WHO news

The emergency polio outbreak response in the Gaza Strip is continuing, with a mass vaccination campaign scheduled from 22 to 26 February 2025. The novel oral polio vaccine type 2 (nOPV2) will be administered to over 591 000 children under 10 years of age to protect them from polio. This campaign follows the recent detection of poliovirus in wastewater samples in Gaza, signaling ongoing circulation in the environment, putting children at risk.  

Pockets of individuals with low or no immunity provide the virus an opportunity to continue spreading and potentially cause disease. The current environment in Gaza, including overcrowding in shelters and severely damaged water, sanitation, and hygiene infrastructure, which facilitates fecal-oral transmission, create ideal conditions for further spread of poliovirus. Extensive population movement consequent to the current ceasefire is likely to exacerbate the spread of poliovirus infection. 

Two previous vaccination rounds in the Gaza Strip were successfully conducted in September and October 2024, reaching over 95% of the target. As poliovirus is found to remain in the environment, additional vaccination efforts are needed to reach every child and strengthen population immunity. The presence of the virus still poses a risk to children with low or no immunity, in Gaza and throughout the region.   

In 2024, health workers faced significant challenges accessing certain areas of central, north and south Gaza, which required special coordination to enter during the conflict. In inaccessible areas such as Jabalia, Beit Lahiya, and Beit Hanoun, where humanitarian pauses for the vaccination campaign were not assured, approximately 7 000 children missed vaccination during the second round. The recent ceasefire means health workers have considerably better access now.   

No additional polio cases have been reported since a ten-month-old child was paralyzed in August 2024, but the new environmental samples from Deir al Balah and Khan Younis, collected in December 2024 and January 2025, confirm poliovirus transmission. The strain detected is genetically linked to the poliovirus detected in the Gaza Strip in July 2024. 

The upcoming vaccination campaign aims to reach all children under 10 years of age, including those previously missed, to close immunity gaps and end the outbreak. The use of the oral polio vaccine will help end this outbreak by preventing the spread of the virus. An additional polio vaccination round is planned to be implemented in April.

The campaign will be led by the Palestinian Ministry of Health and implemented with support from the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and other partners. 

Polio vaccines are safe and there is no maximum number of times a child should be vaccinated. Each dose gives additional protection which is needed during an active polio outbreak.   

WHO, UNICEF, and partners welcome the recent ceasefire and urge for a lasting ceasefire that leads to long-term peace.  

The recent surge in violence in the eastern Democratic Republic of the Congo has led to significant loss of life, trauma, displacement, and the destruction of critical health infrastructure, exacerbating an already dire situation for millions of people.

The situation remains tense and volatile, and the health needs are immense. WHO remains on the ground, and has continued to respond to the health needs by providing lifesaving medical supplies, supporting health workers, and coordinating the emergency response.

Hospitals and morgues are overwhelmed. Since 26 January, 3082 injured and 843 dead have been reported from 31 health facilities in and around Goma, North Kivu.

With the alarming expansion of violence further south, 65 injuries were reported from 3 hospitals in South Kivu.

These numbers are expected to rise further as more injured people are able to reach health facilities and more dead bodies are gathered off the streets. Wound infections are a risk for those who have not been able to reach health care facilities quickly, and as health facilities are running out of supplies they need to clean and disinfect.

The sight of bodies lying uncared for is distressing. Though the bodies of people who have died from injury do not generally carry or spread disease, it is the right of the dead to be identified and receive proper burial, and important for the living to know their loved ones have received this care.  

Over 70 (or 6%) of the health facilities in North Kivu have been affected, with some completely destroyed and others struggling to restart operations. Some ambulances have also been damaged. A WHO-supported health clinic in North Kivu was temporarily occupied by armed groups. Health workers have had to flee in places, while in others, they have been working round the clock for days, with limited resources and overwhelming demand, and sometimes at risk to their own lives.

Cancer, diabetes, hypertension, mental health and other routine services are also affected as medicines have run out and health workers are either absent or overburdened.

The risk of death during pregnancy and childbirth has increased from already high levels. Given the insecurity, pregnant women cannot reach health facilities for safe delivery. Experience with conflict in the region has shown the drastic effect it has, with the rate of births attended to by skilled health workers dropping to near zero during periods of intense violence.

The threat of infectious diseases has multiplied. Cholera, malaria, measles, meningitis, mpox and tuberculosis are among the infectious threats in the area. The water supply in Goma was disrupted and has only partially resumed, leading people to use water from the lake, and heightening the risk of cholera spread. Close to 600 suspected cases of cholera and 14 deaths were reported from North Kivu between 1 and 27 January.

Eastern Democratic Republic of the Congo, especially South Kivu province, is the epicentre of the mpox outbreak that prompted the WHO Director-General to declare a public health emergency of international concern last August. The mpox response is heavily impacted. Ninety percent of the mpox patients (128 of 143) in isolation units in Goma had fled for safety, making it nearly impossible to provide them with care, and increasing the risk of spread.

One in four people in the region was already facing emergency levels of hunger, with the recent violence expected to worsen the situation. Malnutrition and disease go hand-in-hand: malnourished people are less able to fight disease, while disease leads to further malnutrition. This vicious circle is especially concerning when it comes to children, and pregnant and breastfeeding women.

Goma was home to over 2 million people, including 700 000 people displaced by this crisis. These people have had to flee yet again, in search of safety. They are in temporary settlements, with their health and safety at risk.

A rapid assessment of 10 healthcare facilities in and around Goma showed a concerning rise in rape and other gender-based violence: there were 45 cases reported among the displaced, and 21 survivors of gang-rape admitted to two hospitals. These numbers are only the tip of the iceberg. These patients require medical care, psychological support, and support with maintaining their livelihood, especially when they are the sole providers for their families.

WHO has deployed emergency medical supplies, hygiene and water treatment supplies, and tents to increase hospital capacity by 1000 beds. Supplies are being depleted rapidly, and more resources are urgently needed.

WHO is preparing further deliveries as part a European Civil Protection and Humanitarian Aid Operations (ECHO)-led effort to fly in critical supplies. For this, the Goma airport, a critical lifeline, must be urgently reopened. WHO is also exploring options to deliver critical supplies through other routes.

WHO and partners were able to resume mpox vaccination in Goma on Wednesday, 5 February after a 10 day pause.

The United States’ recent decision to freeze foreign aid is significantly impacting relief efforts in the Democratic Republic of the Congo. Last year, the US contributed to as much as 70% of the country’s humanitarian response. Additionally, the US is a major funder of the mpox response, and has pledged a million vaccine doses of its own stock to global efforts. While WHO’s humanitarian response in the region relies on funding from other donors—including the European Union, United Kingdom and the WHO’s Contingency Fund for Emergencies—reductions in overall aid will have repercussions on people’s health.

To meet immediate health needs in eastern Democratic Republic of the Congo, including for safe and dignified burials, WHO has spent US$ 600 000. The overall response requires US$ 50 million.

WHO calls for humanitarian access, the protection of health workers and facilities, and an end to attacks on health care. Health facilities, supplies, workers and patients should be protected. Ultimately, we call for peace, and an end to the unimaginable and long suffering of the people in this region.

Female genital mutilation is a violation of human rights that inflicts deep and lifelong physical, emotional and psychological scars on girls and women. This harmful practice affects more than 230 million girls and women today. An estimated 27 million more girls could endure this violation of their rights and dignity by 2030 if we do not take action now.

Today, on the International Day of Zero Tolerance for Female Genital Mutilation, and in response to the theme "Stepping up the pace: Strengthening alliances and building movements to end female genital mutilation", UNFPA, UNICEF and WHO reaffirm our commitment to work together with countries and communities to end this harmful practice – once and for all.

There is hope. Many countries have seen a decline in the prevalence of female genital mutilation. We are witnessing progress in countries like Kenya and Uganda, where collaborative action and community-led initiatives are proving that by strengthening alliances and building movements, we can accelerate change.

Since the launch of the UNFPA-UNICEF Joint Programme on the Elimination of Female Genital Mutilation in 2008, and in collaboration with WHO, close to 7 million girls and women access prevention and protection services. Additionally, 48 million people have made public declarations to abandon the practice, and 220 million individuals were reached by mass media messaging on the issue. In the last two years, close to 12 000 grassroots organizations and 112 000 community and frontline workers galvanized to effect change at this critical juncture.

Yet the fragility of progress made has also become starkly evident. In the Gambia, for example, attempts to repeal the ban on female genital mutilation persist, even after an initial proposal to do so was rejected by its parliament last year. Such efforts could gravely undermine the rights, health and dignity of future generations of girls and women, jeopardizing the tireless work over decades to change attitudes and mobilize communities.

Of the 31 countries in which data on prevalence are collected nationally, only seven countries are on track to meet the Sustainable Development Goal of ending female genital mutilation by or before 2030. The current rate of progress must accelerate urgently to meet this target.

This requires strengthened alliances among leaders, grassroots organizations and across sectors spanning health, education and social protection – as well as sustained advocacy and expanded social movements with girls and survivors at the centre.

It demands greater accountability at all levels to ensure commitments to human rights are upheld and policies and strategies are implemented to protect girls at risk and provide care, including justice, for survivors. It also requires increased investment in scaling up proven interventions. We are indebted to generous donors and partners who are supporting this life-changing work and call on others to join them.

We all have a role to play to ensure that every girl is protected and can live free from harm. Let’s step up the pace and act with urgency. The time to end female genital mutilation is now.

Notes to Editors

About the UNFPA–UNICEF Joint Programme
The UNFPA–UNICEF Joint Programme on the Elimination of Female Genital Mutilation: Delivering the Global Promise works to eliminate female genital mutilation through interventions in 17 countries where the practice is prevalent. The programme creates opportunities for girls and women to realize their rights in health, education, income and equality to help end the power imbalances that underpin this harmful practice.

For further information, please contact:
Eddie Wright, UNFPA New York, Tel: +1 917 831 2974 ewright@unfpa.org
Sara Alhattab | UNICEF New York | +1 917-957-6536 | salhattab@unicef.org
Laura Keenan | WHO, Geneva | keenanl@who.int and mediainquiries@who.int

About UNFPA
UNFPA is the United Nations sexual and reproductive health agency. UNFPA's mission is to deliver a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled. UNFPA calls for the realization of reproductive rights for all and supports access to a wide range of sexual and reproductive health services, including voluntary family planning, quality maternal health care and comprehensive sexuality education.

For more information about UNFPA and its work visit: www.unfpa.org
Follow UNFPA on X (Twitter), Facebook, Instagram and YouTube

About UNICEF
UNICEF, the United Nations agency for children, works to protect the rights of every child, everywhere, especially the most disadvantaged children and in the toughest places to reach. Across more than 190 countries and territories, we do whatever it takes to help children survive, thrive, and fulfil their potential.

For more information about UNICEF and its work visit:
Follow UNICEF on X (Twitter), Facebook, Instagram and YouTube

About WHO

Dedicated to the well-being of all people and guided by science, the World Health Organization leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life. We are the UN agency for health that connects nations, partners and people on the front lines in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to promote health, keep the world safe and serve the vulnerable.

For more information about WHO and its work visit: www.who.int  

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In a global first, Uganda’s Ministry of Health, the World Health Organization (WHO) and other partners today launched a first-ever clinical efficacy trial for a vaccine from Ebola from the Sudan species of the virus, and at an unprecedented speed for a randomized vaccine trial, in an emergency. This is the first trial to assess the clinical efficacy of a vaccine against Ebola Sudan virus disease. IAVI, the provider of the vaccine, conducted trials for safety and immunogenicity. It is also the first clinical trial of the vaccine during an outbreak.

The principal investigators from Makerere University and the Uganda Virus Research Institute (UVRI), with support from WHO and other partners, have worked tirelessly to get the trial ready in 4 days since the outbreak was confirmed on 30 January. It is the first trial to assess the clinical efficacy of a vaccine against Ebola disease due to Sudan virus. The speed was achieved through advanced research preparedness, while ensuring full compliance with national and international regulatory and ethical requirements.

The candidate vaccine was donated by IAVI, with financial support from WHO, the Coalition for Epidemic Preparedness Innovations (CEPI), Canada’s International Development Research Centre (IDRC), and the European Commission's Health Emergency Preparedness and Response Authority (HERA) and support from the Africa Centres for Disease Control and Prevention (Africa CDC).

“This is a critical achievement towards better pandemic preparedness, and saving lives when outbreaks occur,” said Dr Tedros Adhanom Ghebreyesus, WHO’s Director-General.  “This is possible because of the dedication of Uganda’s health workers, the involvement of communities, the Ministry of Health of Uganda, Makerere University and UVRI, and research efforts led by WHO involving hundreds of scientists through our research and development Filoviruses network. We thank our partners for their dedication and cooperation, from IAVI for donating the vaccine, to CEPI, EU HERA and Canada’s IDRC for funding, and Africa CDC for further support. This massive achievement would simply not be possible without them.”

In 2022, during the previous outbreak of Ebola disease (also from the Sudan species of the virus) in Uganda, a randomized protocol for candidate vaccines was developed. Principal investigators were designated under the leadership of the Minister of Health, and teams were trained to allow such a trial to take place during an active outbreak.

The randomized vaccine trial to assess the recombinant vesicular stomatitis virus (rVSV) candidate vaccine was launched at a ceremony in Kampala today by the Minister of Health of Uganda. WHO is co-sponsoring the trial. WHO was represented by Dr Mike Ryan, Executive Director of WHO’s Health Emergencies Programme and Deputy Director-General, and the WHO representative to Uganda Dr Kasonde Mwinga, along with other colleagues.

Three vaccination rings were defined today. The first ring involves about 40 contacts and contacts of contacts of the first reported and confirmed case, a health worker who has died.

Although several promising candidate medical countermeasures are progressing through clinical development, as of now, there is no licensed vaccine available to effectively combat a potential future outbreak of Ebola disease from the Sudan species of the virus. Licensed vaccines exist only for the disease caused by Ebola virus, formerly known as Zaïre ebolavirus. Likewise for treatments, approved treatments are only available for Ebola virus.

The vaccine for the trial was recommended by the independent WHO candidate vaccine prioritization working group. If the candidate vaccine is effective, it can contribute to controlling this outbreak and generate data for vaccine licensure.

In 2022, the research teams were trained in good clinical practice (GCP) and standard operating procedures for such trials. They completed refresher training in recent days. WHO colleagues experienced in trials and in ring vaccination arrived in Uganda over the weekend to support the trial implementation and GCP compliance.

The vaccine doses were pre-positioned in the country. WHO worked with the principal investigators and national authorities and the vaccine developer to review cold chain documentation and ensure the doses were stored correctly over the previous years. As part of the signed agreement with the Ministry of Health, WHO has a signed agreement with IAVI for additional doses of the candidate vaccine to be made available shortly.

Notes to editors

The trial is a ring vaccination cluster randomized trial designed to assess the effect of one single, promptly given, dose of the candidate vaccine whose safety and immunogenicity have already been demonstrated in Phase 1, in protecting recent contacts and contacts of contacts of a newly confirmed case of Sudan virus disease (SVD).

Ring vaccination consists of the targeted vaccination of the recent contacts of an index case. It might protect the individual vaccinated or help create a small buffer zone of immunized people that could limit propagation of the infection.

The ring vaccination trial involves a population at increased risk of infection as they have recently been in contact with a case of SVD, so it may well provide useful information about the protection of such case-contacts quickly, within just a few months.

The same study design was used in the Ebola ça suffit trial in Guinea in 2015 by WHO and the Ministry of Health of Guinea to evaluate a now-licensed vaccine against a different species of ebolavirus.

On 4 February 2025, a correction was made to the opening sentence of this news release as noted below. 

The sentence in the original news release read: 

In a global first, Uganda’s Ministry of Health, the World Health Organization (WHO) and other partners today launched a first ever vaccine trial for Ebola from the Sudan species of the virus, and at an unprecedented speed for a randomized vaccine trial in an emergency.

This was changed to:

In a global first, Uganda’s Ministry of Health, the World Health Organization (WHO) and other partners today launched a first-ever clinical efficacy trial for a vaccine from Ebola from the Sudan species of the virus, and at an unprecedented speed for a randomized vaccine trial, in an emergency. This is the first trial to assess the clinical efficacy of a vaccine against Ebola Sudan virus disease. IAVI, the provider of the vaccine, conducted trials for safety and immunogenicity. It is also the first clinical trial of the vaccine during an outbreak.

WHO and partners have immediately boosted their support to the Ugandan government’s response to an outbreak of Sudan virus disease outbreak (SVD, part of the Ebola family), including by facilitating access to a candidate vaccine and candidate treatments. The first 2160 doses of the vaccine candidate and the treatments are already in Kampala, Uganda, as they were prepositioned as part of outbreak preparedness.  

The vaccine trial processes underway include orientation of the research teams on the trial procedures, and logistics arrangements. Research teams have been deployed to the field to work along with the surveillance teams as approvals are awaited.

The candidate vaccine and the candidate treatments (a monoclonal antibody and an antiviral) are being made available through clinical trial protocols, which will make it possible to further document their efficacy and safety.

As of 30 January, there was one confirmed case and 45 contacts who are being followed up.  

Uganda has experienced five previous SVD outbreaks. The last one was declared in September 2022 and ended in January 2023, with 164 cases and 77 deaths. During that outbreak, a WHO committee of external experts evaluated candidate vaccines and provided recommendations on their suitability for evaluation in Uganda, as part of a clinical trial against the SVD virus.

WHO is working with the Ministry of Health of Uganda and its designated Ugandan Principal Investigators and their teams from Makerere University Lung Institute and the Ugandan Virus Research Institute, as well as worldwide filovirus and trial experts and regulators, to initiate the trials.

The trials were designed via a global collaborative effort coordinated by WHO, that included developers, academic institutions, regulatory authorities, other experts and researchers from Uganda and other countries at risk of filoviruses outbreaks.

The aim of the vaccine trial is to evaluate a potentially efficacious candidate vaccine, and if efficacious, to possibly contribute to ending the ongoing outbreak and protect populations at risk in the future. Those eligible to join the trial are those at highest risk of SVD, i.e. close contacts of a person who has been confirmed to have had SVD or who has died from the disease. The study sites will therefore be the locations where contacts of the case or cases reside. Study teams will be mobile and able to rapidly move to these areas to do their work using the ring vaccination approach.

WHO is working with the Ministry of Health and with Makerere University Lung Institute and the Ugandan Virus Research Institute, who will lead the trials’ implementation.

The development of the protocols and research priorities has been done via the MARVAC Consortium and the Collaborative Open Research Consortium (CORC) for the Filoviridae Family, and numerous developers facilitated the availability of the candidate vaccine and treatments: IAVI provided their candidate Sudan vaccine, Gilead provided remdesivir, an antiviral.

Among those supporting the trials’ implementation are the Coalition for Epidemic Preparedness Innovations (CEPI), the Africa Centres for Disease Control and Prevention, Canada’s International Development Research Centre, the European Commission's Health Emergency Preparedness and Response Authority (HERA) and WHO. This rapid action is the result of tireless efforts to build international cooperation on research, innovation and evaluation and deployment of countermeasures in the face of dangerous pathogens.

While outbreaks of SVD are controllable without vaccines, control can be achieved more quickly using safe and effective vaccines. In the meantime, a comprehensive outbreak response is underway in Uganda to rapidly halt transmission, identify contacts and carry out epidemiological investigations, while enhancing community awareness.

WHO has allocated US$ 1 million from its Contingency Fund for Emergencies to help accelerate outbreak control efforts.

Sudan virus disease is a severe, often fatal illness affecting humans and other primates that is due to Orthoebolavirus sudanense (Sudan virus), a viral species belonging to the same genus of the virus causing Ebola virus disease.  Case fatality rates of Sudan virus disease have varied from 41% to 100% in past outbreaks. There are no approved treatments or vaccines for Sudan virus, but early initiation of supportive treatment has been shown to significantly reduce deaths from Sudan virus disease.

The World Health Organization (WHO) expresses deep concern about the implications of the immediate funding pause for HIV programmes in low- and middle-income countries. These programmes provide access to life-saving HIV therapy to more than 30 million people worldwide. Globally, 39.9 million people were living with HIV at the end of 2023.

A funding halt for HIV programmes can put people living with HIV at immediate increased risk of illness and death and undermine efforts to prevent transmission in communities and countries. Such measures, if prolonged, could lead to rises in new infections and deaths, reversing decades of progress and potentially taking the world back to the 1980s and 1990s when millions died of HIV every year globally, including many in the United States of America.

For the global community, this could result in significant setbacks to progress in partnerships and investments in scientific advances that have been the cornerstone of good public health programming, including innovative diagnostics, affordable medicines, and community delivery models of HIV care.

We call on the United States Government to enable additional exemptions to ensure the delivery of lifesaving HIV treatment and care.

The United States President's Emergency Plan for AIDS Relief (PEPFAR) has been a flagship initiative of the global HIV response since its establishment over 20 years ago. The current funding pause for PEPFAR will have a direct impact on millions of lives that depend on the predictable supply of safe and effective antiretroviral treatment.

PEPFAR works in over 50 countries around the world. Over the past two decades, PEPFAR funding has saved more than 26 million lives. Currently, PEPFAR is providing HIV treatment for more than 20 million people living with HIV globally, including 566 000 children under 15 years of age.

Over the past year, PEPFAR and partners, including WHO, have been working on sustainability plans with countries for greater country ownership and reduced donor support up to and beyond 2030. A sudden and prolonged stop to programmes does not allow for a managed transition and puts the lives of millions at risk.

WHO is committed to support PEPFAR and other partners, as well as national governments, in managing change processes effectively to minimize the impact on people living with HIV.

Following a nearly century-long effort, Georgia has been certified malaria-free by the World Health Organization (WHO). With today’s announcement, Georgia joins the ranks of 45 countries and 1 territory that have achieved this milestone.

“Today we congratulate the people of Georgia for their decades of targeted and sustained actions to eliminate malaria, one of the world’s leading killers,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Georgia’s commitment and success gives us hope that a malaria-free world is possible.”

“This is a huge milestone worth marking; with Georgia’s achievement, the WHO European Region is another step closer to initiate certification as the first malaria-free region in the world,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “This doesn’t happen in a vacuum, this was made possible thanks to sustained investment, dedication of the health workforce and targeted efforts in prevention, early detection and effective treatment of all malaria cases.”

Certification of malaria elimination is granted by WHO when a country has proven, beyond reasonable doubt, that the chain of indigenous transmission has been interrupted nationwide for at least the previous three consecutive years.

The Minister of Health, Mikheil Sarjveladze, noted that certifying Georgia as malaria-free is a recognition of the sustainability of its healthcare system, “this success means that Georgia can address important health challenges."

Malaria has plagued Georgia since ancient times. Before the introduction of systematic control efforts in the early 1900s, at least 3 malaria parasite species—P. falciparum, P. malariae and P. vivax—were endemic in the country. In the 1920s, an estimated 30% of the population suffered from malaria caused by the P. vivax malaria species.

By 1940, large-scale mosquito control programmes had helped reduce malaria cases significantly through improved access to diagnostic and treatment facilities. A few years later, however, World War II caused a surge again due to population movement and the strain on health facilities. 

In the post-war period, Georgia launched an intensive programme aimed at eliminating malaria, using newer medicines, insecticide spraying and robust entomological surveillance. The campaign successfully interrupted the transmission of P. falciparum by 1953, P. malariae by 1960 and P. vivax by 1970. 

Georgia remained malaria-free for 25 years, but by 2002, malaria had reemerged in the country with 474 cases reported.

In 2005, together with 9 other countries in the WHO European Region, Georgia signed the Tashkent Declaration, reaffirming its pledge to eliminate malaria. The intensified interventions that followed significantly reduced malaria incidence in Georgia, with the last indigenous case recorded in 2009. By 2015, all 53 countries of the WHO European Region, including Georgia, reported zero indigenous cases of malaria.

To prevent further re-establishment of malaria transmission in the region, the original signatories of the Tashkent Declaration issued the Ashgabat Statement in 2017 committing to take all efforts to remain malaria-free. Türkiye is the only country in the WHO European Region remaining to be certified.

In 2024, during the Georgia’s malaria-free certification process, members of the Technical Advisory Group on Malaria Elimination and Certification, an independent WHO advisory body, noted that Georgia has a well-functioning and adequately resourced health system, strong public-private cooperation, and political commitment to maintaining a malaria-free status.

WHO malaria-free certification

The final decision on awarding a malaria-free certification is made by the WHO Director-General, based on a recommendation by the Technical Advisory Group on Malaria Elimination and Certification and validation from the Malaria Policy Advisory Group. For more on WHO’s malaria-free certification process, visit this link.

The World Health Organization (WHO) welcomes the Gaza ceasefire, hostage and prisoner release deal, which brings hope for millions of people whose lives have been ravaged by the conflict.   

The health challenges ahead are immense. The entire population of Gaza has faced multiple displacements. More than 46 600 people have been killed and over 110 000 have been injured. The real figures are likely much higher. Only half of Gaza’s 36 hospitals remain partially operational, nearly all hospitals are damaged or partly destroyed, and just 38% of primary health care centres are functional. An estimated 25% of those injured – around 30 000 people – face life-changing injuries and will need ongoing rehabilitation. Specialized health care is largely unavailable, medical evacuations abroad are extremely slow. Transmission of infectious diseases has massively increased, malnutrition is rising, and the risk of famine persists. The breakdown of public order, exacerbated by armed gangs, raises further concerns.  

Addressing the massive needs and restoring the health system will be an extremely complex and challenging task, given the scale of destruction, operational complexity and constraints involved. Billions in investment are needed to support recovery of the health system, which will require the unwavering commitment of donors and the international community.  

WHO is ready to scale up the response together with UN health partners including UNFPA, UNICEF, UNRWA and 67 Health Cluster partners. However, it is critical that the security obstacles hindering operations are removed. WHO will need conditions on the ground that allow systematic access to the population across Gaza, enabling the influx of aid via all possible borders and routes, and lifting restrictions on the entry of essential items. Also essential are active protection of civilians and health-care workers, expediting medical evacuations through all possible routes for over 12 000 patients (and their companions) who urgently require specialized care, strengthening and speeding up the referral system to East Jerusalem and the West Bank, and addressing road repairs, rubble removal, and the remediation of unexploded ordnances. 

WHO and partners will need a massive scale-up of funding to meet immediate health needs, and to begin to restore the heath system, including the workforce, supply chain and infrastructure.

WHO and partners will implement a 60-day plan to support the urgent restoration and expansion of the health system. Focus will be on key priority response areas, including trauma and emergency care, comprehensive primary health care, child health, noncommunicable diseases (NCDs), sexual and reproductive health and rights (SRHR), rehabilitation, mental health and psychosocial support (MHPSS).  

Given the immense needs, WHO is scaling up operations and mobilizing critical supplies and resources for delivery into Gaza. A priority will be the assessment and rehabilitation of partially damaged health facilities in high-need areas. Work is ongoing to urgently increase bed capacity across selected hospitals in northern and southern Gaza, together with the expansion of operational capacities, supporting the hiring and redistribution of national health workers, and increasing deployment of international health workers to fill gaps. Plans are underway to integrate prefabricated clinics and hospitals with existing health facilities to enhance service delivery in underserved and newly accessible areas.   

Efforts also are underway to strengthen referral processes for critical care within Gaza and facilitate cross-border medical evacuations. Given the high level of malnutrition and disease outbreaks, WHO is working with partners to expand infant and young child feeding programmes, enhance immunization efforts and reinforce disease surveillance systems for timely prevention, reporting, and outbreak management. 

WHO calls on all parties to uphold their commitment to fully implement the ceasefire agreement and to continue working towards a political solution to address the protracted crisis in the occupied Palestinian territory, which is essential for lasting peace. 

Conflict, climate change, epidemics, and displacement are converging to create an unparalleled global health crisis, with 305 million people in urgent need of humanitarian assistance in 2025. In response, the World Health Organization (WHO) is calling for US$ 1.5 billion for its 2025 Health Emergency Appeal (HEA), to support life-saving health interventions worldwide.

The appeal, launched today by WHO Director-General, Dr Tedros Adhanom Ghebreyesus, outlines the critical priorities and resources needed to address 42 ongoing health emergencies, including 17 Grade 3 crises – the most severe emergencies requiring the highest level of response. With health systems stretched to their limits and global financial resources dwindling, the US$ 1.5 billion are needed to help people facing the most difficult situations

“Conflicts, outbreaks, climate-related disasters and other health emergencies are no longer isolated or occasional – they are relentless, overlapping and intensifying,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "From controlling cholera outbreaks to providing mental health support in conflict zones, WHO’s work extends beyond the immediate care we provide. We empower communities to protect themselves, prioritize equity, and build a legacy of preparedness. This appeal is about enabling WHO to save lives, protect the right to health, and provide hope where there is none.”

WHO is committed to delivering emergency health assistance, including in conflict zones such as the Democratic Republic of the Congo, the occupied Palestinian territory and Sudan. WHO’s response in emergencies is aligned with wider humanitarian efforts and prioritizes providing essential care and medical supplies; treating malnutrition and supporting maternal and child health; conducting vaccination campaigns to prevent disease outbreaks; and offering mental health support to populations impacted by trauma.

The Appeal highlights four key challenges facing the world currently:  climate change, conflict, displacement and disease outbreaks. These are responsible for fueling deeper, longer lasting health crises and putting the world’s most vulnerable at greater risk.

The appeal further details the priorities and financial needs for each of the Grade 3 emergencies that WHO is responding to.

With the support of donors and partners, WHO aims to fulfill its unique role in health emergencies, while upholding the principles of international humanitarian law, ensuring that no one is left behind even in the most challenging circumstances.

This appeal is about more than just funding – it is a call to action. As crises grow more frequent and severe, the gap between global needs and available resources continues to widen. Supporting WHO’s Health Emergency Appeal is a vital investment in global solidarity and health equity.

On 18 December 2024, the World Health Organization (WHO) prequalified the first diagnostic test for glucose-6-phosphate dehydrogenase (G6PD) deficiency which can help to safely deliver WHO-recommended treatments to prevent relapse of Plasmodium vivax (P. vivax) infection.

The prequalification of this G6PD diagnostic test marks a significant milestone in facilitating safe and effective P. vivax malaria treatment, reaffirming WHO’s dedication to ensuring equitable access to life-saving health solutions globally. Some 500 000 people die each year from malaria, most of them children.

The prequalification of this test immediately followed the prequalification, in early December, of two new tafenoquine products for anti-relapse treatment of P. vivax malaria, and these therapeutics were recommended in updated WHO malaria guidelines released a few days earlier, in late November.

This package of actions by WHO reflects the organization’s recent adoption of synchronized and parallel processes for two key functions: developing recommendations for essential health products and overseeing their prequalification.

While these processes remain entirely independent, their alignment aims to significantly reduce the time required to bring vital health products to low- and lower-middle-income countries. This streamlined approach underscores WHO’s commitment to improving global health equity by expediting access to life-saving products.

P. vivax malaria is endemic in all WHO Regions except the European Region, with an estimated 9.2 million clinical cases occurring in 2023. P. vivax is the dominant malaria parasite in most countries outside of sub-Saharan Africa. 

G6PD deficiency, a genetic condition, affects more than 500 million people. While most people are unaware of their G6PD deficiency and go through life without suffering ill effects, certain drugs administered to prevent malaria relapse caused by P. vivax can result in acute haemolysis (destruction of red blood cells). Without accessible and reliable G6PD testing, it has been challenging to safely provide anti-relapse treatments, limiting the widespread use of this effective therapy.

“The prequalification of this G6PD enzyme test for patients with P. vivax malaria can help countries in enhancing access to much-needed quality-assured tests, enabling safe and effective treatment and prevention of this type of relapsing malaria,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. “Currently, no other prequalification applications are received for this type of tests. We encourage the submission of additional products to expand the range of effective diagnostic tools available to countries in need.”

“Wider availability of the test can help strengthen the global malaria response by reducing the number of P. vivax infections due to relapse and in turn reduce onward transmission,” said Dr Daniel Ngamije Madandi, Director of WHO’s Global Malaria Programme.

Testing devices that can accurately distinguish patients with G6PD activity levels above and below the normal levels provide critical information to clinicians to decide which of P. vivax anti-relapse treatment regimens is most appropriate, including low- and high-dose primaquine and single-dose tafenoquine.

The STANDARD G6PD System diagnostic tool manufactured by SD Biosensor, Inc., is a semi-quantitative, near-patient solution designed for the measurement of G6PD enzyme activity in capillary or venous whole blood. The device is intended for use in both laboratory and non-laboratory settings and operates with the STANDARD G6PD Analyzer, a hand-held device, delivering results in a few minutes.

Five years ago on 31 December 2019, WHO’s Country Office in China picked up a media statement by the Wuhan Municipal Health Commission from their website on cases of ‘viral pneumonia’ in Wuhan, China. In the weeks, months and years that unfolded after that, COVID-19 came to shape our lives and our world. 

At WHO, we went to work immediately as the new year dawned. WHO employees activated emergency systems on 1 January 2020, and informed the world on 4 January. By 9-12 January, WHO had published its first set of comprehensive guidance for countries, and on 13 January, we brought together partners to publish the blueprint of the first SARS-CoV-2 laboratory test. 

All along, we convened experts and ministries of health from around the world, gathered and analysed data, and shared what was reported, what we learned and what it meant for people. Read about WHO’s actions in this interactive timeline. 

As we mark this milestone, let’s take a moment to honour the lives changed and lost, recognize those who are suffering from COVID-19 and long COVID, express gratitude to the health workers who sacrificed so much to care for us, and commit to learning from COVID-19 to build a healthier tomorrow. 

We continue to call on China to share data and access so we can understand the origins of COVID-19. This is a moral and scientific imperative. Without transparency, sharing, and cooperation among countries, the world cannot adequately prevent and prepare for future epidemics and pandemics. 

As we pose the question, “Is the world better prepared for the next pandemic than we were for COVID-19?” see WHO Director-General Dr Tedros Adhanom Ghebreyesus’s response at a recent press conference: https://who.canto.global/b/SHEJL

WHO is appalled by yesterday’s raid on Kamal Adwan Hospital, which put the last major health facility in North Gaza out of service. The systematic dismantling of the health system and a siege for over 80 days on North Gaza puts the lives of the 75,000 Palestinians remaining in the area at risk.

Initial reports indicate that some areas of the hospital were burnt and severely damaged during the raid, including the laboratory, surgical unit, engineering and maintenance department, operations theatre, and the medical store. Earlier in the day, twelve patients and a female health staff were reportedly forced to evacuate to destroyed and non-functional Indonesian Hospital where it is not possible to provide any care, while the majority of the staff, stable patients and companions were moved to a nearby location. Additionally, some people were reportedly stripped and forced to walk toward southern Gaza. Over the last two months, the area around the hospital has remained highly volatile and attacks on the hospitals and on health workers have occurred almost daily. This week, bombardments in its vicinity reportedly killed 50 people, including five health workers from Kamal Adwan Hospital.

Kamal Adwan is now empty. Yesterday evening, the remaining 15 critical patients, 50 caregivers and 20 health workers were transferred to Indonesian Hospital, which lacks the necessary equipment and supplies to provide adequate care. The movement and treatment of these critical patients under such conditions pose grave risks to their survival. WHO is deeply concerned for their wellbeing, as well as for the Kamal Adwan Hospital director who has been reportedly detained during the raid. WHO lost contact with him since the raid began.

WHO and partners' efforts to sustain the hospitals’ operations have been undone. With Kamal Adwan and Indonesian hospitals entirely out of service, and Al-Awda Hospital barely able to function, and severely damaged due to recent airstrikes, the healthcare lifeline for those in North Gaza is reaching a breaking point. 

WHO calls for urgently ensuring that hospitals in North Gaza can be supported to become functional again. 

Hospitals have once again become battlegrounds, reminiscent of the destruction of the health system in Gaza City earlier this year.

Since October 2023, WHO has repeatedly issued urgent calls to protect health workers and hospitals as per international humanitarian law —yet these calls remain unheard. Health facilities, workers and patients are always off limits. They must be actively protected and never be attacked, nor used for military purposes. The principles of precaution, distinction and proportionality under International Humanitarian Law are absolute and always apply. 

Our mission to negotiate the release of the United Nations staff detainees and to assess the health and humanitarian situation in Yemen concluded today.

We continue to call for the detainees' immediate release. 

As we were about to board our flight from Sana’a, about three hours ago (around 5 pm local time), the airport came under aerial bombardment.  One of our plane’s crew members was injured.  At least two people were reported killed at the airport. 

The air traffic control tower, the departure lounge — just a few meters from where we were — and the runway were damaged.  We will need to wait for the damage to the airport to be repaired before we can leave.

My UN and WHO colleagues and I are safe.

Our heartfelt condolences to the families whose loved ones lost their lives in the attack.

• Vaccination remains an important public health countermeasure against COVID-19. As per the WHO Director General’s standing recommendations for COVID-19, Member States are recommended to continue to offer COVID-19 vaccination based on the recommendations of the WHO Strategic Advisory Group of Experts on Immunization (SAGE).
• SARS-CoV-2 continues to circulate and evolve with important genetic and antigenic evolution of the spike protein since the beginning of the COVID-19 pandemic.
• The objective of an update to COVID-19 vaccine antigen composition is to enhance vaccine-induced immune responses to circulating SARS-CoV-2 variants.
• The WHO TAG-CO-VAC advises retaining the use of a monovalent JN.1 lineage variant as the antigen in future formulations of COVID-19 vaccines.
• In accordance with WHO SAGE policy, vaccination should not be delayed in anticipation of access to vaccines with an updated composition; vaccination programmes can continue to use any available WHO emergency-use listed or prequalified COVID-19 vaccines. 

The WHO Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC) continues to  closely monitor the genetic and antigenic evolution of SARS-CoV-2 variants, immune responses to SARS-CoV-2 infection and COVID-19 vaccination, and the performance of COVID-19 vaccines against circulating variants. Based on these evaluations, WHO advises vaccine manufacturers and regulatory authorities on the implications for future updates to COVID-19 vaccine antigen composition. In April 2024, the TAG-CO-VAC recommended the use of a monovalent JN.1 lineage vaccine antigen as one approach to induce enhanced neutralizing antibody responses to JN.1 and its descendent lineages.  Several manufacturers (using mRNA and recombinant protein-based vaccine platforms) have updated COVID-19 vaccine antigen composition to monovalent JN.1 lineage formulations (JN.1 or KP.2) and some of these have been approved for use by regulatory authorities. Previous statements from the TAG-CO-VAC can be found on the  WHO website.

The TAG-CO-VAC reconvened on 10-12 December 2024 to review the genetic and antigenic evolution of SARS-CoV-2; immune responses to SARS-CoV-2 infection and/or COVID-19 vaccination; the performance of currently approved vaccines against circulating SARS-CoV-2 variants; and the implications for COVID-19 vaccine antigen composition.

The published and unpublished evidence reviewed by the TAG-CO-VAC included: (1) SARS-CoV-2 genetic evolution with additional support from the WHO  Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE); (2) Antigenic characterization of previous and emerging SARS-CoV-2 variants using virus neutralization tests with animal antisera and further analysis of antigenic relationships using antigenic cartography; (3) Immunogenicity data on the breadth of neutralizing antibody responses elicited by currently approved vaccine antigens against circulating SARS-CoV-2 variants using animal and human sera; (4) Preliminary immunogenicity data on immune responses following infection with circulating SARS-CoV-2 variants; (5) Available vaccine effectiveness (VE) estimates of currently approved vaccines during periods of circulation of XBB.1 and JN.1 lineages; and (6) Preliminary preclinical and clinical immunogenicity data on the performance of candidate vaccines with updated antigens shared confidentially by vaccine manufacturers with TAG-CO-VAC. Further details on the publicly available data reviewed by the TAG-CO-VAC can be found in the accompanying data annex. Unpublished and/or confidential data reviewed by the TAG-CO-VAC are not shown.

Summary of available evidence

• In 2024, SARS-CoV-2 continues to circulate globally and cause severe disease, post COVID-19 condition and death. The majority of COVID-19 deaths continue to occur in individuals aged 65 years and older and those with coexisting conditions. There are persistent and increasing gaps in the reporting of cases, hospitalizations and deaths, from WHO Member States, making epidemiological trends difficult to infer.
• Currently circulating SARS-CoV-2 variants are all derived from JN.1. The weekly proportion of XEC sequences among all SARS-CoV-2 sequences submitted to GISAID continues to increase, while the weekly proportions of all other Variants of Interest (JN.1) or Variants Under Monitoring (KP.2, KP.3, KP.3.1.1, JN.1.18 and LB.1) are now declining. There are other JN.1-derived variants that are currently in low proportions, but which have mutations that may give them an advantage over XEC: currently LP.8.1, NP.1, LF.7.2 are variants being monitored and/or characterized.
• In published and unpublished data using antisera from naïve animal models, circulating JN.1-derived variants (JN.1, JN.1.16.1, KP.2, KP.2.3, KP.3, KP.3.1.1, LB.1 and XEC) are antigenically closely related.
  • Analysis of naïve mice immunized with mRNA vaccine antigens (KP.3, KP.3.1.1, XEC) showed that JN.1, KP.3.1.1, XEC are antigenically closely related to each other (approximately 1 antigenic unit in cartographic analysis, which corresponds to a two-fold-reduction in neutralization). Antisera to KP.3.1.1 and XEC generate cross-reactive neutralizing antibody titers to each other and to other emerging variants.
  • Antisera from naïve hamsters infected with JN.1 descendent lineages showed that circulating JN.1-derived variants such as KP.3.1.1 are antigenically closely related to JN.1 and to each other (approximately 1 antigenic unit in cartographic analysis). JN.1 antisera showed greater cross-reactivity to KP.2 and KP.3.1.1, as compared to KP.2 antisera.
• In published and unpublished data from humans, vaccination with monovalent JN.1 or KP.2 antigens significantly increased neutralizing antibody titers that cross-reacted with all JN.1 descendent lineages tested.
  • Analysis of pre- and post-vaccination sera from JN.1 or KP.2 immunized individuals demonstrated that vaccination results in strong rises in neutralizing antibody titers against JN.1 and descendent variants, including KP.2, KP.2.3, KP.3, KP.3.1.1 and XEC.
  • Post-monovalent JN.1 or KP.2 vaccination neutralizing antibody titers against KP.3.1.1 and XEC were modestly lower (consistent 2-fold reductions in titers) than those against the homologous JN.1 or KP.2 antigens.
  • There were greater reductions in cross-neutralization of emerging JN.1 lineage variants using post-monovalent XBB.1.5 vaccination sera, as compared to post-monovalent JN.1 or post-monovalent KP.2 vaccination sera.
• In a context of infection- and vaccine-derived immunity in the majority of the population, contemporary vaccine effectiveness (VE) estimates are relative (rVE) rather than absolute (comparing vaccinated to unvaccinated individuals). rVE, sometimes referred to as “up-to-date VE”, demonstrates the added protection of most recent vaccination over and above pre-existing immunity derived from previous infections and/or vaccinations. There are currently studies reporting VE or rVE estimates using monovalent JN.1 lineage (JN.1 or KP.2) vaccines.  
• Approved monovalent XBB.1.5 mRNA COVID-19 vaccines continued to provide additional protection against severe disease and death during periods of XBB descendent lineage circulation in the first three months after vaccination; rVE point estimates against symptomatic disease were typically lower. During periods of JN.1 descendent lineage circulation, monovalent XBB.1.5 mRNA vaccines continued to show additional protection in the first three months after vaccination, however, available evidence points towards a reduction in rVE estimates against JN.1-derived variants, as compared to XBB.1 lineage variants, for protection against death, severe disease, symptomatic disease and infection.
• The VE estimates for monovalent XBB.1.5 vaccines against JN.1-derived variants are consistent with reductions in neutralizing antibody titers observed in preclinical and clinical immunogenicity studies of post-monovalent XBB.1.5 vaccination sera against JN.1 descendent variants, as compared to XBB.1 lineage variants.
• Preclinical data shared confidentially with the TAG-CO-VAC by vaccine manufacturers show that immunization of naïve mice, as well as of mice previously immunized with SARS-CoV-2 variants with monovalent JN.1-containing or monovalent KP.2-containing vaccine candidates resulted in good neutralization of JN.1 and descendent variants, including KP.3.1.1, XEC and MC.1. However, neutralizing antibody titers against KP.3.1.1, XEC and MC.1 were approximately 2-fold lower than those against the homologous immunizing antigen. A single preclinical immunogenicity study in mice using an XEC vaccine candidate showed comparable neutralizing antibody titers against JN.1, KP.3.1.1 and XEC as compared to a JN.1 vaccine candidate.
• Clinical data shared confidentially with the TAG-CO-VAC by vaccine manufacturers show that post-monovalent JN.1 sera neutralized JN.1 and its derivatives including KP.3.1.1 and XEC well.

The TAG-CO-VAC acknowledges several limitations of the available data: 

• There are persistent and increasing gaps in the reporting of cases, hospitalizations and deaths, from WHO Member States, as well as in genetic/genomic surveillance of SARS-CoV-2 globally, including low numbers of samples sequenced and limited geographic diversity. The TAG-CO-VAC strongly supports the ongoing work of the WHO  Coronavirus Network (CoViNet) to address this information gap.

• The timing, specific mutations and antigenic characteristics of emerging and future variants are difficult to predict, and the potential public health impact of these variants remain unknown. There are JN.1-derived variants such as LP.8.1, NP.1 and LF.7.2 that are currently in low proportions, but which have mutations that may give them more immune escape than XEC. These will continue to be monitored and/or characterized. The TAG-CO-VAC strongly supports the ongoing work of the TAG-VE. 
• Although neutralizing antibody titers have been shown to be important correlates of protection from SARS-CoV-2 infection and of estimates of vaccine effectiveness, there are multiple components of immune protection elicited by infection and/or vaccination. Data on the immune responses following JN.1 descendent lineage infection or monovalent JN.1, KP.2 or XBB.1.5 vaccination are largely restricted to neutralizing antibodies. Data and interpretation of other aspects of the immune response, including cellular immunity, are limited. 
• Immunogenicity data against currently circulating SARS-CoV-2 variants are not available for all COVID-19 vaccines. Further, there are very limited data on immune responses following infection in humans with recent SARS-CoV-2 variants (e.g., KP.3.1.1, XEC).
• Estimates of VE against recently circulating SARS-CoV-2 variants, including XBB or JN.1 descendent lineages, are limited in terms of the number and geographic diversity of studies, vaccine platforms evaluated, populations assessed, and duration of follow-up. Furthermore, the referent population for VE estimates varies substantially with respect to prior history of vaccination. There are currently no direct comparative estimates for monovalent JN.1, KP.2 or XBB.1.5 vaccines versus other antigen composition(s) delivered during the same time period. Finally, VE estimates may be confounded by differences in undocumented infection-derived immunity between groups, leading to potential underestimation of VE.

Given the breadth in immune responses demonstrated by monovalent JN.1 lineage vaccines against circulating variants, the TAG-CO-VAC advises retaining the current COVID-19 vaccine antigen composition, i.e. a monovalent JN.1 lineage variant (NextStrain: 24A, GenBank: PP298019, GISAID: EPI_ISL_18872762) as one approach to induce enhanced neutralizing antibody responses to JN.1 and its descendent variants (e.g., KP.3.1.1 and XEC).

Other approaches that demonstrate broad and robust neutralizing antibody responses against currently circulating JN.1 descendent lineage variants, such as vaccine antigens derived from more recent variants or alternative formulations, could also be considered.

As per the WHO Director General’s  standing recommendations for COVID-19, Member States are recommended to continue to offer COVID-19 vaccination based on the recommendations of the WHO SAGE. Vaccination should not be delayed in anticipation of access to vaccines with an updated composition; vaccination programmes can continue to use any available WHO emergency-use listed or prequalified COVID-19 vaccines.

Given the limitations of the evidence upon which the recommendations above are derived and the anticipated continued evolution of the virus, the TAG-CO-VAC strongly encourages generation of the following data (in addition to the types of data outlined in October 2024): 

• Immune responses and clinical endpoints (i.e. VE and/or comparator rates of infection and severe disease) in varied human populations who receive COVID-19 vaccines with a monovalent JN.1 or KP.2 vaccine antigen composition, across different vaccine platforms, as well as further clinical and laboratory data on the performance of all currently approved COVID-19 vaccines against emerging SARS-CoV-2 variants.
• Strengthened epidemiological and virological surveillance, as per the Standing Recommendations for COVID-19 in accordance with the International Health Regulations (2005), to determine if emerging variants are antigenically distinct and able to displace circulating variants.
• Clinical evaluation of relevant new vaccine antigens derived from more recent variants.

As previously stated, the TAG-CO-VAC continues to encourage the further development of vaccines that may improve protection against infection and reduce transmission of SARS-CoV-2.

The TAG-CO-VAC will continue to closely monitor the genetic and antigenic evolution of SARS-CoV-2 variants, immune responses to SARS-CoV-2 infection and COVID-19 vaccination, and the performance of COVID-19 vaccines against circulating variants. The TAG-CO-VAC will also continue to reconvene every six months to evaluate the implications for COVID-19 vaccine antigen composition. At each meeting, recommendations to either maintain current vaccine composition or to consider updates will be issued.

The ceasefire and the cessation of hostilities took effect on 27 November, offering temporary relief for the millions of civilians caught in the conflict in Lebanon. But Lebanon’s suffering did not end amid staggering unmet health needs. Bordering Syria and Israel, Lebanon’s overburdened health system is reeling from the impacts of an economic crisis, political deadlock, refugee crisis and now war.

The country is host to 1.5 million Syrian refugees: inevitably, events in Syria impact Lebanon and WHO operations. Syrian nationals are entering Lebanon at the same time as Syrian refugees are returning to Syria from Lebanon.

"An already decimated health system remarkably withstood this latest storm, but it has been further weakened. The challenges are complex and call for specialized, sustained support," said WHO Representative to Lebanon Dr Abdinasir Abubakar.

The road ahead for Lebanon‘s health system is rocky and the future uncertain.

Lebanon’s cumulative real GDP has shrunk by 38% since 2019, according to the World Bank, with the war being the latest of many blows. As of today, more than 1 million people displaced by hostilities have returned to southern Lebanon where the physical and health infrastructure is in tatters. Several health facilities remain closed and most hospitals are running below capacity due to financial restraints and shortages of staff, long-standing challenges in Lebanon.

More than 530 health workers and patients have been killed or injured in attacks on health care and thousands of health workers have been displaced or have emigrated leaving the hospitals and the health centres grappling to meet the health needs of the populations. In order to keep hospitals running, the need for health workers is dire.

Water and sanitation systems have been severely disrupted, compounding the risk of disease outbreaks. With nearly 7% of buildings in ruins in the two southern governorates that were hardest hit, thousands remain on the move and won’t be able to return home anytime soon. Those who have returned face the risks posed by explosive remnants of war, as well as greater overall health risks. 

Since 8 October 2023, more than 4000 people were killed and 17 000 injured in Lebanon alone. Since the ceasefire took hold and conflict-impacted areas have become more accessible, the death toll continued climbing as more bodies are found in the 16 000 buildings that have been partially or completely destroyed, leaving an estimated 8 million tonnes of debris.

"The physical destruction is similar to what you see after an earthquake – and that has resulted in complex injuries, open wounds and fractures. And since the treatment provided during the war was often not optimal, the injured end up needing multiple surgeries to prevent complications and disabilities,  " said Dr Ahmad Alchaikh Hassan, WHO Trauma Technical Officer.

One in 4 people with life-changing injuries will need long-term rehabilitation and, in some cases, assistive technologies and prosthetics. Specialized support will be required as the technical capacities in Lebanon cannot cope with the increasing numbers of people in need for these services and commodities.

"This need for specialized health care will persist for months and years to come. Lebanon needs reconstructive surgeons to treat the severely injured, eye doctors to treat the thousands of people injured in the pager attack, physiotherapists to start rehabilitating amputees and prosthetists to assist users of assistive devices," said WHO Representative Dr Abubakar.

Ensuring a sufficient number of trained health workers with expertise in war-related trauma and plastic reconstructive surgery is a priority.

Three weeks into an 8-week ceasefire, WHO and the Ministry of Public Health are working on replenishing medical supplies and restoring health services country-wide.

"WHO and national health authorities have carried out several mass casualty management trainings across Lebanon – resulting in stronger, more life-saving assertive responses.  Without these timely interventions, the outcomes would be unconscionable," said Dr Hassan, WHO's Trauma Technical Officer.

The ongoing WHO operations include scaling up trauma care capacity, training surgeons on specialized trauma care in conflict areas, providing mental health trainings to health workers, capacity building for rehabilitation in post-conflict settings, replacing damaged equipment, identifying gaps in health coverage, and preparing for future scenarios and the subsequent health impact.

WHO also provided 5000 contingency blood bags and reagents to blood banks and developed awareness material on unexploded ordinances and other health risks for first responders and civilians. WHO and the Ministry of Public Health run strong country-wide surveillance for disease outbreaks which pose a heightened risk in post-conflict settings.

"The road to recovery will be long and windy. Our aim is to assist the health system to bounce back, and be resilient and prepared. We are grateful to our many partners who have supported this response but this is not the end of it. This is the start and the need for technical and financial support has never been greater," concluded WHO Representative Dr Abubakar.