LIVE: Media briefing on global health issues

Hello foreigner and good morning wherever you are listening to us today is Wednesday of January 2023, it is the first press conference of the new year and therefore happy new year to all of you, my name is Christian Lindt Maya and I am I give you welcome to today's press conference on

global

health

issues

where simultaneous translation is provided in the six official languages: Arabic, Chinese, French, English, Spanish and Russian, as well as Portuguese and Hindi. Now let me introduce you to the panel and today we have a strong one, first and foremost Dr. Adam Gabriel, CEO of Taylor, to his left we have the first Dr.

Maria van kirkov, technical lead at Covet 19. Followed by Dr. Abdi Ahman Mahmoud, the acting director for alert and response coordination, on the right side of the director general we have Dr. Bruce Elwood senior. advisor to the CEO, then we have Dr. Sylvie Biryan, Director of Epidemic and Pandemic Preparedness, and then we have Dr. Rogerio Gaspar, Director of Regulation and Prequalification, who is online. We're joined by Dr. Mike Ryan, The Witcher's Executive Director of Health Emergencies. program we also have direct immunization vaccines and biologics from Dr. Kate O'Brien and last but not least Dr. Anna Maria in August, triple coordinator of the R&D plan.

Now let me remind you also in the New Year if you want to ask a question after the opening remarks please raise your hand, but to raise your hand I can finish this, let's get started and we'll go back to the CEO for the opening remarks thank you, thank you Christian, good morning, good afternoon and good evening, the dawn of a new year in many countries offers a collective moment for reflection and ambition for the year ahead, now in the fourth year of the pandemic, the world is in a much better place than it was several years ago years due to clinical care management vaccines and treatments for most of last year against covid-19. was in decline, vaccination increased around the world and there was sustained progress in many low- and middle-income countries that had been left far behind in 2021 due to vaccine nationalism and manufacturing capacity being restricted to just a handful of countries. identified last year that helped reduce mortality even further, although the rollout followed a similar pattern: rich countries first, which are working as always to improve access, and on Christmas Day they announce that antivirals near Material Beer and Rito Nabir were prequalified for production by an Indian manufacturer, this is the first generic version of an antiviral to gain WHO approval and should lead to increased production and access, especially in low and middle income countries, but despite Despite the clear progress, the threat of Covid-19 persists, there are still large inequalities in access to trial treatment and vaccination and, ultimately, Covid-19 remains a dangerous virus for our economies and

health

societies in general. , approximately 10,000 people die every week from covid-19, of which we are aware, the real number of victims is probably much higher, we are really worried about the current situation Epidemiological picture of covid-19 with intense transmission in several parts of the world and a rapidly spreading recombinant variant in recent weeks there have been increasing reports of hospitalization and pressure on the health system, particularly in temperate regions of the northern hemisphere where respiratory illnesses, including flu, are common.

It has also circulated in the last week who held a high-level meeting with their counterparts in China to discuss the increase in cases and hospitalizations and, subsequently, who is the Technical Advisory Group on the Evolution of the Sarskov 2 Virus and the Expert Network Groups in clinical management of covid-19 met with Chinese experts. We continue to ask China for faster reliable and regular data on hospitalizations and this, as well as more complete viral sequencing in real time, who is concerned about the risk to life in China and has reiterated the importance of vaccination, including the dose booster, to protect against serious hospitalizations. illness and death, this is especially important for older people, those with underlying medical conditions, and others who are at higher risk of serious outcomes because circulation in China is so high and complete data is not available, as I said the last week, it is understandable that some countries are taking measures they believe will protect their own citizens this data is useful to whom in the world and we encourage all countries to share it data remains essential to whom to carry out regular risk assessments, fast and robust statements of the current situation and I alone Our advice and guidance accordingly Outside of China, one of the omicron variants originally detected in October 2022 is xbb.1.5, a recombinant of two ba2 sublineages that is increasing in Europe and the US .USA and has now been identified in more than 25 countries, who follow it closely and evaluate it.

The risk of the subvariant and we will report accordingly. Covid-19 will undoubtedly continue to be a major topic of discussion, but I believe and hope that with the right efforts this will be the year that the public health emergency officially ends with other good news. in Uganda it has not been detected since November 27 if this continues there will be no cases before January 11 the outbreak will be declared during the last few years they have been hard on our collective health, but I remain confident and firm in the belief that only By working together we can leverage and share posters, offer life-saving solutions, and build solidarity to counter the health challenges we face.

This year also marks the 75th anniversary of the creation of Who and we will share more in the coming weeks and at the Who executive board about our plans for this historic here Happy New Year together Christian back to you thank you very much CEO and with this we open the floor for questions I see a pair of hands raised again please raise your hand with the raise hand icon if you want to receive in signals we start with um from the policy Carmen please go ahead and activate the mute thank you very much Christian and happy new year everyone um just wanted to get an update on the clinical trial of the vaccines um in Uganda um what's been happening over the in the last few weeks and what's the fact that no new cases have been detected since the end of November ?

Does it affect those clinical trials? Thank you, thank you very much and I think with this we go to Dr. Mahmoud, coordinator of the R&D plan, okay, good morning. good afternoon everyone, soon as Dr. Taylor says and the main objective of the Ministry of Health in Uganda of wsotu was to stop the transmission of the outbreak, our brakes give us that unique opportunity to evaluate the effectiveness of the vaccine candidates and work with the Researchers in Uganda, the developers and several partners around the world are preparing for the implementation of a phase 3 clinical trial of REIM vaccination together with the objective of evaluating the immunogenicity of the vaccine, as we reported before the trial was organized, approvals were available and it was done in record fashion. time, 79 days to be precise and, unfortunately, there are no more cases of Ebola, so what we are doing in collaboration with all our partners and the scientific community is to first examine three aspects, what is the best way to proceed with the candidate doses as they are now available in Uganda, so that we can conduct research that improves our understanding of these vaccines, number two, how we can work together with the international community and the developers to ensure that the next time we have an outbreak let us have more data on the safety, immunogenicity and efficacy of these candidate vaccines so that they can be more easily evaluated in the jailbreak context or perhaps implemented with additional data collection and thirdly, we are also preparing and discussing with regulatory authorities both in the countries where these vaccines have been developed, but most importantly in the countries where they will be implemented and to achieve this goal we have organized a consultation on January 12 and Friday of next week that is open to all where they will be considered.

These points. I just want to say that it is important for people to keep in mind that when you have a very high mortality disease like the Sudan Ebola virus, about 60 percent of the people who are infected could die and in the context of a break we are and we develop. clinical trials and we have the experience, colleagues and researchers on the ground to conduct trials if the pause is declared, as Dr. But said on January 11 that the challenge for all of us in the international community and who is created. taking the lead on that and helping people move forward is to move forward in evaluating these vaccines so that the next time we have an outbreak of the Sudan Ebola virus we not only have the candidate vaccines among the buyers but we have also collected them collectively as much information as we can about their safety, immunogenicity and efficacy so that they can be in a position to have regulatory clearance or be implemented without incremental requirements in the field thank you, thank you very much Dr. stripper and I see that Dr.

Michael Ryan may want to I arrived three years late, but then Maria said, but the most important thing is to thank our many partners who work with us throughout this entire process. I think we have taken a big step forward, the fact that the control measures. They have been implemented by the Ugandan government who and other partners have worked so well that it is a positive thing that having the vaccines ready to go gave us a massive contingency plan if that had not worked it would not have worked but we need to increase speed . where we can get clinical material, clinical vaccines into the field, but I think that's the challenge and Maria advances is to really work with our partners, and again we would like to recognize our partners in saving vaccines for the Oxford Vaccine Institute SII in India, Parada, the United States, our colleagues, Sepi and Gavi and, most importantly, our colleagues in Uganda and the leadership of the Ministry of Health and Bruce as the principal investigator there and all the people working with the R&+ plan D for epidemics. a really strong positive transparent collaboration where we have important material in the field in time to make a difference if necessary and I think it's a roadmap for future collaboration in this space and I'm really increasing our capacity to get effective vaccines quickly in the field in the case of rapidly developing epidemics.

Thank you very much, Dr. Ryan. The next question is for pranas upadaya from ABP News. Pranas, please unmute. Hi Christian, thanks for doing this and I wish you all a happy new year. uh, I'm audible very well, so go ahead, okay, uh my question, there are two questions, one is about the propagation of the xbb 1.5 subvariant. This is considered an Omicron variant that spreads very quickly and is considered evasive. vaccine that is actually raising fair fears, so could you clarify this and the second thing about the spread of covid-19 in China, about data sharing that Dr.

Ted Ross mentioned about China having started sharing the data , but who? you still expect faster control and as you know, in data sharing, could you share that at the next executive board meeting there will be some considerations and expectations? Thank you very much, we will start with Dr. Wankerkov in the room here, so thank you very much for the question and happy new year to all of you, so regarding the first question in this xbb.1.5, this is a sublineage of xbb that It is a recombinant of two sub ba.2. um B xbb.1.5 lineages have been detected in 29 countries so far, there may be more as sequencing becomes less and less available

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ly, it is difficult for us to track each of these Omicron subvariants, so It is part of Omicron and as you I have noticed that it is the most transmissible subvariant that has been detected, but the reason for this is the mutations that are within this recombinant, this subvariant of Omicron, which allows this virus to attach to the cell and is easily replicated, and we are worried. about its growth advantage, particularly in some countries in Europe and the US in North America, particularly in the northeastern part of the United States, where xbb 1.1.5 has rapidly replaced other circulating variants, our Technical Advisory Group for Virus Evolution discussed this yesterday in its call. which really focused on the circulation of SARS cov2 in China, but we discussed this particular subvariant because it is rapidly replacing other subvariants in some countries.

Our concern is how transmissible it is, it has immune escape as we have seen with xbb, but it is one of the other Omicron subvariants that is in circulation and the more this virus circulates, the more opportunities it will have to change. We expect more waves of infection around the world, but that does not have to translate into more waves of death. Becauseour countermeasures continue to work, that is something that is on our radar, the Technical Advisory Group for the evolution of the virus is doing a risk assessment specifically on the subvariant that we hope to publish in the coming days, but what we can say is that it has a growth advantage over all other subvariants.

So far we don't have any data on the severity or clinical picture, but we also don't have an indication that the severity has changed with xbb.1.5, but that's something. which we are looking at very closely through studies and experimental studies in the laboratory, but also in real world data when we look at hospitalization rates around the world among people who are infected with this subvariant, so it is an evaluation of risks that will be published in the future. in the coming days by our Technical Advisory Group for the evolution of the virus. I want to take a moment to say how important it is to continue Covid-19 surveillance around the world so that we can track these known subvariants that are in calculation. that can be reassessed that we can understand the epidemiological panorama around the world, we have had more than 13 million cases reported to whom in the last month and we know that that is an underestimate because surveillance has decreased and in addition we have had the holiday period, but more Regarding this, we have had a 15 increase in deaths in the last month and again we know that that is an underestimate because there are delays in reporting and with the holiday period and with the combination of those trends, it is expected to continue, so it's really critical that surveillance continues. we can track known variants and we can better assess what is happening globally regarding the circulation of variants in China.

I should mention that the Technical Advisory Group for Virus Evolution just released a statement based on a meeting we had yesterday. on the circulation of SARS Kobe 2 in China from the data presented to us by the Chinese CDC from the sequencing that has been carried out in the country, the majority of the viruses circulating in China are ba.5 sublineages, but again we need more information. on sequencing across the country, those sequences will be shared with publicly available databases, as just said, so that deeper analysis can be done. It's not just a matter of knowing what variants are circulating, we need the global community to evaluate them to look at mutation by mutation to determine if any of these are new variants that are circulating in China but also around the world, so there is a lot more work to do, there is a lot more data to share from China but also around the world so that we can track this pandemic as we enter the fourth year of this pandemic.

Thank you very much and to Mike Ryan, yes, thank you very much Christian. Regarding interaction with colleagues in China, we also had a meeting with high-level officials from China last year. week and we thank the Deputy Minister Cocoa of the Ministry of Health and also the deputy administrator of the National Disease Control Authority and director general of CBC of China with many colleagues who contacted us that Marie has spoken with the tag see and also with the clinical network. tomorrow there will be a

briefing

on our missions, WHO member states and colleagues from China will also join.

It is a general

briefing

on the global covert situation as described by the TG, largely including the northern hemisphere situation, but there will also be a briefing on our missions. There will be specific updates on the covert situation in China, so we thank colleagues at the Chinese College for that commitment. However, as the D here said, we still do not have complete data, there are certainly problems in terms of the criteria for recording and reporting attributable debts. to covid-19 We believe the definition is too narrow and requires respiratory failure and the association with over 19 years of age to be recorded as a covert related death.

It is a very narrow definition. We know that very often there are difficulties in all countries in recording hospital-related admissions and admissions. use of ICU facilities, but again we believe that the current figures that have been published from China do not represent the true impact of the disease in terms of hospital admissions in terms of ICU admissions and particularly in terms of debt, and We would like to see more data on a more geographical basis across China and we will continue with Endeavor and hope to receive more information on this from our colleagues. We are pleased that more sequencing data is being uploaded and certainly getting more information from expert doctors in China was a big help for us to understand the clinical impact of the disease and the needs of the system.

I think it's worth reflecting again because there are two lessons that emerge from what we're seeing over the past few weeks. Even if you have existing subvariants causing your problem, if you don't have good surveillance then you will be led to understand the problem in terms of its evolution or impact, if you have less adaptive vaccination coverage then there are likely to be more people who will get vaccinated. get very sick. sick and if your healthcare system is not constantly ready and adapted to the surge then you are going to struggle when that surge comes and I think China is a good example as many other situations and countries have been in the last two years, it is not a rocket science, this is how Corbett does his damage now immunity wanes as new variants emerge or variants emerge and again we see with XP the constant xpb, the constant threat of the evolution or emergence of other subvariants that may have characteristics that allow the disease to be transmitted more easily or reinfect previously individuals infected or protected by vaccines, so it is very important and also with specific reference to China I refer to the issue of under-registration In terms of definitions, it is also very important and this is a general message for the world, but also a specific message in relation to China that we do not discourage doctors and nurses who report these debts or these cases and that we have an open approach to being able to record the real impact of the disease on society so that we can take the best measures on behalf of our citizens around the world uh and this is something that every country has an interest in, but we recognize China's increased engagement over the last few weeks and specifically over the last 10 days and we look forward to receiving more complete data through the the meetings that were held.

In the next few days, thank you, thank you, Dr. Van Kirkov and Dr. Ryan. I should mention at this point that we have just published the statement from the Technical Advisory Group on the Evolution of the virus that was discussed. Another meeting was held yesterday. We just published a statement that is now available and it is also on our website in case you want to continue with this, the next question is for Jamil Shad from always Sao Paulo Jamil, please go ahead Christian, happy new year to all of you um uh, Dr. Ted was My question is about Brazil and as you mentioned at the beginning of your speech, the New Year is a time of reflection, so since this is the situation, could you reflect on the government of Bolsonaro during the last four years on how to deal with the pandemic? and obviously we understood by their behavior, not by their behavior, but by their institutions.

The behavior was to look for the scientists, the people who were basically working on science in Brazil to deal with the pandemic and now the new government has elected Minister of Health, someone you know very well is and was one of the scientists in the that you trusted, so what is your message to the new government? Thank you so much. Happy new year, thank you. Let's be brief. We'll start with Dr. Van Kirkov, so many thanks to you. Yes Yes. We know the new Minister of Health quite well and I am the former head of Vista Cruz.

I think I would like to comment on that. the only part of your question is related to scientists and, in fact, scientists in Brazil are very fortunate that one of the superpowers that I think we have is the convocation of world experts and scientists from all over the world, including scientists from Brazil, and I think One of the things that I find encouraging is that it transcends any political leadership in any country in the world, we have scientists dedicated to their jobs, public health professionals dedicated to the work of saving

live

s, advancing science, working with us to be open and transparent and work with us so that we as a World Health Organization can take data and knowledge and turn it into practical knowledge and translate it into saving

live

s, that is the goal and throughout the pandemic, as you know , Worldwide.

All over the world, no matter who was in power and the political moment, scientific collaboration was strong and in fact, I would say we even expanded our reach to countries in terms of scientific collaboration in terms of technical disciplines, just grew and we hope it continues that way. Special thanks to scientists in Brazil based on your particular question, but around the world who continue to work with us, that remains critical not only for this SARS Kobe 2 virus but also for all the epidemic and pandemic threats that exist and that we know. and those who will come in the future, that collaboration to try to gather evidence and turn it into the strongest guidance that we can is the work that we have here at the World Health Organization, so a special thank you to all those scientists and professionals from public health who work every day, regardless of whether there is a holiday or not, to try to advance and convert that knowledge into saving people's lives, so welcome to the new government, congratulations for your role and we look forward to working, thank you very much Dr.

Van kirkov next question is for Naomi Grimley from the BBC Naomi please unmute hello, thank you very much, on China, the EU has offered to donate mRNA vaccines, if the Chinese seriously consider accepting them, and then on xbb. 1.5 there have been some reports that in the northeastern US hospitalizations are increasing. Can we read something about that about gravity? I know Maria said that right now the data wasn't there, but that's why they're really worried. I think we'll start with Dr. O'Brien for Dr. Kate O'Brien vaccines, direct immunization vaccines and biologics, thank you very much. I didn't actually hear a question there and maybe I missed the question, so I'm wondering if it could be repeated on the EU mRNA vaccines.

Yes, there have been reports that the EU has offered to donate mRNA vaccines to help the Chinese if they accept them. The question is whether they accept them. I see it's okay, I'm sorry. I don't quite understand the question, a couple of things to say about vaccines first of all, as we know, from China they report that there are very high levels of vaccination coverage in China and there are a number of products available in China says that the majority of They are inactivated vaccines, the big problem is whether those who are most at risk of serious illness have already had optimal protection from the available vaccines and, as China reported, especially in people over 80 years of age.

For the age group the coverage is not at the level that would be as high as it could be, so very considerable efforts are now being made to try to improve that coverage. What's really important is that the vaccines, both the inactivated ones and the viral vector vaccines, the mRNA vaccines, are all vaccines that have demonstrated a high performance of protection against the severe end of the disease. Spectrum of hospitalization, severe illness, and death when given on a schedule that includes a booster dose. Availability of supply is a key issue and there is ample supply available, so it's really about vaccinating people who are not yet fully vaccinated and especially those who have not yet received their booster dose but have had the option to receive their serious primary doses. of the vaccine and the choice of vaccine product, many countries have a combination of products in their program and we have recommendations on the use of combination and combination programs, as well as when you can have some doses of one product and some doses of another product So certainly, a political decision is really up to each country as to what combination of products they want to have available in the country to provide the widest and greatest acceptance of vaccines across the entire population, so I really want to emphasize that Vaccine performance is something we track very carefully and one of the problems we have is with new variants orOmicron subvariants that are circulating, of course, at this time we have no information.

In terms of how the vaccines perform with the subvariants that are circulating, we don't have a specific reason to believe that they would work differently than the other Omicron subvariants that are circulating right now, but what is it? It's clear from that information that getting the booster dose is one of the most critical things people can do and, again, especially just re-emphasizing what the CEO said in his opening remarks, this is particularly important for those who are most at risk and that is the group that worries us the most, especially in situations where there is very widespread widespread transmission of the virus.

Thank you very much, Dr. Brian, Dr. vanco, please, yes, your second question about the situation in the northeastern US, so we do not have data specifically on the severity related to xbb.1.5 and yet , we note that an increase in hospitalizations has been reported in the northeastern part of the US, where approximately 70 percent approximately. I must verify the exact sequence data that is available in that part of the country are xbb.1.5 what you should also keep in mind is that there are many other respiratory viruses that are in circulation, not just covid-19, which is increasing in everyone, we just had the holidays, so many people came together and we expect transmission to increase which will result in increased hospitalizations.

We also have influenza circulating and other pathogens circulating, so we can't attribute the increase in hospitalizations to xbb.1.5 yet, but we are working. We have been working closely with colleagues at uscdc and have asked them for a detailed risk assessment of xbb.1.5, just as we would with any country in any subvariant that is circulating, we need to dig deeper and analyze the reasons for the increases in hospitalizations and I will determine what what is happening. I will reiterate what Kate just said regarding the vaccine. This is true everywhere in the world. Vaccination remains absolutely critical to preventing serious illness and death, no matter where you live, so if you're out and about. there and you should receive if you are recommended to receive an additional dose, a booster dose, especially if it is higher.

I'm talking to my friends and family who live in the Northeast US and around the world. that next dose really matters when you received your last dose, especially if you are in that risk group, if you are over 60, if you have underlying conditions and of course we want our frontline workers to be fully protected so that vaccination continue to be absolutely critical, but even more so. Risk assessments for xbb.1.5 will be published soon. Some of this information will take some time to become available and we expect more information to come from the US on this particular variant, where it is most notably reported, but remember that this variant has been detected in several countries around the world, so It is important that this evaluation be carried out using all the available data that we can get our hands on.

Thank you so much. The next question now goes to Latiga's book, but let me say first that we have a lot of questions. coming in and raising your hand so please everyone stick to one question and I also ask the panel to keep the answers as short as possible because they want to go through as many questions as possible here that we have or hands up. The first thing we have now is the Sydney Morning Herald's latika book. Go ahead and unmute. Thanks team and Christian, it's a pleasure to see you. Happy New Year to all.

Dr Tedros said it is understandable that some countries are reacting the way they are in relation to China and the imposition of pre-departure testing, but who really supports the imposition of covert country-specific restrictions in this stage of the pandemic because it seems like an attempt to resolve what is basically a political dispute over China? excessive secrecy and its lack of transparency when it comes to data and who has been quite concerned throughout the pandemic about the implementation of ad hoc restrictions depending on the country that was involved at the time of the appearance of the variant or other things that were they loom so I just want to check your views on those two things.

Thank you very much atika and we will turn to Dr. Ryan for this question. The testing requirement is not in itself a travel restriction. It is important to know that the vast majority of countries that have implemented measures only require testing, and that is due to their perception over the last few weeks that I think they have not fully understood the dynamics of transmission in China and fear that there may be other sub - There are variants circulating in that environment, so we said this before. I think Maria, you've referred to it many times in press conferences before, that right now we don't even have sequencing around the world and we don't even have reports of that. sequences, so it means that sometimes countries feel that the only way they are going to detect new and potentially more transmissible variants is to be able to test people when they enter a country, but testing itself is not a restriction of travel, it is a requirement for our trip um, it is not an excessive measure based on the risk assessment of any individual country.

Ideally, it would be much better if we had much more extensive epidemiological and sequencing data and impact data on which countries could make an appropriate risk-based decision regarding what they require for travelers coming from that country, as you may remember. , in the last three years, China had very strict testing requirements to enter China, so the reality for China now is that many countries have felt that they do not have enough information to base their risk assessment on so they are taking an approach precautionary measures, they are applying a precautionary principle and demanding evidence. I hope that as China reports more data into global databases, as they say, shares more data with whom about the impact of disease epidemiology and the impact on the health system that countries would then have more information in the which to base perhaps more precise and more rational policies regarding testing because you are right, as the variants have moved around the world and the requirement for testing has become less and less important and in fact, what it really is important, as María said in the previous intervention, is vaccination and a kind of layer, so we must focus on vaccination, we must focus on that ability to continue to carry out surveillance between those resilient health systems, travel measures in themselves , particularly restrictive travel.

Measures are often counterproductive, but in this case I think the CEO was trying to indicate that at the time and certainly at the time the statements were made we had relatively little information about transmission dynamics in China, very little information about the sequences. was circulating in the country and I think the Director General's intention was to create an understanding that countries in that situation were understandably going to implement risk-based testing requirements and not restrictive travel measures. Thanks again Dr Ryan, next question is for Simon Ativa from Today News Africa Simon, please unmute, thank you Christian for taking my question this time at a table with Today News Africa and Washington.

Happy New Year to you all, as we enter 2023. I was wondering if you could talk more broadly about Covid-19 in Africa. in terms of vaccination surveillance and these new variants, and if you could clarify why Africa has lost even fewer people to covet in three years, even with the lowest vaccination rate and in Tigre, what is the latest update there, thank you , thank you and even if Again there are two big questions, but we will start with Dr. Mahmoud on the African question, thank you sativa. I think a very important question is the million dollars that we are trying to better understand.

I think we did separate because his question had multiple aspects. Testing and surveillance remains a major gap in many countries, not specifically in Africa, but in many lower-middle-income countries, and that hasn't really picked up in the initial startup. Who we have supported, the countries to which we have given a PCR. and a lot, but in 2021 and 2022 other agencies have been supporting the member state, so testing and the laboratory after the initial investment remains a major challenge that needs to be strengthened. That's the second aspect of his question about vaccination, since Kovacs has done a lot. of great work and the Kovacs facilities among the top 34 priorities, but compared to the rest of the wall they are still lagging behind, so how can we attract that attention in 2023 with the spread of misinformation and disinformation in many countries?

I just returned from my home country. in Kenya and the level of interest and vaccination was quite shocking, so how do we get people initially when they saw that it was okay to accept death, but now that vaccines are available, let's just question how to reach the community and, finally, death? I think I have a different perspective - I was just looking at the data coming out of China for 38 days, but from my home country, five thousand deaths in a country where a lot of the deaths are largely underreported, so yeah goes to the rural area. when you go to the church or mosque you will see many elderly people three and a half years later when I visited I could not see any elderly population and that is the number the cultural aspect the historical aspect that the absence of elderly still has in a community, the glue that helps to the older population, so my feeling and that's qualitative, that's what I expected coming back, it really was an underestimate according to reports, yes the whole population is smaller compared to other countries in the world regions, but a significant number have been tied up during the greed just from my im

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te families and almost every family had that so I think in 2023 is how we will bring it back with all the waves of xpb omicrons that are happening around the world how we will bring surveillance, how we will rebuild the vaccination program for the vulnerable population and the support that the work done by Kovacs or the entire team will be a priority, the pandemic is not over, we are watching it and we salute and it is not the time to abandon the entire investment, go to invest in the last two years, but rebuild more. to prepare for the next covered waves, but also for other respiratory diseases, so it's a long answer to your complex question, it is very complex and Africa has been very affected like Canada, but the advantage of having a health population young has also helped, but as we call on China and all other countries to report data in a transparent and timely manner.

Thank you so much. I see Dr. Kate O'Brien has her hand raised as well. If I look at it correctly, yes, just a couple of things I especially wanted to comment on. Around the

issues

of vaccines and coverage in Africa, there are many countries that have made very, very substantial progress in 2022 and I think we really need to highlight that and point out the really rapid progress that many countries have made, especially in the Africa region, in the At the beginning of 2022 we identified 34 countries that had less than 10 percent coverage at the beginning of the year and those have been a set of countries that have been a focus of really intense operational support for UNICEF and other partners in Kovacs effort and many of those countries were countries in the African region at the end of the year, only seven of those countries had less than 10 percent, all the rest of the 34 had well exceeded 10 for some of them and all had exceeded 10 percent. and I think we really need to also focus on countries that have humanitarian emergencies or other conflict environments.

The countries that remain below 10 percent are largely countries, not all, but largely countries that have major conflicts or other problems. Around health care delivery, there is really a combination and also an important intersection of interdigitation of what countries are trying to do to increase their vaccine coverage and the multiple health problems, economic issues and other issues, including the security issues they have. We're dealing with that, so what's really important is that in 2023, as we enter this year, we know that countries have significant demand, vaccine plans, over the course of 2023, we are looking at it very carefully with the countries to ensure that supply.

We can fully meet their demand and we are still in a very good supply situation, so it is good news for 2023 and most countries have important plans to continue the campaigns they are doing to advance the coverage ofvaccines and ensuring that your people are getting booster doses as well, especially those who need them most, and integrating vaccination services with other services that are primary health care services for adults, so these are all the ambitions for 2023 and countries are completely in the lead in making their plans for how much. demand that they have for vaccine to get that vaccine Supply through the Kovacs facilities and through other means and ensuring that there is accurate population information so that it is, um uh, you know, the demand for those vaccines at the population level. at the community level at the family level, especially through primary health care services, so there is still a lot of work to be done in 2023.

We are in a good position to make the supply fully available. Provide an abundant available supply of vaccines and countries are committed to moving forward. towards your objectives and your population coverage objectives towards whose objectives, thank you very much to both of you and now in Tigray we go with Dr. Tedris, thank you, thank you Christian. We were moving fast, so Jamil asked a specific question about the Brazilian government. about the new government I will just say a few things although Maria had already covered but just one aspect first of all um the selection for the ministerial position is excellent, we know Nisha very well and we are a very experienced leader and I hope they do. contribute significantly and then in the new government.

I know that President Lula's commitment to health is a very strong commitment to health for all and we look forward to working closely with him not only in Brazil but also globally. his inauguration was last week, I think Sunday, January 1, actually, and I would like to congratulate him and wish him the best for President Lula, so, the gray one, of course, after the peace agreement, the signature, now there are advances in the delivery of food and There are advances in medicines, there are also advances in both, comparing the need, the enormous need that the region of 6 million inhabitants has, there are still many areas that are not yet covered, but we hope that it can be addressed, but there is good progress and the other area is services, I think in the resumption of banking services, the resumption of banking services, telecommunications, that is good in a good number of parts of the Tegre region, but I think it will be necessary to have full coverage as well, but there is good progress in the resumption of basic services. services I think the only problem we see now is the continued occupation of Tigriy by the Eritrean army and as we speak their massacre of civilians continues to massacre civilians and we believe that could affect the peace and peace agreement and I think the community International should help to ensure that Eritrea respects the peace agreement and withdraws from Tigray and stops the massacre.

I think these are the two issues, Christian, thank you very much, CEO. Now the next one is for Chu Liu from xinhua, please unmute. Hi.Hello, can you please hear me, very good, thank you, thank you Christian, fatigue? My question is like W, who has repeated that the Chinese national health commission's definition of Kobe's death is too narrow, but I've been trying to search the WLW website. I'm trying to figure out Who's specific version of death by greed, but to no avail, so could you first clarify Who's latest specific definition of Kovi's mortality? That's question number one and question number two is who has reiterated the greed test and the sequencing. been declining worldwide, which could have led to an underestimation of the current circulation of the virus.

So what is whose advice on how to accurately formulate anti-coving measures or policies based on such insufficient or inaccurate data and also www's advice on how to strike a balance between ensuring transparency of information about the outbreak and avoiding a possible anxiety and public panic thank you, thank you very much, many questions and apologies if we have to cut this short, but we will see Dr. Van Kirkov, please. so I'll start with the second part of the question, but we'll go ahead and send you the definitions that we've related to the Deaths and the way that we characterize them because there's a specific language that we have in there, um, I think in general, I think So I'm going to generalize your question here about how we provide this best advice with limited information.

I mean what are we really trying to do in the fourth year of this pandemic, you know. We know a lot about this virus and the disease it causes, but we don't know everything and we are humbled by this. We remain humble to learn about this. What we look at in Our Advice is that we try to provide this broad spectrum of advice. In so many different technical areas, how can you protect yourself from getting infected if you are infected? How do we prevent it from being transmitted to another person? How do we prevent you, if you are infected, from developing a disease and dying?

How do we protect our frontline workers? who can provide adequate care provide the best clinical care to patients who are infected with greed and have the covid-19 disease and we modify this over time because we do not have all the answers, what we do is we provide, we ask individuals and we provide Guidance is provided to governments to adopt this risk-based approach to look at the different levels and different types of interventions that can be implemented. The good news is that now, after four years, we have so many different interventions that can be implemented. are used and can be applied can be adjusted over time according to the situation according to the epidemiology the current circulation the variants that are in circulation the response capacities the access to the um the tools the Diagnosis Therapeutics the vaccines the level of Immunity to population level in communities within a country based on vaccination coverage and/or past or reinfection, looking at the other, are crises that countries face and therefore what we intend to do is publish this guide and there is a number of guidance that we still have and we are working with all member states to adjust their policies to deal with covid-19 and manage greed as a disease so that infected people do not die in the context of everything else and since it's been so long that we've been dealing with this virus, it's still relatively new, but it feels like we've been dealing with this for many, many years, it's really only been a couple of years, we have to make sure that the way we deal with greed is built into strong sustainable systems, so addressing greed in the context of other respiratory diseases like flu and RSV, addressing clinical care in the context of appropriately caring for someone you need when you show up at a health clinic or show up. in a hospital making sure they have the correct diagnoses in the context of all the other health and non-health emergencies that countries face, so we aim to regularly update our advice to modify it based on up-to-date information, scientific changes, science it grows. and evolves and therefore our guidance changes, but our advice to countries also takes into consideration the other challenges they face.

How do you handle greed in the context of everything else? So it's a constant challenge for us, but it's all based on what we know. what assumptions can we make based on educated guesses and put pressure on all our member states, everyone everywhere, to collect the right kinds of data, to share that data openly and transparently, to work with us, to challenge us and to Making sure the advice we give out is the best advice available, so it's a constant iterative process. We are doing the best we can. We are imperfect. We know that, but we are grateful to have so many people who work with us, but it is based on the information available. and we have to continue pushing in this fourth year, it is really essential that we analyze the impact of covid-19.

Let's not only look at what's circulating, but also at the impact it has in terms of hospitalization and ICU admissions. and we need to look at how the use of these interventions changes over time, vaccination coverage, boosting vaccination of at-risk groups remains absolutely critical, so it is a determined push and we will continue to work with everyone everywhere to ensure that we as an organization have the right type of information on a regular basis so that we can carry out reliable, robust and rapid risk assessments as often as we need. Thank you very much and Dr.

Mike Ryan, please, yes, just to answer the last part of the question, uh Christian, about people and information. and panic and the spread of fear of panic. I think this pandemic has definitely told us that and many of us would have seen this for many years before. People are smart. Ordinary people are very intelligent and generally do not panic. In fact, people are afraid. and they tend to be more likely to overreact or panic when they get anxious because they don't trust the information they receive, that's when you start to be afraid, that's when you start to fear for your parents, that's when you start to fear for your siblings. , that's when you fear for your children even if you don't actually believe that what they tell you represents the true nature of what is really happening around you and when there is a disconnect between what they tell you and what you can actually see and what hearing from your friends erodes trust that state government should be the primary source of accurate and credible information related to people's health upon which they can take appropriate action to manage their own risks.

That's the key. The key is to source solid, credible information and always be prepared to tell people how things are, but at the same time tell them how things are and what is being done about it and what they can do to manage their risk and what what the government and others are doing to support them in managing that risk, so I think we've collectively learned that transparency, openness and communicating credible information to people in real time results in functional responses from people um and we, we, we must be very careful not to have a kind of perverse approach to the Nanny State where the State thinks it knows what is best for the people, that is not a way for any responsible government to act and it has happened in this pandemic in several countries, so I think it is very important that we learn this lesson.

People need credible and accurate information on which to base their own risk management and manage the risks to their own health and we trust that governments will continue to strive to provide the best information to people so that they can continue to manage those risks. Thank you so much. Dr. Ryan, and just to add that the classification, the international national guidelines for certification classification of deaths from the cause of deaths that Dr. Van Gerkov mentioned, we just put them in the chat to link to this, so I should find them there, thanks. Very much, the next question is for Helen Branswell of Stat News Helen, please admit foreigner and happy new year.

I just put my hand down because I received an answer to my question, thank you, that's very kind of you, thank you and happy new year. Now the next question is for Chantal Srivastava from Radio Canada, please, bonjour, can you hear me? Listen to me very well. Please go ahead. Thank you. I will ask my question in English, but if possible, if someone could answer partially in French, I could use it for broadcast I would greatly appreciate it, so here in Canada we will start testing people uh. Travelers coming from China tomorrow China has previously called this measure unacceptable and not based on science, the European Center for Disease Prevention and Control said it was unjustified.

I just want you to keep reading. People are beginning to wonder what the point of this measure is. How efficient is it? Is it a good measure to evaluate people? What can we expect in terms of the results of this measure that will come into force tomorrow in Canada? Mercy, we have a person who could answer in French, but otherwise we will send it in writing if Dr. Beyond we do not want to try. Well, happy new year everyone, thanks for this question, so yes, it's true, several countries have established it. test for travelers coming from China, as Mike Ryan said, testing does not restrict travel, not directly because people can still travel, so just request the demand that is made for these travelers upon arrival to make sure that they do not arrive sick in any case.

When we talk about a pandemic, sick people are advised not to travel, it is better for them to stay home than to carry a virus. This measure mainly includes thosetravelers who are asymptomatic and could unknowingly bring the virus with them, as Dr. Ryan said. He also said that what is equally important is that this measure allows for the identification of a specific variation upon arrival, again referring to asymptomatic people, people who would not have been texted at home, obviously, the ideal It would be for us to be tested before travel so that potential carriers do not travel, however, it is true that some countries have established testing on arrival and it is simply another way to reduce uncertainty about the virus in terms of the impact on health public, since Omicron is found virtually everywhere in the world, it may not make a dent in that.

However, once again, the goal of these measures is, on the one hand, to reduce uncertainty, as we often do not have much information about the situation in China, and, on the other hand, to allow us to identify possible new variants that could emerge. in any given country, as China is obviously a highly populated country and if there is circulation of a variant of the virus, it could lead to new variants due to the possibility of the virus evolving in cases of high levels of transmission. Thank you, thank you, thank you, Dr. Brian. Next question is for Adam Taylor of the Washington Post Adam, please unmute.

Hello everyone, happy new year. I just had one question. Do we have a sense in China of how much the vaccines used there protect against serious illness, spheric illness, and death? and um, only some outside modelers have made predictions that there could be over a million deaths by April, is that within the realm of credibility or is that not what we're seeing in the data that you who are receiving so far, thank you? thank you, I'll just believe we start with Kate, Dr. Kate O'Brien, on vaccines, thank you, yes, very clear, there are over a dozen vaccines authorized for use in China.

They include inactivated vaccines and viral vector vaccines. It is also an inhaled product used in China, so I am going to focus my comments primarily on inactivated vaccines, which are the most commonly used vaccines. We have followed the data very carefully about the performance of those vaccines when used accordingly. to the schedules that are recommended and when a booster dose of inactivated vaccines is given, they work at a level equivalent to the performance of other vaccines viral actor vaccines mRNA vaccines I am emphasizing the importance of the booster dose as you have heard us throughout At this press conference and others, to get the best performance from the vaccines against the Omicron variants, it is very important to receive the booster dose, so in terms of performance, these are working at an equivalent level for diseases serious, for hospitalization and for death from studies that are some studies in China but studies that also come from other countries where these vaccines are used and where there has been more circulation and I will just emphasize again the importance of the combination and combination schemes.

It is not limited to being able to use only one product in a series of vaccines, but to the total availability of recommendations to combine the use of vaccines and this generated that the vaccines that we have available are highly effective against the severe end of the spectrum of the disease when They are distributed to the right people in the right number of doses and we cannot overemphasize that those who are not vaccinated, even if someone has that infection before, they get better performance, better protection, when they have been vaccinated even in addition to a previous infection thank you, thank you and Dr.

Van Kirkov, yes, very briefly, because I know we still have a lot of questions and more people want to ask, regarding the modeling question. We just want to point out that these models are quite useful to base scenarios on for planning, but the models are not predictions of what needs to happen and I think what we need to point out is that exactly what Kate was talking about in terms of increasing the vaccination coverage, it is never too late to vaccinate.and the vaccines that are in the country, that additional booster will save lives, also the amount of clinical care available in China, access to antivirals, yesterday we also had a clinical management call , yeah, uh, where we had conversations with doctors from around the country in terms of how they're treating patients what they're seeing in terms of severity of patients with Omicron in the sublineages that are circulating there's the whole spectrum from asymptomatic infection to severe illness and death, disease presentation is similar to other Countries have experimented with waves of Omicron, therapies are working to prevent, especially antivirals, to prevent severe disease, but a number of therapies can also be used which could be given to those who are at risk of developing serious illness and dying. so we go back to the basics early diagnosis access to clinical care the use of antivirals and therapies vaccination this is saving lives those predictions do not need to become reality they are very useful for planning purposes in terms of what may be needed throughout the country in In terms of beds, the beds needed for hospitalizations, as well as for access to oxygen and ventilation in the ICU, for example, but those predictions do not need to become reality, we just want to emphasize that they are very useful for kick-starting action, but we have many tools. that there are absolutely critical vaccines to prevent serious disease and that is what needs to be the focus in China right now to prevent those deaths from occurring, but we can also provide events of deaths that are occurring around the world.

The CEO just said more than 10,000 people are reported to die every week, four years into this pandemic, many of those lives can be saved now with the tools available, so let's act accordingly and focus our efforts on saving lives now. Thank you very much and Dr. Mike Ryan is still adding no, no, I think that's Maria Maria who gave the answer is like I would have done and I remember in this when we talked about that, particularly in relation to China, it has a relatively low mortality. Comfort over the In the last three years there have been millions and millions of deaths in other countries and again we need to look at the expected mortality in a population of 1.4 billion over a period of months.

Unfortunately, people die in all countries and die from all courses. The question is what the excess mortality could be in relation to this wave of cover-up and we have said this before in several press conferences to vaccinate as many people as possible, particularly the vulnerable, at this point it is not too late, and ensure that there is adequate clinical care. care for people so that they can have access to oxygen access to sports therapy access to ventilation when they need it and that comes back to the question of having good surveillance if you have good surveillance if you know where the disease is if you know where the impact of the disease is that if you know where hospital beds are running out, if you know where your healthcare workforce is, if you have access to all that information, it's much easier to be agile, it's much easier to be taxable. in your response and Be able to respond to the maximum with the resources you have, so surveillance again, vaccination and hospital or healthcare preparation remain the magic bullet when it comes to dealing with covert diseases, regardless of the wave and the subversion caused by the foreign list, but I believe.

We are already past the hour so we may have one or two more questions and then we may have to close, although there are a lot of people on the list but some of the questions are repeated so we hope we have covered most of them. part, but come on. go ahead now with Naomi or Leary from the Irish Times um Naomi please unmute no me you're gone no so we'll try the last question for Lisa Farm from Bloomberg Lisa please unmute Hello and thank you for your time today with the number of people being infected in China in such a short period of time.

Do you think the country is approaching the widespread level of hybrid immunity already established in other parts of the world and what would the subsequent forms look like there? Thank you very much, so it's very difficult to go into predicting what will happen. We are seeing intense circulation of Sarsko V2 in China and around the world, but in China in particular at the moment, what is the focus we are on. We have both this level of population immunity increasing since vaccination and significant efforts are being made to increase vaccination coverage, but we do see what we will see: more hybrid immunity, as you have pointed out, from infection and vaccination or a combination of both in terms of later waves.

I think what we have to do is We have to learn from other countries. Other countries that have experienced Omicron have seen different waves of infection, but we cannot predict exactly what will happen. It really depends on the measures in force. The comprehensive approach of these different types of measures keeps people alive. their lives, you know, but we are taking ways to reduce the spread where we can, but also preventing those serious illnesses and death, and there is a lot that can be done so that it is not inevitable, but we can learn from other countries and how they have experienced different waves. of infection, the predominant viruses circulating in China and that have been reported to us from the available sequences are these ba.5s lineages, but with further evolution of the virus there and around the world we cannot predict with certainty what will happen , we plan to plan for more cases, those cases don't need to translate into more severe illness if we use those tools more appropriately, so it's about making sure the systems are agile and can adapt to surges in ebbs and flows of circulation to deal with patient care so that the Health Systems are not overwhelmed and where they are overwhelmed how can they handle covid patients but other diseases that are circulating there as well but again we will work with China we continue working with China we continue working with our member states to adjust strategies based on the current situation that they have based on the capabilities that they have to deal with this and that includes addressing workforce issues and addressing access to life-saving tools.

Thank you very much and Dr. Mahmoud. please, thank you, I think Maria covered it, it's very hard to predict, but what we've learned so far is that human nature and human concreteness come together, whether in the Northeast US or the temperate region of the northern hemisphere. masking, I know that masculinity in many countries costs nothing and will save their lives, so I think the message for both China and all the temperate zone people in this very busy area to come together is very, very important, that musk saves lives prevents infections and with the arrival of the Lunar New Year on January 22 in China and many other Asian countries celebrate that in the New Year we all hope that people unite can create a subsequent wave, so the preparation which we have seen well Now, the wave that is going through the Japan area, how is the health authority preparing in the rural area where the health system may not be up to Max?

So I think there's a lot of preparation and lessons that can be learned from the current wave that's going on with large centers opening as we move into the Lunar New Year, how the health system prepares and then the basic measures, like wearing masks. , it saves lives both in those countries and everywhere, so start adding that part, thank you, thank you very much, Dr. Mahmoud, with this. To close our first press conference of this New Year 2020, thank you all very much for attending and being with us. We will send the audio files and Dr. Tedra's comments and most likely the link back to the death ratings right after the press conference.

The full transcript will be posted tomorrow morning. For any other questions, please continue with

media

inquiries at who dot int and with this to Dr. Tendros for closing. Thank you, thank you Christian and thank you to all the members of the press for joining us today. and happy new year and until next time