News Supplied to us by:
The World Health Organization (WHO)
Greater equity in health should be a progress indicator
15 JUNE 2009 | NEW YORK -- With a growing recognition that “blind faith in economic growth and gain as the be-all, end-all, cure-for-all has been misplaced,” WHO Director-General Dr Margaret Chan today responded to leaders who have been calling for a redesign of international systems.
Speaking at the United Nations Headquarters in New York today, Dr Chan said that it is time to build policies based on fairness – using differences in the health status of populations within and between countries – as the “key measure of how we, as a civilized society, are making progress.”
“The world is in such a great big mess,” she said at the UN Secretary-General’s Forum on Advancing Global Health in the Face of Crisis on Monday. The meeting was attended by senior government officials and experts in health and international development.
In the last year, this warming world has suffered a fuel crisis, a food crisis and a financial crisis. This list of challenges grew last week with the addition of pandemic influenza.
The impact of these crises is not felt equally. Pandemic influenza, for example, will hit hardest in developing countries, which have large vulnerable populations. With their weak health systems, these struggling countries will take longer to recover. In many ways, developing countries facing the pandemic are virtually empty-handed, said Dr Chan.
“Fairness, I believe, is at the heart of our ambitions for global health,” she told the world’s ambassadors. But fairness is in short supply. Differences in income, life expectancy, and opportunities are greater now than at any time in recent history. These extremes of privilege and misery, Dr Chan noted, are often “a precursor for social breakdown.”
The soul-searching following the financial crisis has led to a questioning of “blind faith in economic growth.” From this self-examination, leaders are calling for a restoration of other values, especially fairness, to a central role in policy formation.
“We hear clear calls, from leaders around the world, to give the international systems a moral dimension,” said Dr Chan, “to redesign them to respond to social values and concerns... A focus on health as a worthy pursuit for its own sake is the surest route to the moral dimension, the surest route to a value system that puts the welfare of humanity at its heart. Greater equity in the health status of populations, within and between countries, should be regarded as key measure of how we, as a civilized society, are making progress.”
One method for achieving fairness, she suggested, would be for more countries to embrace primary health care. As she noted, a primary health care approach introduces greater fairness as well as efficiency, and allows health systems to reach their potential as cohesive, stabilizing social institutions.
For more information contact:
Dick Thompson
WHO Geneva
Mobile: +41 79 594 2876
E-mail: thompsond@who.int
Thomas Abraham
WHO Geneva
Mobile: +41 79 516 3136
E-mail: abrahamt@who.int
Pedestrians, cyclists among main road traffic crash victims
15 JUNE 2009 GENEVA/NEW YORK
Half of 1.27 million people who die in road traffic crashes every year are pedestrians, motorcyclists and cyclists, finds new WHO study.
The first global assessment of road safety finds that almost half of the estimated 1.27 million people who die in road traffic crashes every year are pedestrians, motorcyclists and cyclists. While progress has been made towards protecting people in cars, the needs of these vulnerable groups of road users are not being met.
The Global status report on road safety published today provides the first worldwide analysis of how well countries are implementing a number of effective road safety measures. These include limiting speed, reducing drink-driving, and increasing the use of seatbelts, child restraints and motorcycle helmets. Funded by Bloomberg Philanthropies, the report presents information from 178 countries, accounting for over 98% of the world’s population. It uses a standardized method that allows comparisons between countries to be made.
For further information contact:
Laura Sminkey
WHO Geneva
Telephone: +41 22 791 4547
Mobile: +41 79 249 3520
E-mail: sminkeyl@who.int
Influenza A(H1N1) - update 49
15 June 2009 -- As of 17:00 GMT, 15 June 2009, 76 countries have officially reported 35, 928 cases of influenza A(H1N1) infection, including 163 deaths.
World now at the start of 2009 influenza pandemic
11 June 2009
Dr Margaret Chan
Director-General of the World Health Organization
Ladies and gentlemen,
In late April, WHO announced the emergence of a novel influenza A virus.
This particular H1N1 strain has not circulated previously in humans. The virus is entirely new.
The virus is contagious, spreading easily from one person to another, and from one country to another. As of today, nearly 30,000 confirmed cases have been reported in 74 countries.
This is only part of the picture. With few exceptions, countries with large numbers of cases are those with good surveillance and testing procedures in place.
Spread in several countries can no longer be traced to clearly-defined chains of human-to-human transmission. Further spread is considered inevitable.
I have conferred with leading influenza experts, virologists, and public health officials. In line with procedures set out in the International Health Regulations, I have sought guidance and advice from an Emergency Committee established for this purpose.
On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met.
I have therefore decided to raise the level of influenza pandemic alert from phase 5 to phase 6.
The world is now at the start of the 2009 influenza pandemic.
We are in the earliest days of the pandemic. The virus is spreading under a close and careful watch.
No previous pandemic has been detected so early or watched so closely, in real-time, right at the very beginning. The world can now reap the benefits of investments, over the last five years, in pandemic preparedness.
We have a head start. This places us in a strong position. But it also creates a demand for advice and reassurance in the midst of limited data and considerable scientific uncertainty.
Thanks to close monitoring, thorough investigations, and frank reporting from countries, we have some early snapshots depicting spread of the virus and the range of illness it can cause.
We know, too, that this early, patchy picture can change very quickly. The virus writes the rules and this one, like all influenza viruses, can change the rules, without rhyme or reason, at any time.
Globally, we have good reason to believe that this pandemic, at least in its early days, will be of moderate severity. As we know from experience, severity can vary, depending on many factors, from one country to another.
On present evidence, the overwhelming majority of patients experience mild symptoms and make a rapid and full recovery, often in the absence of any form of medical treatment.
Worldwide, the number of deaths is small. Each and every one of these deaths is tragic, and we have to brace ourselves to see more. However, we do not expect to see a sudden and dramatic jump in the number of severe or fatal infections.
We know that the novel H1N1 virus preferentially infects younger people. In nearly all areas with large and sustained outbreaks, the majority of cases have occurred in people under the age of 25 years.
In some of these countries, around 2% of cases have developed severe illness, often with very rapid progression to life-threatening pneumonia.
Most cases of severe and fatal infections have been in adults between the ages of 30 and 50 years.
This pattern is significantly different from that seen during epidemics of seasonal influenza, when most deaths occur in frail elderly people.
Many, though not all, severe cases have occurred in people with underlying chronic conditions. Based on limited, preliminary data, conditions most frequently seen include respiratory diseases, notably asthma, cardiovascular disease, diabetes, autoimmune disorders, and obesity.
At the same time, it is important to note that around one third to half of the severe and fatal infections are occurring in previously healthy young and middle-aged people.
Without question, pregnant women are at increased risk of complications. This heightened risk takes on added importance for a virus, like this one, that preferentially infects younger age groups.
Finally, and perhaps of greatest concern, we do not know how this virus will behave under conditions typically found in the developing world. To date, the vast majority of cases have been detected and investigated in comparatively well-off countries.
Let me underscore two of many reasons for this concern. First, more than 99% of maternal deaths, which are a marker of poor quality care during pregnancy and childbirth, occurs in the developing world.
Second, around 85% of the burden of chronic diseases is concentrated in low- and middle-income countries.
Although the pandemic appears to have moderate severity in comparatively well-off countries, it is prudent to anticipate a bleaker picture as the virus spreads to areas with limited resources, poor health care, and a high prevalence of underlying medical problems.
Ladies and gentlemen,
A characteristic feature of pandemics is their rapid spread to all parts of the world. In the previous century, this spread has typically taken around 6 to 9 months, even during times when most international travel was by ship or rail.
Countries should prepare to see cases, or the further spread of cases, in the near future. Countries where outbreaks appear to have peaked should prepare for a second wave of infection.
Guidance on specific protective and precautionary measures has been sent to ministries of health in all countries. Countries with no or only a few cases should remain vigilant.
Countries with widespread transmission should focus on the appropriate management of patients. The testing and investigation of patients should be limited, as such measures are resource intensive and can very quickly strain capacities.
WHO has been in close dialogue with influenza vaccine manufacturers. I understand that production of vaccines for seasonal influenza will be completed soon, and that full capacity will be available to ensure the largest possible supply of pandemic vaccine in the months to come.
Pending the availability of vaccines, several non-pharmaceutical interventions can confer some protection.
WHO continues to recommend no restrictions on travel and no border closures.
Influenza pandemics, whether moderate or severe, are remarkable events because of the almost universal susceptibility of the world’s population to infection.
We are all in this together, and we will all get through this, together.
Thank you.
Education key to preventing early pregnancies
8 June 2009 -- Adolescent pregnancy is a major contributor to both infant and maternal health problems and mortality. The problem calls for more education and support to encourage girls to delay motherhood until they are ready, reports the WHO Bulletin.
Read the article in the WHO Bulletin
Rebuilding lives, healing minds in Gaza Strip
3 June 2009 -- Mental health experts and caregivers are helping to rebuild the lives of 1.5 million people in Gaza Strip, but the task is enormous. WHO estimates that 5% to 10% of people in Gaza may need professional support to address long-term mental health problems like depression, trauma and panic attacks, reports the WHO Bulletin.
Read the article in the WHO Bulletin
Health of 3 million displaced in Pakistan at risk
3 June 2009 -- Immediate funding is needed to provide life-saving health care to the more than 3 million internally displaced people in Pakistan. These people are now residing in temporary camps and in host communities in the country's north-western region.
Tobacco packages must use pictorial warnings
29 May 2009 -- Warnings on tobacco product packaging increase public awareness of the serious health risks of tobacco use. Images are a particularly powerful and cost-effective vehicle for communicating the risks. On the occasion of World No Tobacco Day, WHO is urging governments to require that all tobacco packages display pictorial warnings.
WHO awarded for international cooperation
27 MAY 2009 | GENEVA -- WHO has been given the 2009 Prince of Asturias Award for International Cooperation. The jury for the award announced its decision today in Oviedo, Spain.
"I am deeply honoured that the World Health Organization has received the prestigious Prince of Asturias Award for International Cooperation for its efforts to fight against international health threats and for its leadership in coordinating health in a rapidly changing world," said Director-General Dr Margaret Chan.
This award will serve to further inspire and motivate the entire Organization in all its locations around the world as WHO works with Member States and partners towards creating a healthier world in which the burden of disease is reduced, particularly amongst the world’s poorest and most vulnerable people.
"We are humbled when we see the distinguished list of people and organizations this Award has gone to in previous years. On behalf of the World Health Organization I thank the Prince of Asturias Foundation for honouring the work of the Organization, and for this recognition of the importance of global public health," added Dr Chan.
For more information please contact:
Dr Gaya Gamhewage
Team Leader, Corporate Communications
Department of Communications
Telephone: +41 22 791 4030
Fax: +41 22 791 3111
Mobile: + 41 79 475 5563
E-mail: gamhewageg@who.int
More funding urged for yellow fever vaccine stockpile
26 MAY 2009 | GENEVA/PARIS/NEW YORK -- The International Coordinating Group (ICG) on Yellow Fever Vaccine Provision is warning that the global emergency stockpile of yellow fever vaccine for the world’s most vulnerable populations in Africa is under threat.
The current stockpile will run out in 2010 and there is no funding to cover vaccination campaigns once the stockpile is depleted. Most children and adults in five of the 12 most vulnerable countries in Africa are now protected from contracting yellow fever thanks to recent vaccination campaigns.
But without further funding millions of people will still be at risk of the disease, according to public health experts.
"We have to finish the job we started or the good work that has been done will be lost,” said Dr Edward Hoekstra, UNICEF Senior Health Specialist, speaking from New York. "If the stockpile of yellow fever vaccine is allowed to run out, countries that have not yet been reached by immunization campaigns will be unfairly burdened with the disease.”
Dr William Perea, WHO coordinator for the Epidemic Readiness and Intervention said the yellow fever initiative is feeling the effects of the global financial crisis.
"As we look beyond 2009, we already see serious funding constraints. Although yellow fever vaccine production has tripled since 2001, the roll-out of the programme is limited by insufficient supply of vaccine for 2009,” said Dr Perea.
The five countries that have completed vaccination campaigns so far are Togo, Mali, Senegal, Burkina Faso and Cameroon, which received funding from the International Finance Facility for Immunization (IFFIm), through the GAVI Alliance. There have been no outbreaks in those countries since the vaccination campaigns were completed.
Dr Hoekstra said there is a need to further roll out the programme to protect the remaining 150 million children and adults still at risk for the disease in the region, adding that close cooperation among all partners has been effective in supporting national governments to successfully implement the vaccination campaigns.
"If we do not sustain this programme, yellow fever outbreaks will continue to affect populations who can least afford it,” said Dr Fenella Avokey of the WHO African Regional Office. "This is something we had hoped to resolve by 2015.”
Yellow fever is caused by a virus transmitted by mosquitoes. The disease is endemic in forest areas and people are at greatest risk at the end of the rainy season. According to WHO estimates, 206 000 cases and 52 000 deaths occur every year.
The recent campaigns in Burkina Faso and Cameroon benefited more than 95% of the vulnerable populations targeted. Burkina Faso vaccinated 7.6 million people in 33 districts and Cameroon completed a vaccination campaign for 7.5 million people in 62 districts. Seven other African countries where the threat of yellow fever is highest are Benin, Sierra Leone, Nigeria, Liberia, Guinea, Ghana, and Cote d'Ivoire.
Members of the ICG, including WHO, Médecins Sans Frontières (MSF), the International Federation of Red Cross and Red Crescent Societies (IFRC), and the United Nations Children’s Fund (UNICEF), met on 12-13 May to assess recent yellow fever vaccination campaigns and discuss future actions.
For more information please contact:
Aphaluck Bhatiasevi
WHO Media Officer, Geneva
Telephone: +41 79 484 2997
E-mail: bhatiaseviap@who.int
Christian Moen
UNICEF Media, New York
Telephone: +1 212 326 7516
E-mail: cmoen@unicef.org
Avian influenza - situation in Egypt - update 16
22 May 2009 -- Between 13 to 20 May, the Ministry of Health of Egypt reported five new confirmed human case of avian influenza.
The first case is a 4-year old boy from Kafr Sakr District, Sharkia Governorate. His symptoms began on 10 May 2009 and he was admitted to Zagazig Fever Hospital on 11 May. He is in a stable condition.
The second case is a 3-year old boy from Mahalla District, Gharbia Governorate. His symptoms began on 12 May and he was admitted to Mahalla Fever Hospital on 15 May 2009. He is in a stable condition.
The third case was a 4-year old girl from Meet Ghamr District, Dakahlia Governorate. Her symptoms began on 9 May 2009 and she was admitted to Mansoura Chest Hospital on 17 May 2009. She died on 18 May 2009.
The fourth case is a 4-year old boy from Sherbin District, Dakahlia Governorate. His symptoms began on 18 May 2009 and he was admitted to Mansoura Chest Hospital on the same day. He is in a stable condition.
The fifth case is a 3-year old boy from Sohag District, Sohag Governorate. His symptoms began on 17 May 2009 and he was admitted to Sohag Fever Hospital on 18 May 2009. He is in a stable condition.
Investigations into the source of infection indicated that all the above cases had close contact with dead and sick poultry. All five cases have been confirmed by the Egyptian Central Public Health Laboratory.
Of the 74 cases confirmed to date in Egypt, 27 have been fatal.
World Health Assembly closes with resolutions on public health
22 MAY 2009 | GENEVA -- The 62nd World Health Assembly, which brought together health ministers and senior health officials from WHO's Member States, closed today with the adoption of resolutions on a variety of global health issues including primary health care, the prevention and control of multidrug- resistant and extensively drug-resistant tuberculosis, public health, innovation and intellectual property and pandemic influenza preparedness. The Health Assembly also passed the Programme Budget for 2010 -2011.
For more information contact:
WHO Department of Communications, Geneva
Thomas Abraham
Mobile: +41 79 516 3136
E-mail: abrahamt@who.int
Fadéla Chaib
Mobile: +41 79 475 5556
E-mail: chaibf@who.int
Gaya Gamhewage
Mobile: + 41 79 475 5563
E-mail: gamhewageg@who.int
Media inquiries
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int
UN, WHO heads meet vaccine manufacturers
19 MAY 2009 | GENEVA -- WHO Director-General Dr Margaret Chan and United Nations Secretary-General Ban Ki-moon met with over 30 vaccine manufacturers from developing and developed countries at WHO headquarters today.
Both the Director-General and the Secretary-General stressed the importance of assuring that any eventual vaccine for Influenza A(H1N1) was made available in a spirit of equity and fairness, and invited the manufacturers to continue to work with them to develop a strategy for this. Industry representatives affirmed their wish to cooperate in making supplies available to developing countries, and said they stood ready to produce the vaccine when requested.
At a press conference later in the day, Dr Chan said, "We have a very serious commitment from companies in the North and in the South to work with WHO." She said the Secretary-General's ability to mobilize resources "is extremely vital when the world is under threat of an imminent pandemic." Together with the UN and other members of the global community, WHO would work to find innovative funding mechanisms to ensure that developing countries were not denied access to vaccines because of lack of means.
Both the Director-General and Secretary-General expressed their appreciation of the efforts of the manufacturers, with support from governments, to further increase their production capacity.
Although WHO was not a funding agency, Dr Chan said she took it as part of her job to advocate for the poor. "In the name of solidarity, I have reached out to drug and vaccine manufacturers," she said. "We will look at different mechanisms to make sure poor communities and countries are not left out."
She said she had spoken with UNITAID, GAVI the World Bank and foundations to continue work on funding. The Director-General said she would meet with vaccine manufacturers individually to work out strategies to ensure pandemic vaccine availability.
In response to a question on pandemic alert phase change, Dr Chan explained that the definition of WHO's influenza preparedness phases was developed against the backdrop of H5N1 avian flu. Influenza A(H1N1) has a very different clinical picture, which is so far mostly mild and self-limiting, unlike H5N1, which had a 50% to 60% mortality rate. She said that at the on-going World Health Assembly, Member States had asked that WHO reflect criteria other than geographical spread before moving to Phase 6. The pandemic alert level is currently at Phase 5.
Secretary-General Ban Ki-moon also visited the JW Lee Centre for Strategic Health Operations (also known as the SHOC room) at WHO headquarters, the centre of WHO's emergency response.
For more information contact:
WHO Department of Communications, Geneva
Thomas Abraham
Mobile: +41 79 516 3136
E-mail: abrahamt@who.int
Fadéla Chaib
Mobile: +41 79 475 5556
E-mail: chaibf@who.int
Nyka Alexander
Mobile: + 41 79 475 7061
E-mail: alexandern@who.int
Gaya Gamhewage
Mobile: + 41 79 475 5563
E-mail: gamhewageg@who.int
Media inquiries
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int
Sixty-second World Health Assembly
18-22 May 2009
Location: Geneva, Switzerland
The 62nd session of the World Health Assembly is scheduled to take place in Geneva during 18-22 May 2009. At this session, the Health Assembly will discuss a number of public health issues, including:
pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits;
implementation of the International Health Regulations;
primary health care, including health system strengthening;
social determinants of health; and
monitoring the achievement of the health-related Millennium Development Goals.
The Health Assembly will also discuss the programme budget, administration and management matters ofWHO.
World is better prepared for influenza pandemic
Dr Margaret Chan
Director-General of the World Health Organization
8th May 2009
Honourable ministers, distinguished participants, ladies and gentlemen,
Thank you for convening this special meeting of health ministers, and thank you for giving me an opportunity to address you.
Above all, thank you for your diligence all these years in tracking the H5N1 virus in humans and animals, in reporting and treating so many cases, and in dealing with so many tragic deaths.
For five long years, you have kept this avian virus under watch, and largely under control.
As we know today, the virus with the greatest pandemic potential, the H1N1 virus, has sprung up from another source, on another side of the world.
But H5N1 taught the world to expect a pandemic, and to plan for this event.
The world is better prepared for an influenza pandemic than at any time in history, thanks, in part, to your vigilance and diligence.
Years of alert and expectation mean that most countries now have preparedness plans. Vaccine manufacturing capacity has increased sharply. Large stocks of antiviral drugs have been produced and procured.
Right now, treatment courses from the WHO stockpile are being shipped to more than 70 countries in the developing world.
We are, right now, gaining experience in the use of non-medical interventions, such as social distancing, to delay spread of the H1N1 virus.
WHO and its regional offices have tested their alert and response plans, also in operational exercises. We are prepared.
In addition, we have the backing of the greatly strengthened International Health Regulations.
This is a time of great uncertainty for all countries, and great pressure on ministers and ministries of health. The only certain thing that can be said about influenza viruses is that their behaviour is entirely unpredictable. No one can say how the current situation will evolve.
Countries will, quite rightly, want to do everything possible to prevent the arrival of the virus or, once in a country, to delay its further spread and thus flatten the epidemiological peak.
At the same time, it is important for countries to refrain from introducing economically and socially disruptive measures that lack solid scientific backing and bring no clear public health benefit.
The rational use of travel- and trade-related measures is always wise. It is all the more wise at a time of severe economic downturn.
Ladies and gentlemen,
On this occasion, let me make two additional requests.
First, do not drop the ball on monitoring H5N1. This virus is endemic in poultry in parts of the region. We have no idea how H5N1 will behave under the pressure of a pandemic.
Second, H5N1 has conditioned the public to equate an influenza pandemic with very severe disease and high mortality. Such a disease pattern is by no means inevitable during a pandemic. On the contrary, it is exceptional.
From past experience, ASEAN+3 countries know what it means to be at centre-stage during the outbreak of a new disease. We must battle misperceptions with the facts, and respond to the disease with the facts. I know you will help me on this front as well.
The decision to declare an influenza pandemic will fall on my shoulders. I can assure you, I will take this decision with utmost care and responsibility.
Thank you.
Joint FAO/WHO/OIE Statement on influenza A(H1N1) and the safety of pork
7 May 2009
To avoid any misunderstanding FAO, WHO and OIE would like to reissue their joint statement originally issued on 30 April.
In the ongoing spread of influenza A(H1N1), concerns about the possibility of this virus being found in pigs and the safety of pork and pork products have been raised.
Influenza viruses are not known to be transmissible to people through eating processed pork or other food products derived from pigs.
Heat treatments commonly used in cooking meat (e.g. 70°C/160°F core temperature) will readily inactivate any viruses potentially present in raw meat products.
Pork and pork products, handled in accordance with good hygienic practices recommended by the WHO , Codex Alimentarius Commission and the OIE, will not be a source of infection
Authorities and consumers should ensure that meat from sick pigs or pigs found dead are not processed or used for human consumption under any circumstances.
No rationale for travel restrictions
1 May 2009 -- WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus. Today, international travel moves rapidly, with large numbers of individuals visiting various parts of the world. Limiting travel and imposing travel restrictions would have very little effect on stopping the virus from spreading, but would be highly disruptive to the global community.
Influenza A(H1N1) has already been confirmed in many parts of the world. The focus now is on minimizing the impact of the virus through the rapid identification of cases and providing patients with appropriate medical care, rather than on stopping its spread internationally. Furthermore, although identifying the signs and symptoms of influenza in travellers can be an effective monitoring technique, it is not effective in reducing the spread of influenza as the virus can be transmitted from person to person before the onset of symptoms. Scientific research based on mathematical modelling indicates that restricting travel will be of limited or no benefit in stopping the spread of disease. Historical records of previous influenza pandemics, as well as experience with SARS, have validated this point.
Travellers can protect themselves and others by following simple recommendations related to travel aimed at preventing the spread of infection. Individuals who are ill should delay travel plans and returning travellers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases and not only influenza A(H1N1).
Swine influenza.
Statement by WHO Director-General, Dr Margaret Chan
29 April 2009
Ladies and gentlemen,
Based on assessment of all available information, and following several expert consultations, I have decided to raise the current level of influenza pandemic alert from phase 4 to phase 5.
Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world.
On the positive side, the world is better prepared for an influenza pandemic than at any time in history.
Preparedness measures undertaken because of the threat from H5N1 avian influenza were an investment, and we are now benefitting from this investment.
For the first time in history, we can track the evolution of a pandemic in real-time.
I thank countries who are making the results of their investigations publicly available. This helps us understand the disease.
I am impressed by the work being done by affected countries as they deal with the current outbreaks.
I also want to thank the governments of the USA and Canada for their support to WHO, and to Mexico.
Let me remind you. New diseases are, by definition, poorly understood. Influenza viruses are notorious for their rapid mutation and unpredictable behaviour.
WHO and health authorities in affected countries will not have all the answers immediately, but we will get them.
WHO will be tracking the pandemic at the epidemiological, clinical, and virological levels.
The results of these ongoing assessments will be issued as public health advice, and made publicly available.
All countries should immediately activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.
At this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities.
This change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharmaceutical industry and the business community that certain actions should now be undertaken with increased urgency, and at an accelerated pace.
I have reached out to donor countries, to UNITAID, to the GAVI Alliance, the World Bank and others to mobilize resources.
I have reached out to companies manufacturing antiviral drugs to assess capacity and all options for ramping up production.
I have also reached out to influenza vaccine manufacturers that can contribute to the production of a pandemic vaccine.
The biggest question, right now, is this: how severe will the pandemic be, especially now at the start?
It is possible that the full clinical spectrum of this disease goes from mild illness to severe disease. We need to continue to monitor the evolution of the situation to get the specific information and data we need to answer this question.
From past experience, we also know that influenza may cause mild disease in affluent countries, but more severe disease, with higher mortality, in developing countries.
No matter what the situation is, the international community should treat this as a window of opportunity to ramp up preparedness and response.
Above all, this is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic.
As I have said, we do not have all the answers right now, but we will get them.
Thank you.
Swine influenza
Statement by WHO Director-General, Dr Margaret Chan
27 April 2009
The Emergency Committee, established in compliance with the International Health Regulations (2005), held its second meeting on 27 April 2009.
The Committee considered available data on confirmed outbreaks of A/H1N1 swine influenza in the United States of America, Mexico, and Canada. The Committee also considered reports of possible spread to additional countries.
On the advice of the Committee, the WHO Director-General decided on the following.
The Director-General has raised the level of influenza pandemic alert from the current phase 3 to phase 4.
The change to a higher phase of pandemic alert indicates that the likelihood of a pandemic has increased, but not that a pandemic is inevitable.
As further information becomes available, WHO may decide to either revert to phase 3 or raise the level of alert to another phase.
This decision was based primarily on epidemiological data demonstrating human-to-human transmission and the ability of the virus to cause community-level outbreaks.
Given the widespread presence of the virus, the Director-General considered that containment of the outbreak is not feasible. The current focus should be on mitigation measures.
The Director-General recommended not to close borders and not to restrict international travel. It was considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention.
The Director-General considered that production of seasonal influenza vaccine should continue at this time, subject to re-evaluation as the situation evolves. WHO will facilitate the process needed to develop a vaccine effective against A(H1N1) virus.
The Director-General stressed that all measures should conform with the purpose and scope of the International Health Regulations.
Influenza-like illness in the United States and Mexico
24 April 2009 -- The United States Government has reported seven confirmed human cases of Swine Influenza A/H1N1 in the USA (five in California and two in Texas) and nine suspect cases. All seven confirmed cases had mild Influenza-Like Illness (ILI), with only one requiring brief hospitalization. No deaths have been reported.
The Government of Mexico has reported three separate events. In the Federal District of Mexico, surveillance began picking up cases of ILI starting 18 March. The number of cases has risen steadily through April and as of 23 April there are now more than 854 cases of pneumonia from the capital. Of those, 59 have died. In San Luis Potosi, in central Mexico, 24 cases of ILI, with three deaths, have been reported. And from Mexicali, near the border with the United States, four cases of ILI, with no deaths, have been reported.
Of the Mexican cases, 18 have been laboratory confirmed in Canada as Swine Influenza A/H1N1, while 12 of those are genetically identical to the Swine Influenza A/H1N1 viruses from California.
The majority of these cases have occurred in otherwise healthy young adults. Influenza normally affects the very young and the very old, but these age groups have not been heavily affected in Mexico.
Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern.
The Swine Influenza A/H1N1 viruses characterized in this outbreak have not been previously detected in pigs or humans. The viruses so far characterized have been sensitive to oseltamivir, but resistant to both amantadine and rimantadine.
The World Health Organization has been in constant contact with the health authorities in the United States, Mexico and Canada in order to better understand the risk which these ILI events pose. WHO (and PAHO) is sending missions of experts to Mexico to work with health authorities there. It is helping its Member States to increase field epidemiology activities, laboratory diagnosis and clinical management. Moreover, WHO's partners in the Global Alert and Response Network have been alerted and are ready to assist as requested by the Member States.
WHO acknowledges the United States and Mexico for their proactive reporting and their collaboration with WHO and will continue to work with Member States to further characterize the outbreak.
For more information, please contact:
Thomas Abraham
Communications in English
Mobile: +41 79 516 3136
E-mail: abrahamt@who.int
Fadela Chaib
Communications in English and French
Mobile: +41 79 475 5556
E-mail: chaibf@who.int
Sari Segoti
Communications in English and Bahasa
Mobile: +41 79 701 9467
E-mail: segotis@who.int
Gregory Hartl
Communications in English, French, German and Spanish
Mobile: +41 79 203 6715
E-mail: hartlg@who.int
Aphaluck Bhatiasevi
Communications in English, Thai and Hindi
Mobile: +41 79 647 8395
E-mail: bhataisevia@who.int
Meningococcal disease in Chad
23 April 2009 -- From 29 December 2008 to 5 April, the Ministry of Health of Chad reported 922 suspected cases of meningococcal disease including 105 deaths (case-fatality rate: 11.4%). So far, three districts have crossed the epidemic threshold, including a district in the capital, N'Djamena, while five districts are on alert.
Thirty three specimens of cerebral spinal fluid have been found positive for Neisseria meningitidis serogroup W135 and 30 specimens for Neisseria meningitidis serogroup A, by latex, culture and PCR, suggesting that both serogroups are responsible for the epidemic.
The International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis Control has provided 164,000 doses of trivalent ACW vaccine for a mass vaccination campaign in affected areas of Dourbali, Goundi and Pala district. Additionally, 704 300 doses of trivalent vaccine have been released this week, which will be used for an immunization campaign in the capital, planned to start next week.
WHO, UNICEF, Médecins sans Frontières and the International Federation of Red Cross (IFRC) are working with the Ministry of Health, Chad to implement vaccination campaigns as well as other emergency control measures, including case management and surveillance in neighbouring districts.
New edition of International travel and health available now
17 April 2009 -- The International travel and health provides guidance to medical and non-medical people on potential health risks for travellers and precautions to take. The new 2009 edition includes a chapter on psychological health, detailed maps of major infectious diseases and updated vaccine recommendations and schedules.
International travel and health 2009
Zimbabwe's Cholera Outbreak
9 APRIL 2009 -- International and local health providers, coordinated by WHO, continue to work on bringing Zimbabwe's cholera outbreak under control and ensure treatment availability. More than 95 500 cases of cholera and now more than 4000 related deaths have been recorded since August. The epidemic seems to have come under control almost everywhere, except in Mashonaland West, Harare city and Chitungwiza, where an increase in caseload has been observed in the last few weeks.
WHO takes lead on health as UN tackles crises
9 April 2009 -- In emergency or crisis situations, UN agencies adopt a cluster approach: one agency takes on the overall responsibility for coordinating and implementing the response to a specific aspect of the situation. This article in the WHO Bulletin examines the challenges WHO faces in leading health clusters in 24 countries.
Read the article in the WHO Bulletin
Save lives: make hospitals safe for emergencies
7 April 2009 -- WHO is today celebrating World Health Day by focusing attention on the large numbers of lives that can be saved during earthquakes, floods, conflicts and other emergencies through better design and construction of health facilities and by preparing and training health staff.
Read the news release
World Health Day 2009
Growing drug resistance of TB a major concern
3 April 2009 -- This week, in the Chinese capital of Beijing, health leaders gathered to discuss the threat of the new forms of tuberculosis that are resistant to drugs.
Listen to this podcast episode - duration 00:05:15 [mp3 3Mb]
URL;http://www.who.int/mediacentre/multimedia/podcasts/2009/tuberculosis_drug_resistant_20090403/en/print.html