world health organisation

ICN welcomes WHO focus on nursing, warns of impact of US withdrawal from WHO

March 11, 2025 by Madeline Lucre Leave a Comment

The International Council of Nurses (ICN) has expressed strong support for the recent focus on nursing by the World Health Organisation (WHO).

However, the ICN has also raised concerns about the negative impact of the United States’ withdrawal from the WHO on nurse-led services globally.

During the WHO Executive Board sessions in Geneva, key discussions centered on extending the Global Strategic Directions for Nursing and Midwifery and WHO’s “Workforce 2030” plan.

ICN president, Dr. Pamela Cipriano, emphasised the need for sustainable and equitable global health financing, especially in light of the US decision to withdraw from the WHO.

“The US decision to withdraw from WHO means it is imperative that we accelerate our efforts to ensure sustainable and equitable global health financing,” Dr Cipriano said.

“Without sustained investment in nursing and health, we will not be able to achieve our shared global goals to make sure that everyone, everywhere can access the care they need.”

The ICN warned that the US withdrawal has already halted some nurse-led services, including vaccination programs and care for people with HIV/AIDS.

The ICN participated actively in the WHO Executive Board meetings, making interventions on topics such as Universal Health Coverage, climate change, mental health issues, and the health care workforce. The ICN called on WHO Member States to address workforce shortages and strengthen nurse retention, education, leadership, and practice to build resilient health systems worldwide.

The decisions made at the WHO Executive Board meeting will be presented at the World Health Assembly in May for ratification. A key focus will be extending the Global Strategic Directions for Nursing and Midwifery, informed by the upcoming State of the World’s Nursing report.

The ICN’s statements underscore the vital role of nurses in achieving global health goals and the urgent need for sustained investment in nursing to ensure universal access to quality healthcare.

WHO raises concern over governments deprioritising health spending

March 11, 2025 by Madeline Lucre Leave a Comment

The World Health Organisation (WHO) has released its most recent Global Health Expenditure Report, revealing a concerning trend: governments worldwide are deprioritising health spending.

This shift comes after a surge in health investments during the early years of the COVID-19 pandemic.

The report, titled “Global Spending on Health: Emerging from the Pandemic,” highlighted that average per capita government spending on health fell in 2022 from 2021 across all income groups. This is despite 4.5 billion people globally lacking access to basic health services, while a further 2 billion face financial hardship due to the cost of healthcare.

The report noted that, even in high-income countries, out-of-pocket payments led to an increase in financial hardship and unmet health needs, particularly among the poorest households. In over a third of these countries, more than 20% of total health spending is paid out-of-pocket.

This decline poses significant challenges to achieving Universal Health Coverage (UHC), a key goal of the WHO aimed at ensuring everyone can access necessary health services without financial hardship.

“While access to health services has been improving globally, using those services is driving more and more people into financial hardship or poverty,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus noted.

“Health for all means everyone can access the health services they need, without financial hardship.”

In response to the findings, the WHO has rebuffed its calls for global leaders to prioritise access to healthcare and eliminate impoverishment due to health-related expenses by 2030.

Global decline in drowning deaths, but vulnerable people still at risk

March 11, 2025 by Madeline Lucre Leave a Comment

The World Health Organisation (WHO) has published its first-ever report on drowning prevention, revealing a significant 38% drop in the global drowning death rate since 2000.

The report underscored the effectiveness of practical interventions by governments across the globe, as well as the WHO’s recommendations. However, the report also highlighted that drowning remains a major public health issue, with more than 30 people estimated to drown every hour and 300,000 drowning deaths recorded in 2021 alone.

The report indicated that almost half of all drowning deaths occurred among individuals below the age of 29, with a quarter of these deaths involving children under five years old. Children without adult supervision are particularly vulnerable to drowning.

The report also found that, despite the overall decline, progress in reducing drowning deaths has been uneven across regions. The WHO European Region saw a 68% reduction in drowning death rates between 2000 and 2021, while the WHO African Region experienced only a 3% decline, maintaining the highest drowning death rate globally at 5.6 deaths per 100,000 people.

This difference in rates of decline correlated with the likelihood of regions having national strategies having national prevention strategies. The report found that only 15% of countries in the African Region had a national strategy, compared to 45% in the European Region.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus praised the decline in drowning deaths but stressed that every drowning death is one too many. “This report contains crucial data for policy-making and recommendations for urgent action to save lives,” he stated.

If current trends continue, more than 7.2 million people, primarily children, could die by drowning by 2050.

However, the WHO noted that most of these deaths could be prevented through government and community-based interventions. These interventions include installing barriers to prevent child access to water, providing safe places away from water for preschool children, and teaching school-aged children basic swimming, water safety, and rescue skills.

WHO declares mpox a public health emergency

October 11, 2024 by Madeline Lucre Leave a Comment

Health leaders warn that the global response to the virus is a test case for equity and preparation for future pandemics.

There were 38,465 cases of mpox and 1,456 deaths in Africa from January 2022 to August 2024, including more than 14,000 cases and 524 deaths in the Democratic Republic of the Congo alone this year.

The World Health Organization said the outbreak was serious enough to declare a “public health emergency of international concern”, the category used in the past for Ebola outbreaks, COVID-19 and a 2022 mpox surge in Europe.

WHO’s emergency declaration is meant to spur donor agencies and countries into action including accelerating access to testing, vaccines and therapeutic drugs in the affected areas and to kickstart campaigns to reduce the stigma surrounding the virus.

The Africa Centres for Disease Control and Prevention also announced that mpox was a public health emergency.

Dr Jean Kaseya, the organisation’s director general, said the declaration was “not merely a formality” but “a clarion call to action” and warranted proactive and aggressive efforts to contain and eliminate the virus.

Nick Dearden, director-general of Global Justice Now, told the Guardian: “mpox has been endemic in a handful of African countries for years. Yet despite having the medicines to treat it, no serious action was taken until the outbreak posed a threat to the west.”

“We saw this same inequity play out during the COVID pandemic, where lives lost in the global south were shamefully treated as collateral damage in pursuit of more and more pharmaceutical profiteering.”

Attacks on health care during war are becoming more common, creating devastating ripple effects

October 1, 2024 by Rayan Calimlim Leave a Comment

The head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, has warned attacks on health-care workers, patients and facilities “must not become the norm”.

Yet reports from wars across the world frequently show hospitals being bombed and health workers being attacked.

The increased use of explosive weapons in densely populated areas makes the problem worse as they cause widespread harm to civilians and critical infrastructure, including health facilities. Whether these attacks are targeted or seen as “collateral damage”, there is growing concern they are becoming an accepted part of armed conflict – although they violate protections granted under international law.

But are these attacks on health care truly increasing, or are we just getting better at documenting them? More importantly, is the world beginning to see them as normal?

What does the data show?

Collecting accurate data in war zones is challenging. Many attacks on health care go unreported due to fear of reprisals or the dangers involved in gathering information. In some cases, releasing data can be sensitive, as conflicting parties may use it to sway public opinion or escalate tensions.

Despite these challenges, organisations have been tracking attacks on health care for years, including the WHO, the Safeguarding Health in Conflict Coalition (SHCC) and the International Committee of the Red Cross. Their reports show an increase in both the frequency and systematic targeting of health care in certain regions.

The latest SHCC report shows last year was the deadliest for health-care workers since reporting began a decade ago. In 2023, 480 health-care workers were killed during armed conflict – nearly double the previous year.

Between January and September 2024, the WHO has confirmed almost 700 attacks against healthcare facilities and staff in Ukraine and the Occupied Palestinian Territory alone. This has led to more than 500 injuries and nearly 200 deaths among patients and health workers.

In Sudan and Myanmar, hospitals and clinics continue to be targeted, leaving millions without access to basic care.

This violence can lead to near collapse of health-care systems. For example, by January 2024, 84% of health facilities in Gaza had been damaged or destroyed. This leaves people without essential care, worsens chronic conditions and allows diseases to spread unchecked.

The laws that protect health care

The Geneva Conventions of 1949 and their Additional Protocols form the backbone of International Humanitarian Law, protecting health workers, hospitals and patients during armed conflict. These laws were established after the second world war to ensure that, even in times of war, people can access medical care without fear of attack. Any deliberate targeting of medical services is a violation of international law and, in some cases, a war crime.

Today, every recognised state in the world has committed to complying with these laws. In 2016, the United Nations Security Council also adopted a resolution which condemns attacks on health care and calls for stronger action to ensure compliance.

Yet attacks on health care continue. Some of the most serious examples have occurred in recent armed conflicts, where hospitals and clinics have been directly targeted, often without consequences for the attackers. Earlier this year, Ukraine asked the International Criminal Court to investigate attacks against a children’s hospital in Kyiv.

The persistence of these attacks raises concerns about whether the issue is weak enforcement of the laws or whether the laws themselves need updating for modern warfare.

Some legal and medical experts argue the laws aren’t strong enough, especially with the rise of non-state armed groups such as militias. Others believe the laws are adequate but are not properly enforced.

There are growing calls from humanitarian and human rights organisations for stronger accountability, including the involvement of the International Criminal Court and national courts. Others propose a broader, more systematic approach that treats attacks on health care as a public health issue, not just a legal one.

Are attacks on health care becoming normalised?

One of the most concerning aspects of this trend is the potential normalisation of such attacks, meaning people might begin to see them as an inevitable part of war.

When hospitals are bombed or ambulances are destroyed without any punishment for the perpetrators, it sends the message health-care workers and patients are acceptable targets. This creates an environment where entire populations may feel there is no safe place to seek care when they need it the most.

Modern conflicts, involving non-state armed groups such as militias – as we’ve seen in Haiti and the Central African Republic – contribute significantly to this issue. These groups often do not adhere to international law.

However, even governments have been accused of attacking health-care facilities despite being parties to the Geneva conventions, including attacks on hospitals by Israel in Gaza, Saudi Arabia in Yemen and the United States in Afghanistan.

When these incidents are not met with strong consequences, it sets a dangerous precedent.

Immediate and long-term impacts

The immediate impact of these attacks is clear and devastating: people injured in conflict or suffering from illnesses can’t get the care they need. Health workers, who are often first responders, are directly targeted, reducing the availability of essential care.

The destruction of hospitals also disrupts routine services such as childbirth and vaccinations, leading to preventable deaths and increasing the risk of disease outbreaks. Outbreaks of mpox in the Democratic Republic of Congo and polio in Gaza have worsened because health workers can’t safely reach affected areas, and necessary supplies have been destroyed.

In the longer term, these attacks gravely affect individuals with chronic conditions such as diabetes, cancer or heart disease, which become life-threatening without treatment. Additionally, people are more likely to leave places without health-care services, which contributes to displacement.

Finally, such attacks erode trust in hospitals and clinics, causing fear around seeking medical help. Over time, this can discourage people from getting care, creating ripple effects that harm entire communities and set back global health progress.

Esperanza Martinez, Professor of Practice and Head of Health and Human Security, College of Health and Medicine, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

WHO has declared mpox a global health emergency. What happens next?

August 23, 2024 by Rayan Calimlim Leave a Comment

The World Health Organization (WHO) has declared mpox a public health emergency of international concern, after rising cases in the Democratic Republic of the Congo and the potential for further spread.

This now triggers a coordinated international response to an extraordinary event and the mobilisation of resources, such as vaccines and diagnostic testing, to curb the spread of this infectious disease.

But WHO has not declared mpox a pandemic. Rather, the measures it has triggered are designed to prevent it from becoming one.

What triggered this latest alert?

Mpox, once known as monkeypox, is a viral infection closely related to smallpox. Initial symptoms include a fever, headache, swelling of the lymph nodes and muscle ache. A typical rash follows, mainly on the face, hands and feet.

The spread of mpox through certain African countries led the Africa Centres for Disease Control and Prevention to declare earlier this week mpox a public health emergency of continental security. This is the first time the organisation has issued such an alert since it was established in 2017.

The situation in the Democratic Republic of the Congo in central Africa has been particularly worrying for more than a year.

There are two types or clades of mpox. Clade II, which originates in west Africa, is less severe. It has a fatality rate of up to 1% (in other words, roughly one in 100 are expected to die from it). But clade I, from central Africa, has a fatality rate of up to 10% (up to one in ten die). This compares to a 0.7% fatality rate for the Omicron variant of SARS-CoV-2, the virus that causes COVID. The Democratic Republic of the Congo is seeing large epidemics of the more deadly clade I mpox.

Mpox is endemic in some parts of central and west Africa, where the virus exists in animals and can spread to humans. Outbreaks have been increasing, with more human-to-human spread, since 2017.

This is partly due to very low levels of immunity to the mpox virus, which is related to the virus that causes smallpox. Mass vaccination against smallpox ceased more than 40 years ago globally, resulting in minimal immunity in populations today against mpox.

The WHO designation announced this week relates to the clade I. Not only does this have a higher fatality rate, it has new mutations that enhance spread between people. These changes, and the global lack of immunity to mpox, makes the world’s population vulnerable to the virus.

There are two different epidemics

In 2022, an epidemic of mpox swept through non-endemic countries, including beyond Africa. This was a variant of clade II originating from Nigeria, called clade IIb. This was sexually transmitted, predominantly affecting men who have sex with men, and had a low fatality rate.

That epidemic peaked in 2022, with vaccines made available to people at risk in high-income countries, but there has been an uptick in 2024.

At the same time, large clade I epidemics were occurring in the Democratic Republic of the Congo, but with far less attention.

Vaccines were not available there, even in 2023, when there were 14,626 cases and 654 deaths. Mortality was 4.5%, and higher in children.

In fact, most cases and deaths in the Democratic Republic of the Congo have been children. This means most transmission there is non-sexual and is likely to have occurred through close contact or respiratory aerosols.

However, in 2023 an outbreak in a non-endemic part of the country, South Kivu in the east, appeared to be by sexual transmission, indicating more than one epidemic and different transmission modes in the Democratic Republic of the Congo.

By mid-2024, there were already more cases in the country than all of 2023 – more than 15,600 cases and 537 deaths.

Testing capacity is low in the Democratic Republic of the Congo, most cases are not confirmed by lab testing, and the data we have are from a small sample of genomic sequences from the Kamituga region of South Kivu.

This show mutations to the clade I virus around September 2023, to a variant termed clade Ib, which is more readily transmissible between people. We do not have much data to compare these viruses with the viruses causing cases in the rest of the country.

Mpox is spreading internationally

In the past month, the virus has spread to countries that share a border with the Democratic Republic of the Congo – Rwanda and Burundi. It has also spread to other east African countries, such as Kenya and Uganda. None of these countries have had mpox cases previously.

In an interconnected, mobile world, cases may spread to other continents, as mpox did in 2018 from Nigeria to the United Kingdom and other countries.

A few travel-related cases between 2018 and 2019 may have led to the large multi-country 2022 clade IIb epidemic.

We have vaccines, but not where they are needed

As the mpox virus and smallpox viruses are related (they are both orthopoxviruses), smallpox vaccines offer protection against mpox. These vaccines were used to control the 2022 clade IIb epidemic.

However, most of the world has never been vaccinated, and has no immunity to mpox.

The newer vaccine (called Jynneos in some countries and Imvamune or Imvanex in others) is effective. However, supplies are limited, and vaccine is scarce in the Democratic Republic of the Congo.

WHO’s declaration of mpox as a public health emergency of international concern will help mobilise vaccines to where they are needed. The Africa Centres for Disease Control had already begun negotiations to secure 200,000 doses of vaccine, which is a fraction of what is required to control the epidemic in the Democratic Republic of the Congo.

What happens now?

Ultimately, a serious epidemic anywhere in the world is a concern for all of us, as it can spread globally through travel, as we saw with the COVID pandemic.

Controlling it at the source is the best measure, and WHO’s latest declaration will help mobilise the required resources.

Surveillance for spread of this more serious version of mpox is also essential, bearing in mind that many countries do not have the capacity for widespread testing. So we’ll have to rely on “suspected cases”, based on a clinical definition, to keep track of the epidemic.

Open-source epidemic intelligence – such as using AI to monitor trends in rash and fever illness – can also be used as an early warning system in countries with weak health systems or delayed reporting of cases.

A further complication is that 20-30% of people with mpox may simultaneously have chickenpox, an unrelated infection that also causes a rash. So an initial diagnosis of chickenpox (which is easier to test for) does not rule out mpox.

Effective communication and tackling push-back against public health measures and disinformation is also key. We saw how important this was during the COVID pandemic.

Now, WHO will coordinate the global mpox response, focusing on equity in disease prevention and access to diagnostics and vaccines. It is up to individual countries to do their best to comply with the International Health Regulations, and the protocols for how such a global emergency are managed.

The World Health Organization has more information about mpox, including symptoms and treatment. For information about vaccine access and availability, contact your local health department or doctor, as this varies from country to country.

C Raina MacIntyre, Professor of Global Biosecurity, NHMRC L3 Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.