In 2020, momentous progress was made in improving access to health products. In April 2020, nine leading global health organizations, including WHO, launched an unparalleled effort to accelerate the development and allocation of vaccines, therapeutics and diagnostics: the Access to COVID-19 Tools (ACT) Accelerator. This global collaborative framework – which brings together governments, scientists and civil society – is working to end the acute phase of the pandemic by deploying tests, treatments and vaccines.
One pillar of the ACT Accelerator is COVAX, an initiative to accelerate the development and manufacture of COVID-19 vaccines and to ensure equitable access. The COVAX Facility, which is part of this endeavour, is set to be the largest vaccine procurement and supply operation ever: it will have delivered about two billion doses to participating countries and economies by the end of 2021. The first doses were shipped by COVAX in February 2021, about one year after WHO declared COVID-19 a pandemic.
ACT Accelerator partners are working to make 120 million high-quality COVID-19 rapid tests available and are analysing over 1700 clinical trials to identify promising treatments. ACT Accelerator supported identification of
the dexamethasone as the first life-saving therapy. About 2.9 million treatment courses have been secured for patients in low- and middle-income countries. In addition, 262 million items of personal protective equipment have been shipped to 152
countries in all six WHO regions.
Massive challenges remain, however, to achieving the objectives of this initiative. There is a financing gap of US$ 22.1 billion for 2021 alone. Furthermore, there is a huge, growing divide between high- and low-income countries in vaccine delivery: in early February, 75% of all administered doses had been given in only 10 countries, while 130 countries had yet to give a single dose. Licensing deals and lack of technology transfers continue to limit the global response to the pandemic.
Despite the challenges faced in 2020 as a result of the COVID-19 pandemic, WHO has achieved many milestones in improving access to quality-assured health products globally. These include the new pricing policy guidelines, which provide countries with guidance on increasing the affordability of medicines. A digital version was launched of the WHO Model list of Essential Medicines, a key reference tool since 1978, which guides Member States' selection, use and procurement policies for medicines. WHO is supporting countries in adopting the AWaRe (Access, Watch, Reserve) classification of antibiotics, which guides appropriate policies for use of antibiotics and stewardship programmes to ensure optimal use of these life-saving medicines. In 2020, WHO also updated the Essential Diagnostics List, an evidence-based guide for countries in the use of accurate, high-quality diagnostics in strategies for treatment, control and, in many cases, prevention of disease and outbreaks. An important contribution to control of the global pandemic was assessment of the quality, safety and efficacy of COVID-19-related products for release under the emergency use listing and prequalification procedures. Pharmacovigilance systems in countries were strengthened as well as alert systems for substandard and falsified medical products.
To address antimicrobial resistance (AMR), which further threatens access to essential medicines, WHO supported creation of the AMR Action Fund, which was launched in July 2020 to invest in innovative treatments. Furthermore, WHO published its first overview of the preclinical antibacterial pipeline as well as target product profiles for necessary new antibiotics. A new indicator for achievement of the Sustainable Development Goals was approved, which will encourage AMR surveillance in countries and strengthen infection prevention in health-care facilities. The 2020 report of the Global Antimicrobial Resistance and Use Surveillance System included data from 66 countries, three times more than two years previously, while the number of surveillance sites increased from 729 to 64 000. By the end of 2020, 143 countries had established AMR national action plans and 136 countries had completed and submitted the Tripartite AMR country self-assessment survey. The data are published on a public website and in the annual report.
To find progress on health outcome indicators, visit the World health statistics
The elimination target was set by the WHO global malaria strategy. A country that was malaria-endemic in 2015 had to achieve at least one year of zero indigenous cases and then maintain that status through the end of 2020. Countries that reach at least 3 years of zero indigenous cases are eligible to apply for an official WHO certification of malaria elimination.
Strong public health system infrastructure with skilled, motivated personnel, signed Tashkent declaration with 8 neighbouring countries to scale up response and interrupt transmission completely
Strong public health system infrastructure with skilled, motivated personnel, signed Tashkent declaration with 8 neighbouring countries to scale up response and interrupt transmission completely
Reoriented surveillance according to risk stratification to focus on areas where people are more likely to be affected and maintains surveillance in ports and airports
Reoriented surveillance according to risk stratification to focus on areas where people are more likely to be affected and maintains surveillance in ports and airports
All patients are treated by the public sector with at least 3 days of hospitalization, which helps to improve rates of adherence to medication
All patients are treated by the public sector with at least 3 days of hospitalization, which helps to improve rates of adherence to medication
Inter-ministerial effort in health, education, finance, research and science, development, public security, the army, police, commerce, industry, information technology, the media and tourism
Inter-ministerial effort in health, education, finance, research and science, development, public security, the army, police, commerce, industry, information technology, the media and tourism
Maintains a network of > 3000 community health workers to identify imported cases early before they transmit infections onwards
Maintains a network of > 3000 community health workers to identify imported cases early before they transmit infections onwards
Diagnosis, treatment and prevention provided free of charge, including for migrant workers from neighbouring countries, and volunteers trained in use of rapid diagnostic tests and compliance with treatment regimens
Diagnosis, treatment and prevention provided free of charge, including for migrant workers from neighbouring countries, and volunteers trained in use of rapid diagnostic tests and compliance with treatment regimens
Extensive surveillance system in villages and stratification based on risk of mosquito bites and likelihood of importation particularly on plantations where labourers who often travel receive treatment free-of-charge
Extensive surveillance system in villages and stratification based on risk of mosquito bites and likelihood of importation particularly on plantations where labourers who often travel receive treatment free-of-charge
Effective surveillance combined with mobile clinics enabled prompt, effective treatment in areas of high transmission in the middle of a civil war
Effective surveillance combined with mobile clinics enabled prompt, effective treatment in areas of high transmission in the middle of a civil war
Districts still have reserve stocks of anti-malarial drugs, insecticides and bednets, and health education continues for population in higher-risk areas
Districts still have reserve stocks of anti-malarial drugs, insecticides and bednets, and health education continues for population in higher-risk areas
Launched a Universal Coverage UHC scheme in 2012, which resulted in 98% of the population with coverage, at a cost to the Government of US$ 80 per beneficiary
Because we are poor, we cannot afford not to have universal health coverage.
Thai Minister of Public Health on Universal Health Coverage Day, 2016
Launched a Universal Coverage UHC scheme in 2012, which resulted in 98% of the population with coverage, at a cost to the Government of US$ 80 per beneficiary
Because we are poor, we cannot afford not to have universal health coverage.
Thai Minister of Public Health on Universal Health Coverage Day, 2016
Large, predominantly government participation in health care and services in public facilities provided free at point of delivery and little private expenditure; however, financial hardship due to large household expenditure on health has slightly increased.
Coverage of essential services | < 10% household expenditure on health |
---|---|
Improved from 24/100 (2000) to 52/100 (2017) | Worsened from 2.6% (2001) to 2.9% (2014) |
Coverage of essential services should be improved; e.g. only 57% of births are attended by skilled personnel and only 73.5% of children are fully vaccinated by 12 months of age.
Large, predominantly government participation in health care and services in public facilities provided free at point of delivery and little private expenditure; however, financial hardship due to large household expenditure on health has slightly increased.
Coverage of essential services | < 10% household expenditure on health |
---|---|
Improved from 24/100 (2000) to 52/100 (2017) | Worsened from 2.6% (2001) to 2.9% (2014) |
Coverage of essential services should be improved; e.g. only 57% of births are attended by skilled personnel and only 73.5% of children are fully vaccinated by 12 months of age.
Tripled public spending on health in a decade, increasing public expenditure on primary health care to 37%, as compared with a regional average of < 15%
Coverage of essential services | > 10% household expenditure on health |
---|---|
Improved from 41/100 (2000) to 68/100 (2017) | Improved from 11.06% (2000) to 6.02% (2016) |
1 in 3 Latin American countries close to reaching the goal of allocating 6% of GDP towards public health.
Tripled public spending on health in a decade, increasing public expenditure on primary health care to 37%, as compared with a regional average of < 15%
Coverage of essential services | > 10% household expenditure on health |
---|---|
Improved from 41/100 (2000) to 68/100 (2017) | Improved from 11.06% (2000) to 6.02% (2016) |
1 in 3 Latin American countries close to reaching the goal of allocating 6% of GDP towards public health.
catastrophic health spending
and recommends
90% of essential medicines | |||
on the WHO model list of essential medicines can be subjected to competition only 5-10% are patented agents |
90% of essential medicines | |||
on the WHO model list of essential medicines can be subjected to competition only 5-10% are patented agents |
20 m people | US$ 1.96 b saved | |
worldwide have access to antiretroviral treatment | in international procurement of HIV and hepatitis C medicines and supplied 50 m patient-years of treatment over last 8 years |
20 m people | US$ 1.96 b saved | |
worldwide have access to antiretroviral treatment | in international procurement of HIV and hepatitis C medicines and supplied 50 m patient-years of treatment over last 8 years |
Most countries selecting WHO-recommended medicines for primary care and infectious diseases
More should select WHO-recommended specialty medicines, e.g. for cancer
Most countries selecting WHO-recommended medicines for primary care and infectious diseases
More should select WHO-recommended specialty medicines, e.g. for cancer
of consumption of antibiotics worldwide from “Access” group of the AWaRe classification
of consumption of antibiotics worldwide from “Access” group of the AWaRe classification
antiretroviral medicines available only sporadically |
As an example, climate-resilient water safety improved for:
- 2.5 million people in Ethiopia using 50 water supply systems, 2020
-280 000 people in Nepal, 2020
-605 000 people in Bangladesh, 2020
-240 000 in urban areas of the United Republic of Tanzania, and 6200 people in rural areas, 2017
Simple, low-cost interventions, such as building retaining walls or ditches, prevent contamination of drinking-water during flooding; and planting indigenous trees protects the water table in Ethiopia, 2018.
As an example, climate-resilient water safety improved for:
- 2.5 million people in Ethiopia using 50 water supply systems, 2020
-280 000 people in Nepal, 2020
-605 000 people in Bangladesh, 2020
-240 000 in urban areas of the United Republic of Tanzania, and 6200 people in rural areas, 2017
Simple, low-cost interventions, such as building retaining walls or ditches, prevent contamination of drinking-water during flooding; and planting indigenous trees protects the water table in Ethiopia, 2018.
For example, the assessment in:
- Lao People’s Democratic Republic studied the links between climate change and water-related and vector-borne diseases; water, sanitation and hygiene; mental health; malnutrition; injury and disability; and sudden increases in health service use.
- Madagascar highlighted the health impacts of flooding, cyclones, drought, heatwaves and cold spells, 2015
Health national adaptation plans are informed by the assessments and include:
- Timor-Leste plan for health sector adaptation to climate change finalized in wide consultation with partners, 2019
- health national adaptation developed and endorsed in Nepal, 2018
- climate change action plan for public health officially endorsed by the Ministry of Health in Cambodia, 2020
For example, the assessment in:
- Lao People’s Democratic Republic studied the links between climate change and water-related and vector-borne diseases; water, sanitation and hygiene; mental health; malnutrition; injury and disability; and sudden increases in health service use.
- Madagascar highlighted the health impacts of flooding, cyclones, drought, heatwaves and cold spells, 2015
Health national adaptation plans are informed by the assessments and include:
- Timor-Leste plan for health sector adaptation to climate change finalized in wide consultation with partners, 2019
- health national adaptation developed and endorsed in Nepal, 2018
- climate change action plan for public health officially endorsed by the Ministry of Health in Cambodia, 2020
Climate and weather information integrated into health surveillance and early warning systems to predict outbreaks, such as:
- cholera in Bangladesh and Malawi, 2020
- malaria in Mozambique, 2020
- dengue fever in Myanmar and Timor-Leste, 2020
Climate and weather information integrated into health surveillance and early warning systems to predict outbreaks, such as:
- cholera in Bangladesh and Malawi, 2020
- malaria in Mozambique, 2020
- dengue fever in Myanmar and Timor-Leste, 2020
Action towards climate-resilient and environmentally sustainable health care facilities, for example:
- in 62 health care facilities in Lao People’s Democratic Republic, 2020
- assessments conducted in 25 health centres in Cambodia with focus on climate-resilient WASH, 2020
Action towards climate-resilient and environmentally sustainable health care facilities, for example:
- in 62 health care facilities in Lao People’s Democratic Republic, 2020
- assessments conducted in 25 health centres in Cambodia with focus on climate-resilient WASH, 2020
Action to build climate-resilient health systems in small island developing states, includes:
18 country profiles on health and climate change completed to inform evidence-based decision-making when strengthen the resilience of health systems, 2021
US$ 33-65 m funding mobilized to small island developing states to strengthen the resilience of health systems, health-care facilities, schools and communities to climate change
Action to build climate-resilient health systems in small island developing states, includes:
18 country profiles on health and climate change completed to inform evidence-based decision-making when strengthen the resilience of health systems, 2021
US$ 33-65 m funding mobilized to small island developing states to strengthen the resilience of health systems, health-care facilities, schools and communities to climate change
Best-practice policy takes effect (2009)
Best-practice policy takes effect (2009)
Best-practice policy takes effect (2018)
Best-practice policy takes effect (2018)
First country to legislate a limit on trans fat content in all food products, 2g/100g of total fat; best-practice policy to take effect 1 year later (2003)
First country to legislate a limit on trans fat content in all food products, 2g/100g of total fat; best-practice policy to take effect 1 year later (2003)
Best-practice policy takes effect (2014)
Best-practice policy takes effect (2014)
Best-practice policy takes effect (2011)
Best-practice policy takes effect (2011)
Best-practice policy takes effect (2014)
Best-practice policy takes effect (2014)
Bogotá will become “the Caring City” by promoting an inclusive, sustainable, conscious city for population well-being through a participatory approach. The approach to primary health care will be strengthened by intersectoral mechanisms and strategies, and fostering collaboration among academia, civil society, city sectors such as health, social innovation, planning and development.
Bogotá will become “the Caring City” by promoting an inclusive, sustainable, conscious city for population well-being through a participatory approach. The approach to primary health care will be strengthened by intersectoral mechanisms and strategies, and fostering collaboration among academia, civil society, city sectors such as health, social innovation, planning and development.
Communities and civil society participation at the centre of health promotion | Urbanizationas a key influence on health |
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