In a historic move, Nigeria has become the first country in the world to roll out a new vaccine (called Men5CV) recommended by the World Health Organization (WHO), which protects people against five strains of the meningococcus bacteria. The vaccine and emergency vaccination activities are funded by Gavi, the Vaccine Alliance, which funds the global meningitis vaccine stockpile, and supports lower-income countries with routine vaccination against meningitis.

Nigeria is one of the 26 meningitis hyper-endemic countries of Africa, situated in the area known as the African Meningitis Belt. Last year, there was a 50% jump in annual meningitis cases reported across Africa.

In Nigeria, an outbreak of Neisseria meningitidis (meningococcus) serogroup C outbreak led to 1742 suspected meningitis cases, including 101 confirmed cases and 153 deaths in seven of 36 Nigerian states (Adamawa, Bauchi, Gombe, Jigawa, Katsina, Yobe, Zamfara) between 1 October 2023 and 11 March 2024. To quell the deadly outbreak, a vaccination campaign has been undertaken on 25--28 March 2024 to initially reach more than one million people aged 1-29 years.

Meningitis is a serious infection that leads to the inflammation of the membranes (meninges) that surround and protect the brain and spinal cord. There are multiple causes of meningitis, including viral, bacterial, fungal and parasitic pathogens. Symptoms often include headache, fever and stiff neck. Bacterial meningitis is the most serious, can also result in septicaemia (blood poisoning), and can seriously disable or kill within 24 hours those that contract it.

“Meningitis is an old and deadly foe, but this new vaccine holds the potential to change the trajectory of the disease, preventing future outbreaks and saving many lives,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Nigeria’s rollout brings us one step closer to our goal to eliminate meningitis by 2030.”

The revolutionary new vaccine offers a powerful shield against the five major strains of the meningococcal bacteria (A, C, W, Y and X) in a single shot. All five strains cause meningitis and blood poisoning. This provides broader protection than the current vaccine used in much of Africa, which is only effective against the A strain.

The new vaccine has the potential to significantly reduce meningitis cases and advance progress in defeating meningitis. This is especially important for countries like Nigeria where multiple serogroups are prevalent. The new vaccine uses the same technology as the meningitis A conjugate vaccine (MenAfriVac®), which wiped out meningococcal A epidemics in Nigeria.

“Northern Nigeria, particularly the states of Jigawa, Bauchi and Yobe were badly hit by the deadly outbreak of meningitis, and this vaccine provides health workers with a new tool to both stop this outbreak but also put the country on a path to elimination,” said Prof. Muhammad Ali Pate of the Nigerian Ministry of Health and Social Welfare. “We’ve done a lot of work preparing health workers and the health system for the rollout of this new vaccine. We got an invaluable support from our populations despite this fasting period and from our community leaders especially the Emir of Gumel in Jigawa state who personally launched the vaccination campaign in the state. We’ll be monitoring progress closely and hopefully expanding the immunization in the coming months and years to accelerate progress.”

This new multivalent conjugate vaccine was 13 years in the making and was based on a partnership between PATH and the Serum Institute of India. Financing from the UK government’s Foreign, Commonwealth and Development Office was critical to its development.

In July 2023, WHO prequalified the new Men5CV vaccine (which has brand name MenFive®) and in October 2023 issued an official recommendation to countries to introduce the new vaccine. Gavi allocated resources for the Men5CV rollout in December 2023, which is currently available for outbreak response through the emergency stockpile managed by the International Coordinating Group (ICG) on Vaccine Provision, while roll-out through mass preventive campaigns is expected to start in 2025 across countries of the Meningitis Belt.

“The rollout of one million vaccines in northern Nigeria will help save lives, prevent long-term illness and boost our goal of defeating meningitis globally by 2030,” said Andrew Mitchell, UK Minister for Development and Africa. “This is exactly the kind of scientific innovation, supported by the UK, which I hope is replicated in years to come to help us drive further breakthroughs, including wiping out other diseases.”

WHO has been supporting the Nigeria Centre for Disease Control and Prevention (NCDC) in responding to the meningitis outbreak in the country. This includes disease surveillance, active case finding, sample testing, and case management. WHO and partners have also played a vital role in supporting Nigeria to prepare for the rollout of the new vaccine and training health workers.

“Year after year, meningococcal meningitis has tormented countries across Africa,” said Dr Nanthalile Mugala, PATH's Chief of Africa Region. “The introduction of MenFive® in Nigeria heralds a transformative era in the fight against meningococcal meningitis in Africa. Building on the legacy of previous vaccination efforts, this milestone reflects over a decade of unwavering, innovative partnerships. The promise of MenFive® lies not just in its immediate impact but in the countless lives it stands to protect in the years to come, moving us closer to a future free from the threat of this disease.”

In 2019, WHO and partners launched the global roadmap to defeating meningitis by 2030. The roadmap sets a comprehensive vision towards a world free of meningitis, and has three goals:

“With outbreaks of infectious diseases on the rise worldwide, new innovations such as MenFive® are critical in helping us fight back," said Aurélia Nguyen, Chief Programme Officer at Gavi, the Vaccine Alliance, which funds the global stockpile as well as vaccine rollout in lower-income countries. "This first shipment signals the start of Gavi support for a multivalent meningococcal conjugate vaccine (MMCV) program, which, with the required donor funding for our next five years of work, will see pentavalent meningococcal conjugate vaccines rolled out in high-risk countries. Thanks to vaccines, we have eliminated large and disruptive outbreaks of meningitis A in Africa: now we have a tool to respond to other serogroups that still cause large outbreaks resulting in long-term disability and deaths."

Following Nigeria’s meningitis vaccine campaign, a major milestone on the road to defeat meningitis is the international summit on meningitis taking place in Paris in April 2024 where leaders will come together to celebrate progress, identify challenges and assess next steps. It is also an opportunity for country leaders and key partners to commit politically and financially to accelerate progress towards eliminating meningitis as a public health problem by 2030.

^{WHO and Netherlands Strategic Dialogue in The Hague, Netherlands 10 April 2024. Credit: WHO}

The WHO and the Netherlands convened in The Hague on 10 April 2024, to discuss joint priorities and alignment between the Dutch Global Health Strategy and WHO’s key strategic goals, marking a new milestone in their longstanding partnership.

Rooted in the Netherlands' unwavering commitment to global health, human rights, and universal access to comprehensive health services, the collaboration between the WHO and the Netherlands is instrumental in addressing global health challenges and fostering health and well-being, worldwide and in the country.

Against the backdrop of ongoing conflicts, disasters, and the escalating impact of climate change, and the interconnectedness of the Dutch public health landscape in the Netherlands with global health challenges, this year’s Strategic Dialogue emerged as a critical platform for reflecting on this partnership’s long-term vision.

“In this Strategic Dialogue, throughout all sessions, WHO and the Netherlands showed a commitment to cooperation and to deepening their partnership based on the strong alignment between their respective priorities and objectives”, said Ms Marjolijn Sonnema, Director General for Public Health at the Netherlands’ Ministry of Health, Welfare and Sport.

A key outcome of the Strategic Dialogue was the recognition of the alignment between the Dutch Global Health Strategy and the WHO's forthcoming 14th General Programme of Work, paving the way for synergies in areas such as health system strengthening, pandemic preparedness, climate change and health, anti-microbial resistance (AMR) and mental health support.

"At a time when inequity in health and in access to essential health services and financial protection is increasing, disproportionately impacting the poor and most vulnerable, the Netherlands stands as a global health leader and trusted WHO partner. With shared priorities and commitment to sexual and reproductive rights, gender equity, health systems, security, climate resilience, and mental health, we look forward to strengthening our partnership to enhance the health and well-being of all, globally and in the Netherlands", said Dr Bruce Aylward, WHO Assistant Director-General, Universal Health Coverage, Life Course.

WHO acknowledged the Netherlands' global leadership as a flexible donor, with an agreement around the imperative to ensure WHO's financing is more sustainable, through the inaugural WHO Investment Round. This WHO initiative aims to mobilize predictable, sustainable and flexible resources essential for the WHO to respond swiftly and effectively to global health challenges and improve health outcomes, particularly for vulnerable populations.

Addressing contemporary challenges such as geopolitical tensions while seizing opportunities for advancing global health objectives were also on the table during the dialogue. Both parties stressed the importance of sustained collaboration to address pressing health issues comprehensively.

The outcomes of the 2024 dialogue will inform future collaboration between the Netherlands and the WHO, so that efforts are aligned, and the optimal use of resources is helps achieve improved health outcomes worldwide. The enduring partnership between the Netherlands and the WHO stands as a cornerstone in the global health landscape, reflecting a shared commitment to advancing health and well-being globally.

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The Netherlands is a key supporter and strategic partner of the WHO.

In 2022- 2023, the Netherlands was one of the top five flexible WHO contributors with nearly US$ 19 million in core voluntary contributions. Overall, the Netherlands contributed more than US$ 106 million to the WHO in 2022 - 2023, of which US$ 93 million, nearly 90%, was voluntary funding.

The Netherlands also supports the WHO's technical expertise through secondments of staff and helps boost young people's careers in public health via the WHO's Junior Professional Officer Programme.

This demonstrates the Netherlands' commitment through its Ministry of Foreign Affairs and Ministry of Health, Welfare and Sport to the WHO’s central role in the global health architecture.

Through this support, the Netherlands contributes to crucial activities in the areas of sexual and reproductive health, water and sanitation, mental health in emergencies, emergency preparedness, tuberculosis, One Health, primary health care, antimicrobial resistance, while facilitating cooperation with top Dutch institutions.

See more information on the partnership between Netherlands and WHO.

A WHO-led multi-agency mission accessed Al-Shifa Hospital in north Gaza on 5 April to conduct a preliminary assessment of the extent of destruction and identify needs to guide future efforts to restore the facility. The highly complex mission was conducted in close partnership with the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), United Nations Mine Action Service (UNMAS), United Nations Department for Safety and Security (UNDSS), and in collaboration with the acting Hospital Director.

Prior to the mission, WHO’s efforts to reach the hospital to medically evacuate patients and staff and conduct an assessment were denied, delayed or impeded 6 times between 25 March and 1 April.

Like the majority of the north, Al-Shifa Hospital ­– once the largest and most important referral hospital in Gaza – is now an empty shell after the latest siege. No patients remain at the facility. Most of the buildings are extensively damaged or destroyed and the majority of equipment is unusable or reduced to ashes. The WHO team said that the scale of devastation has left the facility completely non-functional, further reducing access to life-saving health care in Gaza. Restoring even minimal functionality in the short term seems implausible and will require substantial efforts to assess and clear the grounds for unexploded ordnance to ensure safety and accessibility for partners to bring in equipment and supplies.

The hospital’s emergency department, surgical, and maternity ward buildings are extensively damaged due to explosives and fire. The western wall of the emergency department and northern wall of the neonatal intensive care department (NICU) have been torn down. At least 115 beds in what once was the emergency department have been burnt and 14 incubators in the NICU destroyed, among other assets. An in-depth assessment by a team of engineers is needed to determine if these buildings are safe for future use.

The hospital's oxygen plant has been destroyed, leaving Kamal Adwan Hospital as the only source of medical oxygen production in the north. Further comprehensive assessment is essential to evaluate the functionality of vital equipment such as CT scanners, ventilators, sterilization devices, and surgical equipment, including surgical tools and anaesthesia devices. The current situation has left north Gaza without CT scanning capabilities and significantly diminished laboratory capacity, severely compromising effective diagnosis, which will increase avoidable deaths.

Numerous shallow graves have been dug just outside the emergency department, and the administrative and surgical buildings. In the same area, many dead bodies were partially buried with their limbs visible. During the visit, WHO staff witnessed at least 5 bodies lying partially covered on the ground, exposed to the heat. The team reported a pungent smell of decomposing bodies engulfing the hospital compound. Safeguarding dignity, even in death, is an indispensable act of humanity.

According to the acting Hospital Director, patients were held in abysmal conditions during the siege. They endured severe lack of food, water, health care, hygiene and sanitation, and were forced to relocate between buildings at gun point. At least 20 patients have reportedly died due to the lack of access to care and limited movement authorized for health personnel.

Despite deconfliction, yesterday’s mission faced significant delays at the military checkpoint en route to Al-Shifa Hospital. On the same day, another WHO-led mission bound for Al-Awda and Kamal Adwan hospitals in northern Gaza – to deliver medical supplies, fuel, deploy emergency medical teams, and support referral of critical patients – encountered unnecessary delays, including the detention of a supply truck driver who was part of the convoy. He was detained for over an hour at a separate location, out of view of the mission team. Eventually this mission was aborted due to safety concerns as the delays left insufficient time for safe completion and return before nightfall.

Between mid-October and end March, over half of all WHO missions have been denied, delayed, impeded or postponed. As health needs soar, the lack of a functional deconfliction system is a major obstacle in delivering humanitarian aid – including medical supplies, fuel, food and water to hospitals – anywhere close to the scale needed.

Six months – half a year – into the war, the destruction of Al-Shifa Hospital and Nasser Medical Complex has broken the backbone of the already ailing health system. Prior to the latest siege, WHO and partners had supported the revival of basic services at Al-Shifa Hospital, and Nasser Medical Complex was regularly supplied to continue serving as the main hospital in south Gaza. These efforts are now lost.

As WHO marks World Health Day tomorrow, under the theme “My health, my right”, this basic right is utterly out of reach for the civilians of Gaza. Access to health care in Gaza has become totally inadequate, and the ability of WHO and partners to help is constantly disrupted and impeded.

Of the 36 main hospitals that used to serve over 2 million Gazans, only 10 remain somewhat functional, with severe limitations on the types of services they can deliver. The proposed military incursion into Rafah can only result in further diminution of access to health care and would have unimaginable health consequences. The systematic dismantling of health care must end.

WHO repeats its calls for the protection of patients, health and humanitarian workers, health infrastructure, and civilians. Hospitals must not be militarized, misused, or attacked. WHO demands an effective, transparent and workable deconfliction mechanism, and safety guarantees, ensuring that the movement of aid within Gaza, including through checkpoints, is safe, predictable and expedited. WHO calls for additional land crossings to allow access into and across Gaza more safely and directly.

As famine looms, disease outbreaks spread, and traumatic injuries increase, WHO calls for unimpeded access of humanitarian aid into and across the Gaza Strip, and a lasting ceasefire.

To mark World Health Day (7 April), the World Health Organization (WHO) is running the “My health, my right” campaign to champion the right to health of everyone, everywhere.

The campaign advocates for ensuring universal access to quality health services, education, and information, as well as safe drinking water, clean air, good nutrition, quality housing, decent working and environmental conditions, and freedom from discrimination.

All around the world, the core challenges consistently compromising the right to health are political inaction coupled with a lack of accountability and funding, compounded by intolerance, discrimination and stigma. Populations facing marginalization or vulnerability suffer the most, such as people who live in poverty, are displaced, are older or live with disabilities.

While inaction and injustice are the major drivers of the global failure to deliver on the right to health, current crises are leading to especially egregious violations of this right. Conflicts are leaving trails of devastation, mental and physical distress, and death.

The burning of fossil fuels is simultaneously driving the climate crisis and violating our right to breathe clean air. The climate crisis is in turn causing extreme weather events that threaten health and well-being across the planet and strain access to services to meet basic needs.

Everyone deserves access to quality, timely and appropriate health services, without being subjected to discrimination or financial hardship. Yet, in 2021, 4.5 billion people, more than half of the world’s population, were not covered by essential health services, leaving them vulnerable to diseases and disasters. Even those who do access care often suffer economically for it, with about 2 billion people facing financial hardship due to health costs, a situation that has been worsening for two decades.

To expand coverage, an additional US$ 200–328 billion a year is needed globally to scale up primary health care in low- and middle-income countries (i.e. 3.3% of national forecast GDP). Progress has shown to be possible where there is political will. Since 2000, 42 countries, representing all regions and income levels, succeeded in improving both health service coverage and protection against catastrophic health spending.

“Realizing the right to health requires governments to pass and implement laws, invest, address discrimination and be held accountable by their populations,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “WHO is working with governments, partners and communities to ensure the highest attainable standard of health, as a fundamental right for all people, everywhere.”

The right to health is enshrined within the WHO Constitution, and at least 140 countries recognize the right to health in their national constitutions. But recognition alone is not enough, which is why WHO supports countries to legislate the right to health across sectors and integrate human rights into health policies and programmes. The aim of this support is to make health services available, accessible and responsive to the needs of the populations they serve and to increase community participation in health decision-making.

On this World Health Day and beyond, WHO is calling for governments to make meaningful investments to scale up primary health care; to ensure transparency and accountability; and to meaningfully involve individuals and communities in decision-making around health. Recognizing the interdependence between the right to health and other fundamental rights, the campaign includes calls to action on finance, agriculture, environment, justice, transport, labour and social affairs.

Individuals, communities and civil society have long defended their right to health, improving access to health care services by breaking down barriers and advocating for equity. WHO urges the public to know, protect and promote their health rights, including those related to safe and quality care, zero discrimination, privacy and confidentiality, information, bodily autonomy, and decision-making.

WHO Member States agreed to resume negotiations aimed at finalizing a pandemic agreement during 29 April to 10 May. The decision came at today’s end of two weeks of intensive country-led discussions on critical subjects aimed at making all countries of the world better prepared for, and able to effectively and equitably respond to, future pandemics.

This ninth meeting of the Intergovernmental Negotiating Body (INB9) started on 18 March and ended today. Government negotiators discussed all articles from the draft agreement, including adequate financing for pandemic preparedness, equitable access to medical countermeasures needed during pandemics and health workforce strengthening.

“Our Member States are fully aware of how important the pandemic agreement is for protecting future generations from the suffering we endured through the COVID-19 pandemic,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “I thank them for their clear commitment to finding common ground and finalizing this historic agreement in time for the World Health Assembly.”

Next month’s resumption of INB9 will be a critical milestone ahead of the Seventy-seventh World Health Assembly, starting 27 May 2024, at which Member States are scheduled to consider the proposed text of the world’s first pandemic agreement for adoption.

Dr Precious Matsoso, Co-Chair of the INB Bureau, said: “There is clear recognition from governments that the goal of a pandemic agreement is to prepare the world for preventing and responding to future pandemics, built on consensus, solidarity and equity. These goals must remain our North Star as we move toward the finalization of this historic, pressing commitment for the world. We know that if we fail, we will be failing humanity, including all those who suffered from COVID-19, and those at risk of future pandemics.”

Fellow INB Bureau Co-Chair, Mr Roland Driece, said: “Governments said clearly we cannot fail to reach an agreement at the next World Health Assembly to make the world healthier, fairer and safer from pandemics. We are at the finishing line and we are committed to maximizing the remaining negotiations to reach the result the entire world needs.”

In December 2021, the World Health Assembly met in a Special Session, the second-ever since WHO’s founding in 1948, and decided to establish the INB to draft and negotiate a WHO convention, agreement, or other international instrument on pandemic prevention, preparedness and response. The process has involved participation of other United Nations system bodies, non-state actors, other relevant stakeholders, and the public.

WHO has launched a new network for coronaviruses, CoViNet, to facilitate and coordinate global expertise and capacities for early and accurate detection, monitoring and assessment of SARS-CoV-2, MERS-CoV and novel coronaviruses of public health importance.

CoViNet expands on the WHO COVID-19 reference laboratory network established during the early days of the pandemic. Initially, the lab network was focused on SARS-CoV-2, the virus that causes COVID-19, but will now address a broader range of coronaviruses, including MERS-CoV and potential new coronaviruses. CoViNet is a network of global laboratories with expertise in human, animal and environmental coronavirus surveillance.

The network currently includes 36 laboratories from 21 countries in all 6 WHO regions.

Representatives of the laboratories met in Geneva on 26 – 27 March to finalize an action plan for 2024-2025 so that WHO Member States are better equipped for early detection, risk assessment, and response to coronavirus-related health challenges.

The CoViNet meeting brings together global experts in human, animal, and environmental health, embracing a comprehensive One Health approach to monitor and assess coronavirus evolution and spread. The collaboration underscores the importance of enhanced surveillance, laboratory capacity, sequencing, and data integration to inform WHO policies and support decision-making.

“Coronaviruses have time and again demonstrated their epidemic and pandemic risk. We thank our partners from around the world who are working to better understand high threat coronaviruses like SARS, MERS and COVID-19 and to detect novel coronaviruses,” said Dr Maria Van Kerkhove, acting Director of WHO’s Department of Epidemic and Pandemic Preparedness and Prevention. “This new global network for coronaviruses will ensure timely detection, monitoring and assessment of coronaviruses of public health importance.”

Data generated through CoViNet's efforts will guide the work of WHO's Technical Advisory Groups on Viral Evolution (TAG-VE) and Vaccine Composition (TAG-CO-VAC) and others, ensuring global health policies and tools are based on the latest scientific information.

The latest analysis from the Integrated Food Security Phase Classification (IPC) partnership released today warns that the situation in Gaza is catastrophic, with northern Gaza facing imminent famine and the rest of the Strip at risk as well.

"The IPC announcement reflects the dire situation that the people of Gaza are facing," said WHO Director-General Dr Tedros Adhanom Ghebreyesus. "Before this crisis, there was enough food in Gaza to feed the population. Malnutrition was a rare occurrence. Now, people are dying, and many more are sick. Over a million people are expected to face catastrophic hunger unless significantly more food is allowed to enter Gaza."

Before the recent months’ hostilities, 0.8% of children under 5 years of age were acutely malnourished. Today’s report shows that as of February in the northern governorates, that figure is between 12.4 and 16.5%.

Without a significant and immediate increase in deliveries of food, water and other essential supplies, conditions will continue deteriorating. Virtually all households are already skipping meals every day and adults are reducing their meals so that children can eat.

The current situation will have long-term effects on the lives and health of thousands. Right now, children are dying from the combined effects of malnutrition and disease. Malnutrition makes people more vulnerable to getting severely ill, experiencing slow recovery, or dying when they are infected with a disease. The long-term effects of malnutrition, low consumption of nutrient-rich foods, repeated infections, and lack of hygiene and sanitation services slow children’s overall growth. This compromises the health and well-being of an entire future generation.

WHO and partners have been carrying out high-risk missions to deliver medicines, fuel and food for health workers and their patients, but our requests to deliver supplies are often blocked or refused. Damaged roads and continuous fighting, including in and close to hospitals, mean deliveries are few and slow.

The IPC report confirms what we, our UN partners and nongovernmental organizations (NGOs) have been witnessing and reporting for months. When our missions reach hospitals, we meet exhausted and hungry health workers who ask us for food and water. We see patients trying to recover from life-saving surgeries and losses of limbs, or sick with cancer or diabetes, mothers who have just given birth, or newborn babies, all suffering from hunger and the diseases that stalk it.

WHO, as a partner of the Nutrition Cluster, is currently supporting a nutrition stabilization center in Rafah to treat children with severe acute malnutrition with medical complications, who are at the highest risk of imminent death if not urgently treated. We are supporting the establishment of two additional centres: one in the north of Gaza at Kamal Adwan hospital and one at the International Medical Corps field hospital in Rafah. WHO is supporting the pediatric wards of Al-Aqsa and Al-Najjar hospitals through the provision of nutrition supplies and medicines as well as training of medical personnel, and the promotion of appropriate infant and young child feeding practices, including breastfeeding.

WHO has trained health workers on how to recognize and treat malnutrition with complications. WHO is supporting hospitals and the centers with medical supplies for the children being treated.

Further nutrition and stabilization centres need to be added in all key hospitals in Gaza. Communities themselves will need the support to scale up the management of malnutrition locally.

WHO and other UN partners again ask Israel to open more crossings and accelerate the entry and delivery of water, food, medical supplies and other humanitarian aid into and within Gaza. As the occupying force, it is their responsibility under international law to allow for the passage of supplies including food. Recent efforts to deliver by air and sea are welcome, but only the expansion of land-crossings will enable large-scale deliveries to prevent famine. The time to act is now.

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Note to editors

The Integrated Food Security Phase Classification (IPC) is a multi-partner initiative for improving food security and nutrition analysis and decision-making. By using the IPC classification and analytical approach, governments, UN Agencies, NGOs, civil society and other relevant actors, work together to determine the severity and magnitude of acute and chronic food insecurity, and acute malnutrition situations in a country, according to internationally recognized standards.

As a member of the IPC partnership, WHO provided technical expertise and information on the health situation for this evaluation. The conflict is posing extreme limitations to the ability to deliver life-saving health assistance to the population. In February 2024, attacks against health-care facilities, infrastructures and services continued, resulting in 58% of the hospitals not functioning in Gaza, especially in the Northern governorates (75% of the hospitals not functioning). According to the Health Cluster, as of 5 March 2024, only 2 hospitals and no Primary Health Care Centres were fully functioning. Acute respiratory infections and diarrheal diseases are rampant among children under five, exposing them to high-risk nutritional deterioration.

The full recommendations from the IPC

Famine can be halted—both in the immediate term and it requires urgent and proactive measures from parties to the conflict and the international community. They must immediately curb the rapidly escalating hunger crisis in the Gaza Strip, garner political support to put an end to the hostilities, mobilize necessary resources and ensure the safe delivery of humanitarian aid to the people of Gaza.

Overall recommendations

• Restore humanitarian access to the entire Gaza Strip.
• Stop the fast-paced deterioration of the food security, health and nutrition situation leading to excess mortality through: the restoration of health, nutrition, and WASH services and the protection of civilians; and the provision of safe, nutritious, and sufficient food to all the population in need.
• The sustained supply of sufficient aid commodities, including but not limited to food, medicines, specialist nutrition products, fuel, and other necessities should be allowed to enter and move throughout the entire Gaza Strip by road. Traffic of commercial goods should also be fully resumed to meet the volume of commodities required.

A major new study released by The Lancet Neurology shows that, in 2021, more than 3 billion people worldwide were living with a neurological condition. The World Health Organization (WHO) contributed to the analysis of the Global Burden of Disease, Injuries, and Risk Factor Study (GBD) 2021 data.

Neurological conditions are now the leading cause of ill health and disability worldwide. The overall amount of disability, illness and premature death (known as disability-adjusted life years, DALYs) caused by neurological conditions has increased by 18% since 1990.

Over 80% of neurological deaths and health loss occur in low- and middle-income countries, and access to treatment varies widely: high-income countries have up to 70 times more neurological professionals per 100 000 people than low- and middle-income countries.

“Neurological conditions cause great suffering to the individuals and families they affect, and rob communities and economies of human capital,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This study should serve as an urgent call to action to scale up targeted interventions to allow the growing number of people living with neurological conditions to access the quality care, treatment and rehabilitation they need. It is more important than ever to ensure brain health is better understood, valued and protected, from early childhood to later life.”

The top ten neurological conditions contributing to loss of health in 2021 were stroke, neonatal encephalopathy (brain injury), migraine, dementia, diabetic neuropathy (nerve damage), meningitis, epilepsy, neurological complications from preterm birth, autism spectrum disorder, and nervous system cancers.

Overall, neurological conditions cause more disability and health loss in men compared to women, but there are some conditions like migraine or dementia where women are disproportionately affected.

Since 1990, the absolute number of individuals living with, or dying from, neurological conditions has increased, while age-standardized DALY rates have dropped. This means that increases in absolute numbers are mainly driven by demographic change and people living longer.

Diabetic neuropathy was the fastest growing neurological condition. The number of people with diabetic neuropathy has more than tripled globally since 1990, rising to 206 million cases in 2021. This increase is in line with the worldwide increase in diabetes. Other conditions such as neurological complications from COVID-19 (for example, cognitive impairment and Guillain-Barré syndrome) did previously not exist and now account for over 23 million cases.

At the same time, neurological burden and health loss due to other conditions decreased by 25% or more since 1990 as a result of improved prevention (including vaccines), care and research: tetanus, rabies, meningitis, neural tube defects, stroke, neurocysticercosis (parasitic infection that affects the central nervous system), encephalitis (inflammation of the brain), and neonatal encephalopathy (brain injury).

The study also examined 20 modifiable risk factors for potentially preventable neurological conditions such as stroke, dementia and idiopathic intellectual disability.

Eliminating key risk factors – most importantly, high systolic blood pressure and ambient and household air pollution – could prevent up to 84% of stroke DALYs. Similarly, preventing exposure to lead could reduce the burden of idiopathic intellectual disability by 63.1%, and reducing high fasting plasma glucose levels could reduce the burden of dementia by 14.6%. Smoking significantly contributed to stroke, dementia and multiple sclerosis risk.

More investments needed to improve treatment, care and quality of life

At the World Health Assembly in 2022, Member States adopted the Intersectoral global action plan on epilepsy and other neurological disorders 2022–2031 (IGAP) with an ambitious scope to address the long standing neglect of neurological disorders.

“The Intersectoral Global Action Plan 2022–2031 sets out a roadmap for countries to improve prevention, early identification, treatment and rehabilitation of neurological disorders. To achieve equity and access to quality care, we also need to invest in more research on risks to brain health, improved support for the healthcare workforce and adequate services,” said Dévora Kestel, Director, WHO Department of Mental Health and Substance Use.

IGAP sets out strategic objectives and targets to improve access to treatment, care and support for people with neurological disorders; implement strategies for brain health promotion and disease prevention; strengthen research and data; and emphasize a public health approach to epilepsy and other neurological disorders.

`A new report published by the World Health Organization (WHO), “Fair share for health and care: gender and the undervaluation of health and care work" illustrates how gender inequalities in health and care work negatively impact women, health systems and health outcomes.

The report outlines underinvestment in health systems results in a vicious cycle of unpaid health and care work, lowering women’s participation in paid labour markets, harming women’s economic empowerment and hampering gender equality.

Women comprise 67% of the paid global health and care workforce. In addition to this paid work, it has been estimated that women perform an estimated 76% of all unpaid care activities. Work that is done primarily by women tends to be paid less and have poor working conditions.

The report highlights that low pay and demanding working conditions are commonly found in the health and care sector. Devaluing caregiving, which is work performed primarily by women, negatively impacts wages, working conditions, productivity and the economic footprint of the sector.

The report illustrates that decades of chronic underinvestment in health and care work is contributing to a growing global crisis of care. With stagnation in progress towards universal health coverage (UHC), resulting in 4.5 billion people lacking full coverage of essential health services, women may take on even more unpaid care work. The deleterious impact of weak health systems combined with increasing unpaid health and care work are further straining the health of caregivers and the quality of services.

“The ‘Fair share’ report highlights how gender-equitable investments in health and care work would reset the value of health and care and drive fairer and more inclusive economies,” said Jim Campbell, WHO Director for Health Workforce. “We are calling upon leaders, policy-makers and employers to action investment: it is time for a fair share for health and care.”

The report presents policy levers to better value health and care work:

1. Improve working conditions for all forms of health and care work, especially for highly feminised occupations
2. Include women more equitably in the paid labour workforce
3. Enhance conditions of work and wages in the health and care workforce and ensure equal pay for work of equal value
4. Address the gender gap in care, support quality care work and uphold the rights and well-being of caregivers
5. Ensure that national statistics account for, measure and value all health and care work
6. Invest in robust public health systems

Investments in health and care systems not only accelerate progress on UHC, they redistribute unpaid health and care work. When women participate in paid health and care employment, they are economically empowered and health outcomes are better. Health systems need to recognize, value and invest in all forms health and care work.

World Health Organization (WHO) has today published a new, comprehensive diagnostic manual for mental, behavioural, and neurodevelopmental disorders: “ The clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders (ICD-11 CDDR)”.

The manual has been developed using the latest available scientific evidence and best clinical practices and is designed to support qualified mental health and other health professionals to identify and diagnose mental, behavioural and neurodevelopmental disorders in clinical settings.

“An accurate diagnosis is often the first critical step towards receiving appropriate care and treatment. By supporting clinicians to identify and diagnose mental, behavioural and neurodevelopmental disorders, this new ICD-11 diagnostic manual will ensure more people are able to access the quality care and treatment they need” said Dévora Kestel, Director, Mental Health and Substance Use Department, World Health Organization.

The new diagnostic guidance, reflecting the updates to the ICD-11, includes the following features:

• Guidance on diagnosis for several new categories added in ICD-11, including complex post-traumatic stress disorder, gaming disorder and prolonged grief disorder. This enables improved support to health professionals to better recognize distinct clinical features of these disorders, which may previously have been undiagnosed and untreated.
• The adoption of a lifespan approach to mental, behavioural and neurological disorders, including attention to how disorders appear in childhood, adolescence, and older adults.
• The provision of culture-related guidance for each disorder, including how disorder presentations may differ systematically by cultural background.
• The incorporation of dimensional approaches, for example in personality disorders, recognizing that many symptoms and disorders exist on a continuum with typical functioning.

The ICD-11 CDDR are aimed at mental health professionals and qualified non-specialist health professionals such as primary care physicians responsible for assigning these diagnoses in clinical settings as well as other health professionals in clinical and non-clinical roles, such as nurses, occupational therapists and social workers, who need to understand the nature and symptoms of mental, behavioural and neurodevelopmental disorders even if they do not personally assign diagnoses.

The ICD-11 CDDR were developed and field-tested through a rigorous, multi-disciplinary and participatory approach involving hundreds of experts and thousands of clinicians from around the world.

Notes:

• The CDDR are a clinical version of ICD-11 and thus complementary to the statistical reporting of health information, referred to as the linearization for mortality and morbidity statistics (MMS).
• The World Health Organization (WHO) Eleventh Revision of the International Classification of Diseases (ICD-11) is a global standard for recording and reporting diseases and health related conditions. It provides standardized nomenclature and common health language for health practitioners across the world.
• ICD-11 was adopted at the World Health Assembly in May 2019 and came into effect formally in January 2022.