's possible actually to roll out and to use those tests and to make sure that the medicine will be available and that we make sure that the infrastructure for the vaccines is in place. 00:51:58 So it will not be easy, it will be really, really difficult and that's why I am so clear that we need to first make sure that the finance gap, not only the urgent gap of 2020 but we make sure that we mobilise as much money as possible also for the gap in 2021 right now because this will not be easy, it will be really, really difficult. So we need to make sure that we use the momentum and that will not be easy but we will do whatever it takes to make sure that we will have fair and equitable access to all. That's why we also wrote the letter to G20 countries and I really hope we will have some substantial answers with new, fresh money also into the portfolio. But over to my colleague. ZM Thank you very much, Minister. I think we all agree that the approach has to be that of equitable access and the issue has to be that there should be no-one left behind in each country that requires to be assisted does get assisted. On that basis we believe that some of the discussions on the COVAX facility will take us to a point where there is a way of being able to assist those who can't fund themselves to get the basic [inaudible] to start and then the support, to be assisted as well. 00:53:29 So the general message that we're all sending across basically says that we need to focus on the... Everyone needs to be safe on the basis of having some access to a vaccine. Then of course the more vulnerable would need to be targeted first so that with time as the volumes start to increase we're able to reach out to members of society right across. But it would be quite risky to have one side covered because they can afford it and then some other member states not covered simply because they cannot afford it. That still creates a risk of a resurgence of the pandemic. So our approach is more or less the same. TAG Yes, I think the Ministers have said it very well. Maybe to stress, I think there are three important issues here. One is the political commitment to share and second is the financing. Third is preparing the infrastructure of countries. On the political commitment and financing, as the Ministers said, we have brought it to the attention of the G20 and hopefully others outside the G20 will also give their political support and also, we hope, will give their financial support. 00:55:09 It won't be easy, it's going to be tough but at the same time we have now the facilitation council and the facilitation council is chaired by Norway and South Africa. Its objective is to make sure that the political commitment and also the financing is ensured. On the third, preparing infrastructure, the World Bank, UNICEF, WHO, Global Fund have already sent a letter to our country offices to work with countries to prepare the infrastructure for vaccination, to identify gaps and fix and prepare it. That will include training of health workers and so on. All agencies relevant for this are also working on preparing the countries and that's very important, the preparation of countries. One country which we have seen really very advanced is Ecuador in terms of preparing for vaccination. I had the opportunity to speak to the Health Minister and the Foreign Minister last week and they have a very good model. 00:56:30 I think identifying best practices of countries and sharing it with countries to use will be very important. Thank you. MH Thank you so much, Dr Tedros and Honourable Ministers. We're really coming up to the hour but we're going to take one last question from Morocco and that is from Abdullah Hussan from Morocco News. Abdullah, could you unmute yourself and go ahead. I think you may be asking in Arabic. TR Yes, I have a question. Those vaccines that have been readied, that are being prepared; are they effective? Will they be provided to African countries, especially those which come from Pfizer and Sanofi? Thank you very much. MR I think the question is about vaccines. Alaikum-salaam to you. I think Soumya can come in. You asked the question whether the vaccines are effective. I think three of the vaccines have clearly demonstrated efficacy in the trials so far. That data is being put forward to various regulatory authorities over this week and next week and probably in the coming weeks and certainly that data, we hope, will also be provided directly to WHO so WHO can make decisions about emergency use listings and other things. 00:58:28 The question you have regarding providing of vaccine to Africa; I think that is really what the COVAX initiative is about; ensuring that an initiative covers 80% of the world's population and the vast majority of the population of Africa. I don't know if Bruce is online but if he is he can speak to just how many countries in Africa are actually signed up to the COVAX initiative which actually, I think, covers the vast majority of countries on the continent. Bruce. MH Dr Aylward, go ahead. BA Hi, Mike, and greetings, all. I think it's been covered already. The majority of countries on the African continent are signed up to the COVAX facility. It's actually over 45 countries now on the African continent that have actually joined and the remainder are still considering. There're issues, fiduciary and others, that need to be considered but clearly people see this as the key, as Minister Ulstein and Minister Mkhize said; the COVAX facility is key to the equitable allocation of vaccine globally and to ensuring that all countries get some product rather than some countries all product. This is absolutely crucial to getting the world out of the economic/societal health crisis that it's in today. 00:59:51 To the specific question that was asked, yes, it is absolutely possible to see an equitable allocation. This is a function, as Minister Ulstein and Minister Mkhize said, of political choices with respect to financing and to the timing and use of products. But increasingly there's very, very clear recognition globally that this is the best possible way out of this crisis. MS Can I complement? Just to say, as we heard before when the question came about AstraZeneca, it's very important that we have different vaccines and different platforms being developed because some of them, like the Pfizer vaccine, need an ultra-cold chain which brings logistic problems. There are not only challenges for countries in Africa; there are challenges for all low and middle-income countries and some of the high-income countries as well. So we see the portfolio including the other vaccines beyond the MRNA vaccines like Pfizer and Moderna as a very good point ahead in ensuring that there will be access to alternatives as the platforms are easier to use at country level. That's, in a nutshell, how we are seeing it. 01:01:19 It's very important to ensure equitable access but we need to take into account also the characteristics of each vaccine and the [unclear] environment that will make the availability at country level more challenging. Thank you. MH Thank you, Dr Simao. I'd like to ask the Minister for Health from South Africa, Dr Mkhize, if he would like to add something. ZM Yes, thank you very much. I think, following on the response that has been given, just to bring to the attention of the person that asked the question that from the African Union's perspective there's been a task team that's been set to help to co-ordinate the access to vaccine together with the member states, also working together with the COVAX facility, GAVI and the other partners. In this process the African Centre for Disease Control is the one that's at the centre, co-ordinating, looking at the numbers, the needs and so on so that in addition to whatever the WHO and all the other players are doing there is adequate support from the African Union member states. 01:02:42 This is building on the work that was done during the difficult days of the early COVID pandemic where the assistance, the support, the donations, the needs, the new tools for acquisition had to be co-ordinated through the Africa CDC. So they have actually engaged a number of manufacturers and they've engaged COVAX just to be able to understand so that everything is aligned. I think the key issue is also to say, we need to look beyond the point of the public's process in terms of what else needs to be done to reach out to the largest numbers of people who still need to be assisted. So there's quite a bit of work that's being done at that level and certainly we don't believe that the African continent, the member states will actually be left behind so there is lots of work being done at that level. Thank you very much. MH Thank you so much, Minister, and thank you very much to all journalists who joined. Your questions were excellent today. We really appreciate it. We have to finish here now but I'll hand over to Dr Tedros for a few more words. 01:03:54 TAG Yes, thank you. I think they always ask excellent questions. This Wednesday marks the International Day for the Elimination of Violence Against Women. Around the world nearly one in three women have experienced physical or sexual violence, mostly by intimate partners. As countries have implemented stay-at-home orders and other measures to prevent transmission of COVID-19 reports from women experiencing violence at home have increased. At the same time services for survivors have been disrupted. Violence against women is never acceptable. We're calling on governments to include services for women affected by violence in every country's package of essential health services and to allocate the resources to make them accessible. We're calling on health providers to pay more attention to identifying women who experience violence and provide first-line support and we're calling on everyone to show their solidarity with women affected by violence by raising their voices and by wearing something Orange this Wednesday - the day after tomorrow - as a symbol of solidarity and hope. Thank you and see you on Friday. I would like again to thank Minister Mkhize and Minister Ulstein for joining today and also for your leadership of the facilitation council of the ACT Accelerator. Thank you, Norway. Thank you, South Africa. 01:05:42


Asunto(s)
Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control , Pandemias/prevención & control , Betacoronavirus/inmunología , Vacunas Virales/provisión & distribución , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias , Sistemas de Salud/organización & administración , Recursos Financieros en Salud/economía , 50207 , Américas/epidemiología , Vacaciones y Feriados , Monitoreo Epidemiológico , Aislamiento Social , Máscaras
7.
Artículo en Inglés | MEDLINE | ID: mdl-31847380

RESUMEN

Environmental injustice, characterized by lower socioeconomic status (SES) persons being subjected to higher air pollution concentrations, was explored among pregnant women in Scania, Sweden. Understanding if the general reduction of air pollution recorded is enjoyed by all SES groups could illuminate existing inequalities and inform policy development. "Maternal Air Pollution in Southern Sweden", an epidemiological database, contains data for 48,777 pregnancies in Scanian hospital catchment areas and includes births from 1999-2009. SES predictors considered included education level, household disposable income, and birth country. A Gaussian dispersion model was used to model women's average NOX and PM2.5 exposure at home residence over the pregnancy period. Total concentrations were dichotomized into emission levels below/above respective Swedish Environmental Protection Agency (EPA) Clean Air objectives. The data were analyzed using binary logistic regression. A sensitivity analysis facilitated the investigation of associations' variation over time. Lower-SES women born outside Sweden were disproportionately exposed to higher pollutant concentrations. Odds of exposure to NOX above Swedish EPA objectives reduced over time, especially for low-SES persons. Environmental injustice exists in Scania, but it lessened with declining overall air pollution levels, implying that continued air quality improvement could help protect vulnerable populations and further reduce environmental inequalities.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Exposición Materna/estadística & datos numéricos , Mujeres Embarazadas , Clase Social , Adulto , Estudios Transversales , Exposición a Riesgos Ambientales , Femenino , Humanos , Material Particulado , Embarazo , Factores Socioeconómicos , Suecia
8.
Environ Manage ; 61(1): 103-115, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29098362

RESUMEN

Based on a framework for analyzing stakeholder coherence horizontally and vertically, the present study examined the governance of forest threats in Sweden. Opinions of forest risk governance in stakeholder groups with and without a connection to private forestry were compared (n = 2496) and the opinions were analyzed in relation to current governance practices. More specifically, forest threat appraisals, trust in the Swedish Forest Agency (SFA), and the acceptability of forest risk policy measures directed at private forest owners were assessed. Results revealed an overall coherence between different stakeholders in this context. However, the groups differed in, for example, the acceptability of the hypothetical regulative measure aiming to reduce damages threatening the forest long-term (e.g., climate change). Furthermore, an extensive use of advice for a fee may challenge particularly the internal, but also the external, legitimacy of forest risk governance. The forest owner stakeholder group showed lower threat appraisals when evaluating threat to one's own forest rather than to the Swedish forest, except regarding browsing by animals. Regulations were not disapproved of in any of the stakeholder groups, although the forest owner group generally displayed higher acceptability of encouraging measures compared to the general public. Trust in the SFA was furthermore confirmed as an important driver of policy acceptability, and higher threat appraisals of novel threats, such as climate change and fire, resulted in a higher acceptability of measures less central or new in this context. The value of analyzing stakeholder coherence for natural resource management and governance is discussed.


Asunto(s)
Conservación de los Recursos Naturales/economía , Conservación de los Recursos Naturales/métodos , Agricultura Forestal/economía , Cambio Climático , Comercio/economía , Comercio/organización & administración , Agricultura Forestal/organización & administración , Bosques , Gobierno , Humanos , Suecia
9.
Scand J Work Environ Health ; 43(6): 519-525, 2017 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-28599022

RESUMEN

Objectives National quantifications of the health burden related to traffic noise are still rare. In this study, we use disability-adjusted life-years (DALY) measure to assess the burden of disease from road traffic and railway noise in Sweden. Methods The number of DALY was assessed for annoyance, sleep disturbance, hypertension, myocardial infarction (MI) and stroke using a method previously implemented by the World Health Organization (WHO). Population exposure to noise was obtained from the Swedish Environmental Protection Agency and the Swedish Transport Administration. Data on disease occurrence were gathered from registers held by the National Board of Health and Welfare and Statistics Sweden. Disability weights (DW) and duration were based on WHO definitions. Finally, we used research-based exposure-response functions or relative risks to estimate disease attributable to noise in each exposure category. Results The number of DALY attributed to traffic noise in Sweden was estimated to be 41 033 years; 36 711 (90%) related to road traffic and 4322 (10%) related to railway traffic. The most important contributor to the disease burden was sleep disturbances, accounting for 22 218 DALY (54%), followed by annoyance, 12 090 DALY (30%), and cardiovascular diseases, 6725 DALY (16%). Conclusions Road traffic and railway noise contribute significantly to the burden of disease in Sweden each year. The total number of DALY should, however, be interpreted with caution due to limitations in data quality.


Asunto(s)
Exposición a Riesgos Ambientales/estadística & datos numéricos , Ruido del Transporte/estadística & datos numéricos , Años de Vida Ajustados por Calidad de Vida , Femenino , Humanos , Hipertensión , Masculino , Vehículos a Motor , Infarto del Miocardio , Ruido del Transporte/efectos adversos , Vías Férreas , Factores de Riesgo , Trastornos del Sueño-Vigilia , Suecia/epidemiología
10.
Waste Manag Res ; 34(12): 1292-1299, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27742875

RESUMEN

The present research studies the characterisation and the physico-chemical properties of an excavated fine fraction (<10 mm) from a Swedish landfill, the Högbytorp. The results showed that the fine fraction represents 38% by mass of the total excavated wastes and it contains mainly soil-type materials and minerals. Higher concentrations of zinc, copper, barium and chromium were found with concentrations higher than the Swedish Environmental Protection Agency (EPA) for contaminated soil. The found moisture and organic contents of the fine fraction were 23.5% and 16.6%, respectively. The analysed calorific value (1.7 MJ kg-1), the potential of CH4 (4.74 m3 t-1 dry matter) and Total Organic Carbon (TOC) (5.6%) were low and offer low potential of energy. Sieving the fine fraction further showed that 80% was smaller than 2 mm. The fine represents a major fraction at any landfill (40%-70%), therefore, characterising the properties of this fraction is essential to find the potential of reusing/recycling or safely redisposing.


Asunto(s)
Residuos Sólidos/análisis , Instalaciones de Eliminación de Residuos , Metales/análisis , Metano/biosíntesis , Tamaño de la Partícula , Plásticos , Contaminantes del Suelo/análisis , Suecia , Contaminantes Químicos del Agua/análisis , Madera
11.
Environ Sci Pollut Res Int ; 21(4): 2455-64, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24078237

RESUMEN

Bottom sediments in coastal regions have been considered the ultimate sink for a number of contaminants, e.g., toxic metals. In this current study, speciation of metals in contaminated sediments of Oskarshamn harbor in the southeast of Sweden was performed in order to evaluate metal contents and their potential mobility and bioavailability. Sediment speciation was carried out by the sequential extraction BCR procedure for As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn and the exchangeable (F1), reducible (F2), oxidizable (F3), and residual (R) fractionswere determined. The results have shown that Zn and Cd were highly associated with the exchangeable fraction (F1) with 42­58 % and 43­46 %, respectively, of their total concentrations in the mobile phase. The assessment of sediment contamination on the basis of quality guidelines established by the Swedish Environmental Protection Agency (SEPA) and the Italian Ministry of Environment (Venice protocol for dredged sediments) has shown that sediments from Oskarshamn harbor are highly contaminated with toxic metals, especially Cu, Cd, Pb, Hg, As, and Zn posing potential ecological risks. Therefore, it is of crucial importance the implementation of adequate strategies to tackle contaminated sediments in coastal regions all over the world.


Asunto(s)
Arsénico/análisis , Sedimentos Geológicos/análisis , Metales Pesados/análisis , Contaminantes Químicos del Agua/análisis , Arsénico/química , Fraccionamiento Químico , Monitoreo del Ambiente , Metales Pesados/química , Suecia , Contaminantes Químicos del Agua/química
12.
Ambio ; 42(2): 188-200, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23475655

RESUMEN

Forest landscapes provide benefits from a wide range of goods, function and intangible values. But what are different forest owner categories' profiles of economic use and non-use values? This study focuses on the complex forest ownership pattern of the River Helge å catchment including the Kristianstad Vattenrike Biosphere Reserve in southern Sweden. We made 89 telephone interviews with informants representing the four main forest owner categories. Our mapping included consumptive and non-consumptive direct use values, indirect use values, and non-use values such as natural and cultural heritage. While the value profiles of non-industrial forest land owners and municipalities included all value categories, the forest companies focused on wood production, and the Swedish Environmental Protection Agency on nature protection. We discuss the challenges of communicating different forest owners' economic value profiles among stakeholders, the need for a broader suite of forest management systems, and fora for collaborative planning.


Asunto(s)
Agricultura Forestal/economía , Propiedad , Ciudades , Conservación de los Recursos Naturales , Entrevistas como Asunto , Suecia
13.
Regul Toxicol Pharmacol ; 64(2): 329-41, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22813725

RESUMEN

The United States Environmental Protection Agency (USEPA) developed an inhalation unit risk factor (URF) of 4.3E-03 per µg/m(3) for arsenic in 1984 for excess lung cancer mortality based on epidemiological studies of workers at two smelters: the Asarco smelter in Tacoma, Washington and the Anaconda smelter in Montana. Since the USEPA assessment, new studies have been published and exposure estimates were updated at the Asarco and Anaconda smelters and additional years of follow-up evaluated. The Texas Commission on Environmental Quality (TCEQ) has developed an inhalation URF for lung cancer mortality from exposures to arsenic and inorganic arsenic compounds based on a newer epidemiology study of Swedish workers and the updates of the Asarco and Anaconda epidemiology studies. Using a combined analysis approach, the TCEQ weighted the individual URFs from these three epidemiology cohort studies, to calculate a final inhalation URF of 1.5E-04 per µg/m(3). In addition, the TCEQ also conducted a sensitivity analysis, in which they calculated a URF based on a type of meta-analysis, and these results compared well with the results of the combined analysis. The no significant concentration level (i.e., air concentration at 1 in 100,000 excess lung cancer mortality) is 0.067µg/m(3). This value will be used to evaluate ambient air monitoring data so the general public in Texas is protected against adverse health effects from chronic exposure to arsenic.


Asunto(s)
Arsénico/normas , Arsenicales/normas , Exposición por Inhalación/normas , Neoplasias Pulmonares/epidemiología , Enfermedades Profesionales/epidemiología , Exposición Profesional/normas , Arsénico/toxicidad , Femenino , Humanos , Exposición por Inhalación/efectos adversos , Neoplasias Pulmonares/inducido químicamente , Masculino , Metalurgia , Montana , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/efectos adversos , Valores de Referencia , Medición de Riesgo , Suecia , Texas
14.
Environ Technol ; 33(7-9): 1013-9, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22720428

RESUMEN

Recent guidelines from the Swedish Environmental Protection Agency recommend stricter regulations for phosphorus (P) reduction in small-scale wastewater treatment, which raises the need for additional and novel treatment steps in small-scale facilities. Following a biological pretreatment, filter systems can be a convenient option. In this study, the P binding capacity of the filter material Filtra P was investigated in batch tests. The batch test method was evaluated with respect to the effects of liquid-to-solid ratio and particle size on P binding capacity. For initial concentrations (c(i)) between 3 and 100 mg L(-1), the P in the solution was completely and rapidly bound to the material, indicating that Filtra P was an efficient substrate for this process. The maximum amount of bound P was 4.3 +/- 0.64 g kg(-1) at c(i) = 300 mg L(-1). The P binding capacity and turbidity measured in the supernatant correlated positively. Turbidity was probably caused by calcium-P precipitates, suggesting precipitation was the major removal mechanism. Neither the liquid-to-solid ratio nor the particle size affected P binding capacity significantly (alpha = 0.05) at c(i) = 1000 mg L(-1), confirming that the conditions used in the batch tests were appropriate. In full-scale applications, the precipitate formed may be at risk of being washed out of the filter, leading to low total P reduction and recovery.


Asunto(s)
Compuestos de Calcio/química , Filtración , Fósforo/química , Eliminación de Residuos Líquidos/métodos , Tamaño de la Partícula
15.
J Toxicol Environ Health A ; 75(7): 374-90, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22524593

RESUMEN

Cadmium's noncancer effects on the kidney represent a useful case study of the unified approach to toxicity assessment described in a recent National Academy of Science report. Cadmium (Cd) is recognized to exert toxic effects on the kidney at low dose without a demonstrable threshold. The implications of current dietary exposure and regulatory limits can be understood in terms of risk for chronic kidney disease (CKD) since both Cd adverse effects and CKD are defined by the same continous parameter (loss in glomerular filtration rate [GFR]). The Cd dose response on GFR derived from a study of Swedish women was applied to the baseline population distribution of GFR to determine the effect of Cd on CKD risk. The baseline population of 47.8-yr-old women was estimated to carry a 10% rate of Stage 3 CKD, similar to national statistics in the United States. A chronic daily dose of Cd at 1 µg/kg/d produced a left shift in this distribution and increased the population risk of CKD by an estimated 25%. A 10-fold lower Cd dose was associated with an increase in population risk of 2.7%, and this rose to 3.4% in 75-yr-olds. These estimates (1) provide additional perspective to the traditional risk/no risk approaches used in setting U.S. Environmental Protection Agency (EPA) reference doses (RfD) and Agency for Toxic Substances and Disease Registry (ATSDR) minimum risk levels (MRL) and (2) demonstrate the utility of considering chemical additivity to background disease in assessing human risk.


Asunto(s)
Cadmio/toxicidad , Exposición a Riesgos Ambientales/efectos adversos , Tasa de Filtración Glomerular/efectos de los fármacos , Insuficiencia Renal Crónica/inducido químicamente , Factores de Edad , Anciano , Relación Dosis-Respuesta a Droga , Femenino , Contaminación de Alimentos , Humanos , Persona de Mediana Edad , Modelos Biológicos , Medición de Riesgo
16.
Int J Inj Contr Saf Promot ; 19(2): 163-9, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22126404

RESUMEN

The objective of this study was to explore whether all-purpose health or safety promotion programmes and sports safety policies affect sports safety practices in local communities. Case study research methods were used to compare sports safety activities among offices in 73 Swedish municipalities; 28 with ongoing health or safety promotion programmes and 45 controls. The offices in municipalities with the WHO Healthy Cities (HC) or Safe Communities programmes were more likely to perform frequent inspections of sports facilities, and offices in the WHO HC programme were more likely to involve sports clubs in inspections. More than every second, property management office and environmental protection office conducted sports safety inspections compared with less than one in four planning offices and social welfare offices. It is concluded that all-purpose health and safety promotion programmes can reach out to have an effect on sports safety practices in local communities. These safety practices also reflect administrative work routines and managerial traditions.


Asunto(s)
Ciudades , Agencias Gubernamentales/organización & administración , Promoción de la Salud , Administración de la Seguridad/organización & administración , Deportes , Traumatismos en Atletas/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Humanos , Gobierno Local , Instalaciones Públicas/normas , Política Pública , Suecia
17.
Radiat Prot Dosimetry ; 142(2-4): 347-53, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20858675

RESUMEN

In an industrial hall, with large variations of radon concentration within minutes, simultaneous measurements were done with two types of passive radon detectors and an active radon measuring device. The widely used passive radon detector of the National Radiological Protection Board (NRPB) [Health Protection Agency (former NRPB) (HPA)]/Statens strålskyddsinstitut (Swedish Radiation Protection Institute) (SSI) type produced anomalous results, seemingly uncorrelated to the radon concentration which was in the order of hundreds of becquerels per metre, usually underestimating but occasionally overestimating. We tried to reproduce similar exposure characteristics in our laboratory, but failed to reproduce the anomalous readings. We suspected, but could not prove, that the anomalous results were due to the combination of high radon concentration gradients, with pressure-driven air exchange between the inside of the detector holder and the outside atmosphere. Moreover, this theory was at least partly contradicted when we drilled holes in the detector holder. Although of interest, this effect is not likely to have substantially influenced any radon surveys, given the unusual nature of the exposure that caused the effect.


Asunto(s)
Contaminación del Aire Interior/análisis , Exposición a Riesgos Ambientales/análisis , Dosis de Radiación , Monitoreo de Radiación/instrumentación , Protección Radiológica , Radón/análisis , Humanos , Laboratorios , Equipos de Seguridad , Monitoreo de Radiación/métodos
18.
Ambio ; 38(7): 394-400, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19943396

RESUMEN

The European Union (EU) member states have agreed on the Water Framework Directive. The vision is that all European waters will achieve "good" ecological status. Each member state has agreed to meet these commitments. In Sweden, the Environmental Protection Agency regulates the methods used for classification of the ecological status of inland and coastal waters. The aim of this study was to evaluate how these criteria (using diatoms, benthic fauna, fish, water chemistry, hydromorphology) principally affect the classification of two typical forest streams. Forestland constitutes approximately 70% of the Swedish land area and forestry is the dominating human impact on many waters. Particular attention was paid to evaluate how the classification may vary with catchment size and between years. The results indicate that there is an obvious risk that many Swedish forest streams will not achieve "good" ecological status. The classification outcome may vary between years and regarding fish status; it also seems to depend on stream size.


Asunto(s)
Agricultura Forestal , Agua Dulce/química , Animales , Diatomeas , Monitoreo del Ambiente/normas , Unión Europea , Peces , Geografía , Humanos , Suecia , Contaminación del Agua/legislación & jurisprudencia
19.
Environ Int ; 35(7): 1096-107, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19632722

RESUMEN

The very significant impact of European legislation (Directive 91/414/EEC) on the authorization of plant protection products is reviewed herein, which has resulted in withdrawal of 704 active substances (AS) out of 889 assessed so far. The list of currently approved 276 AS includes 194 AS "existing" in the market before 1993 and 82 "new" AS introduced during the last 15 years. Results of toxicity characterization of the approved AS are also summarized, utilizing several well-known databases. Although significant data gaps exist for a rather large part of the approved AS, it is found that 84 AS are positive for at least one health effect (after chronic and/or acute exposure) including carcinogenicity, reproductive and neuro-developmental disorders, as well as endocrine disruption. The toxicity characterization results of this study are compared to those of recent assessments by other organizations (KemI, the Swedish Chemicals Agency, and the Pesticide Safety Directorate of the UK), where interpretation and use is made of AS "cut-off" criteria foreseen in new EU legislation. These studies report a comparatively smaller AS number with positive toxicity characterization. The possibility of some additional AS withdrawal in the near future, combined with the rather small rate of new AS introduction (approx. 5 per year) suggest that the list of approved AS over the next 10-15 years may not change very drastically. Consideration of the above trends is necessary and instructive in evaluating results of existing health impact assessment (HIA) studies, as well as in planning new ones. Due to the very drastic change in the number and type of marketed AS, that took place within the past 8-9years, it is suggested that new HIA studies (based on epidemiological data after year 2000) should focus on a rather short time frame and, therefore, on appropriate cohort groups, e.g. young children. For the same reason, results of epidemiological studies of the past (involving banned AS) should be carefully interpreted and used with caution.


Asunto(s)
Contaminantes Ambientales/toxicidad , Contaminación Ambiental/legislación & jurisprudencia , Plaguicidas/toxicidad , Exposición a Riesgos Ambientales , Contaminantes Ambientales/economía , Europa (Continente) , Unión Europea , Plaguicidas/economía
20.
Ambio ; 36(6): 502-11, 2007 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-17985705

RESUMEN

Investigations of polluted brownfield sites and sample analyses are expensive, and the resulting data are often of poor quality. Efforts are needed, therefore, to improve the methods used in investigations of brownfield sites to both reduce costs and improve the quality of the results. One approach that could be useful for both of these purposes is the triad strategy, developed by the US Environmental Protection Agency, in which managing uncertainty is a central feature. In the investigations reported here, a field study was conducted to identify possible ways in which uncertainties could be managed in practice. One example considered involves optimizing the uncertainty by adjusting the sizes of samples and the efforts expended in analytical work according to the specific aims of the project. In addition, the potential utility of several toxicity assessment methods for screening sites was evaluated. As well as presenting the results of these assessments, in this contribution we discuss ways in which a flexible work strategy and screening methods inspired of the triad philosophy could be incorporated into the Swedish approach to remediate brownfield sites. A tiered approach taking advantage of field and screening methods is proposed to assess brownfield sites focusing on the response and acceptable uncertainty that are required for the task.


Asunto(s)
Monitoreo del Ambiente/métodos , Contaminantes del Suelo/análisis , Contaminantes del Suelo/toxicidad , Aliivibrio fischeri/efectos de los fármacos , Aliivibrio fischeri/metabolismo , Animales , Línea Celular , Proliferación Celular/efectos de los fármacos , Daphnia/efectos de los fármacos , Daphnia/fisiología , Mediciones Luminiscentes , Metales/análisis , Metales/toxicidad , Ratones , Compuestos Orgánicos/análisis , Compuestos Orgánicos/toxicidad , Plaguicidas/análisis , Plaguicidas/toxicidad , Suecia , Incertidumbre , Estados Unidos , United States Environmental Protection Agency , Contaminantes Químicos del Agua/análisis , Contaminantes Químicos del Agua/toxicidad
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