WHO Daily press conference on novel coronavirus - 29 January 2021
00:02:52
FC Hello,
all. I am Fadela Chaib, speaking to you from WHO headquarters in Geneva and
welcoming you to our global COVID-19 press conference today, Friday 29th
January. We will be joined by guests whom I will let Dr Tedros introduce in a
moment. We have simultaneous interpretation in the six official UN languages
plus Portuguese and Hindi.
Let me tell you who is in the room here. We have
the WHO Director-General, Dr Tedros, Dr Mike Ryan, Executive Director, Health
Emergencies, Dr Maria Van Kerkhove, Technical Lead on COVID-19 and Dr Bruce
Aylward, Special Advisor to the Director-General and lead on the ACT
Accelerator.
Joining remotely are Dr Kate O'Brien, Director,
Immunisation, Vaccines and Biologicals and Dr Soumya Swaminathan, Chief
Scientist. We have also in the room Dr Jim Campbell, Director, Health Workforce
and Elizabeth Iro, our Chief Nursing Officer. Welcome, all. Now without further
ado I will hand over to Dr Tedros for his opening remarks and to introduce our
guests. Dr Tedros, you have the floor.
TAG Thank
you. Thank you, Fadela. Good morning, good afternoon and good evening. Tomorrow
marks one year since I declared a public health emergency of international
concern over the outbreak of novel coronavirus, the highest level of alarm
under international law.
00:04:34
At the time there were fewer than 100 cases of
the disease we now call COVID-19 and no deaths outside China. This week we
reached 100 million reported cases. More cases have been reported in the past
two weeks than during the first six months of the pandemic.
A year ago I said the world had a window of
opportunity to prevent widespread transmission of this new virus. Some countries
heeded that call; some did not. Now vaccines are giving us another window of
opportunity to bring the pandemic under control. We must not squander it.
The pandemic has exposed and exploited the
inequalities of our world. There is now real danger that the very tools that
could help to end the pandemic, vaccines, may exacerbate those same
inequalities.
Vaccine nationalism might serve short-term
political goals but it's ultimately short-sighted and self-defeating. We will
not end the pandemic anywhere until we end it everywhere. The world has come to
a critical turning point in the pandemic but it's also a turning point in
history. Faced with a common crisis can nations come together in a common
approach?
00:06:13
When a village is on fire it makes no sense for
a small group of people to hoard all the extinguishers to defend their own
houses. The fire will be put out faster if everyone has an extinguisher and
works together in unison. More vaccines are being developed, approved and
produced. There will be enough for everyone but for now vaccines are a limited
resource. We must use them as effectively and as fairly as we can. If we do
that lives will be saved.
That's why I have challenged government and
industry leaders to work together to ensure that in the first 100 days of 2021
vaccination of health workers and older people is underway in all countries.
My message to governments is to vaccinate your
health workers and older people and share excess doses with COVAX so other
countries can do the same. My message to people in countries that are now
rolling out vaccines is use your voice to advocate for your government to share
doses. If you're someone at lower risk please wait your turn.
00:07:44
Health and care workers have been on the front
lines of the pandemic but are often under-protected and overexposed. They need
vaccines now. They and their families have already paid an extremely high price
in this pandemic. Protecting the people who protect us is the right and smart
thing to do.
In the early days of the pandemic, as you
remember, people showed their love and appreciation for health workers by
applauding on their balconies. Now it's time to show our love and appreciation
for health workers by making sure all health workers are vaccinated.
Today I'm honoured to be joined by two health
workers who have been delivering health services throughout the pandemic.
Harriet Nayiga is a a midwife from Uganda. Harriet, thank you so much for
joining us today. Please tell us about your experience working through the
pandemic. You have the floor, Harriet.
00:09:05
HN Thank
you very much, Dr Tedros, for this great opportunity. My name is Nayiga Harriet
from Uganda. I'm a midwife. I'm a Director of MLCoT. MLCoT is Midwife-Led
Community Transformation, which is a community-based organisation which is
aimed at bridging that gap which is existing between the midwife and the local
community through provision of sexual reproductive health and rights to
marginalised adults and [unclear] adults. So I'm very practical in the community
through preventive initiatives.
My work is going down to the grass roots to
engage with the community adolescents and young adults. However when the
pandemic came in things changed and I could not access these groups. We could
only access them via phone calls and then when the lock-down was opened, we do
not have enough SOPs in the marginalised communities and that means I was a
mid-wife, together with my team I lead, are very, very vulnerable to the
disease.
Because the communities that we engage with do
not have enough to prioritise having SOPs in place so that means we need to be
prioritised when the Government gets the vaccines in the country, as well as my
fellow nurses and midwives whom I engage with, who are in the health facilities
because we do also engage with them as we provide them with resilience, with
the knowledge and skills towards the provision of youth-friendly, healthy
services.
00:11:10
But they also say that they would love to have
the vaccines as early as possible because they engage with large numbers of
patients and as nurses and midwives being on the front line we engage with the
patients for more hours than any other health worker.
So we need to be prioritised and we really thank
WHO for the move that you have taken on producing the vaccine that will be very
great for us, the nurses and midwives if it comes. I appeal to the Government,
because of the efforts that it is putting in to have the vaccine in place, we
also ask the Government that when it comes nurses and midwives are prioritised
to be vaccinated first. Thank you very much.
TAG [Inaudible]
and I hear your call that you would like to be vaccinated so that you know
you're safe to protect the mothers and children you work with. Thank you so
much again. Asante sana, my sister.
00:12:20
Now to our second guest. Sana Baloch is a nurse
from Pakistan who started her career during the pandemic. Sana, thank you so
much for joining us today and we look forward to hearing about your experience
working on the pandemic and your hopes for the year ahead. Sana, you have the
floor.
SB Thank
you so much, Dr Tedros. Thank you for inviting me here. My name is Sana Baloch
and I'm a recent graduate of science and nursing from [Unclear] University,
Pakistan. I actually started my career as a nurse during the pandemic when I
[unclear] to a profession that is itself usually a challenging time when you
need the best supervision and the best mentorship to [unclear] your skills on
the clinical side.
Unfortunately we were [unclear] in a time when we
were the only ones who had a great responsibility to deal with the patients
when most of the staff were isolated, they were infected and they were exposed.
The burden and the shortage of staff was huge and we had a huge influx of
patients.
We were trained within a few weeks to take care
of the patients in the COVID ICU when there were new units built up in a couple
of weeks. So we as nurses, the doctors and paramedics were in great stress, but
yes, we had no escape. It is our moral responsibility and it was our job to
take care of those patients.
00:13:54
We were the only hope of the patients and the
families who were isolated and admitted into the COVID wards and where they
were not allowed to meet or to see anybody. We cannot deny this, we cannot
leave them alone but at the same time we need protection, we need understanding
what the policymakers or management and the Government to protect us by
providing the complete PPE and of course vaccinations because the PPE is
disposable but the actual workers are not disposable.
So we thought that the cycle was continuous
during the year. In the pandemic in 2020 we were exposed, we were isolated and
we just had to wait until we recovered so we could go back and take care of our
patients again in the COVID ward.
There were our colleagues who were really sick,
who were not able to breathe but after 20 days of their hospitalisation they
were there standing in the wards and taking care of the patients. Around 10,000
of the healthcare staff have been infected in Pakistan and hundreds died. They
were not old, they were young; they were my colleagues.
00:15:06
Because of less resources, less PPE and of
course now when we talk about the vaccination it is the responsibility of the
world leaders and most of their countries to help humanity and the healthcare
providers first, to protect them so that they are able to deliver the best
quality of care and they are safe I provide care because the healthcare
providers are the ones who are not going to any gatherings, they are the ones
who are following all the SOPs but yet they are the most vulnerable; they have
to take care of the patients.
We have to give them a bath, we have to take
care of the clothing and everything of COVID patients and people who are on
ventilators, unable to breathe. There is no escape and we as healthcare
workers, the doctors, young doctors, nurses, midwives and all paramedics look
forward to the world that they will decide on the basis of humanity because it
is not something at state level; it is something as a human being.
We as a world can only fight with the virus when
we think of providing safe services as healthcare providers despite borders so
yes, I appeal to the leaders of the world; please distribute the vaccine on
equitable categories, if you have enough of the resources vaccinate all your
elderly and all your healthcare providers.
00:16:41
So do consider donating or helping out less
developed countries who do not have enough to even vaccinate their healthcare
providers or elders before moving towards the less vulnerable population of
yours. Thank you, Dr Tedros.
TAG Thank
you so much indeed. Thank you, that's very, very clear. Again, thank you, Sana
and Harriet, for joining us today. You have my deep respect and admiration for
the work you do every day to save lives and deliver health services to those
who need them most. We're proud of you and you have my commitment that we'll do
everything that we can to ensure you and your colleagues are vaccinated as soon
as possible.
The theme for World Health Day this year is
health equity. Equity is at the heart of everything WHO does. This week we have
released two products to close gaps in care and improve health outcomes
globally. The first is the essential diagnostics list, a basket of diagnostics
that WHO recommends should be available at point of care and in labs to improve
timely and life-saving diagnosis.
00:18:05
The COVID-19 pandemic has reinforced the value
of timely and accurate diagnostics to save lives. Without them you're flying
blind. The latest edition of the essential diagnostics list includes tests for
the COVID-19 virus, expands the suite of tests for vaccine-preventable and
infectious diseases and non-communicable diseases such as cancer and diabetes,
and introduces a section on endocrinology which is important for reproductive
and women's health.
The second product is a new ten-year plan for
neglected tropical diseases; a set of 20 illnesses that affect more than a
billion people, most of them poor. The plan includes ambitious but achievable
targets to reduce the number of people who need treatment for a neglected
tropical disease by 90%, to achieve the elimination of at least one disease in
100 countries and to eliminate two diseases - guinea worm and yaws - globally
by 2030.
Together WHO and our partners are working to
ensure neglected tropical diseases are neglected no more. These are just two
examples of the many ways WHO works every day to fulfil our mission to promote
health, keep the world safe and serve the vulnerable. I thank you. Fadela, back
to you.
00:19:44
FC Thank
you, Dr Tedros. I will now open the floor to questions from members of the
media. I remind you that you need to use the raise your hand icon in order to
get in the queue to ask your question and don't forget please to unmute
yourself. We welcome also questions from journalists to our wonderful guests,
Harriet and Sana so please don't hesitate to ask your questions. They have the
experience from the field and it's interesting to hear from them also.
I would like to start the questions and answers
with a journalist from Cancun, Mexico, Paulina Alcazar. Can you hear me,
Paulina?
TR Hi,
Fadela. Yes, we can hear you. Can you hear me, please? Thank you. International
travel is still going on but there are new requirements that countries would
like to impose but there is a new pressure now imposed on testing. Do you aim
to prioritise the international travel sector, staff and travellers as a second
priority group for vaccinations? Thank you.
FC Thank
you, Paulina. Dr Ryan will take it.
00:21:21
MR I
can start. I think the question specifically relates to vaccination of people
working in the industry but with specific reference to testing as a measure,
testing is being increasingly used in different parts of our society to do
different things and certainly the expansion of rapid diagnostic tests is
bringing a new and very useful tool to bear, taking pressure off the existing
PCR-based testing systems and fully expanding the use of validated rapid
diagnostic tests is a major aim of WHO, our partners in FIND and UNITAID and
within the ACT Accelerator. I think Bruce will confirm that.
The specific issue around increased testing
requirements; countries right now are in different situations. Those countries
with very low incidence are very, very afraid about reimporting cases and may
have more stringent testing in place.
Other countries are worried about the arrival of
potential variants that will further complicate their situations and they're
targeting reducing movement from certain countries in order to be able to avoid
that. It's a difficult prospect and what we do need is coherent messaging
around travel requirements.
00:22:44
The process of travel itself has been
significantly de-risked and the travel industry and others deserve credit for
having put in place a lot of measures to reduce the risk of transmission during
the travel process.
Managing the arrivals in terms of quarantine and
supported quarantine, testing and other measures is difficult and I know a lot
of countries now - and it's something we've been saying for many months when
we're talking about dealing with either contacts of cases or people arriving
from high-incidence countries. If you're going to require that travellers
arriving in the country quarantine for a particular period or have to be tested
then governments should be supporting that process.
It is very difficult for a traveller arriving to
be able to comply sometimes if they don't get the support to comply so if
governments are going to require that people stay in a hotel for a period of
time then those facilities that are provided should be adequate and people
should be able to do that with a minimum level of comfort and be able to live
properly.
00:23:49
So as you see, governments are continuing to try
and increase and ramp up their efforts to break chains of transmission and to
manage risks but we also must do that an invest properly in those mechanisms so
not only citizens in countries but people who are travelling between countries
are treated with respect and with due regard to their comfort and their human
rights.
BA Thank
you, Fadela, and thank you, Mike. Thank you for the question. On the issue of
prioritising the use of vaccines - an extremely important point and thank you
for raising it again - we need to be clear - and again the Director-General
spoke about the toll of this disease and the disproportionate effect of this
disease on highly exposed populations in the course of their work; healthcare
workers, as we heard from Sana and Harriet today; and then also of course our
older populations.
When faced with a life-threatening disease and
what is a ubiquitous risk and threat here of this virus we have to be extremely
careful about how we use the scarce resources that we have to reduce that risk.
One of the most precious things we have right
now is the vaccines. You have seen in the media reports and elsewhere the
struggles, the challenges companies are having just making even what they had
planned to make and getting it out there on time, getting it distributed.
00:25:13
In that situation we have to prioritise the
people not who are inconvenienced by COVID-19 but the people who need this to
help prevent them from possibly dying of the disease. We know the people at
greatest risk are healthcare workers. You've just heard from two heroes of the
healthcare profession, right at the front line, who cannot help but be exposed
in the nature of the work they do.
Then we have our older populations and then we
have populations with no comorbidities, as you've heard about. We need to make
sure that the vaccine, this precious, rare, scarce - unfortunately - commodity
right now is used to reduce the risk of severe disease in these people.
Then on the issue of testing, as Mike mentioned,
you will have seen just over the last couple of weeks some exciting new
partnerships that are evolving to try and make sure that we can make accurate
testing available on even a bigger scale.
00:26:12
One of the things two of the ACT A partners
announced just last week was that they have now struck a deal to try and make a
highly accurate rapid diagnostic test available for low/low-middle-income
countries for $2.50. So that's the kind of partnerships we're getting down now
to the price ranges where we can really get testing up, as you said, Mike, to
the levels it needs to be if we're going to be able to rapidly detect and
isolate people who are infected with the virus to prevent that spread.
FC Thank
you both. I would like now to call on Christiane Ulrich from DPA to ask the
next question. Christiane, are you online?
CH Thank
you, Fadela. My question is on the expert mission in China. Can you update us
on what exactly is going to be on their schedule for the weekend, is there a
visit to the biovirology institute, for example, or to the market? Thank you.
MR Thanks.
I'd be very good if I could tell you what my schedule was for the weekend never
mind our team's. I'm sorry. I think you'll understand that the team is in a
dynamic situation. There is a very long list of site visits planned and
face-to-face meetings continue.
00:27:42
The visits will include the Wuhan Institute of
Virology, other labs, the Hunan market, early responders, hospitals in which
the first clusters of cases occurred. It's a very busy schedule and I also
wonder; sometimes the media accompaniment of the teams is much larger than the
international and Chinese team put together.
It's obviously a very good thing that we have
that transparency but it's also important that we let the team get on with the
business of the work they're doing. We're here to support them, we continue to
support them logistically and diplomatically and we'll continue to do so and
again the DG has said that we continue to be hopeful that all of the data and
all of the meetings that they need will be had.
Just to reconfirm, all hypotheses are on the
table and we're looking forward hopefully to a successful conclusion of the
mission but in that I would just like to caution everyone. Success in the case
of animal/human interface investigations is not measured necessarily in
absolutely finding a source on a first mission.
00:29:02
This is a complicated business. What we need to
do is gather all of the data, all of the information, summarise all of these
discussions and come to an assessment as to how much more we know about the
origins of the disease and what further studies may be needed to further
elucidate that. Maria, any comment?
MK Just
very quickly to say that the team is on the ground and we're all watching them,
as you are, with the media attention so I would advise to please be careful
with the team and as you are taking those pictures because we have seen some
harrowing videos of people following them in cars.
But, as Mike has said, the scientists are at
work. Just one thing to mention; I myself have been on many missions for WHO.
The mission team needs to decide what they do as they learn and so they may
show us a schedule - which we haven't seen - but they're working very hard to
see all of the different places they want to go. They may change their mind and
go to different places. We need to give them that freedom and that liberty to
go and evaluate what they need to evaluate and visit where they need to visit.
So we wish them very well and, as Mike said, we
look forward to learning more.
00:30:16
FC Thank
you. I would like now to invite Simon Ateba from Africa News Today to ask the
next question.
SA Thank
you for taking my question. This is Simon Ateba from Today News Africa in
Washington DC. Last Thursday WHO Africa warned that Africa was again in danger
of being left behind with only 25 people vaccinated in Guinea so far.
Yesterday WHO Africa said the new variants were
pushing up deaths and new cases with almost 6,200 people dead on the continent
in the past week alone. Can you please give us an update on vaccinations in
Africa, on other new variants in the continent? When exactly do we expect
serious vaccination to start happening in Africa beyond repeated promises from
COVAX?
What does the WHO think about the Russian
vaccine that was discussed yesterday with authorities in Algeria? Thank you.
FC Thank
you, Simon. I would like maybe to invite Dr Soumya Swaminathan to take part of
this question. Soumya, are you online?
00:31:38
SS Yes.
Thank you, Simon. I will start and Kate or Bruce might want to add. I think
this is what is topmost of our minds and in terms of getting vaccines to
people, especially to those who are at the highest risk - we have two
front-line workers who've spoken to us today so clearly healthcare workers and others
who are at high risk of getting the infection and dying from it need to be in
the front of the queue to get the vaccines regardless of where they live.
This takes us back to what the DG has called for
already; in the first 100 days of this year we should start seeing vaccines
rolling out in all countries. How will we do that? We're doing that through
COVAX and last week we announced that we had signed a deal with Pfizer, which
is a vaccine that has received WHO emergency use listing as well as SAGE policy
guidance.
It has challenges of ultra-cold chain but those
can be overcome and so we are hoping very soon, in the next couple of weeks to
start dispatching the first consignments of this vaccine to countries around
the world that are part of the COVAX facility so that they can start
vaccinating their health workers and the most high-risk.
00:33:03
We also expect to start receiving doses of the
AstraZeneca vaccine. Currently it is going through the regulatory review at
WHO. You must have heard that the European Medicines Agency has just given it a
conditional marketing authorisation. We need to review the dossiers independent
of that because the manufacturing sites for the vaccines that will come to the
COVAX facility are different from the vaccines that will go to Europe.
So we are hopeful that in the next two weeks at
the most this should happen, that we should have an emergency use listing
provided that everything of course goes according to plan and all the data is
there and that we can then start receiving doses of the AZ vaccine from the
manufacturing sites in India and South Korea and those should also be going out
to the countries.
Meanwhile of course we're working with the
countries on getting absolutely ready with everything that's needed and we've
gone through that before and what are all the elements of preparedness at the
country level so the day the vaccines arrive in the country they can start
being deployed.
00:34:18
There are many, many things that countries need
to do to get ready. We've seen even in the high-income countries that it's not
just a question of having the vaccine in the refrigerator; it takes a lot from
that point to actually getting it into people at the pace at which we want to
move.
So February is definitely our goal; the earlier
the better and we will try to expand as rapidly as possible through the COVAX
facility. Thank you.
FC Thank
you. Dr Swaminathan. Now we'd like to ask Dr Simao to address the question
about the Russian vaccine. Thank you.
MS Thank
you, Fadela, and thank you for the question, Simon. WHO actually has under
assessment at this stage four vaccine candidates. Two are AstraZeneca-derived
and just bringing back the issue of the EMA approval today, it's a very useful
approval because it approves the core data and the core data is useful for all
the sites. You know that AstraZeneca has eight different manufacturing sites so
WHO is at the final stages of assessing the sites that will provide to the
COVAX facility, which are SK Bio in Korea and the Serum Institute in India.
00:35:37
We are also in an advanced stage of assessment
of Sinopharm and Sinovac and at this stage we do have a team in China to do the
inspections in the Chinese facilities.
Regarding the Russian vaccine, last Friday we
had a new meeting with the manufacturers and WHO is still waiting - there will
be subsequent meetings - WHO is still waiting for some core information, some
vital information to be presented and this should be happening in the next few
weeks. Thank you.
FC Dr
O'Brien, you have the floor.
KOB Yes,
just to add a couple of things to what Soumya and Mariangela have contributed.
On the country readiness I think what I really want to communicate is the full
readiness that many countries have to get started and yet there are countries
that still have a ways to go to be prepared.
In addition to that there are choices, as has
been indicated, about the vaccines that are coming through the COVAX facility
and not all countries want to proceed with some of the ultra-cold-chain issues
that are at hand and are making decisions about what the optimum mix of
vaccines will be in the programme.
00:37:03
So the COVAX facility, as Soumya said, is ready
to deploy vaccines in the coming weeks and countries are in the process of
communicating and being communicated with about what those allocations will be.
I want to direct your attention to the COVAX
facility website which does have now supply projections over time by region and
by product and I think those are useful pieces of information for you to draw on
about what the COVAX facility is projecting to deploy.
FC Thank
you. I would like now to invite Jeremy Launch from Radio France Internationale
to ask the next question. Jeremy, can you hear me?
JE Yes,
thank you, Fadela, thank you so much. Apologies if the question has been asked
earlier but I was a bit late. I just wanted to have a comment from the WHO
about the recent vaccine exportation ban from the European Union. Thank you.
00:38:10
FC Dr
Simao.
MS I'll
start. Thank you for the question, Jeremy. Actually it's a very worrying trend.
We have seen last year, in the beginning of the year when we had the first
lock-downs affecting the big producers of essential medicines, we had export
restrictions at the time of active ingredients for essential medicines so this
is very much a movement that concerned WHO because we understand that no
product nowadays - not that WHO understands; that's the truth - actually is
made in only one place.
There are multiple elements; when you get a
medicine or a vaccine you are getting products that are coming from many places
in the world so it's not helpful to have any country at this stage putting
export bans or barriers that will not allow for the free movement of the
necessary ingredients that will make vaccines, diagnostics and other medicines
available to all the world. I don't know if anyone wants to complement.
BA I
think - and this is the kind of thing Mike is really on top of - at the
beginning of this crisis, you'll remember, one of the things that made it particularly
difficult for countries to manage the challenge as cases escalated in their
countries was the increasing nationalisation in some cases of some of the
products that were needed to fight this pandemic.
00:39:55
What we saw as we got out of the challenges
around PPE, around ventilator shortages, etc, was really a tremendous
commitment to work together and a recognition, as Mariangela said, that the
world was going to have to collaborate to get out of this together.
So a huge amount of work was done through the
ACT Accelerator, the COVAX mechanism and numerous other approaches to try and
ensure we didn't end up in that situation again because the tools that we need
to tackle this disease are scarce and they're not available everywhere.
But the people who are at risk, who are
threatened by this disease of course are distributed throughout the world so
it's absolutely essential that trade barriers or restrictions do not get in the
way of trying to beat this disease on a global scale.
Ultimately, as Mariangela outlined, it is such
an interconnected world that we are working in today. Parts of vaccines and the
raw materials may come from one country; it may be made into the vaccine in
another country; it may be filled and finished in yet another country or
labelled so this can end up being a self-defeating approach actually as well.
00:41:09
Of course most people are well aware of that and
most people are very, very keen to ensure that these tools can get to the
people who need them everywhere in an equitable manner because ultimately
that's what we're trying to do; ensure the equitable roll-out of these products
everywhere. So anything that gets in the way of equity is a challenge.
FC Thank
you. I would like now to invite Lynne Eaton from the BMJ, British Medical
Journal, to ask the next question. Lynne, can you hear me?
LY I
can and thanks for taking my question. Obviously, being based in London, we're
very much aware of the concerns between the UK and the EU over supplies of
AstraZeneca's product. Aside from that particular debate I'd really like to set
that in the context of what would it mean globally if we get different
countries having different vaccines, failing to supply to the level recommended
in the original licence and then we've got gaps in provision; what does that
mean to the progress of the virus particularly and risk of it mutating further?
Thank you.
00:42:19
FC Thank
you, Lynne. Dr Aylward will take this question.
BA Thank
you, Lynne. I think that's an important point that you make because what we
talked about the last time was the challenge in terms of just getting the
vaccine out to people everywhere.
But, as Mike has emphasised every time he
speaks, unless we keep this disease under control everywhere we are providing
it more and more opportunity to mutate, to have new variants which you're
already seeing evidence of, have concerning trends in terms of their
transmissibility or the disease they may cause.
So anything, once again, that restricts ability
to get these products out to as many people in as many countries as possible,
the more we are going to have challenges not just in terms of that equitable
goal we talked about and that goal of reducing the risk of severe disease or
death but also our ability to control the disease and prevent the emergence of
new variants. Mike, I don't know if you wanted to speak to that, or Maria.
MK Yes,
thank you, Bruce. Just because you brought up the variants I think it's worth
mentioning, there's a lot of attention to these virus variant that are being
detected in a number of countries and on the one hand we expect the virus to
change given we've had more than 100 million cases globally and that's an
underestimate.
We're tracking these changes over time and we
need to evaluate each one of them to better understand any changes in
transmission and severity and impact on diagnostics, therapeutics and vaccines.
Yesterday we held a seminar with more than 2,000
of our partners; partners in our international networks, partners in our
R&D blueprint for epidemics working groups related to COVID research, GOARN
partners and interested individuals - we've sent this to our networks, to our
networks, to our networks - to discuss variants and transmission.
This is really important because we have these
tools, we have these interventions that are in place; individual-level
measures, population-level measures and we have diagnostics, therapeutics, we
have these vaccines that are coming online.
00:44:25
All of these work and what we are learning from
the research that is being undertaken in countries like South Africa, in the
United Kingdom, in Denmark, in Brazil is that there may be some increased
transmissibility but the interventions still work; the interventions that are
in place can break chains of transmission, can protect individuals from
infection.
We need to stay focused and use all of the
resources that we have. We need to make sure that we prevent as many infections
as we can for the obvious reasons of preventing infections and severe disease
and death and putting our health workers at risk, who are risking their lives
every day to care for our loved ones.
But also as vaccines roll out we need to keep
the pressure on the virus as low as we can to minimise the pressure on the
virus to change. So there are many, many reasons we need to stay the course,
stay focused on what we can do to save as many lives as we can as vaccines are
rolled out.
But this meeting we held yesterday was really
important to put on the table everything we know about the studies that are underway
and there are many; there are epi studies and phylogenetic studies and
hospital-based studies and environmental sampling studies. We are working for
partners and grateful for partners sharing with us these results in real time
so that we can advise on any changes.
00:45:51
Our IPC guidelines development group also met
today to discuss any of these changes that may be necessary and based on the
information that we have at the present time - and, as I say, we are still
continuing to learn - we're not making changes to our recommendation.
But we are constantly looking at the evidence to
see if anything is different and we will make changes as necessary but we have
to stay the course, use all of the interventions that are in place to keep
people safe.
BA Just
to come back in for a second, the last point that Maria made is so important
because we often answer the question we're asked; okay, what about vaccines?
But this is not just about vaccines.
Lynne, to your point, any time we back off on
any of the measures we're giving the virus more space and we're taking the
pressure off the virus, as Maria said. So it's not just a question about
vaccines; every time we're asking these questions on vaccines we should be
asking about the other things that we're doing; the rapid detection, the
isolation, the quarantine, the masking because these are the measures that
we're going to rely on this year.
Too often the conversation is just about the
vaccines, it's just one part of the armamentarium; we need the whole thing to
work and if anything the emergence of variants of concern on three different
continents and three different settings should just be a clarion call to the
world that you need to keep the pressure on the viruses.
You're not going to have enough vaccine to do
that the way we'd like to this year and we don't even know if the vaccine would
be able to do that completely so we've got to be applying the other measures,
as Maria's spoken to and Mike always does.
MR Just
very briefly on this issue around vaccines and vaccine contracts, we heard
nursing colleagues; I think we all need to step into their place, where they
are today, fighting in the front line, standing in ICUs. They're right down at
the end of the queue right now and they're looking up to the top of the queue
and the people at the top of the queue are fighting about where they are in the
queue.
00:48:11
That's what it looks like; fighting over the
cake when they don't even have access to the crumbs. So I think we need to step
back and reflect upon our brave colleagues and where they stand today and what
we're going to do about that and we need to reflect on that. We're all
desperate, everyone is desperate, governments are desperate to service the
needs of their citizens; that's their mandate.
But we all need to say, would I put a vaccine in
my arm today if I thought that a health worker in the south would not get a
vaccine today? I think we all need to examine our own consciences and then tell
our political leaders and others what we want them to do.
FC Thank
you. I would like now to call on Christophe Vogt from AFP to ask the next
question. Christophe.
CT Can
you hear me now?
FC Yes.
00:49:15
CT Thank
you for taking my question. I was just wondering about what we talked about and
saying that we need to share the vaccines that we have. I was just wondering if
there is a way that WHO could be a go-between. I have seen a few tries at
enhancing capacity of production with Sanofi and just today Novartis. Is there
anything where the WHO could help to find more production capacity in the world
and to make all the people work together?
Just a very quick second question; are you
worried about how safe the deals are with COVAX?
FC Thank
you, Christophe, for your two questions. We try to allow only one. Dr Simao, you
have the floor.
MS I'll
start with the production capacity because this is quite an important question
and because we're looking at two things. First of all we're looking at the
vaccines that have proved to be safe and effective and that are also quality-assured;
that's one side.
The other side is how fast they can be
manufactured around the world and WHO has put together at the request of Costa
Rica a proposal for a COVID technology access pool where we have on one side a
call for increased sharing of knowledge and technologies including technology
transfer and on the other side also a call for increased voluntary licensing
through the medicines patent pool.
00:51:06
The World Health Assembly is also discussing it
and will be discussing in May a resolution on increased local production
capacity in different countries. This is very important right now because what
this global crisis has shown us is that we need to diversify the supply chain,
we need to make sure that we have increased capacity in different parts of the
world.
Right now it's very concentrated in some
countries and with some companies so this is a venture that goes beyond COVID
but this CTAP provides a platform where voluntary mechanisms can be put in
place to help countries and to increase the possibilities of technology
transfer between different manufacturers across the world.
I think this is important for vaccines but it's
going to be important also for any therapeutics that prove to be safe and
effective against COVID. Thank you.
00:52:15
FC The
second question; Dr Aylward.
BA Sure,
thank you very much. The question was, how safe are the deals with COVAX in
terms of the products. I think, as most of you know and we announced, if I
remember correctly, last Friday in the DG's presser, the COVAX facility has now
got secured and guaranteed deals for over two billion doses of vaccine for this
year and we have options on over a billion doses additional.
So how safe are those deals? The deals are safe.
The question is how safe are those volumes. As you've seen a number of
companies recently announce, making vaccines is hard and there's
unpredictability in some aspects. This is a biological process. The projections
that companies made about how doses; they were pushed very, very hard.
They tried to maximise their doses but that
depends on many, many factors, whether they'll be successful in doing that.
Some companies in some places had had problems with what we call the yields
from their products, which ultimately tells you how many doses you can get of
the vaccine. They've been lower than expected, meaning that they've had to
announce lower amounts.
00:53:36
So the deals are safe; the question always is
the volumes; will we get to the volumes that are very, very ambitious? That
will be the challenge as we go forward and this is why, to the point that
Mariangela was talking about, COVAX and the ACT Accelerator; much of it has
been a fantastic success; the ability to repurpose the international health
architecture and move so quickly on an end-to-end global solution for something
as challenging as this, taking an unknown disease and having a vaccine to reach
billions of people in a year is simply extraordinary.
But as you look at that end-to-end solution we
had a great research capacity around the world that really kicked in; we've got
great procurement capacities through GAVI and then working with UNICEF, PAHO
and others and great distribution networks.
But right in the middle of that there's a
critical piece of the pie and that's the ability to scale up those products
very, very quick to scale and we're paying a bit of a price for the fact that
there's been a contraction in global producers of vaccines for years. It's a
difficult business to be in and as we go forward part of what we're going to
have to look at is take a hard look at how we solve that and make sure that we
move more quickly.
00:54:52
Because in the middle of a crisis trying to
just, as Mariangela was saying, move the technology to another company or
someone who's never made a vaccine is very, very difficult. These are hard
products to make so this is going to require a longer-term solution as we go
forward.
FC Thank
you. Let's go now to Colombia; Andras Jeel from NTN 24. Andras, are you with
us?
TR Good
afternoon, can you hear me? Thank you. My question is the following; we have
had the approval of vaccines through the COVAX facility for Latin America and
we were hoping to hear an announcement on this for today. In case this is
confirmed, which would be the countries that would be receiving these vaccines
and do we have dates or quantities for these vaccines? Thank you.
BA Sorry.
I was getting tired of hearing my own voice and hoped somebody else would take
a question. Indeed, you're correct; what's happening today; the COVAX facility
is working on what they call indicative allocation so they're looking at the
products that they have in the pipeline for the next quarter or two quarters.
These are primarily AstraZeneca products, products from the Serum Institute of
India, etc.
00:56:25
They're looking at the volumes that have been
confirmed by the company and then they're working with WHO and the allocation
mechanisms that Mariangela runs to do what we call an indicative allocation, to
try and give countries a picture of how much of that vaccine they can expect
and when they can expect it based on two critical factors though; when the
regulatory processes will be complete.
We have promised the people of the world that we
will only supply products that we can absolutely assure the efficacy, the
safety and the quality of. That takes time; it takes a lot of data, a lot of
review to go through that and that's what's happening right now.
So if that part goes properly, which we're
anticipating, by early to mid February for these products - and then the second
thing is the volumes; are the companies going to have the volumes? As you know,
some companies are having challenges so that is going to affect eventually what
those volumes actually look like.
00:57:21
So the goal this afternoon - or this evening,
pardon me, or in the next days - is to provide what would be called indicative
volumes and that will help the countries to really being planning that; all of
a sudden it's very, very real; you know the baby's coming and it's time to
start planning and getting everything in place, those parts of the readiness
that aren't ready so that's to help countries plan and get their readiness in
place with the hope that then these products will start to move in February.
In addition they're also looking at a potential
first wave activity that involves the Pfizer product that was announced last
week so these are the pieces that we're hoping to communicate as soon as
possible to countries.
FC Thank
you. I would like now to invite Jamie Keaton to ask the next question. Jamie,
Associated Press.
JA Thank
you, Fadela, and nice to see you all again. There was an important decision
that came from the European Union today about restrictions on the possibility
of export of vaccines from the bloc. Dr Tedros talked about vaccine
nationalism, about getting to the front of the queue; we're talking about
worrying trends.
00:58:41
I would really like you to please try to address
that specifically, about how concerned you are. Is that a sign of the vaccine
nationalism that you're talking about? How concerned are you about that
decision and in particular what is the specific impact that it could have on
countries that are waiting for the AstraZeneca vaccine? Thank you so much.
FC Thank
you, Jamie. Dr Simao.
MS Hi,
Jamie. I think we have already answered a similar question before. Of course
there is always a lot of concern when any country or any bloc decides on
restrictions or export bans on what we call global public goods.
What was mentioned before today already was that
it's particularly concerning because the global supply chain is so diverse now
and it's so fragmented, products come from everywhere in the world so you may
have active ingredients for vaccines for example coming from China that will
come for the production in Europe; the vials will come from somewhere else.
00:59:59
So it's such a globalised chain of products that
it's very concerning when any country or bloc starts to put restrictions on the
movement of what are actually public health goods. We all need these vaccines
to be equitably distributed and for that we need that the flow of the
ingredients and the flow of the material that will be used at the end of the
line and that we will allow - going even to syringes because it goes from the
R&D production and then the production of the actual vaccine to the vaccine
being injected in a real person.
All this has a line of products that comes from
everywhere in the world so actually these are measures that don't benefit
global health, don't benefit any country specifically and actually can hamper
the plight and the global efforts to ensure there is equitable access to these
products.
BA Maybe
further just to add another point, I think at a time like this we always need
to take a step back and make sure that we approach this in a way that is going
to ensure everyone gets as much access as possible to these products.
Of course right now there're tremendous
frustrations, there're disappointments. There's been a lot of excitement about
the vaccines, a lot of promise and companies have been pushed very, very hard
to maximise the amount of products that they can make and ultimately some of
those promises and ambition are falling a bit short.
01:01:51
That doesn't mean that things will stop. Of
course the vaccines will continue but they're not going to be at quite the
levels that they needed to be but if you look at the counterfactual, companies
are trying to make as much vaccine as possible and they are trying to honour
the obligations that they have in terms of those products.
Then they're further stressed by the fact that
we're making demands to go further than these obligations and make sure these
get shared everywhere. What concerns us the most in a situation like this is
that ultimately it's the most vulnerable countries and often low-income, low
middle-income countries that suffer the most in any situation where we end up
with trade restrictions or barriers.
01:02:37
Those countries are already incredibly
disadvantaged right now, as you're seeing, in the roll-out of these products
and we're trying to rectify that and we certainly wouldn't want to see anything
further complicate it.
Because ultimately the higher-income countries
find ways around, they find solutions to these sorts of problems but the damage
that can be done to others along the way is what concerns us the most.
FC Thank
you. Let's take a last question from Michael Boziutkiv from CNN Opinion.
Michael, can you hear me?
MI I
can hear you, Fadela. Can you hear me?
FC Very
well. Go ahead, please.
MI Thank
you for taking my question. Sorry, it's a bit of a double-barrel. As you know,
elected leaders, public officials are key to disseminating public health
messaging in a pandemic but over the past few weeks countless elected and
appointed officials have been caught out going on vacations or non-essential
travel either domestically or beyond our borders, in violation of the same
advice or regulations which they themselves have either drawn up or espoused.
01:03:42
I think this is very important to hear from WHO especially
because so many people have been adhering to the guidelines but what would your
words of advice or peer advice be to these individuals, public officials who
have violated the public trust and gone against their own guidance?
Just quickly - forgive me - because the DG spoke
of vaccine nationalism, Canada has secured access to more vaccine doses per
capita than any other country in the world. They've struck deals for about 414
million doses or about nine doses per person. You've already talked about the
shortages and challenges facing COVAX but is there an issue here with fairness
in your opinion and should Canada release some options rather than betting on
every vaccine production horse, so to speak? Thank you.
FC Thank
you, Michael. Dr Van Kerkhove will take the first part of your question.
MK Thanks,
Fadela. Thanks for the question. I won't comment on individuals. I think the
bottom line is that all of us have a role to play and all of us need to be
following the recommendations with the common goal of ending this pandemic.
01:04:51
This pandemic has had a tremendous impact on all
of our lives. We are living through probably one of the most challenging
situations that most of us will have ever dealt with although if we look to our
loved ones of older age they've also been through very difficult times and we
need to stay the course.
There are actions that all of us take every day
that will have positive consequences or negative consequences and this is
tough. We know that a year plus into this we're tired, we're exhausted, we want
this to be over but we also have a role to play.
We are working with populations and people all
over the world to listen, to engage, to understand what are the barriers to
compliance and some of these are really legitimate concerns. People have to
make a living, they have to leave their house to make a living, to feed their
families.
Others; there are inconveniences and we need to
do what we can to minimise our exposure to this virus especially in areas where
it's circulating. We've seen a number of countries that have brought
transmission under control which are having sporting events outside and are
living their lives because they have brought the virus under control.
01:06:11
We will get there but we have to make the right
decisions every single day to minimise our exposure and all of us have a role
to play. So going back to barriers for compliance, we listen and engage with
many different groups, with different ages, with people all over the world to
really understand what are those barriers.
I think we have a lot more to do in this area of
work and understanding behaviour and understanding the social determinants of
all of this and working through that.
So when we say to stay home people can stay
home; governments can support them in doing so but we need everyone's help so
do what you can. We have health workers who are online, who have contributed to
this press conference today who may want to comment on this because they are
out and about every single day putting their lives at risk and we as non-health
workers need to do what we can to minimise our exposure to not need healthcare,
to not overburden an already overburdened healthcare system and keep them safe.
01:07:18
So thanks for the question but the bottom line
is we need to put in the work and we all have a role to play.
FC Thank
you. I think that was the last question. Dr Aylward, do you want to...
BA Sure.
I think I'm getting the second barrel of your question, Michael, which was
about countries that have contracted doses and the ability of those countries
to share those doses.
When we look at the early part of this crisis
before we knew which vaccines might work there were many deals set by many,
many countries across many different products and while we were trying to
consolidate some of those deals - at the end of the day what the many deals did
was they really did spur a lot of innovation by a tremendous number of
companies.
It resulted not just in innovation but also a
lot of expansion of manufacturing capacity and building out capacity for those
products.
01:08:26
Of course at that time these were bets that many
of the high-income countries were making; not just Canada, it was a wide range
of countries. But ultimately they drove what we're now reaping some of the
benefits of in terms of many products proving to be successful vaccines.
We heard just yesterday and again today some
encouraging news about new products, even a new platform as well so all of
that's very, very encouraging. By November or December, if we just walk through
the little bit, of last year it became obvious that a number of these products
were going to be successful.
So the COVAX facility, working with the EC, with
Canada actually, with other countries tried to establish what we now call the principles
for dose sharing with the COVAX facility. What we've done is created a
mechanism through which countries that do find that they have excess doses
contracted, meaning that they have enough products that they know are
efficacious that go beyond their needs or even before they go beyond their
needs, they're able to share those doses through COVAX because that's the
mechanism to make sure of the most equitable distribution of those possible.
01:09:41
So we're at a point today now where many
countries are looking at that and despite the challenges now around supply,
around uncertainties, around the variants as well they're looking at the map of
vaccine distribution around the world and they are trying to now plan when they
can begin to share doses.
It's like the Director-General said; his
concern, I think last week, he laid out was that as countries now vaccinate
their healthcare workers and vaccinate their older populations we need to make
sure that the healthcare workers, as we saw today, Sana and Harriet, are
getting vaccinated before we move into the non-risk populations in other
countries.
So really the challenge is the one that the
Director-General laid out in his speech and we unite and collaborate across all
of the contract holders on these products, all of the companies to ensure that
every country within 100 days of the beginning of this year is able to be
vaccinating at least their healthcare workers and their older populations.
01:10:47
So that's the goal and we're trying to create
the mechanism to make sure that's possible. We believe that is the situation
today, it is possible to do that but it is going to take still another step up
in collaboration internationally to achieve it.
MS One
last comment in the sense that because we're seeing two movements; we know
about these big bilateral deals last year; we've been discussing these a lot.
But we're seeing a movement also of private sector trying to buy directly from
the industry and we see also increasing numbers of small bilateral deals from different
countries in the past month.
We've been alerting that this is a movement that
is actually counterproductive and it's also not necessary because the COVAX
facility is about to start the distribution of the vaccines as soon as they
become approved by WHO through the emergency use listing.
01:11:51
So I think this is important to highlight
because we're seeing that companies are being... some of them have already - we
know that some of the private sector has already said no to buyers that are not
for public use; for private use.
So these two movements need to stop because we
have a global facility that's becoming operational quite soon, countries will
be receiving doses of the vaccines that have been assessed by WHO or a
stringent regulatory authority so things will be normalising in the next few
months. Besides the donations that Bruce has already mentioned I think it's
important to think that countries are going to receive vaccines; don't panic.
MR Just
very briefly, the DG spoke about a year ago at the announcement of a global
public health emergency and he outlined at that time what we were going to
need; a comprehensive strategy applied relentlessly because at that time we
didn't have the perfect tools.
We had tools and those tools were built around
case detection, contact tracing, public health and social measures like
physical distancing, hand hygiene and other things. We've learnt so much about
the virus in terms of better and more available diagnostics, better ways of
treating and saving lives and we've seen fatality rates drop when health
workers have the time and the space and the training and the PPE and the
availability of medical oxygen and other things and we can see death rates
plummet in that situation.
01:13:50
So we've not been helpless in this and we are
not helpless in this so I would hate to think that our fears around vaccines
create a helplessness again, that feeling that we can't be the masters of our
own destiny.
I think the DG has been absolutely persistent in
calling us all to use every single tool in the toolbox, to do it all and I just
don't want us to get... The vaccines are an important issue; the controversies
around vaccine are important that they're resolved; it's important that we make
progress.
But as Bruce said, there's been remarkable
scientific progress to get where we are. There're serious teething problems,
there are huge equity issues but they have to be resolved but that doesn't mean
we're helpless.
So we need to get back to business here together
- ourselves, scientists, governments, communities - and we need to apply the
knowledge that we've learned systematically and comprehensively and answer the
call that the DG has made again and again. We have to redouble our efforts and
just not get distracted by the controversies and just solve the problems, one
step in front of another.
01:15:00
I think today we do that in honour and in
service of those front-line workers who joined us today, to put them in a
position to do the best job they can to control transmission in communities and
to save lives. I believe we can do that and we are doing that; we just need to
bring vaccines online in a more stable and predictable way and that's just what
the team here are trying to do and what the partners in the ACT Accelerator and
COVAX are trying to do.
FC Thank
you. Dr Tedros, final words?
TAG Thank
you. Thank you, Fadela, and thank you to all our colleagues who have responded
in a very powerful and effective way. Thank you also to those who have joined
today, especially to Harriet and Sana; our respect and appreciation and we're
her to support you. We hear you very clearly and we will continue to support
you.
01:16:00
Then on the vaccines and other products, I think
we have to look back into history. If you take HIV/AIDS there were medicines
available for several years after the pandemic was raging but then when
medicines were available in high-income countries, in rich countries they were
not available in developing countries and the medicines actually arrived in
developing countries almost a decade later. I don't think that's a good
history; it's a bad history.
Then second was during the epidemic of H1N1;
there was vaccine; the vaccine was purchased by wealthy countries and vaccines
arrived actually in the developing world when the epidemic was over.
So it's a choice; do we want to repeat the same
history now? I don't think so. If we hoard vaccines and if we're not sharing
there will be three major problems. One - I said it - there will be a
catastrophic moral failure. Two, it keeps the pandemic burning. Three, very
slow global economic recovery.
So it's morally wrong, in terms of arresting the
pandemic it wouldn't help and it also wouldn't bring livelihoods back. Is that
what we want? It's our choice and I hope we will choose the right things.
01:18:17
For now what WHO is saying is if countries can
vaccinate their health workers and elderly and people with underlying health
conditions it's enough so let's have the world, at least all countries have
this first and then we can move to the next.
This is a small world now, a village, a global
village and we need to help one another. It's only through solidarity and unity
that we can defeat this pandemic. It's not through a me-first attitude. I thank
you and see you in our next presser. Thank you.
FC Thank
you, Dr Tedros, and to our participants including our guests. I would like to
remind you that we will be sending you the audio file plus Dr Tedros' remarks
just after this press conference.
01:19:22