Although handwashing with soap is vital in the fight against infectious diseases, including COVID-19, billions of people around the world do not have ready access to a place to do it, the UN Children’s Fund (UNICEF) said on Thursday.
According to new estimates from UNICEF, 40 per cent of the world’s population – or 3 billion people – do not have a handwashing facility with water and soap at home. The number is much higher in least developed countries, where nearly three-quarters go without.
Kelly Ann Naylor, Associate Director of Water, Sanitation and Hygiene at UNICEF, said that it was “unacceptable” that the most vulnerable communities are unable to use the simplest of methods to protect themselves and their loved ones.
“The pandemic has highlighted the critical role of hand hygiene in disease prevention. It has also stressed a pre-existing problem for many: handwashing with soap remains out of reach for millions of children where they’re born, live and learn.”
“We must take immediate action to make handwashing with soap accessible to everyone, everywhere – now and in the future,” she urged.
The situation is also alarming at schools: 43 per cent globally (70 per cent in least developed countries) lack a handwashing facility with water and soap, affecting hundreds of millions of school-age children, according to the estimates.
‘Hand Hygiene for All’
Against this backdrop, UNICEF, along with the UN World Health Organization launched the “Hand Hygiene for All” initiative to support the development of national roadmaps to accelerate and sustain progress towards making hand hygiene a mainstay in public health interventions.
This means rapidly improving access to handwashing facilities, water, soap and hand sanitizer in all settings, as well as promoting behavioural change interventions for optimal hand hygiene practices, said UNICEF.
The initiative brings together international, national, and local partners, to ensure affordable products and services are available and sustainable, especially in vulnerable and disadvantaged communities.
The estimates were released on Thursday, coinciding with Global Handwashing Day, which serves as a platform to raise awareness on the importance of handwashing with soap.
COVID-19: ‘Little or no’ benefit from trials of anti-virals
Latest results from a UN-coordinated international trial on four COVID-19 therapeutic drugs, indicate that they have “little or no” positive impact on preventing deaths in patients infected with the new coronavirus.
The Solidarity Therapeutics Trial, overseen by the World Health Organization (WHO), shows that medications Remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon, repurposed to treat new coronavirus infections, “appeared to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients”, WHO said in a statement on Friday.
The study, which began in March and spans more than 30 countries, looked at the effects of these treatments on overall mortality, initiation of ventilation, and duration of hospital stay in hospitalized individuals.
Other uses of the drugs, for example in treatment of patients in the community or for prevention, would have to be examined using different trials, the WHO explained.
Associated blood pressure risks
In a related announcement, the UN health agency said that COVID-19 had also highlighted the increased vulnerability of people with high blood pressure to the coronavirus.
The warning is based on data from more than 120 countries showing significant COVID-related disruption to treatment for people suffering from chronic health conditions, with findings showing these patients make up 50 to 60 per cent of all deaths from COVID.
Dr. Bente Mikkelsen, Director of WHO’s Department of Noncommunicable Diseases, said that more than 1.13 billion people around the world suffer from hypertension.
Of this number, 745,800,000 live in low and middle-income countries and 80 per cent of these nations have fewer than 50 per cent of people on treatment.
Many unaware they are sick
On average, one in four men suffer from the condition, compared with one in five women, according to WHO data. In addition, two in five people are not aware that they even have hypertension.
“When it comes to COVID-19 and hypertension, the 122 countries that have reported tells us that in over 50 per cent of the countries their health care services is disrupted fully or partially…In addition, we see a high number of fatalities”, Dr. Mikkelsen told journalists in Geneva.
Noting that global figures have yet to be calculated, she added that for those countries where data was available, “we see in the range of 50, 60 per cent of the people that are severely ill and die in hospitals from COVID have hypertension, diabetes”, and other non-communicable diseases.
Highlighting how the pandemic has made a resurgence in many countries across all continents after the easing of restrictions, and the additional health threat posed by the impending influenza season in the global north, the WHO official appealed to governments everywhere to address hypertension urgently.
She also cited growing evidence that poor and salty diets along with rising inactivity, have contributed to worsening hypertension rates globally.
To coincide with World Hypertension Day on 16 October, Dr Mikkelsen unveiled a series of recommendations and products developed by the WHO to promote action on hypertension “during and beyond the pandemic”.
By doing so, health authorities can help people to keep their blood pressure under control and prevent stroke, heart attack, and kidney damage, the WHO believes.
The new protocols are based on successful patient blood pressure management in 18 countries involving more three million people.
Today, only 20 per cent of the world’s nations are on track to reduce hypertension by 25 per cent by 2025, a global target set by the World Health Assembly in 2013, according to the UN health agency.
China joins global effort to ensure COVID vaccine access for all
China is among three additional countries to have signed on to a global initiative that aims to ensure fair and equitable access to a COVID-19 vaccine once developed, the World Health Organization (WHO) reported on Friday.
The country, together with the Republic of Korea and the tiny Pacific island of Nauru, joined the COVAX Facility this week, bringing the total number of participating nations and economies to 171, WHO chief Tedros Adhanom Ghebreyesus announced during his regular media briefing on the pandemic.
“Once we have an effective vaccine, we must also use it effectively, and the best way to do that is by making sure it’s available to all countries equitably through the COVAX Facility.”
More countries, greater prospects
The global mechanism will work to deliver two billion doses by the end of next year. It currently has the largest portfolio of potential vaccines, with several in advanced human trials.
WHO was asked about the impact of China’s participation.
“The more countries that participate in the COVAX Facility, the greater opportunity of being able to roll out vaccines as rapidly as possible, as fairly as possible, to reduce the risk of severe COVID disease globally”, said Dr. Bruce Aylward, Senior Advisor.
He added that details on China’s enrollment “(are) still being worked out”, with specific information anticipated early next week.
Notably, both the United States and Russia have not so far signed on.
A sign of solidarity
WHO has also welcomed the announcement this week that vaccine developer Moderna will not enforce patent rights over its COVID-19 shots during the pandemic.
Tedros expressed appreciation for “this act of solidarity”, which aligns with another initiative for sharing scientific knowledge, data and intellectual property in efforts to beat back the disease.
The COVID-19 Technology Access Pool (C-TAP) was launched in May and is described as a “one-stop shop” for affordable access to technology.
It draws on existing mechanisms such as the UN-backed Medicines Patent Pool, which expands access to treatments for HIV and hepatitis for low and middle income countries.
Praise for the World Food Programme
Tedros began the briefing by congratulating sister UN agency the World Food Programme (WFP), which was awarded the Nobel Peace Prize earlier on Friday.
His praise was echoed by Dr. Michael Ryan, Executive Director of WHO’s Health Emergencies Programme, who has worked in conflict areas and led many responses to epidemics, including containing Ebola in the Democratic Republic of the Congo.
“WFP not only feeds the hungry but moves most of the humanitarian workforce into the most extreme of environments,” Dr. Ryan told journalists.
“WFP feeds and protects us in the field and allows us to do our job. We used to say this in West Africa, and I will say it to the world: WFP rocks”.
COVID-19 rise in Europe a great concern: WHO
COVID-19 is now the fifth leading cause of death in Europe, where nearly 700,000 cases were reported this week: the highest weekly incidence since the pandemic began in March, the regional head of the UN World Health Organization (WHO) told journalists on Thursday.
Dr. Hans Henri P. Kluge said the tightening up of restrictions by governments is “absolutely necessary” as the disease continues to surge, with “exponential increases” in cases and deaths.
“The evolving epidemiological situation in Europe raises great concern: daily numbers of cases are up, hospital admissions are up, COVID-19 is now the fifth leading cause of death and the bar of 1,000 deaths per day has now been reached,” he reported.
Cases reach record highs
Dr. Kluge said overall, Europe has recorded more than seven million cases of COVID-19, with the jump from six million taking just 10 days.
This past weekend, daily case totals surpassed 120,000 for the first time, and on both Saturday and Sunday, reaching new records.
However, he stressed that the region has not returned to the early days of the pandemic.
“Although we record two to three times more cases per day compared to the April peak, we still observe five times fewer deaths. The doubling time in hospital admissions is still two to three times longer,” he said, adding “in the meantime, the virus has not changed; it has not become more nor less dangerous.”
Potential worsening a reality
Dr. Kluge explained that one reason for the higher case rates is increased COVID-19 testing, including among younger people. This population also partly accounts for the decreased mortality rates.
“These figures say that the epidemiological curve rebound is so far higher, but the slope is lower and less fatal for now. But it has the realistic potential to worsen drastically if the disease spreads back into older age cohorts after more indoor social contacts across generations,” he warned.
Looking ahead, Dr. Kluge admitted that projections are “not optimistic”.
Reliable epidemiological models indicate that prolonged relaxing of policies could result in mortality levels four to five times higher than in April, with results visible by January 2021.
He stressed the importance of maintaining simple measures already in place, as the modelling shows how wearing masks, coupled with strict control of social gathering, may save up to 281,000 lives across the region by February.
This assumes a 95 per cent rate for mask use, up from the current rate, which is less than 60 per cent.
Restrictions ‘absolutely necessary’
“Under proportionately more stringent scenarios, the model is reliably much more optimistic, still with slightly higher levels of morbidity and mortality than in the first wave, but with a lower slope – as if we should rather expect a higher and longer swell instead of a sharp peak, giving us more reaction time,” said Dr. Kluge.
“These projections do nothing but confirm what we always said: the pandemic won’t reverse its course on its own, but we will.”
The WHO bureau chief underlined the importance of targeted national responses to contain COVID-19 spread.
“Measures are tightening up in many countries in Europe, and this is good because they are absolutely necessary,” he said. “They are appropriate and necessary responses to what the data is telling us: transmission and sources of contamination occur in homes and indoor public places, and within communities poorly complying with self-protection measures.”
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