COVID-19 Virtual Press conference transcript - 21 October 2021
Overview
00:00:21
MH Hello,
everybody. This is Margaret Harris in Geneva welcoming you today, October 21st,
to our global COVID-19 press conference. Speaking today will be, as ever, Dr
Tedros Adhanom Ghebreyesus but as today's press conference has a special focus
on health and care workers as well as vaccine equity Dr Tedros will be joined
by Mr Gordon Brown, the WHO Ambassador for Global Health Financing, who will
speak on vaccine equity, Ms Annette Kennedy, President of the International
Council of Nurses, and Dr Heidi Stensmyren, President of the World Medical
Association.
And of course we have as usual our full team of
experts available to answer your COVID-19 questions during the
question-and-answer session in the room here. We have Dr Zsuzsanna Jakab, the
WHO Deputy Director-General, and we have Dr Mike Ryan, who will be joining us
soon. He is the Executive Director of World Health Emergencies.
Dr Bruce Aylward, Lead for the Act Accelerator,
Dr Mariangela Simao, our Assistant Director-General, access to medicines and
other health products, and Mr James Campbell, Director for the health workforce
department. We will also have experts joining us online.
00:01:45
We've got a very full and interesting programme
and as ever we will have a team providing simultaneous translation in the six
official UN languages plus Portuguese and Hindi and so you may ask your
questions in those languages. But now, as I said, we have a very full programme.
Without further ado I will hand over to Dr Tedros for his opening remarks. Dr
Tedros, you have the floor.
TAG Thank
you. Thank you, Margaret. Good morning, good afternoon and good evening. I have
often said that universal health coverage and health security are two sides of
the same coin. Both depend on health systems that are resilient, efficient and
effective and able to surge to respond to emergencies.
Health systems like that are a vital first line
of defence against outbreaks with epidemic and pandemic potential but they're
also essential for promoting health, preventing communicable and
noncommunicable diseases and for reducing inequalities and inequities.
This week WHO published a new position paper on
building resilient health systems as the foundation of socio-economic recovery
and development. The position paper outlines seven policy recommendations with
specific actions in each area. We urge all countries to implement these
recommendations and reap their benefits.
The backbone of every health system is its
workforce, the people who deliver the services on which we rely at some point
in our lives. The pandemic is a powerful demonstration of just how much we rely
on health workers and how vulnerable we all are when the people who protect our
health are themselves unprotected.
A new WHO working paper estimates that 115,000
health workers may have died from COVID-19 between January 2020 and May this
year. That's why it's essential that health workers are prioritised for
vaccination.
Data from 119 countries suggests that on average
two in five health and care workers globally are fully vaccinated but of course
that average masks huge differences across regions and economic groupings.
In Africa less than one in ten health workers
have been fully vaccinated. Meanwhile in most high-income countries more than
80% of health workers are fully vaccinated. Today WHO and several partner
organisations have issued a statement calling for action to protect health and
care workers around the world.
00:04:58
First, we call on all countries to improve
monitoring and reporting of infections and deaths among health and care
workers.
Second, we call on all countries to ensure all
health and care workers are protected and supported with safe and healthy
working conditions, regular salaries, pay equity, appropriate education, career
opportunities and social protection.
Third, we call on all countries to ensure that
all health and care workers in every country are prioritised for COVID-19
vaccines alongside other at-risk groups. Today I'm pleased to be joined by two
women who represent millions of health workers around the world, Dr Annette
Kennedy, President of the International Council of Nurses, and Dr Heidi
Stensmyren, the President of the World Medical Association, which represents
the world's physicians.
Thank you both for joining us. Annette, you have
the floor and then we will hear from Heidi. Annette.
[Asides]
00:06:49
AK Thank
you. Thank you, Dr Tedros, and thank you, WHO, for giving me the opportunity to
speak on behalf of the International Council of Nurses and on behalf of the 27
million nurses that I represent.
I wish it was a better day today. I wish it was
a day that we would celebrate that all healthcare workers had been vaccinated
or that we had come to the end of COVID-19 but it is not that day. It is a day
when we're hearing about 115,000 health workers who have died, many needlessly,
many we could have saved.
We know from ICN that that's an underestimate of
the number that have actually died. We welcome the publication of the data but
we still grieve for those who have lost their lives. They have sacrificed their
lives for other people who they have tried to save.
Is it that healthcare workers' lives mean so
little? Is it that we cannot look after them and protect them? Is it that
governments do not realise that they have a duty of care to their health
workers, the most valuable resource?
It's a shocking indictment of governments. It's
a shocking indictment of their lack of duty of care to protect healthcare
workers who have paid the ultimate sacrifice with their lives.
00:08:24
Nurses - and I speak for nurses although we're
talking about all healthcare workers - went into this pandemic six million
nurses short. Not only that but globally the world was not prepared for the
pandemic. It had weak health systems, it had unresilient health systems.
Now we find that nurses have left orphan
children and they have left many family members behind without compensation or
recompense because it's not looked on as an occupational health injury.
We have been calling for systematic standardised
data collection for over a year-and-a-half. We know from our associations, 135
associations throughout the world that many nurses have become infected and
many have died.
We also know that nurses are burnt-out. They
have given their all for a year-and-a-half or two years. They have worked long
hours. They have worked without breaks and they have been called to do a duty
without protective equipment and without support.
00:09:42
They are now burnt-out. They're devastated. They
are physically and mentally exhausted and there is a prediction that 10% of
them will leave within a very short time.
Added to the six million nurses that we our
short our estimates show that in the next ten years or less we will lose 4.7
million nurses who are due to retire before 2020 [sic], mainly from North
America and the European countries.
That makes 10.7 million nurses. Add 10% more to
that from the associations that we know that have said there's an intention of
at least 10% to leave the profession. That makes 30 million nurses. 30 million
is 50% of the current workforce.
No health system can survive without that many
nurses. No health system can even function without 50% of its workforce and we
have seen that nurses are now going into different jobs already.
The most educated of our profession are looking
for agency work so that they can make two, three and four times the salary but
work a third of the time. That reduces the number in the workforce.
00:11:10
So what are governments going to do? What are
they going to do to protect our workforce. If you were to see a plane crash
every day for a week the whole aviation industry would close down. In fact the
world would be investigating it yet there's no investigation into the 115,000
healthcare workers who have died.
Are we not valuable? Are we not valuable to
society? Are we not valuable because we put our lives at risk? There is
something seriously wrong and we all have responsibility and what we would find
is that the lack of sharing of vaccines across the world because countries are
only vaccinating their own and they're going into booster doses and they have
vaccines that have not been used because they have a choice and they have
decided that through misinformation or disinformation they're not using their
vaccines.
But they are left unused and yet we have other
countries crying out for vaccines, particularly healthcare workers and yet
those same countries would be aggressively recruiting very quickly nurses from
those countries who cannot afford to lose their nurses or their healthcare
workers.
00:12:38
So I am sad, I am devastated, I am upset that so
many people have lost their lives and that still our governments fail to
protect the healthcare workers that they need most. So when is this going to
stop? When are they going to step up to the plate and take the responsibility
seriously?
They need to vaccinate all their healthcare
workers. They need to invest and they need to retain their health workforce. So
I urge all governments, I urge all people and I even urge the media to ensure
that we make this clear. There is another crisis coming down the tracks and
that is a shortage of healthcare workers. Thank you.
TAG Thank
you. Thank you, Annette. Heidi, over to you.
HS Thank
you, Dr Tedros, and thank you for the invitation to speak on behalf of the
World Health Professional Alliance and the World Medical Association. Thank you
especially for the support of the necessity to vaccinate health and care workers,
individuals who are not only left alone on the front line but are not always
heard.
00:13:59
So with those words we want to put forward that
we thank the WHO for the initiative raised and regret together with you that
many member nations have not provided the data necessary to really document and
understand the impact of the pandemic on health personnel and healthcare.
Aggregated data is a resource needed so that we
can be more resilient now and in the future. We have learnt to use data and we
do have the possibility to collect data. It is time that it is done [?].
We have all experienced and witnessed the harm
the pandemic has done not only to our patients but also to us and our
colleagues, many of whom we have seen suffering or even dying, some still left
with long COVID problems.
Left alone with shortages in material often due
to disrupted supply chains or unfortunately even hoarding, left alone with
staff shortages, unfortunately insufficient staffing already before the
pandemic but during the pandemic getting really worse.
00:15:21
So both material shortages and staff shortages
are partly consequences of economic planning and regimes which have squeezed
out the last reserves of healthcare systems and, as I mentioned before, we saw
it even before the pandemic and we also had knowledge about it.
On-demand delivery left the systems with lack of
resource. We were not resilient enough when the pandemic hit us. Those
priorities, political priorities and choices turned out to be extremely costly,
not only with a view to the many lives lost but also with a view to the economy
and the health and welfare of our countries.
Because healthcare is not a commodity to be
acquired at the lowest price possible. Healthcare including reserve capacities
is an investment in the future. It's insurance. It's the way we can be more
resilient, just as you mentioned in opening this meeting.
Back to the working conditions. Working
conditions, as pointed out earlier, have been inappropriate during the pandemic
and even the payment for the work during the pandemic has led to a higher
attrition rate and we will see even higher attrition in the future.
This will be an obstacle and a challenge to
achieve the necessary accessibility to healthcare for the populations around
the world.
00:17:01
And unfortunately to this we can add attacks and
harassment of health and care workers during the pandemic. We have addressed
this many times but the calls to protect us against violence have unfortunately
been widely ignored and even here documentation is important.
So back to where I started. Collecting data
about the spread of public health threats is neither a luxury nor is it a
national business. It is essential and it is affecting us all. We all respect
those colleagues who succumbed during the pandemic in order to serve their
patients. They are truly heroes. Their families need our support but we owe
them more. We owe them not to make the same mistakes again.
So if there is a revision of the International
Health Regulations coming up or, even better, if there is a pandemic treaty,
collecting and reporting the essential figures to observe, measure and
understand the public health emergency will be crucial both to control but also
to contain it.
00:18:16
So we will say that complete, correct and
instant reporting should be part of our international collaboration. The WHO
offers the right platform for this and we would encourage all countries in the
world to stand up for this.
Without that beating future pandemics will be
more difficult and would risk repeating what we have seen in the last two
years. Thank you for this.
MH Thank
you. Thank you, Heidi, and also thank you to Annette and to both of your
organisations also for your continuing partnership, to the International
Council of Nurses and the World Medical Association.
More than ten months since the first vaccines
were approved the fact that millions of health workers still haven't been
vaccinated. is an indictment on the countries and companies that control the
global supply of vaccines.
High and upper-middle-income countries have now
administered almost half as many booster shots as the total number of vaccines
administered in low-income countries. In ten days' time 20 people will meet in
Rome with the ability to change that, the leaders of the G20 countries.
00:19:44
Between now and then roughly 500 million vaccine
doses will be produced. That's the amount of additional doses we need to
achieve our target of vaccinating 40% of the population of every country by the
end of the year.
82 countries are at risk of missing that target.
For three-quarters of those countries it is simply a problem of insufficient
supply. The other quarter of countries have some limitations in their ability
to absorb vaccines and we're working to address those problems.
The target is reachable but only if the
countries and companies that control supply match their statements with actions
right now. The barrier is not production. The barriers are politics and profit.
The G20 countries have pledged to donate more than
1.2 billion doses to COVAX. So far only 150 million have been delivered. For
most donations we have no timeline. We don't know what's coming and when.
00:20:58
Manufacturers have not told us how much COVAX
will receive or when we will receive it. We cannot have equity without
transparency. Ahead of the G20 summit next week we plan to publish a new
12-month strategic plan and budget for the ACT Accelerator, which will set out
the actions and resources needed to achieve our targets.
It's clear what needs to happen. The countries
that have already reached the 40% target, which includes all the G20 countries,
must give their spot in the vaccine delivery queue to COVAX and AVAT.
The G20 countries must fulfil their dose-sharing
commitments immediately. Manufacturers must prioritise and fulfil their
contracts with COVAX and AVAT as a matter of urgency and be far more
transparent about what's going where.
And they must share know-how, technology and
licences and waive intellectual property rights. We're not asking for charity.
We're calling for a common-sense investment in the global recovery.
COVAX has the money and contacts to buy
vaccines. What we don't have is any visibility on when the manufacturers will
deliver.
00:22:31
One of the clearest and strongest voices for the
need to invest in vaccine equity is Gordon Brown, the former Prime Minister of
the United Kingdom and WHO's Ambassador for Global Health Financing. It's my
great pleasure to welcome Gordon today. Gordon, thank you for your continuing
work and partnership and leadership. You have the floor.
GB Thank
you. I want to start by thanking Annette and Heidi for their moving and
challenging statements about the loss of 115,000 health workers, so tragically
lost during this COVID crisis.
I count it a privilege to work with Dr Tedros,
who's just introduced me, and with his brilliant, dedicated team and I'm here
today to issue a warning that in the ongoing race we are in between the virus
and vaccines we're once again at a moment of truth and the next ten days to
October 31st will be decisive.
00:23:29
If at the G20 summit in Italy the world's
richest countries cannot mobilise an extraordinary and expedited airlift of
doses to the unvaccinated and unprotected of the world and do so starting
immediately an epidemiological, economic and ethical dereliction of duty will
shame us all.
We may have lost our last chance before winter
to initiate what is urgently needed to save hundreds of thousands of lives - a
globally co-ordinated, month-by-month operational plan and timetable that
transfers what are unused vaccines we now hold in the richest countries of the
world to the world's poorest countries that are in desperate need, as Dr Tedros
has said, of vaccines now.
For it's urgent we close this yawning and unconscionable
gap between the promises of vaccines that our richest countries have made and
the painfully slow delivery of them to the poorest. It's time to bring to an
end the tragic and unacceptable but still growing divide between global north
and global South, that by December on current projections the West will be
stockpiling 600 million unused vaccines and by February almost a billion that
could, starting today, if airlifted to the South help prevent the loss of
lives.
00:24:49
To have the vaccines available in one half of
the world and yet to deny them to the other half of the world is one of the
greatest international public policy failures imaginable and it's a moral
catastrophe of historic proportions that will shock future generations.
For if the G20, who hold the lion's share of
vaccines, do not act to switch their stockpile of vaccines and delivery
contracts from North to South the World Health Organization's latest forecast
is that there'll be 200 million more COVID cases in the next year, three-quarters
of them in the countries where most remain unvaccinated and unprotected, and
five million lives hang in the balance.
If this were to be the case we're only a little
more than halfway through the damage caused by this pandemic.
In the face of this crisis with only 5% of
adults vaccinated in Africa, just 1.4% in low-income countries, the first
target of 10% vaccinated in all countries was not met by deadline day,
September 30th. 56 countries did not reach 10%. 18 countries managed
no more than 1% vaccinated. The failure is such that having made a promise to
meet that September deadline we're in mid October still 200 million vaccines
short.
00:26:09
The 40% adult vaccination target for November,
confirmed only a few weeks ago at the Global Vaccine Summit, chaired to his
great credit by President Biden, has, unless we act now, no chance of being
met.
Despite the heroic work of COVAX, the bulk
purchasing agency, we still appear to be 500 million vaccines short to reach
that 40% target. Since the start of the pandemic the number of COVID cases has
reached 242 million and will, say the World Health Organization, almost double
again to 440 million in 2022.
The death toll is officially now at 4.9 million
and it could virtually double to an overall figure of nearly ten million within
the next year or more. So failing to vaccinate the world is self-defeating,
it's against our self-interest, it's against all our security interest. The
longer vaccine equity persists the more the virus will keep circulating and
mutating, the greater the likelihood of the pandemic continuing uninhibited for
at least another year, delaying our containment of COVID, prolonging the
economic and social disruption the virus is causing.
00:27:17
Airfinity, the expert data research agency, are
showing us that even if we account for boosters and vaccinating the over-12s
and even younger 240 million vaccines are lying today unused in the West.
If we do not act and use them the figure of
vaccines either unused or about to be delivered under contract will exceed 400
million next month, by the end of December 600 million. So the 500 million
shortfall in vaccines that we've talked about can be bridged by transferring
500 million unused vaccines south by switching delivery contracts to do so.
By February the unused stock could be one
billion and, what is more, Airfinity estimates that if we do not transfer these
vaccines quickly 100 million of these vaccines could pass their use-by dates
and expire and would have to be destroyed and wasted.
But there is a way forward. In advance of the
G20 on October 30th Western leaders should decide on a plan and a
timetable to transfer the vaccines that are available from North to South. If
this was agreed then the other G20 members who also have unused vaccines could
be persuaded to add their vaccines and switch their delivery contracts.
00:28:37
This would enable us to reach 40% vaccination
rates in all countries by December so we are now in a countdown to the start of
the G20 under Prime Minister Draghi. The G20 is our chance to agree and
co-ordinate an operational plan and a timetable to meet our vaccine targets and
to make progress where previously we've fallen short.
Of course an extraordinary humanitarian effort
is also needed, as Dr Tedros has so eloquently said, with the World Bank, IMF
and other agencies making additional resources available to ACT-A and to the 91
hardest-pressed countries to build the medical capacity they need and the
staffing to administer the vaccines in urban and rural areas over the coming
months.
But, friends, the alternative is unthinkable. A
fractured world where bitterness and a two-track future grows and where the
disease spreads uninhibited in unprotected places and then as it mutates new
variants threaten to infect even the fully-vaccinated.
It's in everybody's interests and there is no
greater cause today than us acting decisively now to bridge the unacceptable
divide between the world's vaccine-rich and the world's vaccine-poor. Thank you
very much.
00:29:59
TAG Thank
you. Thank you so much indeed, Gordon, for your leadership and advocacy. We can
only hope the G20 countries hear your call so thank you so much again and I
hope you will stay with us for the interaction with the media. Margaret, back
to you.
MH Thank
you very much, Dr Tedros, and to our distinguished speakers. As Dr Tedros said,
we will now open the floor to questions. We've got a lot of you online with
your hands up already so please keep your questions short. Please keep to one
question. We will start with Antonio from the Spanish news agency, EFE.
Antonio, unmute yourself and ask your question.
AN Hello.
Good afternoon. To start with I want to send my condolences to the health
workers all over the world for all these many lives lost.
My question is on another topic. It's on the
election of the Director-General of the WHO. The nomination deadline ended a
month ago but we still don't know how many candidates there are, who they are
or whether Dr Tedros is going to run for re-election. Can you please give us
some information on this process? Thank you very much.
00:31:25
TAG Okay,
thank you. I cannot go into details because of many reasons but it will be
announced at the end of this month. Thank you.
MH Thank
you, Dr Tedros. That was short. The next question goes to Corinne from
Bloomberg News Agency. Corinne, please unmute yourself and ask your question.
CO Hi,
thank you. How concerned are you about the surge in cases in the UK? Do you
think we are in for another winter of potential lock-downs in places that
either aren't using protective measures like masks or that don't have high
vaccination rates?
MH Thank
you, Corinne. I think Dr Mike Ryan will answer that question.
MR I
think first of all the United Kingdom has achieved very high levels of
vaccination across the board in all its target populations including health
workers and congratulations to them for that.
00:32:31
The National Health Service has held up very
well under more than a year-and-a-half of extreme pressure and our respect to
the health workers and to the managers and others who've kept that system
running so well through such a difficult and demanding period.
There is no question if you look across Europe -
and it's all the way from Azerbaijan to my own country, Ireland - we've seen an
up-tick in the number of reported cases in a large number of countries. In fact
the trend in Europe has been upwards for three weeks and the UK is no different
in that.
In fact the increase in cases week-on-week in
the UK is much less than the week-on-week increase in some countries in Eastern
Europe for example but we're seeing that general trend.
I think what we're seeing is, in essence,
communities going back to what people consider as normal and restrictions have
been progressively lifted in many countries in stages over the last number of
months. Most of those restrictions are now not in place any more in many
countries and we're seeing that coincide with the winter period, in which
people are moving inside as the cold snaps appear.
00:33:43
So in that sense there is more social mixing,
there is more movement and when you have more social mixing and more movement
in the presence of a virus that spreads by a respiratory route then you're
going to get more cases. That's a reality.
We know that the vaccines that have been used
are highly effective at preventing severe disease and hospitalisation and we
can see that decoupling of the incidence data, the number of cases from the
number of hospitalisations and deaths.
Particularly in the UK it's really instructive
to look at the curve, that despite the increasing number of cases over the last
number of weeks we've seen a very flat number of cases of hospitalisation,
severe disease and death so that is definitely holding.
But the vaccines are not perfect in preventing
further infection or in preventing transmission so the reality is that in a
situation where there is intense social mixing in the winter period with people
inside we are going to see further transmission of the virus.
00:34:47
The question is whether that transmission turns
into severe cases, hospitalisations and deaths and the way that the
hospitalisations and deaths can be avoided is ensuring that particularly those
people in high-risk groups have the appropriate vaccination.
That again is the tragedy that's been outlined
here by so many speakers. The fact that countries like the United Kingdom and
many countries in the European Union are able to decouple the incidence from
the deaths speaks to the value of the vaccines and the job that the vaccines
are actually doing.
The issue is that that benefit is not available
to so many millions of people in so many countries, including those health
workers in countries all around the world. So we will expect to see increases
in cases. The question remains as to whether or not we will have the same
experience as last year with health systems coming once again under pressure
and again if you look to Eastern Europe...
And I think in the Russian Federation yesterday
they had the highest number of deaths in a very, very long time so this is not
just a phenomenon in one place. This is a phenomenon across many countries and
the difference between having intense transmission with some cases of
hospitalisation and death and having large-scale hospitalisation and death
associated with pressure on the health system really comes down to vaccination
and getting vaccines into people and having people increase their demand for
those vaccines.
00:36:21
That doesn't mean that we don't have to be
careful. This is still a very dangerous virus and we can protect ourselves and
if you're a person who has high vulnerability then even if you are doubly
vaccinated or vaccinated with the appropriate number of doses in your primary
course you should still be careful, you should still take care.
We also have influenza and respiratory syncytial
virus. We are seeing unusual activity in both of those viruses as those
infections kick back in. We've had a holiday from those viruses in a way with
all the measures put in place for SARS-CoV-2 and COVID. We've had very low
incidence of those two diseases so again I would advise people to make sure
that if it is offered you get the influenza vaccine as well this winter for
those in the northern hemisphere and that you protect yourself against that as
well.
00:37:14
So again just to say, the United Kingdom has not
only been part of developing vaccines but has also delivered those vaccines
very effectively to its population. Its NHS has stood up well and I believe the
Health Minister and others yesterday have put in place contingency plans for
further measures should they be needed.
I think all countries need to be considering
what they will need to do to support their health service should the incidence
of disease result in higher numbers of hospitalisations - that's just good
planning - and ensure that we get particularly...
I think this is one issue. Sometimes we look at
this number of the percentage of people vaccinated. That's not necessarily the
most important number. It's the people you've missed in the high-risk groups.
They're the ones who will get sickest. They're the ones who may die.
So please let us not focus purely on the number
of people vaccinated or the proportion. Let's look at the people who we need to
vaccinate as an absolutely highest priority and have we covered those people,
especially those with underlying conditions and older persons. Thank you.
00:38:23
MH Thank
you, Dr Ryan. I think Dr Aylward wants to add something.
BA I
think we can move on but it was just the point that the Director-General and
Mike emphasised so often. We don't have to see those surges. The vaccines are
an important part of it but the vaccines are only part of the issue. The social
distancing, the masking, etc.
We've had lots of countries try to mix the
vaccination, high coverage with those other measures that Mike and
Director-General emphasise so much and that's what we have to remember again
and again and again. It's not an inevitability to have big surges of disease.
It's a function of how we behave in the face of this virus as well.
MH Thank
you, Dr Aylward. I'm looking around the room to see if any of our experts on
health systems would like to point out what this means for their healthcare
workers. No, okay. Then the next question will go to Gunila from Svenska Media.
Gunila, please unmute yourself and ask your question.
00:39:24
GU Thank
you for taking my question and first of all my condolences to all the health
workers in the world but my question concerns vaccines. All Nordic countries
have actually suspended the use of Moderna vaccine for people under 30 years of
age after a new study about heart inflammation.
I'd like to have your view on this. Is this a
reasonable decision and what is the risk of giving the Moderna vaccine to
younger people considering this new data? Can younger Nordics who have already
taken one dose of Moderna now safely do a mix-and-match and take Pfizer?
I think you have been preparing a statement
after viewing this data but so far I have not seen anything. Thank you.
MH Thank
you, Gunila. Dr Mariangela Simao will answer your question.
MS Thank
you, Gunila. First of all let me say that WHO has a global advisory group on
vaccine safety that meets regularly and it's currently assessing the decision
in Sweden and Denmark to stop vaccinating with the Moderna vaccine and
comparing the very rare - actually let me again re-emphasise - the very rare
side-effect, adverse event of myocarditis in younger people, especially 18 to
24 years of age and who have taken either the Moderna or the Pfizer vaccine.
00:40:52
So again these vaccines... First of all the
myocarditis that has been observed is very benign. Some people do have to be
hospitalised but we don't have any deaths associated with it and the assessment
we have so far from the different regulatory agencies and also the internal
assessment of WHO is that the benefits of having the vaccine still outweigh the
risks.
So we shall be seeing a statement of the global
advisory group on vaccine safety in the next two days. Thank you.
MH Thank
you very much, Dr Simao. The next question goes to Jeremy from RFE. Jeremy,
please unmute yourself and ask your question.
JE Thank
you, Margaret. I would like to ask a question about the nurses. I was wondering
regarding health workers, does WHO recommend or is it working on a
recommendation for health workers to receive a third dose? If Ms Kennedy is
still online I would like to know if that's a demand from the nurses for
themselves. Thanks.
00:42:09
MH Thank
you very much. We'll go to Annette, I think, first of all and then Dr James
Campbell will answer.
AN I
think, if I heard you correctly, you're asking if healthcare workers like
nurses should get a third dose. Is that what I heard?
JE Correct.
AN Of
course, if we are talking about the safety of healthcare workers we would agree
with what the evidence suggests. However what we are saying too is we would
like to see equity in distribution of vaccines across the world, not just in
high-income countries receiving vaccines, two vaccines or three vaccines or
booster doses.
That would be ICN's ethos in relation to
healthcare workers, equity of vaccines across the world to protect everybody so
that's where ICN would be coming from. But of course we would do everything in
our power to protect the healthcare workers because we need them. The loss of
one more life is a loss too much.
00:43:19
MH Thank
you very much. Dr Aylward, would you like to add anything on that? That's fine,
okay. The next question goes to Gabriela Sotomayor from Proceso, Mexico.
Gabriela, please unmute yourself and ask your question.
GA Thank
you. Thank you very much for taking my question and my condolences to all the
health workers in the world. My question is to Dr Tedros. The President of
Mexico, Mr Andres Manuel Lopez Sobrador, expressed harsh criticism of the WHO
because of the delay in the authorisation for emergency use of certain
vaccines.
At his press conference he criticised the
organisation for its inefficiency and asked you to accelerate the process to
authorise the use of certain vaccines, for example Sputnik or Cancino. This is
the second time that he put pressure on the WHO to hurry with the process of
vaccine authorisation and he questioned if the reason was political or
ideological so I kindly ask for your comments. Thank you.
MH I
was going to say perhaps Dr Simao will begin.
00:44:43
MS Thank
you, Gabriela. This is an important question because actually, let me make very
clear, the WHO use international standards and the procedures that guide the
emergency use listing are published in WHO's website and they are followed by
all manufacturers.
But the procedures in themselves are procedures.
What needs to happen is that the manufacturer needs to apply for... needs to
make a submission to WHO and then once it's accepted needs to submit all data
and, as I am saying, WHO is not inventing new data or creating differential
requirements.
We use the internationally accepted, recognised
standards and norms for the quality and safety of health products. Then the
speed with which the vaccines are listed, which is the emergency use listing,
depends on how fast the manufacturer submits all the data.
In some cases we do need to do inspections in
the manufacturers. If the inspection was recent we don't need to do it again
but in the case specifically of the emergency use listing of Sputnik that was
mentioned let me say that we did start what we call the rolling submission,
which means that the applicant starts to upload to WHO's website the technical
data, clinical data, the clinical trials, the good manufacturing practice, the
quality management system.
00:46:31
There's a series of data that needs to come in.
We haven't received all the submissions from Sputnik yet and let me say that
the process was on hold until yesterday evening because of a legal procedure.
We still needed the applicant to sign that they agreed to the WHO's rules and
procedures to continue to do the assessment.
So it has restarted as of today so we expect
that we will be able to redo the inspections in the next few weeks so we're still
going to receive additional data from the Sputnik applicant. This is the
process that works for everyone. WHO doesn't differentiate from where the
manufacturer is, which country it is, whether it's this or that, state-owned or
private-sector. We follow the rules that are equal to everyone.
Then there are different timelines because of
the different processes in terms of the speed with which the manufacturer can
provide the data to WHO. Thank you.
00:47:53
TAG Thank
you. She wanted me also to respond so I'd be happy to say a few words. First of
all, we haven't heard from Mexico straight. if they have any concerns they can
ask us, they can send us a message and we can give them any answers so this is
the first time I'm getting information that they have concerns.
Second, if they're interested they can send
experts to see how we do it here so instead of the President raising these
issues without any contact with our experts, first it's better to leave it up
to the experts to discuss.
As I offered earlier, if he wants to know I
think he can send experts and our experts and their experts can discuss it. One
thing I would like to assure His Excellency, the President, though is we use
data and evidence and principles, nothing else and the final recommendations come
from experts with the right skills and experience.
So we always use evidence and science so that's
what I would like to assure His Excellency. Thank you.
MH Thank
you very much, Dr Tedros and Dr Simao. The next question will go to John
Zaracostas. John, please unmute yourself and ask your question.
00:49:38
JO
Good afternoon. I'd like to follow up on some of the interventions by the
representatives from the nurses' association and the World Medical Association
and if they could shed some light on the tragic situation in Yemen where health
workers have not been paid for many months, more than a year in some cases and
they're treating life-saving cases on the ground, paediatricians, etc.
I know the WHO's been trying to do something
about it. It would be great to know what's being done given that 11 million
children's lives are at risk there. Thank you.
MH Thank
you, John. We'll also go to Dr Heidi from the World Medical Association who's
got her hand up but we'll go to Dr Annette first.
AK Thank
you for the question. It's not just in Yemen that this is a problem. We have
seen it in many countries throughout the world where there hasn't been
investment in health systems and consequently nurses are not paid and they're
not even employed even though there are shortages in those countries.
00:50:56
I'm not sure what we can do except to put
pressure on governments to invest in their health workforce because without a
health workforce you don't have a health economic system in country.
So I understand that it's not just in Yemen that
there is an issue in relation to the delivery of care to children and to the
society at large. We're funding it in many, many countries throughout the world
so we have to all put pressure on governments to ensure that there is employment
and that people are paid to actually deliver care and that this is as important
as investment in banks or investment in any other area of work.
Because it seems as if healthcare is not as
important as having your money invested in a bank. Really which is more
important, that you die or that you have money in the bank? To me there's no
equation there.
So I am just extraordinarily taken aback that
governments see so little reality in the reason to invest in healthcare and to
invest in healthcare workforce and to protect the general population. We saw
what happened when COVID came. The whole world shut down, the economy shut
down, everything shut down but the only people that could keep going were the
healthcare workforce and the hospitals and the institutions to try and protect
the people and to save their lives.
00:52:38
So it's time that governments learnt and it's
time that governments learned their lesson from this pandemic.
MH Thank
you, Dr Annette. We'll now go to Dr Heidi who had her hand up, I think, for an
earlier question. Over to you, Dr Heidi.
HS Yes.
Thank you so much. Yes, it was for an earlier question but I'd like to address
this as well because we see it in many countries and we appeal to the humanity
and ethics of the health professionals on the floor but a country, a society
can't build on that because even they are leaving to save their lives many
times.
I just spoke to a colleague in Lebanon and we
see colleague after colleague leaving to other countries and this we have seen
before the pandemic. It has just been worse and we have to see to it that
healthcare is part of the infrastructure just as the health of the population
is an asset, not only money in the bank but is an asset, that personal
healthcare is an important asset.
00:53:47
So it's about politics, about investments but
also about global collaboration. We have to support each other so yes, we
acknowledge the problem and it is actually very big.
So I wanted to answer the last question but I
wanted to add on a former question about vaccination of healthcare
professionals, third dose, yes or no. I'd like to address the opening remarks
by Dr Tedros. where he pointed out that two out of five healthcare personnel
are not vaccinated yet - or that two out of five are vaccinated. Sorry.
That's too low a number and the healthcare
personnel, physicians such as myself have a responsibility to get vaccinated as
well because between the situation where we have access to vaccine and the
possibility to vaccinate healthcare personnel and where there's a total lack of
vaccines there is a range in between where there's also a choice of the
healthcare personnel.
00:54:57
So it is our responsibility as well to get
vaccinated. We meet vulnerable people all the time and there's a risk if we are
not vaccinated that we carry and spread the virus to patients. We are also
role-models to the population. We need to tell the population of the importance
of being vaccinated.
We also have a role in promoting the right
information about vaccines because there is a lot of misinformation and
incorrect information about both the vaccine and the pandemic but also about
the spread of the virus.
We need to promote clinical data as fast as
possible and as much as possible so that we and the populations around the world
will accept being vaccinated. as well. That's important to address.
Then the question of a third dose is coming
later but to be vaccinated in the first place must have seniority.
MH Thank
you so much. Now Mr James Campbell will answer this excellent question that's
getting a lot of interest.
JC Thank
you, Margaret. John, thank you very much for the question. Yes, the situation
in Yemen is of real concern. You will have seen in today's joint statement, the
healthcare professional associations, WHO, many of the partners, IOO included,
the second call to action is on the decent work agenda, to ensure that these
health and care workers who are putting themselves often in situations of great
difficulty, who are having a higher risk of infection and a higher rate of
deaths are in positions where the basic conditions, remuneration included, are
being put forward.
00:57:03
In the working paper that is published today
with the estimates of the deaths we also present all the other measurements
that the data scientists, the epidemiologists here in the organisation with
member states are conducting.
That includes looking at the negative impact on
the work environment. We have seen labour protests in over 80 jurisdictions,
many examples of which are due to the work environment, the personal protective
equipment, acceptable levels of risk.
It's also to do with the burden of mental
illness, the stress, the anxiety that we heard Annette Kennedy, President of
the ICN, talk about. So pay, terms and conditions is part of the action and
we're working with our colleagues in Yemen, with the Government to try and find
solutions.
00:58:01
As Bruce Aylward and many colleagues are talking
about, if we look at the 40% targets, the 70% targets for population coverage,
that is going to translate into several million healthcare workers working
full-time on vaccination. If we're not paying them we will not have vaccine
equity.
Just one comment, if I may, on the either/or
question of the third dose. As Gordon Brown gave the presentation earlier, it
is not a question of either/or. We can do both. There is enough vaccine supply
if we have the political decision-making, all health workers protected and that
includes first, second and, where necessary, third doses. Thank you.
MH Thank
you, Mr Campbell. Dr Zsuzsanna Jakab will add some more comments.
ZJ Thank
you very much. I would like to share the concerns of Annette and Heidi on the
need to move towards more resilient health systems and that will be a very
important part of the recovery and the transformation. That will definitely
also include issues around the workforce.
00:59:16
We have been very pleased to release the WHO
position paper just two days ago in this room on this topic together with Mike.
It was a joint workload, learning from the COVID experience and many of the
ministers joined us in that meeting and also the regional directors.
They welcomed the timeliness, the relevance, the
utility of this integrated approach to move towards UHC and health security
together. There are many actionable recommendations in that paper.
One of them is that we have to invest more into
the foundation of the health system, which is primary healthcare, essential
public health functions, IHR implementation, integrated approaches and as there
is interdependency between these issues it is very important to use the primary
healthcare approach as a nexus.
We also agreed that we need to invest more into
FCV settings, which is the fragile and conflict-ridden countries and they have
to be our priorities. We have to start or support intensified programmes in
these countries.
01:00:29
One additional element is that if we want to
address all these issues around the workforce and other things we have to
invest more into the health system. COVID has made it very clear that health is
an investment and not a cost and all these issues around the workforce are
definitely linked to that.
So we have already started the discussion on how
we turn this into an implementation plan in the countries at the three levels
of the organisation, working with the country and regional offices.
In the meantime also we implement the guidelines
that have been developed by James and his team during COVID when we addressed
many of the workforce issues and actually adapted lots of the WHO guidelines to
the COVID and COVID-related issues.
It's not only a guideline that sits here in
Geneva. It's a guideline that we shared with the countries, country offices and
are actively implementing it. Thank you.
MH Thank
you so much, Dr Jakab, for explaining exactly what countries really can do to
make the health systems resilient. We've run out of time. the questions were so
excellent and the responses so rich, so I'm now going to hand over to Dr Tedros
for his final remarks. Over to you, Dr Tedros. Pardon? And over to our speakers
to ask if they would like to make any final remarks. Do we have final remarks
from our speakers? Yes, [overtalking].
01:02:06
AK Yes,
just very quickly. I suppose what I would like to see is standardised data
collection across all countries and fed to WHO. I would like to see
implementation of safety and protective measures and just as an outside [?]
most of the PPEs, all of the PPEs were designed for men, not for women yet 90%
of nurses are women, 70% of all healthcare workers are women. It's interesting
that they were designed not safely for women.
That there would be mental and physical support,
that there will be vaccination for all healthcare workers by the end of the
year and that there would be incentives to retain staff, particularly older
staff, nurses in the workforce. There're lots of recommendations on how to do
that both by ICN and by WHO, and to build capacity in home countries, not to be
aggressively recruiting from other countries.
01:03:00
And finally I hope that government have learnt
their lesson for the future. I'm not convinced yet. Thank you.
HS May
I take the floor?
MH Please
do.
HS Thank
you. Excellent and I can just say that I support what Annette said. I'd like to
add the importance of global collaboration and that the window of opportunity
we have to make substantial change, to strengthen the global collaboration
should not be overestimated.
We might not have that much time so we need to
act now to get greater support to our initiatives such as GAVI has and the WHO.
So we must all help each other to urge all countries in the world to support
the global institutions who have the mandate to make global collaboration and
guidelines because we need action taken and substantial action.
I'd like to thank the WHO for the
acknowledgement to all health and care workers around the world, supporting us
of course because many healthcare workers are alone in the front line and it's
difficult for healthcare workers for speak for themselves.
Many times they're standing there with very sick
patients so it's so important that we acknowledge their role and their
vulnerability. If healthcare is vulnerable in a country then the population and
the health will be vulnerable and then society will be vulnerable.
01:04:51
To become more resilient we need continuing
investments in the health of the population and healthcare workers are core for
that. Finally thank you for highlighting the importance of healthcare workers
around the world.
MH Thank
you so much for those comments. Unfortunately Mr Gordon Brown has had to go to
another meeting so I'll hand over to Dr Tedros for his final remarks and to
close the press conference.
TAG Okay.
Thank you, Margaret, and thank you to our guests today, to former Prime
Minister Gordon Brown, to Dr Annette Kennedy and Dr Heidi Stensmyren. I would
also like to thank our media colleagues for joining today. See you in our
upcoming pressers. Thank you.
01:05:46