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WHO press conference on monkeypox, COVID-19 and other global health issues – 25 August 2022

WHO Team
Department of Communications

Transcript


00:00:19

TJ Hello to everyone from the headquarters of the World Health Organization here, in Geneva. My name is Tarik and I wish you a warm welcome to our regular press briefing on global health issues. This press conference, as always, has simultaneous interpretation in six UN languages, as well as Portuguese and Hindi.I will start by introducing our speakers here, in the room. With us is, as always, Dr Tedros, our Director-General. We have also Dr Socé Fall, who is Assistant Director-General for Emergency Response. Dr Maria Van Kerkhove is Technical Lead for COVID-19. Dr Rogério Gaspar is Director for Regulation and Prequalification. Mr Tim Nguyen is Unit Lead for High Impact Events.

00:01:12

We have a number of our officials online. Dr Mike Ryan is with us. He is Executive Director of Health Emergencies Programme. Dr Soumya Swaminathan is our Chief Scientist. She should be also with us online, as well as Dr Kate O’Brien, Director for Immunisation, Vaccines and Biologicals. We should also have with us Dr Sylvie Briand from Emergency Preparedness and Olivier le Polain, who is an epidemiologist. Also, with us only by audio, maybe not with video, is Dr Rosamund Lewis, who is Technical Lead for monkeypox.With this, I will give the floor to Dr Tedros for his opening remarks and journalists who would like to ask questions, please click the icon Raise Hand right now, so we can put you in the queue. Dr Tedros.TAG Thank you. Thank you, Tarik. Good morning, good afternoon, and good evening. First to Ukraine. Yesterday marked six months since the Russian Federation’s invasion, which has had a devastating impact on the health and lives of Ukraine’s people. Although shaken, the health system has not collapsed.WHO continues to support the Ministry of Health of Ukraine to restore disrupted services, displaced health workers and destroyed infrastructure, which is essential not only for the health of Ukraine’s people but for the country’s resilience and recovery.WHO has helped to deliver more than 1,300 metric tonnes of critical medical supplies, with more on the way. These include power generators, ambulances and oxygen supplies for medical facilities, supplies for trauma and emergency surgeries, and medicines to help treat noncommunicable diseases. We have also helped to train more than 9,000 health workers on trauma surgery, mass casualties, chemical exposure, epidemiology and lab diagnostics.

00:03:42

Mental health is another key focus. Stress management training is being provided to health workers and the general population on how to safeguard mental health given the sharp rise in war-related psychological distress. However, attacks on health continue unabated. In the past six months, WHO has verified 473 attacks on health, with at least 98 deaths and 134 injuries. No health system can deliver optimum health to its people under the stress of war, which is why we continue to call on the Russian Federation to end this war.Now, to COVID-19. This week we crossed the tragic milestone of one million reported deaths so far this year. We cannot say we are learning to live with COVID-19 when one million people have died with COVID-19 this year alone when we are two and a half years into the pandemic and have all the tools necessary to prevent these deaths.Once again, we ask all governments to strengthen their efforts to vaccinate all health workers, older people and others at the highest risk, on the way to 70% vaccine coverage for the whole population. It is pleasing to see that some countries with the lowest vaccination rates are now making up ground, especially in Africa.In January this year, WHO, UNICEF and partners established the COVID-19 Vaccine Delivery Partnership to accelerate vaccine coverage in the 34 countries that were below 10% coverage, all but six of which are in Africa. Just six months later, only ten countries still have less than 10% coverage, most of which are facing humanitarian emergencies.

00:05:56

It’s especially pleasing to see that coverage of high-priority groups is improving, with many countries making impressive progress towards vaccinating 100% of health workers and 100% of older people. However, much more needs to be done. One-third of the world’s population remains unvaccinated, including two-thirds of health workers and three-quarters of older adults in low-income countries.All countries at all income levels must do more to vaccinate those most at risk, to ensure access to life-saving therapeutics, to continue testing and sequencing, and to set tailored, proportionate policies to limit transmission and save lives. This is the best way to drive a truly sustainable recovery.Now, to monkeypox. Last week, the number of weekly reported cases fell by more than 20% globally, although new cases increased in the Americas, where we are continuing to see intense transmission. In the early stages of the outbreak, most reported cases were in Europe, with a smaller proportion in the Americas. That has now reversed, with less than 40% of reported cases in Europe and 60% in the Americas.There are signs that the outbreak is slowing in Europe, where a combination of effective public health measures, behaviour change and vaccination are helping to prevent transmission. However, in Latin America in particular, insufficient awareness or public health measures are combining with a lack of access to vaccines to fan the flames of the outbreak.

00:07:06

Yesterday, the manufacturer of one vaccine, Bavarian Nordic, signed an agreement with WHO’s Regional Office for the Americas to support access to its vaccine in Latin America and the Caribbean. We thank Bavarian Nordic for this agreement and we hope that it will help to bring the outbreak under control in the region. WHO continues to encourage all countries to establish vaccine effectiveness studies to ensure data collection, even while enhancing access.Last week, I spoke about the drought and famine in the Greater Horn of Africa, where WHO has launched an appeal for US$124 million to prevent and control outbreaks, to treat malnutrition and to provide essential health services and medicines. So far, we have received just 12% of the funds we need.In the Ethiopian region of Tigray fighting resumed yesterday. It’s tragic to see the resumption of active conflict but, in reality, the war had never stopped. For more than 21 months the six million people of Tigray have been under a suffocating siege that has killed people, not only with bullets or bombs but by weaponising banking, fuel, food, electricity and healthcare. That’s why we have been calling for the resumption of essential services and an end to the blockade systematically enforced by the governments of Ethiopia and Eritrea. The only solution is peace and we continue to call for a peaceful resolution.The emergencies in Tigray and the Greater Horn are far from the only crises in Africa. The Sahel region is facing one of the largest, fastest-growing and longest-lasting crises in the world. Across Burkina Faso, Far North Cameroon, Chad, Mali, Niger and North-East Nigeria, more than 33 million people are in need and there are 6.7 million displaced people due to conflict, the worst drought in 40 years, and disease outbreaks.

00:09:49

Last year, more than 3,600 people in the Sahel died with cholera, and transmission of yellow fever is at the highest in 20 years. Disrupted immunisation campaigns due to COVID-19 have led to increasing transmission of measles and vaccine-derived polio. WHO has released US$8.3 million from the Contingency Fund for Emergencies to cover life-saving services in the Sahel but that’s a fraction of the almost US$63 million we need this year. We continue to urge donors not to forget the Sahel.Finally, earlier this week health authorities in the Democratic Republic of the Congo confirmed a case of Ebola in the north-eastern town of Beni, which was the epicentre of the 2018-2020 Ebola outbreak. So far, 179 contacts have been identified. Vaccination of contacts and contacts of contacts began today. Since the last major outbreak ended in 2020, there have been occasional flare-ups, which have been brought under control immediately.WHO will continue to support health authorities in DRC and the province of North Kivu to respond to this case and to prevent further transmission. Last week, WHO published new guidelines recommending the use of two therapeutics against Ebola, which have demonstrated clear benefits in reducing deaths by about 60%. DRC has supplies of these medicines, should they be needed. With highly effective vaccines and therapeutics, Ebola is now a preventable and treatable disease. Tarik, back to you.

00:11:58

TJ Thank you, Dr Tedros, for these opening remarks. I would just remind journalists to click the icon Raise Hand if they have a question to ask, and they can use any of the six UN languages, Portuguese or Hindi. We will start with the first question, and that’s Erin Prater, from Fortune magazine. Erin, please go ahead. Do we have Erin? You will just need to press the unmute button. Erin? We will try to come back to Erin.EP Can you hear me?TJ We can hear you now. Please.EP Sorry, about that. Now, I’ve got it changed. Thank you. Good morning. Just curious if there are any further developments as far as genetic sequencing of the variants that are currently circulating of monkeypox outside of Africa in this current global outbreak. Thank you.TJ Thank you. Dr Lewis can you hear us and try to answer this question? Dr Lewis?RL Thank you, Tarik. We are monitoring the situation and the genetic evolution of the virus but we don’t have further information at this time. Thanks.TJ Dr Lewis, the line wasn’t really good. Can you just repeat, please?RL I can try again to say that we don’t have further information on the genetic variants that are currently being reported. They continue to be uploaded on spaces where scientists can access them and research is underway to assess those variants. We don’t yet have information on what they mean in terms of genetic variability.

00:14:12

TJ Thank you, Dr Lewis. I understand Dr Lewis is on the train right now, so that may be why the sound is not the best. I hope, Erin, this answers your question. I will go now to Simon Ateba, from Today News Africa. Simon, please.SA Thank you, Tarik. Thank you for taking my question. This is Simon Ateba, with Today News Africa in Washington DC. I personally believe that the WHO DG has been addressing health issues from around the world, not just in Ethiopia or Tigray. I just wanted him to address the accusation that he’s using his position at the WHO to influence opinion on Tigray, where he comes from. Is that the case? And if you can also comment on Dr Anthony Fauci, who will be leaving his position in December. Thank you. TJ Thank you. Thank you, Simon.TAG Okay, Tarik. Thank you. Thank you, Simon. I think you could answer that question because you have been following our pressers regularly and we comment on any country about the health situation or health conditions, be it Syria or now Ukraine, Yemen and other places.For instance, if I bring similar conditions like Tigray, if you take Syria, there are people who don’t have access, who didn’t have access to humanitarian aid and WHO, as part of the other UN agencies, and myself, as one of the heads of the agencies, we have been pushing for unfettered access. Not only unfettered access. We have been even pushing for a corridor to keep a corridor to Syria from Turkey.

00:16:25

On Ethiopia’s issue, when we push for unfettered access, the responsibility is given to the Ethiopian government, but in Syria’s case the UN Security Council had decided to have a corridor through Turkey and the UN has been supportive of this. So, we also advocate for unfettered access and access to medicines, access to food and people to get the necessary support they need, and we have been doing the same thing in all conditions where there is the same problem.For instance, if you take the Syrian issue, it’s resolved because there is another corridor. Even if the Syrian government doesn’t want to give access, there is another corridor through which those who need access get access. So, I don’t know why this is seen as special, the Tigray one, but it’s exactly the same. And I will repeat again, there should be unfettered access to support the more than six million people of Tigray.What makes it even very unique, the Tigray situation, is it’s completely sealed off by both Ethiopian and Eritrean governments. So, not only access to food is limited, it’s trickling now, and access to medicine is very limited, ourprogrammes, HIV programme, TB programme, have collapsed and people on chronic follow-up, hypertension, diabetes, they don’t get medicine, so that has also collapsed. And many people that could be saved are dying because more than six million people are completely sealed. What they get is a trickle.

00:18:28

But not only that, not only the food and medicine, they can’t have even access to their own money because banking service has been blocked for almost two years now. I told you last time, imagine if you were prevented by your own government from accessing your own money, Simon. Not just six million, even one inpidual. I don’t think you would survive. And, then, not only banking services. There is no telecom services. That’s also blocked by the government, and electricity and other basic services.I will tell you my own story. I have many relatives there. I want to send them money. I cannot send them money. They’re starving, I know. I cannot help them. I cannot help them. I can help them. I can share from what I have. I cannot do that because they are completely sealed off. I want to speak to them. It’s a long time since I have spoken to them. I can’t speak to them. I don’t know even who is dead or who is alive. Can you tell me any place in the same situation in the world, Simon? Can you tell me?I’m talking about the six million people who are collectively being punished and I can tell you the world can do this. It has the means. For instance, the world came together two weeks ago and did a very good job in helping Ukraine to export its grains. Okay, that’s a good job but why can’t we also push, as a global community, so that the six million people can get food to eat, medicines to be treated and telecom to talk to their people, banks to access their money, and media, so that they can speak and the world can know about their problems?Why can’t we do that? Why can’t we push for unfettered access? So, unfettered access, asking for unfettered access for the opening of basic services and for also asking the Ethiopian government and the Eritrean government who are enforcing the siege systematically, to end the siege is part of my job.

00:21:14

I did it for Yemen. I have travelled there. I did it for Syria. I’m doing it for Ukraine. You remember my statement several times, all the reports we have been saying since the invasion of Ukraine by Russia, and we asked Russia to end the war many times, and we’re also helping. What’s different about Ethiopia? We are not actually doing as much as what we did in Syria.Maybe it’s time to ask for another corridor to help the six million people, like what is being done in Syria. We can even push for that, of course, because this is about humanity, nothing else. I have no interest. That’s my interest and I will do it anywhere. I will do it for Yemen. I will do it for Ukraine. I will do it for Syria. I will do it for other countries.I think, Simon, you know better. You have been following us. You can say it yourself. And others are also following. That’s it. It’s about humanity. I am one of them. I am one of the six million people. That’s personally hurtful, very painful but, at the same time, I’m doing it because six million people are human beings. Because I’m one of them, conflict of interest, whatever, what I should do, I should do, like I do for others. I even did more for others. I think that’s very, very clear. That’s very clear.

>00:22:55

Then, on my friend, Tony, Tony Fauci. We have been friends for many years. I respect him dearly and greatly. He’s an incredible scientist, amazing human being and congratulations to him for all the job that he has done. I know retirement doesn’t mean he will stop working. Retiring for him is like changing a tyre, meaning another mission, and I look forward to continue working with him closely through other things he will, I know, continue to do. So, I wish him all the very best. Tony is so special and everybody knows, I think. Thank you. Tarik.TJ Thank you, Dr Tedros. Dr Fall, would you like to add something?SF Thank you, Tarik. I just wanted to add to the comments made by Dr Tedros. I think that every time human lives are imperilled it is a matter for the WHO, that is we need to underscore the situation. When there is a single case of Ebola, that is discussed, as we have seen. When there are three cases of another disease, we discuss it. When there are extreme situations, we discuss them.But everyone has been disappointed by international efforts in humanitarian terms regarding the situation in Tigray. There’s been no progress for 21 months and this blockade situation has created inhumane conditions. Recently, with changes, it has been shown by the World Food Program that there is great food insecurity around the world. Many women are suffering from malnutrition and not able to feed their children.Up to April 2022, we have not been able to send any medicines. I think this is an extreme situation that requires exceptional efforts from the international community to save lives. We have not even mentioned the excess mortality that there has been for treatable diseases.

>00:25:32

The medicine and the personnel are not going to the places they need. They’re not paid and they don’t have the working conditions that they need because even finding food to eat is an issue. I think the world really needs to act, even if it’s not too late already. Thank you.TJ Thank you, Dr Fall. We will now go to the next question. We have Trent Murray, from Channel News Asia. Trent, if you can hear us, please unmute yourself and go ahead.TM Thank you very much. I just wanted to ask about the monkeypox situation, if I could. Obviously, numbers across APAC are still very, very low but I would just be interested in whether the WHO is still speaking to governments there about possible vaccine rollouts in that region.Then, just on the same theme, I was wondering whether I could get a WHO reaction to the news out of Singapore around the decision to decriminalise sex between men. I’m just wondering, from a health standpoint, do you think thatthat could help men who have sex with men in Singapore to perhaps be more willing to come forward to get appropriate health treatment more broadly. Thank you.

00:26:48

TJ Thank you very much. Do we have Dr Lewis still with us, who can maybe try to answer? Dr Lewis, unfortunately the line is not very good, so we may try with the next question and then try to come back to the question that was asked by Trent Murray from Channel News Asia, hoping that your line will be better.MR Tarik, this is Mike.TJ Yes. Dr Ryan, please.MR Rosamund can come back in, or Sylvie, on how we’re working with the South-East Asian and Western Pacific countries but I do think the point made by the journalist, the second point, we very much welcome and celebrate and congratulate the government and people of Singapore in terms of decriminalisation of sex between men.It’s always a positive step when we recognise and include all people in our society, when we are inclusive, when we are understanding and we recognise and celebrate the persity that we have within our communities. It helps. It takes diseases which may be driven underground and brings them into the open.It has so many positive benefits in so many parts of our society, in so many parts of our culture, but it has a particular benefit in public health in ensuring that everyone has access to appropriate diagnostics, everyone has access to appropriate healthcare and that we work together to control those diseases that threaten us all. So, we would celebrate this event and would hope that countries will go further. Decriminalisation is but one step towards full inclusion of everybody in our society.

00:29:00

TJ Thank you, Dr Ryan, very much, on this answer for the second question. On the first question, we will try, Trent, maybe to answer you in writing. If it’s possible, just send us and email. We may also need to get in touch with our regional colleagues, who have a better overview of the situation there. Let’s now go to Helen Collis, from Politico. Helen.HC Thank you. It’s also a question for Rosamund Lewis, actually. We will see how we go but it was about the US saying it is now administering the monkeypox vaccine at one-fifth of the standard dose to stretch its supplies, and countries in Europe are now also considering the same thing. I wanted to get the WHO’s response to this approach to vaccination with this vaccine and any concerns that there may be. Thank you.TJ Thank you. Maybe we can start with Dr Kate O’Brien, who is online with us. Dr O’Brien.KO Thanks so much for the question. This strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines. There are a number of vaccines where this has been studied and evaluated, and there arereasons why the way you administer a vaccine and the dose that you administer it in can have impacts on the response of people who receive those vaccines in a positive way, depending on how those doses are administered.

00:30:42

So, this is not a new idea and we are looking really carefully at the evidence for the performance of these vaccines, these smallpox, monkeypox vaccines to look at the equivalence or, in fact, possibly the improved performance using fractional doses. Our Strategic Advisory Group of Experts will be meeting at the beginning of October to evaluate the evidence, and that includes looking at some of these factional dose issues.Certainly, there are national regulatory authorities who are also looking at the same evidence and making decisions but what really want to emphasise on the monkeypox vaccines is that we really don’t have a very substantial amount of information about what their performance is.So, what’s really important, as they’re rolled out in different countries, is that we have careful evaluation and evidence that is actually generated so we can understand much better what their performance is and especially in the context of this outbreak and the way that transmission is occurring in this outbreak. So, those are two big points that we want to encourage countries to do. Thanks.TJ Thank you, Dr O’Brien. Maybe we can just try to go back to Dr Rosamund Lewis. We may have a better connection. Dr Lewis, Dr Ryan has answered the second part of the question we got from Channel News Asia but maybe you can try to get something about the situation with monkeypox in that region. Dr Lewis.RL Thank you very much. We monitor very closely the situation in all the regions, and although we have now reached 99 countries with this outbreak, that’s a sign that the outbreak will continue to spread even if the numbers of cases are small in some areas.

00:32:44

We’re also very mindful that some countries may not yet be able to be completely report or that some people may still be concerned about accessing testing because of fear of stigma or discrimination. So, the news from Singapore, as Dr Ryan mentioned, is of course very excellent news that will reduce stigma and discrimination in certain areas.For the other countries, the temporary recommendations that were issued after the declaration of the public health emergency of international concern were very clear. There’s an entire set of our recommendations which you can find in the report online that are to help countries with their readiness, with their preparedness and readiness, so that they already have their emergency committee, they already have their advisory groups in place in advance of even receiving the first case.This is critical for rapid response. In that way, it will be possible for countries that don’t yet have cases of very few cases, to actually, hopefully very much limit the spread in the countries at the time. So, very much this is the case forSouth-East Asia and Western Pacific as well as other regions, that we must support those countries, as we do, for their readiness as well as for their response.

00:34:00

TJ Thank you, Dr Lewis. I hope those combined answers from Dr Lewis and Dr Ryan answer the question Trent had for us. Then, we will go to Radio Free Asia. We have Sangmin Lee with us. Sangmin, please unmute yourself.SL Thank you. Thank you for taking my question. My question is about North Korea, the COVID situation. North Korea today said it found four new fever cases in its border region with China that may have been caused by coronavirus infection but this is two weeks after North Korea leader Kim Jong-un declared victory after COVID-19. So, I want to know how do you assess the COVID situation in North Korea, as of now?TJ Thank you very much, Sangmin. Dr Van Kerkhove.MK I only have a very limited answer because I have very limited information on the situation there. We continue to offer support as best can, in terms of technical assistance, in terms of supplies and will continue to do so but the information that we are receiving is the same information that you are.TJ Thank you. Dr Ryan, please.MR Thank you, Maria. I think it is important and it is difficult for WHO and has been and is difficult in other outbreaks as well. In engaging with or Member States, when we are in a situation where it’s very difficult to get information on a day-to-day, week-to-week, month-to-month basis, it’s very tough for us to give the necessary assistance to countries.We are here as a Member State organisation. We are constantly offering assistance, help, advice, materials, supplies to our Member States. We’re constantly bringing global expertise and regional expertise together on platforms that give support to our Member States but it is difficult do that in a consistent way with a public health benefit at the end of that if it’s a constant struggle to get information.

00:36:14

This is not only the case in the Democratic People’s Republic of Korea. It is the case in a number of countries around the world where issues around transparency and openness and engagement lead us to a situation where it is difficult for us to provide the necessary and adequate support. So, we will continue, as Maria said, to offer support, to continue to try and give whatever support we can.But it’s also very important that countries tell us what’s going on within their countries because we’re tracking this virus. This virus can evolve in any part of the world. As we’ve seen in many, many countries on every continent, we’ve seen at times serious deteriorations in the situation, sometimes very unexpected.So, it’s very, very important that our Member States keep us updated on the evolution of the disease with their borders so that we can help them, first andforemost, but also so we can keep the rest of the world informed of the situation and we can build up a risk assessment that’s based on reality and not on fantasy.

00:37:16

TJ Thank you, Dr Ryan. Thank you, Dr Van Kerkhove. We will have time for one more question before we conclude today’s press briefing. We will call on Lynne Peterson, from Trends in Medicine. Lynne, if you can hear us, please unmute yourself.LP Thanks very much. One of the unanswered questions has been the safety of the blood supply. As I understand it, there is no testing being done of blood that is being donated and donors aren’t being tested. So, what reassurance can we have that the blood supply is safe? This reminds me of the early days of HIV, back in say ‘83-’84, when the blood supply actually got contaminated.TJ Thanks, Lynne. I suppose this question relates to monkeypox. Dr Lewis, do we have anything on the blood supply regarding monkeypox?RL Hi. Sure. I’ll see if the video works too. Thanks very much for the question. As you know, people are screened very carefully when they do come for donation of blood. They’re screened by symptoms, by fever, and that is the first line of screening for anyone who is donating blood and for anyone receiving blood.The second thing is that, as we’ve heard, although some cases of monkeypox are severe, many are less severe and have fewer lesions, and in all cases the period of time that any virus might be in the blood is actually quite limited, which is why specimens are taken from skin lesions as opposed to taken from blood because the viremia period is very short. So, the probability of someone who is otherwise completely well also having viremia from monkeypox would be most unlikely, not impossible but very low probability.

00:39:25

TJ Thank you very much, Dr Lewis, and it was nice to see on you on video as well. With this, we will conclude today’s press briefing. Our colleagues from the Audiovisual Unit will send the audio and video files later and it will be distributed to our global media list. The transcript of today’s press briefing will be posted sometime tomorrow morning. I wish you all a nice evening and I give the floor for the closing remarks to Dr Tedros.TAG Thank you. Thank you, Tarik, and thank you to the members of the press for joining us today. See you next time. 

Speaker key

TJ Tarik Jasarevic TAG Dr Tedros Adhanom Ghebreyesus RL Dr Rosamund Lewis SF Dr Ibrahima Socé Fall MR Dr Mike Ryan KO Dr Kate O’Brien MK Dr Maria Van Kerkhove EP Erin Prater SA Simon Ateba TM Trent Murray HC Helen Collis SL Sangmin Lee LP Lynne Peterson

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