Infectious Disease & Antimicrobial Stewardship

Today, as part of its commitment to strengthening health information systems and improving health[1], especially in the context of the COVID-19 pandemic, WHO announced a new approach to improving access to life-saving data: the SCORE for Health Data Technical Package. The COVID-19 pandemic has highlighted the urgent need for timely and reliable data to drive strategic health action. Too many countries still lack both the infrastructure to routinely gather health data and the analytical capacity to use these data for effective health actions and emergency response. “Countries must be able to measure progress to make progress,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Particularly during COVID-19, reliable data is the best way to coordinate response efforts and improve health in all areas.” Accurate health data are necessary to understand specific country needs in order to improve health and save lives. Data also helps direct scarce resources to where they are needed most. The SCORE (Survey, Count, Optimize, Review, Enable) Technical Package aims to improve the availability of timely, reliable, validated, and comparable health data. For the first time in a single, harmonized package, it represents all the key elements for optimized health information system performance. Simply put, SCORE will help governments around the globe set benchmarks and improve standards in healthcare.In response to the challenges of data availability highlighted in the WHO World Health Statistics 2020 report, SCORE includes more than 90 universally-accepted tools and standards for health information systems strengthening. “Using data to inform public health priorities and strategies has never been more important,” said Dr Kelly Henning, Director of Public Health Programs at Bloomberg Philanthropies[2]. “The SCORE Technical Package provides country governments around the world with high-quality, essential technical guidance so that countries can strengthen their own data systems.” WHO is proud to partner with the Bloomberg Philanthropies Data for Health Initiative to deliver this timely resource to countries.  Below are some examples of how SCORE can improve individual lives and communities:The birth of a child is registered so they can access essential health services, attend school, and apply for a passport;A death is registered with cause-of-death accurately captured so that policy-makers have a better understanding of all-cause and COVID-specific mortality and associated risk factors and implement programs and policies to save lives;Health data are disaggregated by age, sex and cause of death to illustrate the root causes of health disparities and help direct resources to the most vulnerable groups such as those who do not speak the local language or face stigma and discrimination in their community; Health facilities have the capacity to regularly measure the quality of their services, workforce and patient data and can make a compelling case for increased funding to national and international stakeholders;Health data are integrated with other sectors so that social determinants of health such as pollution, sanitation and nutrition are addressed to reduce the overall burden of disease.The package's initial release includes two documents: SCORE Essential Interventions – including an overview of health information systems, underlying elements, and indicators to assess progress with sample actions; andSCORE Tools and Standards -- including resources to address critical health data gaps and strengthen country health data.“We must keep score to save lives. WHO is committed to working with countries and partners to rapidly scale up capacity for data collection and use in order to improve policy and performance,” added Dr Samira Asma, Assistant Director-General for Data, Analytics and Delivery for Impact at WHO. “We must act now to invest in statistical systems in countries, respond to this pandemic and meet the SDGs and the Triple Billion targets. Our window of opportunity is closing, and we cannot wait to address data gaps. Data use to address country needs has to be a priority today.”Country-owned, disaggregated data will be essential for more resilient and sustainable health systems going forward. COVID-19 is both a wake-up call and a stark reminder of the challenges we still have to address. But it is also an opportunity to build back better through solidarity, information-sharing and collaboration. SCORE is one example of how a collaborative approach can benefit countries by providing a common set of tools based on shared standards. This package is designed to be practical, actionable and flexible. We will only be successful in combatting COVID-19 if we work together.Future components of the SCORE Technical Package are due to be released later this year, including the SCORE Assessment Instrument and global, regional and country status reports.  Together, these will provide a complete package of information to plan and monitor progress against national and subnational priorities as well as global targets.-----[1] https://www.who.int/about/what-we-do/thirteenth-general-programme-of-work-2019---2023#:~:text=The%20Thirteenth%20General%20Programme%20of,health%20at%20the%20country%20leve[2] Bloomberg Philanthropies Data for Health Initiative provided funding to support the SCORE for Health Data Technical Package  

The COVID-19 pandemic has disrupted or halted critical mental health services in 93% of countries worldwide while the demand for mental health is increasing, according to a new WHO survey. The survey of 130 countries provides the first global data showing the devastating impact of COVID-19 on access to mental health services and underscores the urgent need for increased funding.The survey was published ahead of WHO’s Big Event for Mental Health  ̶  a global online advocacy event on 10 October that will bring together world leaders, celebrities, and advocates to call for increased mental health investments in the wake of COVID-19.WHO has previously highlighted the chronic underfunding of mental health: prior to the pandemic, countries were spending less than 2 per cent of their national health budgets on mental health, and struggling to meet their populations’ needs.And the pandemic is increasing demand for mental health services. Bereavement, isolation, loss of income and fear are triggering mental health conditions or exacerbating existing ones. Many people may be facing increased levels of alcohol and drug use, insomnia, and anxiety. Meanwhile, COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke. People with pre-existing mental, neurological or substance use disorders are also more vulnerable to SARS-CoV-2 infection  ̶  they may stand a higher risk of severe outcomes and even death. “Good mental health is absolutely fundamental to overall health and well-being,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “COVID-19 has interrupted essential mental health services around the world just when they’re needed most. World leaders must move fast and decisively to invest more in life-saving mental health programmes  ̶  during the pandemic and beyond.”  Survey finds major disruptions to critical mental health services The survey was conducted from June to August 2020 among 130 countries across WHO’s six regions. It evaluates how the provision of mental, neurological and substance use services has changed due to COVID-19, the types of services that have been disrupted, and how countries are adapting to overcome these challenges.Countries reported widespread disruption of many kinds of critical mental health services:Over 60% reported disruptions to mental health services for vulnerable people, including children and adolescents (72%), older adults (70%), and women requiring antenatal or postnatal services (61%).67% saw disruptions to counseling and psychotherapy; 65% to critical harm reduction services; and 45% to opioid agonist maintenance treatment for opioid dependence.More than a third (35%) reported disruptions to emergency interventions, including those for people experiencing prolonged seizures; severe substance use withdrawal syndromes; and delirium, often a sign of a serious underlying medical condition.30% reported disruptions to access for medications for mental, neurological and substance use disorders. Around three-quarters reported at least partial disruptions to school and workplace mental health services (78% and 75% respectively). While many countries (70%) have adopted telemedicine or teletherapy to overcome disruptions to in-person services, there are significant disparities in the uptake of these interventions. More than 80% of high-income countries reported deploying telemedicine and teletherapy to bridge gaps in mental health, compared with less than 50% of low-income countries. WHO has issued guidance to countries on how to maintain essential services  ̶  including mental health services  ̶  during COVID-19 and recommends that countries allocate resources to mental health as an integral component of their response and recovery plans. The Organization also urges countries to monitor changes and disruptions in services so that they can address them as required.Although 89% of countries reported in the survey that mental health and psychosocial support is part of their national COVID-19 response plans, only 17% of these countries have full additional funding for covering these activities.This all highlights the need for more money for mental health. As the pandemic continues, even greater demand will be placed on national and international mental health programmes that have suffered from years of chronic underfunding. Spending 2% of national health budgets on mental health is not enough. International funders also need to do more: mental health still receives less than 1% of international aid earmarked for health.Those who do invest in mental health will reap rewards. Pre-COVID-19 estimates reveal that nearly US$ 1 trillion in economic productivity is lost annually from depression and anxiety alone. However, studies show that every US$ 1 spent on evidence-based care for depression and anxiety returns US$5. Note on World Mental Health Day: Mobilizing the global community to #MoveforMentalHeatlh On World Mental Health Day (Saturday 10 October), as part of its campaign Move for mental health: let’s invest, WHO is inviting the global community to take part in The Big Event for Mental Health, an unprecedented online advocacy event that will call for increased investment in mental health at all levels  ̶  from individuals to businesses to countries to civil society  ̶  so that the world can begin to close the gaps highlighted by today’s report. The Big Event is free and open to the public and will be broadcast on 10 October from 16:00 to 19:00 CEST on WHO’s YouTube, Facebook, Twitter, TikTok and LinkedIn channels and website. For updated information about the Big Event for Mental Health, including the latest lineup of performances and participants, visit the Big Event web page. To learn more about World Mental Health Day, visit WHO’s campaign page. 

A full access package includes WHO policy guidance on the use of antigen-based rapid diagnostic tests, manufacturer volume guarantees for low and middle-income countries,  catalytic funding to assist governments to deploy the tests and an initial US$50 million procurement fundSeveral rapid, point-of-care antigen tests are being assessed by WHO for Emergency Use Listing (EUL)Agreements between the Bill & Melinda Gates Foundation and test manufacturers Abbott and SD Biosensor make available innovative tests priced at a maximum of US$5 for low- and middle-income countries (LMICs)The Global Fund commits an initial US$50 million to enable countries to purchase the new tests, with the first orders expected to be placed this weekExpedited market introduction of these tests in multiple LMICs is being supported through the Africa Centres for Disease Control and Prevention (Africa CDC), Unitaid, FIND, CHAI, and their partnersThis is the latest move from the Access to COVID-19 Tools (ACT) Accelerator to develop, procure and distribute critical new tools to fight the pandemic; new tests are urgently needed to meet the huge unmet needs for testing worldwide A set of agreements to make available, for low and middle-income countries, affordable, high-quality COVID-19 antigen rapid tests were today announced by the Access to COVID-19 Tools (ACT) Accelerator. Organizations involved in the milestone agreement include the Africa Centres for Disease Control and Prevention (Africa CDC), the Bill & Melinda Gates Foundation, the Clinton Health Access Initiative (CHAI), the Foundation for Innovative New Diagnostics (FIND), the Global Fund, Unitaid, and the World Health Organization (WHO).As part of this comprehensive, end-to-end effort, the Bill & Melinda Gates Foundation has executed separate volume guarantee agreements with rapid diagnostic test (RDT) producers Abbott and SD Biosensor. These two arrangements will make available to LMICs 120 million antigen rapid diagnostic tests (Ag RDTs) – priced at a maximum of US$5 per unit – over a period of six months. These tests provide results in 15–30 minutes, rather than hours or days, and will enable expansion of testing, particularly in countries that do not have extensive laboratory facilities or trained health workers to implement molecular (polymerase-chain reaction or PCR) tests.The tests developed by Abbott and SD Biosensor are highly portable, reliable, and easy to administer, making testing possible in near-person, decentralized healthcare settings. Both companies’ tests are faster and cheaper than laboratory-based tests, enabling countries to increase the pace of testing, tracing and treating people for COVID-19 at the point of care particularly in areas with under-resourced health systems. A number of other Ag RDTs are at various stages of development and assessment.To scale up the Ag RDTs, the Global Fund today announced that it has made available an initial US$50 million from its COVID-19 Response Mechanism to enable countries to purchase at least 10 million of the new rapid tests for LMICs at the guaranteed price, with the first orders expected to be placed this week through the Global Fund’s pooled procurement mechanism.FIND and WHO are working together to accelerate appropriate use by supporting implementation research that will optimize Ag RDT use in multiple LMICs, in line with WHO guidance. This includes provision of catalytic volumes of tests to understand how Ag RDTs can best fit into health systems.Unitaid and Africa CDC will combine resources to initiate the roll out of these tests in up to 20 countries in Africa starting in October 2020. This multi-million-dollar intervention, currently undergoing final sign-off by their Boards, is designed to engage multiple partners active in the COVID-19 response in these countries, such as CHAI, African Society for Laboratory Medicine (ASLM) and local organizations. This will bolster efforts by the African Union’s Partnership to Accelerate COVID-19 Testing (PACT) initiative, launched in August 2020 to mobilize experts, community workers, supplies and other resources to minimize the impact of the pandemic on the African continent by testing, tracing, and treating COVID-19 cases in a timely manner.Testing is a critical cornerstone of the COVID-19 response, enabling countries to trace and contain the virus now, and to prepare for the roll-out of vaccines once available. Effective testing strategies rely on a portfolio of test types that can be used in different settings and situations. While molecular tests started to be rolled out within a month of the virus being sequenced, these tests are mainly laboratory based, relying on infrastructure and trained personnel to conduct them. Rapid tests to detect the presence of the virus at the point of care, which are faster and cheaper, are a vital addition to the testing arsenal needed to contain and fight COVID-19.WHO guidance published on 11 September 2020 highlights the value of these tests in areas where community transmission is widespread and where nucleic acid amplification-based diagnostic (NAAT) testing is either unavailable or where test results are significantly delayed.  As well as supporting test-trace-isolate strategies, the tests can help identify or confirm new outbreaks, support outbreak investigations through screening; monitor disease trends; and potentially test asymptomatic contacts.The ACT-Accelerator Diagnostics Pillar is co-convened by FIND and the Global Fund, working closely with WHO and over 30 global health expert partners to accelerate innovation and overcome the technical, financial, and political obstacles to achieving equitable access to effective and timely testing. Such unprecedented global collaboration has enabled development and deployment of the first WHO EUL-approved Ag RDT within eight months of the first identification of the virus. In comparison, it took nearly five years to develop the first RDT for HIV. Several more antigen RDTs for COVID-19 are currently under WHO EUL review. Overall, the ACT-Accelerator Diagnostic Pillar aims to facilitate the supply of 500 million tests to LMICs within 12 months.These agreements are critical to fulfil the key objective of the ACT-Accelerator: to ensure all countries, regardless of income, have fair access to new tests and tools to fight COVID-19. The exceptional speed with which the Ag RDT access package has been created demonstrates the breadth of the impact of the ACT-Accelerator initiative, and this and future achievements in testing will complement similar milestones anticipated to emerge from the Vaccines and Therapeutics Pillars.Dr Tedros Adhanom Ghebreyesus, Director General of WHO, said: “High-quality rapid tests show us where the virus is hiding, which is key to quickly tracing and isolating contacts and breaking the chains of transmission. The tests are a critical tool for governments as they look to reopen economies and ultimately save both lives and livelihoods.”Mark Suzman, Chief Executive Officer of the Gates Foundation, said: “Testing is an essential tool in the fight against COVID-19. We are delighted to join a partnership that will help ensure that the latest, high-quality diagnostics do not just go to the highest bidder but will be available at an affordable price to the world’s lower income countries. In addition, all of the actions announced today point to the growing success of the ACT-Accelerator in catalyzing global cooperation for a fair and effective response to this global crisis.”Dr Iain Barton, Chief Executive Officer of CHAI, said: “These agreements will help ensure that millions of people in low- and middle-income countries have access to high-quality rapid testing in villages and towns as well as cities. This has the potential to revolutionize government’s ability to respond to the pandemic, enabling quick diagnosis and response to contain localized virus outbreaks before they spread.”Andrea F. Wainer, Executive Vice President of Abbott’s rapid and molecular diagnostics businesses, said: “Abbott is pleased to bring our Panbio COVID-19 rapid antigen test and Sympheos digital solution to people and health authorities in low- and middle-income countries through this innovative partnership. We have long been committed to making sure our life-changing technologies are affordable and accessible, and for decades have been supporting many of these countries with our rapid tests for malaria, HIV, hepatitis, and other deadly infectious diseases.”Hyo-Keun Lee, Chief Executive Officer of SD Biosensor, said: “We, SD Biosensor, are pleased to supply our STANDARD Q COVID-19 rapid antigen tests for people who really need fast and accurate COVID-19 diagnosis. Through this partnership, we will keep striving do our best to provide the best quality of COVID-19 antigen rapid kits for fighting COVID-19.”Dr John Nkengasong, Director of the Africa CDC, said: “Antigen tests are an important complement to PCR testing, and are crucial to expand testing capacity throughout Africa. The beauty of antigen testing is that it is fast and gives quick results. It will allow healthcare workers to quickly isolate cases and treat them while tracing their contacts to cut the transmission chain.”Dr Philippe Duneton, Unitaid’s Executive Director a.i., said: “Access to these point-of-care rapid tests with be a game changer in the fight against COVID-19. We are working to support countries to rapidly deploy and use these new tests in the best possible way. Today’s news shows what the ACT-A partners working together can deliver in our efforts against the COVID-19 pandemic.”Dr Carolyn Gomes, Special Advisor for the Board, ProActividad, Jamaica, and Alternate Board Member (Developing Country NGOs), The Global Fund “Ensuring equitable access to rapid diagnostic tests is essential for controlling COVID-19 in all countries and to opening up economies across the world. Ensuring an affordable price is a major step forward.  Tests that can be used at the point of care by front-line workers will greatly facilitate community access to testing. To ensure equity in access for those who need it most, there will need to be much greater support of the ACT-Accelerator and the Diagnostics Pillar in particular. Much more money is needed to meet the needs of the most vulnerable.” Peter Sands, Executive Director of the Global Fund, said: “This is the ACT-Accelerator in action. It is proof that by working together at a massive global scale, we can develop and deploy a vital new tool to help contain and fight the pandemic. This is not just a new test – it’s the money and the deployment plan to get it to where it’s needed, fast. This is the power of global collaboration.”Dr Catharina Boehme, Chief Executive Officer of FIND, said: “With this Ag RDT package, the ACT-Accelerator partners have secured much-needed tools for LMICs to dramatically increase COVID-19 testing. With the financial support of several countries, we have made great progress, but to ensure we reach all those who need testing and bring the prices down, we urgently need substantial funding from public, philanthropic, and multilateral sources.” About the ACT-AcceleratorThe Access to COVID-19 Tools (ACT) Accelerator, is a new, ground-breaking global collaboration to accelerate the development production, and equitable access to COVID-19 tests, treatments, and vaccines. It was set up in response to a call from G20 leaders in March 2020 and launched by WHO, the European Commission, France and the Bill & Melinda Gates Foundation in April 2020. The ACT-Accelerator is not a decision-making body or a new organization, but works to speed up collaborative efforts among existing organizations to end the pandemic. It is a framework for collaboration that has been designed to bring key players around the table with the goal of ending the pandemic as quickly as possible through the accelerated development, equitable allocation, and scaled up delivery of tests, treatments and vaccines, thereby protecting health systems and restoring societies and economies in the near term. It draws on the experience of leading global health organizations which are tackling the world’s toughest health challenges, and who, by working together, are able to unlock new and more ambitious results against COVID-19. Its members share a commitment to ensure all people have access to all the tools needed to defeat COVID-19 and to work with unprecedented levels of partnership to achieve it. The ACT-Accelerator has four areas of work: diagnostics, therapeutics, vaccines and the health system connector. Cross-cutting all of these is the workstream on Access & Allocation. The Diagnostics Pillar of the ACT-Accelerator is focused on ensuring that everyone who needs a test can get one. Workstreams span research and development, market readiness, procurement, and country preparedness. Achievements to date include laboratory trainings in partnership with Africa CDC in early February, and a suite of online courses deployed within weeks. Nearly 20 million tests have been procured with the Diagnostics Consortium, ensuring diagnostic access for LMICs and readiness for test-and-treat implementation in these countries. Independent evaluations of antibody tests are also being conducted, as high-quality antibody tests are essential to understand population immunity for future vaccine roll out. For information about WHO’s Emergency Use Listinghttps://www.who.int/teams/regulation-prequalification/eul https://www.who.int/publications/m/item/200922-eul-sars-cov2-product-list

The Coronavirus disease (COVID-19) is the first pandemic in history in which technology and social media are being used on a massive scale to keep people safe, informed, productive and connected. At the same time, the technology we rely on to keep connected and informed is enabling and amplifying an infodemic that continues to undermine the global response and jeopardizes measures to control the pandemic.

As the world comes together at an unprecedented virtual session of the 75th UN General Assembly (UNGA), WHO has three messages to share.