Media briefing on COVID-19

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World Health Organization (WHO)

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Hello and good day to verwe you're listening to us today it is friday 14 may 2021 apologies for the late start today therefore let's get started my name is christian lindman and welcome you to today's global covet 19 press conference simultaneous translation is provided in the six official u.n languages arabic chinese french english spanish and Russian plus portuguese and hindi now let me introduce the participants in the room dr tedros adonam gabrieles wgo director general dr mike ryan executive director for w joel's health emergencies program dr maria van kerkov technical lead on covet 19. dr sumiya swaminathan chief scientist dr marian hilasimao assistant director general for access to medicines and Health products dr bruce elwood special advisor to the director general and the lead on act accelerator with this let me hand over to the director general for the opening remarks dr teddrus thank you thank you christian good morning good afternoon and good evening earlier this week i was vaccinated against covet 19. it was a bittersweet moment On the one hand vaccination is a triumph of science and global solidarity alongside public health measures vaccination is key to controlling this pandemic and i'm very grateful to the health workers at the geneva university hospital who hug for helping me play my part however my thoughts were very much with the health workers around the world Who have been fighting this pandemic for more than a year the fact that so many are still not protected is a sad reflection on the gross distortion in access to vaccines across the globe last september in the economist we warned about the threat of vaccine nationalism and some said we were being alarmist in january i spoke about the potential unfolding Of a moral catastrophe unfortunately we're now witnessing this play out in a handful of rich countries which both up the majority of the vaccine supply lower risk groups are now being vaccinated i understand why some countries want to vaccinate their children and adolescents but right now i urge them to go to reconsider And to instead donate vaccines to kovacs because in low and lower middle-income countries vaccine supply has not been enough to even immunize health and care workers and hospitals are being inundated with people that need life-saving care urgently at present only 0.3 percent of vaccine supply is going to low-income countries trickle down vaccination is not an effective strategy For fighting a deadly respiratory virus india remains hugely concerning with several states continuing to see a warring number of cases hospitalizations and deaths who is responding and has shipped thousands of oxygen concentrators tents for mobile field hospitals mosques and other medical supplies and we thank all the stakeholders for supporting india But it's not only india that has emergency needs nepal sri lanka vietnam cambodia thailand and egypt are just some of the countries that are dealing with spikes in cases and hospitalizations some countries in the americas still have high numbers of cases and as a region the americas accounted for 40 percent of all copied 19 days last week There are also some spikes in some countries in africa these countries are in heightened response mode and who will continue to provide support in all ways possible kovit 19 has already cost more than 3.3 million lives and we're on track for the second year of this pandemic to be far more deadly than the first saving lives and livelihoods with a Combination of public health measures and vaccination not one or the other is the only way out of the pandemic vaccine supply remains a key challenge but this week i have been pleased to see leaders and manufacturers working to address some of these issues first there have been a number of new country announcements about sharing vaccines with kovacs Which is the fastest way to ensure equitable rollout of vaccines second new deals involving tech transfer and sharing of know-how between international manufacturers to scale up vaccine production has been announced and third leaders including the prime minister of spain pedro sanchez have called for all trade barriers to be lifted as soon as possible muchas gracias As we welcome this momentum who has again convinced researchers and scientists from around the world to update the research and innovation roadmap to take stock of what we have learned and identify the most pressing knowledge gaps from the outset of this pandemic who's rnd blueprint for epidemics played a facilitating And coordinating role convening expert networks to drive progress across a range of thematic areas and connecting key funders to focus on identified research priorities in the past 18 months major advances have been made in the understanding of modes of transmission epidemiological trends clinical management development of Point-of-care diagnostics treatments and a large number of vaccines social and behavioral scientists and ethics experts have also worked to ensure that research was up to the highest ethical standards the research forum is being webcast live over two days and i challenged them to deliver complete solutions that take the Development evaluation and deployment of tools from their beginning to their end prioritizing both equity and efficiency i urge them to expand collaboration between expert groups and partners and utilize global research capacity that has not yet been sufficiently leveraged particularly in lower income countries and finally i urge them to further Promote large platform trials across the world this is the fastest way to prove the efficacy of new diagnostics treatments and vaccines it's amazing how far the world has come in less than 18 months but i have high hopes that breakthrough innovation will continue at record pace yesterday i announced the winners of the second wgo health for all film festival And i have been thinking since about the importance of telling stories to increase awareness build solidarity and foster positive change i was struck by how each film winner creatively reflected new situations and different realities highland highlighting challenges but also a way through watching the news sometimes It might seem that the world's problems are intractable but i want you to know that who will keep fighting to defend the health rights of all people everywhere in the world the one thing they had in common was that to beat the challenges of our time we must bridge our divides and craft new stories together this week muslim brothers and sisters Have been celebrating eid al fatir and i want to end by wishing ed mubarak to everyone celebrating stay safe and again aid mubarak christian back to you thank you very much dr tedros this opens the floor to questions from the media and let me start with belisa goggino from the w magazine portugal lisa please unloot yourself Belisa please unmute yourself if you can hear us right we'll come back to you belisa if we don't uh if we can reconnect apparently that opens the floor to kai kopfersmith from science sky please unmute yourself thanks christian thank you um i wanted to ask um all of you about a reaction to the ippr report i mean specifically there's a number of Recommendations in there and i'm curious whether you feel that they are the right recommendations i mean there's the recommendation to restrict the future dgs to one term of seven years there's other recommendations to make the whole more powerful like having standing visas for experts to to allow them to go into countries to investigate outbreaks just in general terms do you Feel that that the report basically you know lays out a roadmap also for who reform for the next few years okay thank you thank you kai on the reports as you rightly said it's not only ippr but we will have a report from ihr review committee we will have a report from iosc the independent oversight advisory Committee so there are sets of recommendations from them as well and there are other platforms also who are sending us recommendations so one thing we need to do is we will pull all these recommendations together and discuss with member states as you know we will have an assembly soon at the end of this this month and then you know all recommendations Will be uh assessed so very difficult now to say to comment on one or or the other recommendations and in addition to the three we're encouraging other stakeholders and you know institutions also to give us ideas and recommendations so that's going to be an incredible process and you know this pandemic is really unprecedented and we have to be open-minded And learn and use the recommendations that are coming to the best we can and to prepare the world in you know for the future thank you thank you very much dr tedros next question goes to agnes pedrero from afp agnes please donate yourself yes good afternoon everybody uh it's a question uh on the u.s uh u.s have just decided uh to waive The mask requirements uh when people are fully vaccinated so i wanted to know what the blitzchill think about that move do you consider it as a safe move or dangerous and is it a recommendation that the blade show plans to do do you plan to to um to waive the mass requirements when people are fully vaccinated and if yes In which conditions thank you thank you very much and we'll hand to dr frank herkoff please thanks very much so as you know um who recommends masks to the use of masks as part of a comprehensive strategy towards controlling covid um part of many different measures that are that are used to prevent the spread um in setting up policies to use masks as part of that strategy it's very Contextual it's about how much virus is circulating around in the country it's about the amount of vaccines and vaccinations that are rolling out it's about the variance of interest the variance of concerns that are circulating we have to keep all of this in mind when thinking about how to adjust the policies associated with the use of masks so it is contextual so all of these Considerations need to be taken into account controlling covid controlling the circulation of cyrus cov2 virus is key no matter what else is happening around if they're variants or not a vaccination is around how much virus is circulating is really important the use of vaccines which vaccines the age of the person the underlying conditions Whether they've had one dose or two dose or fully vaccinated or not all of this needs to be taken into account so it isn't a simple yes or no answer it's about setting that risk based approach and using masks appropriately in the setting i'll remind you that in some countries they've been able to control covet and they've been able to adjust their public health and social measures Including the use of masks without the use of vaccines so i always think of australia and new zealand and i picture people in the stadiums you know going to sporting events and so any adjustment that is made whether it's masks or physical distancing all of these considerations need to be uh put in place you know we're not out of this yet there are Uncertainties ahead because of these virus variants we just have to stay the course do everything that we can first and foremost to prevent infections reduce the spread and save lives just supplementing what maria said because you asked would who be issuing specific advice i think in this case we need to re-emphasize that clearly Getting vaccinated protects you from serious illness and death and in the case of many of the vaccines there that would where the data is available significant impact on your likelihood to infect others or be infected by others but as maria said this is all in the context of the local transmission conditions so in us in australia and new zealand even when there weren't any vaccines People could take the mass off because there wasn't any virus even in situations where you have high vaccine coverage if you've got a lot of transmission then you wouldn't take your mask off so you cannot make one decision without the other in the instance of a country that wishes to reduce the or take away a mass mandate or take away other measures of public health and social measures that should only be Done in the context of considering both the intensity and and of transmission in your area and the level of vaccination coverage now obviously if you have high vaccination coverage you should have low community transmission but we're in a strange period of being transitioning as vaccination coverage increases and as transmission levels go down and we're at the point where many countries are facing a situation where The transmission hasn't completely ended and their people aren't completely vaccinated and that's where we are on the curves one is meeting the other and as long as we can sustain the public health measures as long as we can keep the distance and as long as we can reduce exposure while we get vaccination levels to the highest level then countries will be in a much stronger position when they do get to High vaccine coverage levels to start saying to people you don't have to wear a mask anymore so maria is absolutely correct in that regard so each country will need to look at those two issues our vaccine coverage and the local incidence rate in any given setting as to whether the mandates for public health and social measures can change i Don't know bruce if you have a comment but well thanks for the invitation mike i would i would reinforce what marie and mike have just said and and um you know we've been in previous uh press conferences we've been asked about places that are having uh escalating outbreaks in the face of rising vaccination coverage because they've not reached all of the population there are still other drivers And that's the reality right now you want to be doing everything possible to get your your you want to get your transmission down to as low levels as possible and take advantage of every counter measure every societal behavioral measure one can to do that and countries will make decisions uh for for various important context specific reasons exactly as mike Said and at a global level the world health organization you know the wonderful thing about being an organization of 194 member states is the diversity of what they will do and that learning and the ability to learn there's no complete right or wrong in this crisis we're learning as we go we all are and what's happening in different countries right now as they get higher Vaccination rates will help inform that global policy as we go forward thank you very much all next question goes to simon attibar from today news africa simon please donate yourself thank you for taking my question this time on a table with today news africa in washington d.c i would like the who to react to recent report that a small number of people very small Number of people who had been fully vaccinated have tested positive for the coronavirus i was wondering what that means and how long do various vaccine protect against the virus and if you may allow me on president biden his administration would like to share their studies the astrozenica vaccine is not using now by july i was wondering if the Whomd has called the white house to ask for those vaccine now thank you thank you very much simon and we'll hand to dr sumiya swaminathan yes thank you for that question um i think we need to understand what is expected of vaccines and how they work we are very fortunate that the majority of vaccines that have been developed and tested are highly effective against Preventing disease and particularly against preventing the severe forms of the disease which result in people having to be hospitalized and needing critical care and and ventilation so again majority of vaccines approved till now almost all of them that are being used are accompanied by reductions in the need for hospitalization and definitely in the deaths that occur in the groups that are being immunized However these vaccines are all not 100 percent effective against preventing infection the good news is that they do prevent infection in the range of 70 to 80 percent again from the data that's coming out now from real world studies in countries that are scaling vaccination we are learning more and more about how these vaccines behave at the population level Rather than how they behave at the critical in in clinical trials so we know that they do protect against infection but not completely so you can still get infected you can have asymptomatic or mild illness or even moderate symptoms even after being vaccinated so that's not a complete surprise and again that's why the who has said that vaccination alone is not a guarantee against infection or Against being able to transmit that infection to others it it may be a rare occurrence but it could still occur and that's why we need the other protective measures like the mask wearing and the distancing and so on till countries get to the level at which a large number of people are protected and where virus circulation and the Transmission goes to very low levels as dr ryan was explaining so very few countries are at the point now where they can drop you know these measures by individuals and by governments because there's the viruses at such low levels in most countries we still need to continue to do that what is also important is on the research side is to continue to document The performance of vaccines and so the who has put out guidance on on designs for research studies both for randomized trials when you're testing a vaccine for the first time or comparing different vaccines but also for vaccine effectiveness studies once they're being rolled out we need to study both the effectiveness and the safety of these vaccines and different populations you know peop countries have Used different regimes you know some have used standard duration of the gap between the first and second doors other countries have used longer gaps some have used a mix and match approach for the second dose so all of this if it's documented properly will give us a lot of information and finally i think we also need to continue to Do the studies with the efficacy of the vaccines against the different variants as as we're seeing these different variants emerge and increase in numbers we need to to accompany the effectiveness studies with sequencing of the breakthrough infections so that we can also do an analysis and understand about vaccine of efficacy against particular variants Again at this point in time most of the vaccines in use are effective against severe disease whatever the variant that's circulating in the country but this is an evolving area and we need to to continue to collect high quality information thank you thank you and for part two we'll go to dr bruce elwood thank you very much uh christian and to the point that Samya just made there was a you know sometimes we talk at the population level about the impact of vaccines and the possibility of breakthrough transmission etc there was a very nice piece actually yesterday by a journalist actually had been fully vaccinated did actually get the disease and then uh just contrasted his situation with another person at a very similar Age a situation to that he did it was a science journalist who wrote a very nice piece and just contrasted the clinical course that they made and really brought to life that while he may still get infected he thinks it was the vaccine that probably saved his life and and a journalist with a lot of experience in science reporting i i thought it was an interesting piece to see it at that human level in terms Of that second issue about uh donations of vaccines and whether we're in touch with uh with countries that have uh the potential to donate to kovacs in particular yes absolutely i think there's a specific question simon you had are we in touch with the united states and absolutely and we have been for some time and the u.s has been absolutely fantastic in reaching out to Us as well it's a two-way conversation about how to optimize the use of potential uh doses and this is not an issue unique to that country we're in conversations with many many countries that have potentially can provide some of their doses and we have to be careful because we often talk about excess or surplus doses and you know these countries all um explain Like we talked about last week with sweden that no one has surplus doses everyone's trying to use as all of their doses to the greatest possible impact but they recognize that sharing those doses may help ensure greater impact overall and in that regard what countries are looking at is you know how could they have to get a greatest reach guess get to the most Countries and that is through kovacs we've gotten to 122 countries some of the most disadvantaged how can they get out there as fast as possible and clearly that's through kovacs after the french signed the agreement within 24 hours the doses were in the target country we were working out with mauritania how can the highest possible impact and most equitable distribution again through kovacs we have that global View through the kovacs facility to ensure that countries that aren't receiving enough doses to reach their health care workers reach their older populations can reach them so that's the conversation simon it's with a very broad range of countries it's an ongoing discussion and uh you know with the united states in particular they've highlighted that they want to be ready when the doses are Ready because there is still you know there's this idea that there's a huge stockpile sitting somewhere but there's a lot of work to releasing batches ensuring that all they've been through all the steps necessary so we're working in parallel to ensure when doses can flow they go as fast as possible to have as high an impact as possible in many as many places as possible Thank you thank you very much dr edward next question goes to nikolai warrening from the bbc world service nikolai please note yourself hello thank you for taking my question uh i'm going to ask about postcode syndrome which is mounting pressure on healthcare system uh all around the world and people keep suffering tremendously from consequences Months after official recovery in the usa they suggest classifying postcode syndrome as a disability what's who position on that and as a follow-up what do you know for sure um scientists know for sure about what causes long coverage postponing syndrome and what other perspectives possible outcomes thank you thank you very much nikolai over to dr van kerkov Yeah thank you i'll start this is a this is a really good question and it's a huge area of work right now your question was what do we know for certain and i can say we don't know anything for certain but there is a lot of research that's underway for individuals who have been infected with the sars cov2virus as you know there are some people who have an acute infection they recover from that infection That come recover from that illness that disease that they've had and they're individuals who are suffering from some long-term effects we're working with our clinical management group our rehab group brain health mental health many many many different disciplines are working together to understand this post-covet syndrome you know even to just define it to put boundaries around what it is and what it Isn't requires a lot of research dr tedros and i and others have met with patient groups for almost a year now maybe not quite a year and they have asked for recognition that this is a real thing and it is a real thing we're trying to better define the case definition what it is there have been several seminars that we've had workshops that we have had with researchers around the world from Many different disciplines because this affects many different organs to define postcovid syndrome making sure that we have good research that is uh cohort studies that are following individuals who may not have had a diagnosis early on in the pandemic because testing wasn't up uh up uh wasn't as widespread as it needed to be in the beginning for Example but we want to make sure that these cohorts of individuals cover areas around the world that they don't just cover patients from high income countries so we're working to set up these studies these multi-center studies looking at the long-term effects and what it actually means and then lastly to make sure that we could have good rehabilitation what does Rehabilitation need and and how do we tailor that to make sure that people receive the care that they need whether they had a diagnosis or not so there's a lot of work that is underway we do know that this is real we do know that this affects many different organs but we're trying to do is to have good systematic data collection to be able to Inform the treatments protocols the rehab protocols so that anyone can get the care that they need around the world but really this is a this is a dangerous virus there's a lot that we need to learn from this this teaches us that even though some people may have what what is classified as a mild disease there may be a short-term Disease and then there may be some long-term effects so we really need to do what we can to study this to make the best treatment policies rehab policies as we can thank you very much dr van kerkov next question goes to priti putnik from geneva hellfires pretty please unmute yourself hi uh good afternoon uh thanks for Taking my question uh this is about uh rendezvous we see that a lot of people in india are using up precious resources they have to buy up a drug that who has said is not effective for treatment of covet 19 in hospitalized patients um and it's a bit puzzling because a number of countries are also donating doses of reserve and we also understand that the company Is expanding production um could you comment on this thanks thank you very much pretty just looking around who may want to start dr swaminathan please yeah thank you preethi i can start and others might want to come in um you know the area of therapeutics and treatments for kobit 19 obviously is is of great interest to people and unfortunately has not been you know with as much dramatic progress As we've seen in the vaccines or even in the diagnostics for example so while a large number of clinical trials you know have been done and are ongoing we're tracking something like 9 000 clinical trials in our registry uh they've been very few large trials which have which have given concrete results on on on some drugs and and i think the first one and still i think the most Important one is the role of steroids corticosteroids and dexamethasone in the treatment especially of uh severe covid uh severe and critical cases of covid19 those who require oxygen and those who require ventilation benefit there's a mortality benefit the um solidarity trial is probably the largest trial in the world to have testosterone deserve All the other trials there are four or five others much much smaller and also the solidarity trial was able to look at mortality because it's a large trial and mortality is really the end point that most clinicians and patients would want to see an impact on and as far as ramdas severe and impact on mortality was concerned there was no difference in this large trial and also in the Meta-analyses compared to the control group so this is why the who guideline development group which is a completely independent group of experts nothing to do with the research group and which looks at evidence that synthesized across all of the different studies done across the world and as you know we we now perform something called a living meta-analyses And a network meta-analyses which looks at the impact of different drugs when they're used in combination or alone found that rem decived did not have a benefit in terms of mortality or in terms of deterioration what it did do in a in the trial conducted by the nih was it reduced hospitalization duration so so one has to look at the benefits versus the costs of a drug and that's again Depends on the country context some countries reducing hospitalization by four days would be an advantage in other countries that is not the major driver and it should be based more on the impact on patient outcomes which is again mortality or deterioration so our guideline at the moment recommends against the use of rem decived will look at emerging Evidence and update our guidelines as it becomes available but i think it's important for physicians and doctors to be aware of the latest uh evidence and to use it in very whichever drug it is to use use it judiciously and wisely and at the right uh time and and also to look at the benefit versus the cost so obviously every country Makes their own treatment guidelines based on the evidence that's available and based on their local context and so we would leave it to the country to adopt who's guidelines and adapt them as they see fit but there really needs to be analysis of benefits and cost costs when a drug is being used to treat covet 19. and again it's steroids it's antithrombotics and it's oxygen Oxygen is probably the most essential and the most life-saving right now of all the drugs and all countries need to be prepared now with the oxygen supplies that they're going to need if and when cases go up thank you and dr mike ryan please yeah thank you samia and just re-emphasize point this isn't just in relation to drugs like rhyme disorder This also relates to drugs like ivermectin and others and the majors issued guidance on that and manufacturers themselves official strong guidance saying please use our drug for the proper reasons and using the proper evidence and also i think this is one of these situations where you need to use the right drug at the right time in the right patient And that's why primary health care and having trained doctors and nurses in the front line of a health service that can do a proper clinical examination of a patient and decide which drug which care that patient needs that's what's missing in our health systems yes we're missing commodities but our systems are also missing capability the capacity to triage patients the capacity to treat patients the capacity to diagnose Those patients and beyond the diagnosis of co-word is to assess the severity of that disease in that patient and ensure they get the proper care an example of this would be something like dexamethasone which is a powerful steroid which is called a powerful anti-inflammatory that drug is life-saving when given at the right time in the right patient Because it doesn't stop the virus it stops the dramatic inflammation that results in oxygen not transferring into the blood and when that stops and you have inflammation and a person can't get oxygen from their lungs to their blood the combination of oxygen given by a mask or ventilator with dexamethasone can be absolutely life-saving but that virus or dexamethasone or Steroids don't stop the virus giving steroids very early in the course of disease to otherwise well people has its own side effects and can be detrimental so again i would just appeal that we need to have a health-centered approach to this and just using pharmacies to get cocktails of drugs on in the hope that these drugs may help you i understand the The i understand the instinct and everyone wants to help their own family and everybody wants to to access the best possible health care but these drugs are tools and like all tools they can have great benefit but they can also hurt you if they're not used properly and doctor from cargo yeah sorry so i'm gonna i'm gonna come in as well because it's such an important question um uh both suemia and mike mentioned Oxygen so oxygen is something that is life-saving medical oxygen is life-saving and who and partners have been working around the world to scale up oxygen availability in countries this is a work in progress because this is a medicine this is a treatment that does not have a substitute we've recently launched a website i think it was launched even today Around some technical consultations around the medical use of oxygen these are for medical providers to be able to give this life-saving medicine to people who are sick with covet but not just covered with pneumonia with other life-threatening diseases but the most important thing that every single one of us can do in in terms of keeping ourselves safe is prevention so if you could prevent Yourself from being exposed to this virus you prevent yourself from getting infected in the first place that's the best medicine of all and so anything that you can do to keep yourself safe do it because it's so much easier to keep yourself alive through all of this if you are not infected with this virus once we get to the point if someone is Infected entering that clinical care pathway that early initial assessment to have your oxygen checked with one of those oxygen saturation to see what type of clinical care you need this is really critical and then we have medicines like dexamethasone for people who are severe and critical but it's really about as much as we can about prevention so do what you can keep yourself safe Keep your loved ones safe know what your risk is every day throughout your day and take steps to lower the risk of being exposed to this virus in the first place thank you all very much next question goes to sophie mcqueen from sabc sophie please unmute yourself thank you i just want to ask you a question around the current developments in Countries such as south africa for a year we've dealt with uh first wave second wave now people are fearing a third wave and because of what we saw during the second wave when there was this new variant the fears now that we are likely to have another variant when we ex when we experience uh the third wave particularly at the peak of the Circus and already south africans are panicking the numbers are rising have you detected something in sub-saharan in terms of the rising numbers and this fear of a new variant that's likely to be detected if we go to a dead wave as people who are experienced in these issues what's your view are we likely to see a new variant Thank you very much sophie handing over to dr vankakov uh thanks sophie for your question um your question the way that you posed it was about a fear of a third of a third peak or a third wave in south africa one of the things i'm most impressed with in south africa is the ability to get through that first peak that first wave or that second peak of that second wave You know what to do the country knows what to do in terms of detection the sequencing capacity across south africa has increased dramatically over the course of this pandemic the scientists across the country who are sequencing using intelligent sequencing of samples around the country supporting other countries on the continent for sequencing where they don't have Capacities themselves sharing of that information in fact many of the scientists have been working directly with us with our virus evolution working group sharing their findings about what is circulating what these virus variants which mutations are being detected and what it means carrying out the research to look at transmission severity neutralization all of that so the capacities in country For detection are strong the work around the use of public health and social measures again you in south africa detected the b1351 and um that was a that is a variant of concern um showing us that the application of public health and social measures could drive transmission down so what i would hope is that that fear is really turned into something productive just be at the ready you know you have The systems in place to be vigilant to be at the ready to know what to look out for to know what the warning signs are in case there is a slight upsurge we are all of us you know living in a globally connected world variants are circulating more variants will certainly be detected but we know what to do so we need to be ready to detect be ready to quickly act put in those Measures in place so that any slight increase any of these cases or clusters do not turn into community transmission having an engaged population to know what to do is part of this army so to speak to fight against this virus so i think you know you in in the country people around the country researchers around south africa have taught us have taught the world What to do and we need to constantly learn from each other so what we are seeing in other countries can be adopted in south africa and vice versa so i would i would like to see that fear be turned into something productive turned into something of strength because i think you know what the country knows what it needs to do to be able to detect and respond to any virus thank you and dr please yeah and just to Follow up and commend south africa public health authorities and researchers and others uh south africa showed away at the end of last year beginning of this year when we were confronted with a large wave uh with the the detection of a of a of a new variant and there was a lot of concern at that time south africa controlled that wave of disease which included a significant transmission with that Variant by applying the same measures that had for the first wave um and it didn't have the access to vaccine to do that so it it clearly demonstrates that good surveillance knowing where your problem is at some national level understanding and intensity of community matching your public health and social measures to the local need keeping your eye on the big picture at National and global level investing in surveillance and linking that to genomic surveillance and again south africa is one of the leading lights in the world and been able to link real-time genomic surveillance to public health action and congratulations for that and it's putting all of those things together that's allowed south africa to keep this under control but south africa also faces its own problems with Health access and and we have many many people living in conditions in which this virus could spread very easily so constant vigilance is needed but i do think we should take a moment to recognize when countries get it right and when they apply all of the resources that are at their disposal even though those resources are not perfect and use public health tools to the best Possible benefits of population doctor swimming i just wanted to add that you know we had professor abhijeet banerjee today the economics nobel laureate speak at the research forum and he talked about the economic impact of this pandemic and the impact on poverty and on the lives of people who were already living on the edge you know who've been further impacted and Particularly when countries have had to put in stringent measures and shut down live normal life people who earn a daily wage living are the ones who get affected uh you know migrants and and others who have to go to work every day so he suggested several initiatives several actions that governments could and should take To protect those to make sure that people are not starving that people children are not going to get undernourished you know and and he you know he called it good economics but it's also the right thing to do and so i would invite people to listen to this talk which is going to be up on our uh on a youtube channel it's being broadcast live now but it's going to be there and we've had some excellent uh talks Also by you know michelle bachelet the un high commissioner for human rights uh professor peter singer well-renowned philosopher and ethicist really talking not just the pure science of it but also how it's impacted people and what we need to do to address their other needs thanks i just want to follow up on that because i think it's worth speaking and saying more the research and development blueprint for epidemics and all the Partners in it uh in nwho sumiya's team and my we call lead on the project but the real driver are those thousands and thousands of we were just remarking before the meeting sumiya just how this group had grown from hundreds to thousands and thousands of scientists around the world working together across so many different areas and Coming together unselfishly to share knowledge um and knowledge is power when it comes to this virus so we just again like to thank all of our partners who are they're not listening to this press conference thank god they're all upstairs talking about really important stuff like understanding how better to control this virus And for the next year and laying out the roadmap and i'd like to thank sumia for her leadership in this and i do think this demonstrates that you have to if you can link science to action we do it here through the work that sumi leads in science and marie angela on on technology and pre-qualification and and and myself and so many others uh our organization is only The best when it brings together the power of science the power of public health practice the power of health systems and the power of our capacity to respond quickly so it's it's a it's a really impressive thing to see and point you all to go look at that conference when it's rebroadcast thank you very much uh all looking at the time i think we can squeeze in one More last question as we started late and that would be latika burke from sydney morning herald latica please admit yourself thank you always lucky last um in april the who released a statement following the seventh meeting of the ihr emergency committee one of those temporary recommendations he made to state parties was to quote reduce the financial burden on international travelers for the measures Applied to them for the protection of public health the eeg testing isolation warranty and vaccination and so i wanted to ask you in the context of hotel quarantine where countries require this to enter the country should the governments or the citizen be paying for that because dr mike ryan i know we've talked before about vaccine Passports leading to huge inequity it strikes me that this is actually something that's going to become a public health measure but actually trap people in terms of their own financial circumstances if they can't travel for urgent pressing needs and say even separate medical health care in their home countries thank you very much dr ryan yes thanks it's a complex Question because there are obviously very severe resource implications for specifically around issues like quarantine for travelers arriving in the country and dr neddress and roglo is with us as well and edward may be able to comment on this as well i think the recommendation in general from the ihr is that and this is a general principle in the ihr is that the traveler in the case of Restrictions should not suffer economically from measures that are used to improve and protect the health of population as a whole because that then is unfairly burdening and individual with the costs of a public health action so when you when you go into quarantine because you're a case in a country you should get the support of the Government and not have to pay for that if you're put in a quarantine hotel let's say you're a case in a country and there's a quarantine hotel or somewhere where you go you're a contact and there's a quarantine hotel if you're a citizen and you're a contact and you go to a hotel and then someone charges you for the stay then that's that's that you'd imagine the state would pay for that it's not so clear when visitors are Coming from the country outside because they're non-citizens but the purpose of the measure is to protect the citizens of the country in which the other person is entering that's the stated purpose so in that sense what has to be worked out is who should bear the burden of that protection the state doing the protection of his own citizens or the traveler coming into the country And countries have policies for entry and if if people breach those policies of entry uh then the state could turn and say well you've entered on false pretense therefore you must cover the cost of your quarantine but if someone is entered on with full disclosure and someone has entered with full disclosure within the policies of the Country then what i think the committee were saying to governments that they really do need to consider that they should be covering the cost of that but that is very difficult not all countries can do that so therefore it's a recommendation for the committee that all states should seriously consider the arrangements they put in place how those arrangements were put in place and the Fairness of those arrangements vis-a-vis the traveler because one of the the principles underpinning the ihr is that with the maximum amount of effort to reduce the international spread of disease with the minimum impact on those who are traveling and trading and therefore we have to balance those two within that with the primary interest being in the public health Nedwit if you'd like to add microphone please thank you thank you very much mike you covered most of it but maybe two points they repeated this this recommendation during their last meeting due to two reasons actually one is the standardized approaches they would like to have harmonized standardized approach not only to to to costing and and who pays for it but also to the Overall travel restrictions as well all requirements in terms of vaccination testing and quarantine and the other area they would like to really emphasize is that this should not further push the inequities so that has to be one of the areas that needs to be protected by by some of the mechanisms thank you very much and that was uh dr nedward emiroglu co-chair of the double joe secretariat To the commission thank you with this we reached the end of today's press conference and again sorry for starting late thank you all for your participation we will be sending the audio files and dr teddra's remarks right after the press conference and the full transcript is again available as of tomorrow if you have any follow-up questions please send an email to media inquiries At and apologies to all those who we didn't get to today many thanks and heading over to dr tedros for the final remarks thank you christian and thank you to all colleagues from the media for joining us today and see you in our upcoming presser and bon weekend

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