Health situation in Pakistan, COVID-19, monkeypox & Other Global Health Issues Virtual Press conference transcript - 31 August 2022

Overview

00:00:17

TJ           Hello to everyone from Geneva, from the headquarters of the World Health Organization. My name is Tarik and today is August 31st. I’m happy to moderate our regular WHO press briefing on global health issues. As always, we have a simultaneous translation of this press briefing into six UN languages, and Portuguese and Hindi.

I will start by introducing our experts here, in the room, who will be talking to you. As always, with us is Dr Tedros, WHO Director-General, Dr Ibrahima Socé Fall, who is Assistant Director-General for Emergency Response. We have also Dr Soumya Swaminathan. She’s WHO Chief Scientist. Dr Rosamund Lewis is a Technical Lead on monkeypox. We have also Dr Maria Van Kerkhove, who is a Technical Lead on COVID-19.

Dr Rogério Gaspar is Director for Regulation and Prequalification. Dr Kate O’Brien is Director for Immunisation, Vaccines and Biologicals. Dr Bruce Aylward is also with us, and he’s Senior Advisor to the Director-General. With us online, also we have Dr Sylvie Briand, who is Director of the Epidemic and Pandemic Preparedness and Prevention Department and she will also answer questions, if needed.

Journalists who are online, please click the icon Raise Hand, so you will be put in a queue when we get to the question and answer session. With this, I will give the floor to Dr Tedros for his opening remarks. Dr Tedros.

00:02:05

TAG        Thank you. Thank you, Tarik. Good morning, good afternoon and good evening. First to Pakistan, where weeks of heavy monsoon rains have caused extensive flooding and landslides, resulting in death, displacement and damage. More than 1,000 deaths have been reported and almost 900 health facilities have been damaged.

Three-quarters of Pakistan’s districts and 33 million people have been affected, with more than six million in dire need of humanitarian aid. Damage to health infrastructure, shortages of health workers and limited health supplies are disrupting health services, leaving children and pregnant and lactating women at increased risk.

Pakistan was already facing health threats including COVID-19, cholera, typhoid, measles, leishmaniasis, HIV and polio. Now, the flooding has led to new outbreaks of diarrhoeal diseases, skin infections, respiratory tract infections, malaria, dengue, and more. In addition, the loss of crops and livestock will have a significant impact on the nutrition and health of many communities who depend on these resources.

And more rain is expected. Under our internal grading system, WHO has classified the flooding in Pakistan as a grade 3 emergency, the highest level, which means all three levels of the organisation are involved in the response: the country and regional offices, and headquarters.

We are releasing US$10 million from the WHO Contingency Fund for Emergencies, which is supporting our work to treat the injured, deliver supplies to health facilities, and prevent the spread of infectious diseases.

Floods in Pakistan, drought and famine in the Greater Horn of Africa, and more frequent and intense cyclones in the Pacific and Caribbean all point to the urgent need for action against the existential threat of climate change.

00:04:58

Now to COVID-19, where we are now seeing a welcome decline in reported deaths globally. However, with colder weather approaching in the northern hemisphere, it’s reasonable to expect an increase in hospitalisations and deaths in the coming months. Subvariants of Omicron are more transmissible than their predecessors, and the risk of even more transmissible and more dangerous variants remains.

Meanwhile, vaccination coverage among the most at-risk people remains too low, especially in low-income countries. But even in high-income countries, 30% of health workers and 20% of older people remain unvaccinated. These vaccination gaps pose a risk to all of us, so please get vaccinated if you are not and get a booster if it’s recommended that you have one.

Even if you are vaccinated, there are simple things you can do to reduce your own risk of infection and to reduce the risk of infecting someone else. Avoid crowds if you can, especially indoors. If you are in a crowded indoor space, wear a mask and open a window, and continue to clean your hands, which will help to protect you and others from all kinds of viruses and bacteria.

Living with COVID-19 doesn’t mean pretending the pandemic is over. If you go walking in the rain without an umbrella, pretending it’s not raining won’t help you. You’ll still get wet. Likewise, pretending a deadly virus is not circulating is a huge risk.

00:07:19

Living with COVID-19 means taking simple precautions to avoid getting infected or, if you are infected, from getting seriously sick or dying. Once again, I am asking all governments to update their policies to make best use of the life-saving tools that exist to manage COVID-19 responsibly.

Finally, to monkeypox. In the Americas, which accounts for more than half of reported cases, several countries continue to see increasing numbers of infections, although it is encouraging to see a sustained downward trend in Canada.

Some European countries, including Germany and the Netherlands, are also seeing a clear slowing of the outbreak, demonstrating the effectiveness of public health interventions and community engagement to track infections and prevent transmission.

These signs confirm what we have said consistently since the beginning, that with the right measures this is an outbreak that can be stopped and, in regions that do not have animal-to-human transmission, this is a virus that can be eliminated.

But it won’t just happen. Eliminating monkeypox needs three things; the evidence that it’s possible, which we are now beginning to see, political will and commitment, and the implementation of public health measures in the communities that need them most.

We might be living with COVID-19 for the foreseeable future but we don’t have to live with monkeypox. WHO will continue to support all countries to stop this outbreak and eliminate this virus. Tarik, back to you.

00:09:38

TJ           Thank you, Dr Tedros, for opening remarks. We will now open the floor to questions from journalists and, again, please click the icon Raise Hand and we will come to you. We will start with the first question. We have Helen Branswell, from STAT. Helen, please go ahead.

HB         Thank you very much, Tarik. I have a question for Dr Fall. I was wondering if there’s any update on the Ebola case in Beni. Particularly, I’m wondering if there’s any indication of whether the [inaudible] had been vaccinated earlier in the 2018 outbreak there. Thank you.

TJ           Dr Fall.

SF          Thank you, Helen, for your question related to the Ebola outbreak in Beni. So far, we have only recorded one case and now what we know is, from the sequencing, the outbreak is linked to the 2018-2020 outbreak because we have had the same family cases of outbreak, including the husband and the sister.

We have identified 172 contacts and vaccination is ongoing but it is important to know that the risk of Ebola outbreak is still important in North Kivu because of the ecological conditions, the ecological niche, but we also have more than 1,000 people who survived the disease, knowing that we can still have reactivation of the virus, emergence of the disease.

00:11:32

We have a programme working very closely with our Congolese colleagues and are working very closely with the community to be able to activate a response programme whenever we have a new outbreak. We still have a number of alerts because we are doing active case search. We have identified more than 1,600 alerts and identified 180 situations where we needed to take samples. All are negative but we are still very actively working in the community to identify any new case. Thank you.

On vaccination, clearly we have vaccination going on very actively and we have already vaccinated 118 contacts and contacts of contacts. At this stage, the most important thing, after more than 15 deaths, after the first case, is really to make sure that contacts of contacts are vaccinated to avoid any secondary cases. We have an important stock of vaccine at global level using the ICG mechanism. We have over 400,000 doses still available, so ICG is a very effective mechanism to rapidly allocate and send vaccine to the country. Thank you.

TJ           Thank you, Dr Fall. We will now go to Simon Ateba, from Today News Africa. Simon.

SA          Thank you, Tarik, for taking my question. This is Simon Ateba, with Today News Africa in Washington. First, can you please address the allegation that UN agencies, including the WHO, the WFP and others are not helping doctors in Tigray, for instance denying them fuel to power their generators to treat patients?

Also, can you give us an update on the funding you’ve been trying to raise to tackle hunger in the Horn of Africa? How do you go about it? Do you approach countries like the US or do you go directly to rich folks like Zuckerberg, Musk, Bezos? The amount is not too much since that is what is used to feed cats in the US for one day. Thank you.

00:13:52

TJ           Thank you, Simon. Maybe, Dr Fall.

SF          Thank you. I’m not clear about the first question on Tigray. The UN denying fuel to who? I’m not sure. This is a bit unclear but I’m not aware of any action of the UN trying to block anything. Our work is to save life and we work very closely with health workers, local health workers, local health authorities as WHO to make sure that we provide the necessary health intervention, although it’s very limited because of the issue of access, the issue of access to fuel and so on. So, we are still very limited because of the security situation, of course.

In terms of resource mobilisation for the Horn of Africa and for other crises, we have a mechanism with our team working on resource mobilisation to alert donors and to brief them on the situation and the risk and to present the needs we have. We talked about 124 million for the Horn of Africa and we started responding using the WHO Contingency Fund for Emergencies, with 16.5 million.

So far, we are not receiving the support we need to save life and, as we always say, a nutrition crisis is already a health crisis because people who are malnourished are more likely to get disease and more likely to have a negative outcome from disease. At the same time, people who are sick are more likely to get malnutrition.

00:15:29

So, the situation is really bad. The combination of malnutrition and disease outbreaks like cholera, measles, meningitis, as we already said the combination is killing a lot of people and we need to act now but we are not getting the funds we need to act on. This is a cross-sector response. It’s not only about health or only about nutrition. We need to act from all sides to be able to save lives.

TJ           Thank you, Dr Fall. If any of your questions have not been fully answered, Simon, please contact us via email and we will be happy to assist. Let’s now go to Lynne Peterson, from Trends-in-Medicine. Lynne, unmute yourself, please.

LP          Hi. Thank you. Have you learned any more about whether monkeypox can be transmitted through blood or semen? We know that it can be detected in both but what have you learned? What’s new about that? And, secondly, it has been characterised mostly as a problem in the men who have sex with men community but men who have sex with men include bisexual men, so doesn’t that mean that they sometimes have sex with women, so therefore it could spread outside that community?

TJ           Thank you. Maybe, Dr Rosamund Lewis can take this question.

RL          Thank you very much. There have not been any reports so far of transmission of monkeypox through blood transfusions. There have definitely been reports of the detection of the monkeypox virus DNA in semen. One study did illustrate that the virus could be isolated from that specimen.

However, other studies are still underway. We’re still monitoring this space and still looking to understand it. This is an area where we need to learn more. There’s a lot we don’t know and monkeypox can be transmitted through the close contact that is involved in sexual activity.

00:17:45

There may be a contribution from infection through contact with semen, itself, but we don’t fully know the answers to this question yet, so protecting oneself involves the actions we’ve been talking about from the beginning, which is reducing physical contact with anyone who has monkeypox, reducing number of sexual partners, reducing casual sex or new partners and being more open about one’s risks and having conversations with others that may highlight mutual protection and protection of each other.

These are the important features. As long as we don’t have the answers to these questions, the actions to protect oneself remain critically important and some agencies, including WHO, are recommending the use of condoms. That is, in part, as a precautionary measure because we don’t know how much of the infection is transmitted through semen but it is also because it does reduce skin-to-skin contact.

It’s preferable to avoid skin-to-skin contact altogether if someone has monkeypox but at the very least using a condom may reduce that risk while we do more studies to learn more information.

00:19:01

This applies, as you highlight, to bisexual and gay men who have sex with men and anyone who has multiple sexual partners. This is not a disease that is limited specifically to a specific group. What is happening is that it is being spread primarily in one risk group. We know that the majority of cases are occurring among men who are gay or bisexual, as they report themselves when their cases are reported to WHO.

However, as you point out, physical contact of any kind with anyone who has monkeypox would put someone at risk. We are seeing a few cases of women and others who may have acquired monkeypox through a different route of infection, different mode of transmission, but the vast majority today are still among men who have sex with men, whether they be gay, bisexual or otherwise have contact with other men who have monkeypox.

So, the actions remain the same. Protect yourself, protect each other, access to testing and vaccine where it’s available and reduction of, of course, any discrimination or stigma, because that prevents people from accessing care. Thanks.

TJ           Thank you, Dr Lewis. Today’s press briefing is going to be shorter than usual, so we will conclude, with this, today’s briefing. We will have audio and video files sent to our global list later today and then we will have a press briefing transcript available on our website tomorrow. With this, I’ll give the floor to Dr Tedros for his closing remarks. Dr Tedros.

TAG        Thank you. Thank you, Tarik. Thank you to all members of the press who have joined us today and see you next time.

00:21:02

WHO Team
Department of Communications (DCO)