WHO press conference on coronavirus disease (COVID-19) - 4 November 2021
00:00:34
TJ
Hello, everyone, from Geneva, from WHO Headquarters. My name is Tarik Jasarevic
and I welcome you to the regular COVID-19 press conference. I will introduce
you to the speakers who are here with us today. With us are Dr Tedros, WHO
Director-General, Dr Maria Van Kerkhove, Technical Lead, COVID-19, Dr Mike
Ryan, who's Executive Director of the HWO Programme of Emergencies, Dr Soumya
Swaminathan, WHO Chief Scientist, Dr Bruce Aylward, Senior Advisor to the
Director-General and the Lead on the ACT Accelerator.
We also have with us Dr Rogerio Gaspar, who's
the Director of Regulation and Prequalification. Also with us is Dr Olivio
Bedrasco, who is Unit Head, Country Simulation Exercises and Reviews. We also
have the Legal Council, Derek Walton online.
There is also a special guest today, mentioned
in our media advisory, whom Dr Tedros will specifically introduce in his
opening remarks. For journalists who are online, please click raise hand so you
can get in line to ask a question and if possible ask only one so we can get as
many as possible.
As always, this press briefing has simultaneous
interpretation in six UN languages plus Portuguese and Hindi so you can use
those languages to ask your question. With that I'll give the floor to Dr
Tedros for opening remarks.
00:02:15
TAG Thank
you. Thank you, Tarik, and welcome. Good morning, good afternoon and good
evening. 22 months since the first cases of COVID-19 were reported and almost a
year since the first vaccines were approved reported cases and deaths from
COVID-19 are increasing again.
More than five million deaths have now been
reported and we know the real number is higher. We're still losing more than
50,000 of our sisters and brothers every week. Last week 56 countries from all
regions reported an increase in deaths from COVID-19 of more than 10%.
We hear reports from many countries about lack
of ICU beds, lack of supplies, overwhelmed health workers and hospitals
deferring other needed procedures. Let me be very clear. This should not be
happening. We have all the tools to prevent transmission and save lives and we
continue to call on all countries to use those tools.
00:03:30
Yesterday we added another new tool with the emergency
use listing of Covaxin, the eighth vaccine to receive WHO validation for
safety, efficacy and quality. Emergency use listing contributes to vaccine
equity by enabling countries to expedite their own regulatory approval to
import and roll out vaccines.
We encourage all vaccine manufacturers who have
not yet received emergency use listing to contact WHO to discuss how to
accelerate the process through rolling submissions. We continue to call on
manufacturers of vaccines that already have WHO emergency use listing to
prioritise COVAX, not shareholder profit.
We continue to hear excuses about why low-income
countries have only received 0.4% of the world's vaccines. One is that
low-income countries can't absorb vaccines. That's not true. With the exception
of a few fragile, conflict-affected and vulnerable countries most low-income
countries are ready to go.
The problem is simply that they cannot get the
vaccines. I repeat, they cannot get the vaccines. Another excuse from
manufacturers is that low-income countries have not placed orders for vaccines.
Most low-income countries are relying on COVAX, which has the money and the
contracts to buy vaccines on their behalf but manufacturers have not played
their part.
00:05:19
We still don't know when the manufacturers will
deliver. We continue to call on all manufacturers to prioritise their contracts
with COVAX and the Africa Vaccines Acquisition trust or AVAT. No more vaccines
should go to countries that have already vaccinated more than 40% of their
population until COVAX has the vaccines it needs to help other countries get
there too.
No more boosters should be administered except
to immunocompromised people. Most countries with high vaccine coverage continue
to ignore our call for a global moratorium on boosters at the expense of health
workers and vulnerable groups in low-income countries who are still waiting for
the first dose.
We cannot end the pandemic without vaccines but
vaccines alone will not end the pandemic. Vaccines do not replace the need for
public health and social measures, they complement them. Physical distancing,
avoiding crowded spaces, masks, ventilation, hand hygiene and other effective
public health measures remain important in every country.
00:06:39
Every country must continue to adjust and adapt
its strategy. To support countries to do that WHO has developed a tool called
the intra-action review which countries can use to evaluate what's working and
what's not.
More than 100 intra-action reviews have now been
conducted by 68 countries. Several countries have conducted multiple reviews,
including South Africa which has done ten, making it a central component of its
response.
Several key lessons emerge from these reviews.
The need for strong and active national leadership at the highest levels,
flexibility and adaptability by adjusting and repurposing existing systems,
guidelines and resources, multi-sectoral co-operation and in the case of
vaccine roll-out the need for adequate cold-chain capacity and real-tie
monitoring of vaccine stock.
Ending the pandemic as rapidly as possible must
remain the central focus for every country. At the same time we owe it to those
who have lost their lives to this virus to learn the lessons it's teaching us
and take whatever action is necessary to prevent a future disaster on this
scale.
00:08:06
The world was not prepared for COVID-19 and we
knew we were not prepared. In 2018 WHO and the World Bank formed the Global
Preparedness Monitoring Board, the GPMB, an independent panel of experts to
identify gaps in the world's defences and make recommendations to how to close
them.
We did not know then when the next global crisis
would arise or what it would be but we know that disease X would come
eventually. The GPMB published its first report in September 2019, just months
before the pandemic hit. It identified many of the vulnerabilities that
COVID-19 had exposed and exploited.
The lack of political leadership and commitment,
the lack of health system readiness, the lack of trust with communities and the
lack of international co-operation.
The second GPMB report, released in the middle
of the pandemic last year, incorporated hard-won insights with calls for
predictable and sustained financing, equitable access for vaccines and other
life-saving tools and global governance for preparedness.
00:09:30
The GPMB published its third report last week.
Instead of making more recommendations the GPMB is calling the world to act on
the recommendations it has already made, which are more relevant now than
before the pandemic but on which there remains little action.
We have no shortage of reports, reviews and
recommendations but we have a shortage of action. It's clear what needs to
happen. Better governance for global health security, including a binding
treaty on pandemic preparedness and response, better financing to strengthen
the capacities of all countries, especially the most vulnerable.
Better systems and tools to prepare for,
prevent, detect and respond rapidly to outbreaks with epidemic or pandemic
potential and a strengthened, empowered and sustainably financed WHO at the
centre of the global health architecture.
To say more about its latest report I'm
delighted to welcome my friend and brother, Mr Elhadj As Sy, the GPMB Co-Chair
and the former Secretary-General of the International Federation of the Red
Cross and Red Crescent Societies. As Sy, thank you for your leadership and you
have the floor.
00:11:10
EAS Thank
you. Thank you very much, my brother. I think I could build on one of the very
powerful sentences that you just used. We need action. We already know what we
need to do. What we need is action and action now because the window of
opportunity is closing by the day.
So we need that urgency and we need ambition.
You're absolutely right. Report after report - what we predicted happened and
we were congratulated for being right and those are moments when it is not nice
to be right.
What is it that we know, what is going to
happen? We were smart enough to predict it and not smart enough to take the
action required, from preventing the outbreaks from becoming pandemics, from
preventing shocks becoming disasters.
You mentioned the numbers, 17 million
COVID-related deaths. Millions of people have lost their lives. Millions more
are without parents or grandparents. To put it as we feel in the region where I
am now, let me just say bluntly, it is deeply shameful. We should grieve, we
should be angry because millions of deaths are neither normal nor acceptable
and these are just numbers that we're quoting.
00:12:47
We forget that behind each unit of these numbers
there is a face, there is a human being, there is a story, a story of a parent,
of a child, of a friend, of a colleague. Many of them also we have lost
ourselves, being on the front line and trying to respond to this challenge.
The rift between the haves and the have-nots is
growing and you're right, it's not just vaccine equity that should be front and
centre. It is also a matter of how low-income countries are able to implement
public health measures within their communities and fragile economies to keep
people safe.
We are indeed facing extraordinary challenges
and the world is clamouring for solutions yet global leadership continues to
step back and shy away from what needs to be done. We've seen it happen once
again with the recent G20 leaders' statement.
Honestly, we had hoped for firm financial
commitments to fully fund global efforts to curb the pandemic. We had hoped for
an agreement to establish the financing mechanism that would provide predictable
financing at the scale required to prevent future pandemics.
00:14:13
But what we got was a commitment to keep talking
about it. We shouldn't be surprised. The COVID-19 pandemic has exposed a world
that is unequal, divided, in many instances unaccountable. Through the pandemic
polarisation, geopolitical conflicts, nationalism and skepticism of
multilateralism have meant that many countries are raising the drawbridge
rather than seeking global solutions.
We shouldn't be surprised but we should be dismayed
and we must demand more. We need to see signs that political leaders are
willing to work together, all political leaders, and take the bold steps that
are urgently needed to protect the one and only planet we share as well as the
one and only humanity we share.
In our report we have challenged world leader to
take five steps, only five, that would demonstrate their commitments to change
and how they will go about it urgently, inclusively and equitably, five simple
steps over the next eight weeks that will give a clear signal to the world that
they agree on what needs to be done and are very serious about doing it.
00:15:41
Let me spell them out. First, agree at the
November 2021 special session of the World Health Assembly on the need to adopt
an international agreement on pandemic preparedness and response and establish
a process for taking forward negotiations.
Second, agree to convene a summit of heads of
state and government on pandemic preparedness and response together with other
stakeholders and set in motion a preparatory process for this summit.
I emphasise here, together with other
stakeholders because it's been a multidimensional problem that will require a
multisectoral approach and solution.
Third, agree to a significant increase in
WHO-assessed contributions in order to adequately and sustainably finance the
organisation's essential functions and core capacities. Year in and year out
WHO has been weakened by less financing, less authority yet if things are not
working the fingers are being pointed towards WHO. That has to change.
Fourth, agree to establish a new financial
intermediary fund for pandemic preparedness and response. And finally, develop
terms of reference for design of an end-to-end mechanism for research,
development and equitable access to common good.
00:17:21
Is there a hope? Yes. After years of inaction we
are finally seeing some traction on climate change. World leaders gathered in
Glasgow this week at COP26 are taking political responsibility and making
commitments for change. The current political context is challenging but there
are some signs of progress.
Pandemic preparedness and response should be a
simpler problem in comparison so why is it so difficult to get world leaders in
a room to agree on the bold solutions required? If COVID-19 is not the catalyst
for change what will it be?
It is easy to be cynical today and think that
nothing can change, that we are forever condemned to repeat a cycle of panic,
apathy and neglect but we must reject pessimism and recognise our common
humanity and growing interdependence.
We must recognise that we live in a shared world
with shared risk and shared responsibilities. The solutions must match the
magnitude of need to bring this pandemic to an end and to prepare for the next
one and even better prepare for the next one.
00:18:42
We must support those individuals and
organisations working tirelessly to end this epidemic, many of them or some of
the most important of them gathered in this room today. We're indebted to you,
my brother, Dr Tedros, and to the WHO for the leadership you continue to show
in working towards the global health ecosystems that serve everyone everywhere.
That is the spirit in which this report has been
published and more than a report, it should be instantly raising action and we
continue our mobilisation in a frame of an independent framework to see things
happening, action taken and accountability shown. Thank you very much.
TAG Thank
you. Thank you very much, my brother, As Sy. I will quote you from what you said.
If COVID is not the catalyst for change, what could it be? That's really true.
Thank you for your clear call to action and we can only hope that the
international community acts on that call.
As you said, we know what needs to happen. What
we need now is action, urgency and ambition. Thank you so much again for your
leadership. Tarik, back to you.
TJ Thank
you, Dr Tedros. Thank you, Mr As Sy. Mr As Sy will be with us throughout this
press conference and will be available to answer some of your questions. With
this we will open the floor for questions from journalists who are online and
we will start immediately with Nina Larson from AFP. Nina.
NI Hi.
Thank you very much for taking my question. As you've mentioned, the world this
week passed the devastating milestone of five million officially registered
COVID deaths since the start of the pandemic and at the same time we're seeing
case numbers rising in many places, including Europe which now appears to be
the epicentre of the pandemic again, as Dr [Unclear] said today.
As we approach the end of the year I was
wondering if you cold say how you expect this pandemic to evolve in 2022, if
you think there's any chance at all the pandemic could be declared over next
year or are we instead looking at a worsening, possibly even a doubling of this
death toll? Thank you.
MK Thanks
very much for the question. I will begin and I'm sure others may want to come
in. I just hope that marking this tragic milestone doesn't become just that,
that it's just another number that we reach. I don't think the world has even
begun to grieve this many deaths and we know it's far, far higher and every
single one of us on the planet has been impacted by this pandemic.
00:21:51
The trajectory of this pandemic is in our hands,
it has always been in our hands and your question about what will happen into
2022 remains up to us. Is there a possibility where we can reach a state where
we have gained control over transmission in 2022? Absolutely.
Is there the possibility that we can remove the
death, the severe hospitalisations and death in 2022? Absolutely. We could have
done that already but we haven't and collectively as individuals, as leaders we
have to take stock of that and make a choice and make conscious choices every
day of how we're going to address that.
You ask about 2022 and it's a good question, we
get that question a lot but right now we are seeing increases where we
shouldn't be. You mention Europe. There's been a more than 55% increase in
cases over the last four weeks in Europe, where there's ample supply of
vaccines, where there's ample supply of tools.
00:23:05
We mentioned grieving and being angry and being
frustrated. What we need to see is that anger, that emotion turn into action.
We need actions that protect ourselves, that protect our loved ones from
infection, from the spread.
We need leaders to provide communities with
consistent, accurate information to enable communities to keep themselves safe
and their loved ones safe, to invest in systems and surge those systems for
surveillance, for testing, to support our health workers.
It's happening now. We can't make these changes
once this pandemic is over to prepare for the next one. One of the themes of
today is these inter-action reviews and many countries have used this to assess
where they are and to make necessary changes and that is something we advise to
countries, to regularly assess the epi situation, the severity of the situation
I their country and the capacities that they have and to course-correct where
needed.
This is a strength, this is not a weakness of
countries so the question is not what we do in 2022, it's what we do right now
and we have the opportunity and we have to do this now. How many more people
need to die, how many more countries need to be put into severe situations
again before we take action?
00:24:27
So everyone that's watching this, whether you're
an individual, whether you're a journalist - and thank you for putting out good
information through your networks - leaders, what will you do today?
TJ Mr
Elhadj As Sy, would you like to add something on this particular question on
the prospects?
EAS [Inaudible]
not. Just to reinforce, I think Dr Maria Van Kerkhove said it very nicely. The
anger and the emotion should not paralyse us. It should lead to passion and
that is the reaction that we all are hoping for. Let's get inspiration, I
think, from the hundreds of thousands of people on the front line who are
confronted with these challenges on a daily basis and doing their best to
alleviate human suffering and to save lives.
Let us think often of those who have hosted the
virus in their own bodies, including myself, who were very, very sick and
knowing what it means to have healthcare workers on your side and to know how
oxygen tastes, to save your life.
00:25:51
All the things that we're talking about are not
abstract, all these things we are talking about are realities on a
day-to-day... that we are all facing and confronting. So again we will continue
to express this anger, continue to express these emotions.
But emotion means to be in motion, to be in
action and that is the partnership that we're calling for and will continue to
do so every day.
TJ Thank
you very much, Mr As Sy. We will go now to the next question, Shoko Koyama from
Japanese broadcaster NHK. Shoko, the floor is yours.
SH Hi,
Tarik. Can you hear me?
TJ Yes.
SH Nice
to see you again. Regarding Covaxin, for which WHO issued an emergency use
listing yesterday, I was following the social live Q&A yesterday and heard
the explanation of which strain has been used. I understood it is closer to the
original strain but not the delta strain but didn't quite understand how WHO
considers the effectiveness towards variants.
00:27:02
Was it found to have 78% efficacy against
COVID-19 of any severity including delta variant?
My second question, if I may. What impact do you
consider this approval gives to increase the capacity of distribution of the
COVAX facility? Thank you.
TJ Thank
you. Maybe Dr Swaminathan will start and also Dr Rogerio can add.
SS Yes,
I can start. I'm sure Dr Gaspar will comment. Yes, as you heard, the WHO did
provide emergency use listing yesterday to Covaxin. That's the latest and this
process is ongoing. We have a rolling submission. The committee looks at
efficacy and safety data from all of the clinical trials and also
post-marketing surveillance studies as well as the manufacturing itself, the
quality of the manufacturing.
SAGE, which is the independent strategic
advisory group of experts on immunisation, also looks very carefully at the
clinical trial data. So what was said was that this vaccine, the Covaxin, in
its trial of about 25,000 people, the phase three trial of adults over 18
years, had an efficacy of about 78% against symptomatic infection.
00:28:30
At the time that the trial was being done in
India there was a lot of delta. It was around the time that the delta virus was
becoming the predominant virus so in the trial when they did the genotyping of
the infected participants they had people with delta infection.
They also had people with previous variants like
alpha so when they looked at the subgroup of delta infection they found that it
also had a fairly good efficacy of close to 70%, I think it was around 68%.
That's why the clinical trial data actually
shows overall efficacy of 78%, a higher efficacy against severe disease, close
to 90% but the number of cases was less so that's why the confidence intervals
are quite wide.
They also were able to give an estimate of the
efficacy against the delta variant because some of the trials that were done
for other vaccines were done at a time when the delta was not the predominant
variant and then subsequent studies had to be done to find out the efficacy
against a different variant.
So it's always good to have that information as
well from the manufacturers. What emergency use listing provides is a couple of
things. One is that it enables countries' regulatory agencies to approve very
quickly based on the WHO EUL because many countries go by the WHO EUL or
pre-qualification.
Therefore it provides opportunities for expanded
use and access of this product and it's basically a stamp of safety, efficacy,
quality and hopefully it also enables people easier travel as many countries
are looking at vaccination certificates even though the WHO continues to say
that vaccine certificates should not be the exclusive criterion for travel
entry.
Rogerio might want to add.
RG Thank
you, Soumya. Just to complement - because I think you already covered part of
the question - on the procedure for approval which was in the media with
several questions in the weeks before this one.
Now that the process is completed we can go to
the numbers and to the facts as we normally wish to do so the approval of the
eight vaccines that were EULed since the beginning varied between 40 and 165
days.
00:31:07
Specifically Covaxin, the Bharat vaccine was
submitted on 9th July and approved on 3rd November which
means 120 days on the calendar.
But if you consider the relevant data that was
submitted by the end of July it's closer to 90 days in terms of the process of
approval. I hope these numbers, which are transparent and on the website of
WHO, as we normally do every week, put an end to a number of questions that we
have seen in the previous weeks. Thank you.
TJ Many
thanks. Now we will go to the next question. That's Donato Mancini from the
Financial Times. Donato.
DO Hi,
everyone. Thank you so much for taking my question.
TJ Donato,
can you just speak a bit louder?
DO Hi,
sorry. I know you've been asked about the trajectory of the pandemic in 2022
but what is your assessment of the situation in Europe currently with cases
rising, especially in Eastern Europe and Benelux, where new restrictions are
being imposed, among other places? Thank you so much.
00:32:18
MK I
can begin. I think, as we are seeing cases and deaths increase across large
parts of Europe - it's not just in Eastern Europe but in many other countries
as well - our recommendations are really to use the tools that you have, to act
fast, to use public health and social measures in addition to increasing
vaccination coverage.
And to tailor the response as locally as
possible, understanding what the situation is because it is diverse and it's
not the same. We don't give prescriptive information or advice because the
situation is so dynamic and capacities are also different.
So our recommendation is to assess where you are
with the epi but when you're looking at cases what we do see is that in
countries that have access to vaccine the vaccines are incredibly effective
against hospitalisations and against deaths.
So you may see case numbers increasing but the
deaths are not increasing at the same rate. The fact that there still are
people that are dying needs to also be addressed of course and part of this is
ensuring we have adequate vaccination coverage in all countries of those who
are most at risk, people with underlying conditions, those who are over the age
of 60 and critically our front-line workers.
00:33:36
But in addition to that, even if you are
vaccinated, to continue with the public health and social measures, continue to
wear a mask, a well-fitting mask over your nose and mouth. Mask supplies are
ample now and this is perhaps an inconvenience for some but this is one of the
proven measures that can limit the spread in addition to physician distancing,
avoiding crowds, working from home as much as you can - not everybody has that
luxury - and for leaders to really invest in surveillance and build up those
capacities and systems right now.
It's about a combination approach, it's not just
vaccines, it's vaccines and, not vaccines only. So what we need for countries
to do is to really stay the course - you've heard us say that before - and what
that means is to apply a number of measures.
Some people like the Swiss cheese analogy of
building and layering upon and adjusting that and tailoring as needed and we're
here to support. We support through our regional offices, through our country
offices to help with supply if necessary, to ensure that there's adequate
clinical care and we will continue to do that.
00:34:53
TJ Many
thanks, Dr Van Kerkhove. We go to the next question, Gunila Van Hall from
Svenska Dagbladet. Gunila, you have the floor.
GU Yes,
can you hear me?
TJ Very
well.
GU Thanks
for taking my question. It is about Europe and the situation, cases going up
and Europe is now again, we heard today, the epicentre of the pandemic. At the
same time, in the same week we have the G20 in Rome, we have the climate summit
in Glasgow with 30,000 participants.
How wise is this, how advisable is it to have
big international meetings in person when we have this situation especially in
Europe right now? Thanks.
MR I
think both of those gatherings that you mentioned have very strict protocols in
place in terms of the status that the participants have had to demonstrate
before attending those conferences.
00:35:54
We've been supporting many mass gatherings over
the last two years in trying to ensure that we can continue to gather safely in
reduced numbers, virtually and increasingly face-to-face.
I do think though that, in referring back to
what Maria has spoken about, the reality for Europe in general is that we've
had that again and we're two years into this but we seem to be constantly
surprised by the simple behaviour of viral pathogens.
We have come out of the summer period with
increased mixing, increased mobility, increased gatherings, a lot of
restrictions have been reduced. The onus has been put back onto individuals to
continue individual risk management with little support from the governments in
being able to continue doing that.
Temperatures have dropped, the weather has
disimproved and people are moving back inside and they're doing that in two
contexts, in the context of countries that have relatively or very high
vaccination levels in vulnerable groups but transmission has been transferred
into younger age groups so you have intense transmission without necessarily a
huge increase in hospitalisations and death.
00:37:20
Then you have other scenarios in which there's
been relatively low vaccine uptake in some countries and they're really facing
into a very difficult situation because they have suboptimal vaccine coverage
and there are countries in Europe who have this.
There may be plenty vaccine available but uptake
of vaccine has not been equal and uptake of vaccine particularly amongst highly
vulnerable groups. So when you look at coverage of vaccination in any country
and say it's 60%, for me I want to know which, who's covered.
If you've got 95 or 99% of people over 65 with
underlying conditions covered then clearly you're not going to have the same
risk. If half of your vulnerable population are still not covered with vaccine
then they remain extremely vulnerable in a context of increasing intensity of
transmission.
The other factor, I think, that's not really
being considered is health systems have already been weakened by this massive
effort over the last 22 months. Health workers are exhausted, many health
workers are leaving the profession and hospitals around Europe were just
getting back with doing elective work and the normal work and now we're seeing
country after country having to switch back to cancelling elective surgery or
non-essential medical interventions and having to reprogramme back to shoring
up their intensive care and their high-support care facilities.
This is again putting a lot of pressure back on
health workers so even where you're not seeing the same increases in
hospitalisations as we saw earlier in the year a smaller number of cases is
placing an even greater burden on the system because the systems are tired, the
people in the system are tired.
They're still fighting very hard but it's very
hard for them to be able to react in the same way. It is very difficult to
sustain the kind of effort that's needed on everyone's part, on the part of
health workers, on the part of communities, on the part of government.
There's exhaustion and exhaustion is leading to
complacency and complacency is leading to gaps in our system, gaps in testing,
gaps in clinical management, gaps in vaccination.
00:39:38
It is through those gaps that we see
transmission, it is through those gaps that we see the hospitalisations and the
deaths and we need to close the gaps. We need to close the gap in vaccination,
we need to close the gap in protected, safe, well-rested health workers, we
need to close the gap in protecting ourselves through public health measures,
as Maria has said, wearing masks and being cautious.
Just because you're vaccinated does not mean
you're perfectly protected against every outcome in COVID-19 and the numbers of
deaths are also rising in other regions and cases are rising in other regions.
It's very important to reflect that Europe represents over half of the global
cases in the last week but that trend can turn. Look what can happen.
We're all epidemiologists now. We only have to
look at the roller-coaster epidemiologic curve to know that when you're coming
down the mountain you're usually about to go back up another one and the fact
that Europe is climbing that mountain again should really stand everybody up
around the world and say, what are we going to do?
Because Europe does have the capacity and
European countries have the capacity, they have the vaccine access, they have
the money, they have the systems in place that they can react. Many other
regions don't necessarily have those capacities in place.
So I think it's a warning shot for the world to
see what's happening in Europe despite the availability of vaccination and I
think we all have to double down and recommit ourselves to doing everything we
can to be the last person in the chain of transmission.
That's going to mean, I think, increased use of,
for example, things like antigen testing and expanded... changing the way... We
were discussing this this morning. Sometimes to stay the course you have to
change course and at the moment we seem to be hell-bent on a course that says,
the pandemic is over and we just need to vaccinate a few more people and this
will all be over. That is not the case.
Maria spoke to this. Each and every country now
needs to look at its strategic preparedness and response plan for this
pandemic. It needs to look at the gaps in the system that exist right now and
it needs to plug those holes in their response.
00:42:02
Some countries are going to need a lot of
assistance with that. Many European countries are well able to deal with that
and I know governments don't want to disappoint their populations by going
backwards and there's this perception that we're moving forwards now towards
the end of the pandemic and any step backwards is a retrograde step.
I think every country now needs to look at its
epidemiology, look at protecting its health workforce or its health system and
ensure that it can get through the next few months without systems going into
collapse again.
That will require in many countries a course
correction and a real focus on ensuring that every single vulnerable person has
had full vaccination.
TJ Thank
you, Dr Ryan. Next question comes from Mexico, [Unclear] Mexico and we have
Manuel Lino with us online. Manuel, could you please unmute yourself and ask
your question.
MA Yes,
thank you very much. My question is, I read an article in the BMJ that says
that WHO is needed now more than ever but is handcuffed by a lack of funds and
structure that leaves it vulnerable to politics. These problems can be fixed,
says the author, and must be urgently. Could you share some thoughts on this
statement?
00:43:33
TJ Thank
you. Maybe Mr As Sy could start as he mentioned funding and then we will come
back to the room here. Mr As Sy.
EAS Yes,
I personally have witnessed in my professional lifetime that when we were
confronted with a huge HIV epidemic not enough was invested in WHO but we
created UNAIDS and I worked for UNAIDS.
I also remember very well after [unclear] in
2001 when we needed to invest more on STB and malaria, we did not invest more
in WHO but we created the Global Funds.
I also witnessed when GAVI was created, when we
needed to do more on immunisation and most recently we saw the creation of stop
TB partnership, roll back malaria partnership. Maybe there's a good intention
behind all of that, to call for a multi-stakeholder, multi-sectoral response to
these challenges that we see.
But at the end of the day if any of those
sectors did not deliver and at the end of the day we had some problems and
issues, at the country level or at the local level fingers have been pointed at
WHO.
00:45:05
So when we call for greater funding for WHO,
more support, more accountability and more authority this is not a favour that
we're doing to WHO. This is because we care about global health and we care
about the support that is required and that needs to be given now to countries.
We believe that a much stronger-funded WHO with
greater authority out of the geopolitics positioning will be the way to go and
that can also make the organisation more accountable and then we can all be
more demanding vis a vis the organisation.
We only hope now that with this current crisis
we do not repeat the same, if not mistakes but the common practices but again
let's try to see outside of WHO what we can do and then continue to blame WHO
if things are not working.
So we strongly believe that a stronger WHO, a
fully funded WHO with greater authority that comes with greater accountability
is something that is required now and urgently.
MR I
might just add to As Sy's comments. Again, we speak about WHO as the World
Health Organization. Again some people imagine that as a secretariat building
in Geneva, Switzerland.
00:46:45
The World Health Organization is effectively the
combination of 194 member states around the world who come together to agree on
what priorities should be for health and what policies should be for health.
It is our work as a secretariat under the
leadership of Dr Tedros to implement those policies and implement the will of
countries in terms of what countries consider to be the priorities in terms of
health.
In my view the way we're dealing with our
transnational health issues at the moment is we're trying to deal with a global
threat using individualised solutions. I was on a foresight roundtable this
morning and Professor Alice Roberts, who many of you will know, was on that roundtable.
She's a medical anthropologist and communicator and said that we're effectively
operating a mediaeval feudal system where each country can build its own castle
and pull up the drawbridge and that represents safety.
00:47:54
That concept may have worked in mediaeval times.
It doesn't work in the face of a globalised viral pathogen and it doesn't work
when we talk about other issues in healthcare like HIV or TB or malaria. We
need collective solutions, we need transnational and what would be called
multilateral solutions.
We need agreement at a global level on what is
to be done to protect the health of the world's population, health for all. You
can't deliver health for all unless you prioritise health for all and when we
talk then about putting more money into health it's not about putting more
money into WHO or more funding into WHO.
It's about putting more funding into healthcare
systems, into public health systems, into protecting health at local,
community, national and global level. WHO can do its part but the main
investment here - and I'm sure Dr Tedros would speak to this - is investing in
universal health coverage, investing in public health systems at national
level.
Epidemics and pandemics begin and end in
communities. The deaths we've seen in COVID have primarily been due to
unmanaged underlying health conditions that people have borne for years and
years without proper access to healthcare, be it for financial reasons, ethnic
reasons, many other reasons.
00:49:14
So yes, there needs to be a massive scale-up in
funding in the space of health. Health is not a cost, health is an investment
and no more than with climate change it cannot be addressed through
single-country responses. It can only be addressed when we all come together
and invest in health and health for all.
In that sense, yes, I would agree that I see
clearly WHO has a huge role to play in that but the real gap here is investment
in health, in healthcare systems and in health protection.
TJ Many
thanks, Dr Ryan and Mr As Sy. We have time for one, maximum two more questions.
We also want to hear at the end from Dr Liviu Adrescu on the interactive
exercises on preparedness. Let's go to John Zaracostas from the Lancet. John.
JO Yes,
good afternoon on a cloudy Geneva day. My question is to some of the
participants on the panel and in particular Mr Elhadj. You mentioned you would
like to see an international instrument and some guidance going forward on the
negotiations and Dr Tedros also mentioned that.
00:50:37
Can you please elaborate a little bit and make
the case why it's so important, given you had the International Health
Regulations, negotiated over five years and ignored in the first few months of
the pandemic?
So can you please make the case and since Mr
Elhadj is there I'd love his views also on the epidemic of indifference right
now worldwide on the catastrophic food insecurity in Madagascar, in Yemen, in
Afghanistan?
TJ Thank
you, John. Mr As Sy.
EAS Thank
you very much. Let me go back to the initial recommendations that were made
that were based on the consultation of really what is lacking. We realised
there are some many instruments already existing. They cover certain areas and
they work well for that purpose.
When we are now facing a pandemic of unprecedented
magnitude we will need responses and instruments at the same level and same
scale, not only for this pandemic but for similar cases that we will be
confronting in the future and many like myself believe that it is not a
question of if, it is only a question of when.
00:52:03
Now we have already said that the world is in
crisis, we said that the world is fragmented, we said there is a lack of
leadership, we said there is a lack of accountability. How can we make sure
that all those lacks that we're talking about can be remedied and that we find
systems and framework that are bringing people together for action, for
monitoring and for holding each other accountable?
That is the reason why we are supporting pretty
much that instrument, be it the conventions, be it the treaty, that will be
defining rules and responsibilities of countries and it includes a high-level
monitoring framework of member states at the highest level to make sure that we
hold each other accountable.
If that is not defined in a form of a treaty
that commits the states to do something then you don't have the basis upon
which that accountability can also be exercised and that is the reason why
we're supporting it.
There are many activities already going on, many
negotiations, many discussions. This is not in lieu of the IHR, this is not a
substitution but it is an instrument that is much more transversal, which we
believe will also reflect the multi-sectoral, multi-dimensional issue of the
kind of problems that we are talking about.
00:53:37
A parallel discussion on the IHR is certainly
happening to draw lessons from what has been learnt so far and further
strengthening it. We will be living in a world that is not going to be a matter
of either/or or how these different instruments will be complementing each
other and taking it to another scale.
The issue that you are mentioning in Yemen, in
Madagascar and others, all that again has been revealed now by COVID-19 and
when we talk about strong leadership, active citizenship, common humanity,
finding solutions to the problems of the people on the ground, all that comes
together.
I think that is the reason why I was starting by
saying, an outbreak should not be a pandemic, a shock and a hazard should not
be a disaster. That could apply for food security, that could apply for the
climate, that could apply also for epidemics.
I think that is that common platform of
leadership and accountability that is required and it is pretty much frustrated
by the COVID-19 pandemic.
00:54:44
TJ Many
thanks, Mr As Sy. Maybe as we are nearing the hour of this press briefing we
could give the floor to Dr Liviu Adrescu to tell us more about those
inter-action reviews that have been talking place in a number of countries that
have been mentioned in our opening remarks. Dr Adrescu.
LI Thank
you. Thank you, Tarik. Many speakers called for course corrections, course
adjustment and global action and while perhaps it is difficult to prompt these
actions at the global level, at the local level and subnational level intra-action
reviews do exactly that.
They identify what needs to be corrected in a
particular locality and, as Dr General mentioned, 100 intra-action reviews have
been done at country levels and many countries found value in them and are
repeating them - ten intra-action reviews in South Africa, many intra-action
reviews in New Zealand and many other countries.
Countries see value in targeted intra-action
reviews. They're looking at their vaccination effort, they're looking at their
crisis communication effort. So I want to also commend many countries that are
choosing to publish their intra-action reports on their government portals.
This promotes transparency, accountability and sharing of their strengths and
challenges with their populations and with their neighbours. Thank you.
00:56:23
TJ Thank
you, Dr Adrescu. Just to let everyone know, we have been also joined by Dr
Landry Majugane [?], who works with Dr Adrescu. in country simulation exercises
and reviews. I don't know if Dr Landry would like to add something on this
topic.
LA Yes,
thank you so much for this opportunity. It's just again to reiterate the need
for continuous learning because it's only when we are learning and we are able
to identify where the gaps are and course-correct and apply those lessons
learned, this is the best way we can really address this pandemic as quickly as
possible.
I believe intra-action review can play a
critical role in that and I really urge countries... As Dr Maria Van Kerkhove
mentioned on several occasions, we really need to learn and apply the critical
lessons learned as we move forward.
TJ Many
thanks, Dr Landry. Maybe before I give the floor to Dr Tedros, Dr Ryan would
like to add something.
00:57:39
MR Just
on the issue of instruments and treaties, I'm sure people are aware of this but
the World Health Assembly was convened at the end of this month with Dr Tedros
for only the second time in its history in an extraordinary meeting to consider
one issue, one agenda item and one agenda item only and that is the need for
and the merits of concluding a new agreement or framework treaty, convention
that would allow the world to react collectively in preparedness and response
to the next pandemic.
That will be led by our member states, as I said
in my previous intervention and it's going to be a very important convening of
all the member states of WHO with the Director-General to consider that very
question.
I think it's a very, very important moment in
the history of global public health and, as the Director-General has said
before, a generational moment to consider the future of pandemic preparedness
and response.
TJ Thank
you, Dr Ryan. I will just go back to Mr Elhadj As Sy for any final remarks
before we give the floor to Dr Tedros.
00:59:04
EAS Thank
you very much. Just one final remark again to thank WHO and the World Bank for
convening the GPMB and to stress again the importance of an independent
monitoring framework, moving ahead with all these negotiations going on, all
those ideas on the table including a [unclear] connection and again monitoring,
calling for action, incentivising for action and holding people accountable.
So the GPMB is committed to that and will be
looking forward to continuing working with with all of you in that trigger.
Thank you very much.
TJ Thank
you very much for your participation and very strong messages today, Mr As Sy.
With this we will conclude the press briefing. The audio file will be sent
shortly and the transcript will be available tomorrow. The last floor is as
always for Dr Tedros.
TAG Thank
you. Thank you, Tarik. I think it was a very important presser and thank you,
As Sy, for joining us. Your message was very clear. We know what to do. Now
it's time for action. I think that would be the best message to take from
today's presser and move forward to take action, the immediate thing being
vaccination.
01:00:35
As you know, we have set a 40% target for
vaccination for each and every country by the end of this year and that's
possible so I would like to use this opportunity to call on those who can
afford to share and also supporting any other way and also co-operation from
the manufacturers and to achieve the 40% target.
So I think that's a clear goal and where our
action should be focused, among other things. Of course the long term is key.
While fighting the pandemic now we need to prepare for the long term and that's
why, as Mike said, we are now going to have a special session of the World
Health Assembly at the end of this month to discuss the need for a pandemic
treaty.
This pandemic has been really unprecedented and
I will again quote As Sy, if this COVID pandemic cannot be a catalyst for
change it's very difficult to understand what could be a catalyst. That's why
the treaty, the discussion or the assembly to discuss the treaty is very
timely, very crucial and I hope the world will agree to have a treaty or
agreement that can help us to fight the next pandemic in a better way.
So thank you so much again to As Sy for your
leadership and thank you also to the media for joining us today and see you
next time.
01:02:29