OMS: TEDROS informa sobre la SITUACIÓN de la VIRUELA del MONO | RTVE Noticias

August on global health issues let me introduce uh our colleagues who are in the room we have Dr tedos adom gesus W2 director General Dr Maria vov director at interim epidemic and pandemic preparedness and prevention Dr abdar Rahman Muhammad director at interim alert and response coordination Dr Teresa Zakaria incident manager for conflict escalation in Israel and occupied Palestinian territory and Dr deos mbong gizi director Health Products policy and standards we have also a certain number of expert joining online I will introduce them when it's time but let me just uh tell you that we have Dr Rick peer con W representative for opt and Dr Ahmed Jafari emro director of the polio program and we have also Dr shii sahbani Who is the W representative for Sudan now without any further delay I would like to give the floor to Dr tedos for his introduction remark Dr tedos you have the floor thank you thank you Fila good morning good afternoon and good evening first and an update on the empo outbreaks in Africa more than 18,000 suspected cases of empo have been reported in the Democratic Republic of the Congo so far this year with 629 death that includes more than 5,000 cases and 31 days from the Eastern provinces of North and South kibu where the new CL one B train has been spreading the number of reported cases of Cl 1B has been rising rapidly for several weeks fortunately relatively few deaths have been reported in recent weeks in addition 258 cases of clay 1B have been confirmed in Burundi four in Rwanda four in Uganda two in Kenya and one each in Sweden and and Thailand we also remain concerned about outbreaks of CA 1A in other parts of DRC this morning I returned from DRC where yesterday I had the honor to meet with his Excellency president Felix sishi to discuss the outbreaks I thank the president for his leadership in the response to the outbreaks demonstrated by the government commitment of 10 million us to the response and for his leadership on the response I assured him of wh's full support together with the Africa CDC and other partners I also had the opportunity to meet with the United Nations country team where we discuss coordination of the empo response among un agencies under the government's leadership we discussed the critical importance of clear communication with people at risk of empo and strong engagement with communities and local Partners I also met with global and local Health Partners to discuss scaling up routin immunization for other dises including polio misles and malaria and mobilizing Frontline polio workers to support the empo response who is working to accelerate access to and delivery of vaccines the manufacturers of the two vaccines submitted their applications for emergency use listing last Friday the 23rd of August and we're working to review those applications as fast as possible the safety and efficacy of vaccines are our highest priority we will not not take shortcuts the two main buyers of vaccines for low-income countries gab and UNICEF require who emergency use listing to buy vaccines for use in countries that have not issued their own National regulatory approval last week I gave gab and UNICEF the green line to proceed with procuring vaccines in parallel with the eul process however who emergency use listing is not a barrier to vaccines being deployed in DRC drc's medicines regulator approved both vaccines in June of this year and the government has requested bilateral donations of vaccines from high income countries with large stock piles together with the Africa CDC who has also helped to secure donations from the European Union and some of its member states who is working with the Africa CDC gab UNICEF sepi and Hera to set up a coordination mechanism to allocate the donated vaccines and increase access in affected countries yesterday we also invited manufacturers of empo Diagnostics to submit an expression of interest for emergency use listing today we have received the first expression of interest over the past two days we have also convened a meeting of researchers to identify research priorities and to foster a coordinated and collaborative approach to the development of vaccines Diagnostics and theraputics it's vital to stress that although vaccines are a powerful tool they are far from the only tool there are many things that and our partners are doing to prevent and diagnose infections and treat the sick the outbreak of C 1B empo is occurring in one of the poorest and most insecure regions of DRC complicating the response despite these challenges hundreds of who Personnel are on the ground in DRC and the other affected countries working with our partners to stop transmission and bring these outbreaks under control under the government's leadership and with the government's leadership and close cooperation between partners we believe we can stop these outbreaks in the next 6 months but what this region of DRC needs more than anything else is a political solution to the long running insecurity especially in the easn thec now to Gaza on Sunday wh and our partners will begin a polio vaccination campaign in Gaza in which we aim to reach more than 640,000 children under 10 years of age the campaign will involve two dos of vaccine given in two rounds four weeks apart more than 1.2 million doses of vaccine have been delivered to Gaza and 400,000 more dos will arrive soon we have trained more than 2,180 health workers and community outreach workers to provide vaccination and inform communities about the campaign our aim is to reach at least 90% vaccination coverage during each round of the campaign to stop the current outbreak and prevent the international spread of polium the campaign will be delivered in a phased approach over three days in each round starting with Central Gaza followed by South Gaza and then North Gaza I thank the Palestine Ministry of Health UNICEF and unra and others for their partnership in this campaign I welcome the commitment to humanitarian poses in specific areas to allow the vaccination campaign to be carried out due to insecurity damage to roads and infrastructure and population movement and displacement three days in each area is unlikely to be enough to achieve adequate coverage vaccination coverage will be monitored throughout the campaign and it has been agreed that vaccination will be extended by one day wherever necessary the vaccination teams must be protected and allowed to conduct the campaign safely we urge all parties to ensure their protection and that of health facilities and children humanitarian POS are welcome but ultimately the only solution to safeguard the health of the children of Gaza is a ceasefire the best medicine is peace now to Sudan where fighting has now been continuing for 500 Days hospitals are shutting down and life saving supplies are running out outbreaks of chera Deni malaria and mles Are Taking Lives and putting further pressure on the health system who is particularly concerned about the situ situation in elaser and surrounding areas in North darur with farming already reported from the zum Camp who has verified more than 100 attacks on Health Care since the conflict began the recent attack on Elin Hospital in E darur killed 16 civilians including children and the nurse the attack damage the dialysis and Gynecology departments and stocks of life-saving vaccines and other supplies who is working with UNICEF and partners to support the Federal Ministry of Health as it responds to multiple health challenges this includes rolling out essential vaccines to children and providing technical operational and financial support to the chera response preposition colera and other Essential Medical Supplies helped jumpstart the response who recently deployed 51,000 doses of oral colera vaccines in Cella state which has a high number of cases the international coordinating group on vaccine allocation has approved a request for more than 450,000 dose to be sent to scale up the vaccination campaign in Cella State last week five tracks from wh and partners delivered over 175 tons of Health supplies this supplies including medicines diagnostic materials and nutrition supplies will be used by humanitarian Partners to provide emergency Health Care treat infectious disease and help elevate the threat of malnutrition but much more is needed to stop diseases from spreading and avert fine in parts of the country a ceasefire and unhindered humanitarian access is the best way to stop the Health crisis worsening finally earlier this week I was in brazaville for the annual Regional committee meeting of the wh regional office for Africa the committee nominated a new Regional director Dr fostul of Tanzania to succeed Dr shidi moti Who second term ends in January next year I congratulate drul on his nomination and I thank Dr Muti for her 10 years of leadership dedication vision and commitment to serving the people of Africa the regional committee also hosted a pledging event for The Who investment round which aims to mobilize the sustainable funding we need to implement our work over the next four years I have asked every member state to contribute according to its means and every partner I'm deeply grateful to the 14 African member states at and partners who pledged more than $45 million us to the investment round Africa is leading by example I call on other regions to follow fedil back to you thank you Dr tedras and now I would like to open the floor to journalist questions if you want to ask a question raise your hand using the raise your hand icon and unmute yourself um first journalist is Helen brenell from stat Helen can you hear me hi fidela thank you very much um yes my question uh relates to empx vaccines at the last uh press conference uh Maria van kirov suggested that countries should coordinate with who if they are giving um donations of vaccine because who needs to have a sense of of how much vaccine is being offered and where do you have an updated number at this point about how many doses have been donated or are being donated thank you drov yeah thanks very much I also have um we have have some people online who I'm sure will want to supplement this so thanks very much Helen for the question and thanks for flagging the request that we had made to work with us um to set up this allocation mechanism as the DG mentioned in his speech just now we are setting up this access and allocation mechanism working with a number of different part Partners on this it's really important that we coordinate um because there are a limited number of supplies so far um and these vaccines need to reach the countries at risk um they need to be used in a targeted way um in the DRC in Bundi in countries that are facing this upsurge and that's really critical at the moment but we are working with Partners to set up this allocation mechanism looking at the donations not only where they're coming from which vaccines when they expire when they might get into country the conditions um all of that needs to be coordinated so that we can work with countries so that the countries take the ownership of the use of these vaccines and they use them um when they become available as part of the response so maybe I could pass to my colleague Tim who can answer more on that oh thank you Maria and thank you Helen yeah I think um we have a good understanding about the existing pledges that have been uh expressed by different countries and entities uh for this uh response however pledges need to be turned into donation following then the discussion and agreement and negotiation around that so these pledges will turn into donation at different time frames and we have a good understanding on know the different quantities that will be available in the coming weeks and months but also uh pledges that will probably materialize towards you know in the next two to three months and I think that's important then to match what we know will be coming down that pipeline uh to match with the different uh uh needs on the ground as the countries are preparing now for different uh uh vaccination uh uh strategies thanks uh thank you uh just to give you the exact title of uh Tim Guan his unit head high impact events preparedness now I would like to give the floor to Emma F from roers imma Emma can you hear me yes um the unmute button took a second to come up uh I wanted to ask about um the polio vaccination campaign in Gaza please I'm wondering how satisfied you are with the plans for a pause I understand that not all of Gaza will be subject to a pause so is that going to be work able from your point of view or are there shortcomings with the plan and secondly just a compliment please could you um give a little bit more information about the company that's expressed interest in the empo vaccine thank you um thank you Emma I would like to invite Dr peperon to take your first question Dr peper corn thank you very much uh so first of all greetings from Gaza greetings from The Who for Cabella and I think as we speak uh there actually the technical team uh the technical polio team is meeting here in the wh office where we have established an emergency Operation Center uh just actually uh had a meeting with my UNICEF colleague uh as well and it is actually inspiring I want to say inspiring to see it's the the people from the Ministry of Health uh w show UNICEF and and other partners many other partners Etc and it was when I arrived up till late yesterday evening Etc and the whole day fine-tuning the campaign now the I think it's an a very good question so are we are we happy are we confident with this campaign that's actually basically what you're are saying uh let me very clear it's not ideal but nothing is ideal in in Gaza and I think we we have an have an agreement where we all agreed as technical partners that we can work with and we think it is feasible if all the pieces of the puzzle are in place and I think the DG was very clear on those pieces of those uh of that puzzle we will do we will start with Central Gaza then we move to the south then we move to the north everywhere we do through three days of campaign every day and the polio program we also got some other polio experts in from who and Unis also to assist this is one of the program which analyzes very well they analyze every day we analyze where are we where what went well what went wrong where where are we missing children where are we doing well so this is an an an a combination and an an a combination fortunately I mean and that is the thing we we cannot do house toh house uh campaign that's what she would normally want uh for all reasons we know we cannot do house to house but what did what did we do what we do did we plan we trained 2,180 health workers and Community outre workers we managed to have 392 almost 400 fix points where the polio vaccine will be delivered from and we have almost 300 mobile teams now this is a massive operation and the security is Paramount I think in the DG been very clear we urge all party to ensure protection as has been agreed to and discussed that the parents can bring the children to those fix points and in places where that is difficult we will we will go with our mobile team with the mobile team to reach those children it's an ambitious Target we need to reach 90% plus but I think if if everything is in place as we discussed the we have focused Community strategy and and and a community communication strategy and that's in place as well so we are really looking forward to start coming Sunday three days in a central everyday analysis as the DG point pointed out we are almost sure that we will need an extra day if an agreement for that we will constantly see where we have to put in place the mobile teams Etc then we move to the southern Zone and consequently to the northern zone so yeah a feasible and a workable approach Etc and we are all backing this we are actually they're inspiring to see how many people are actually excited about this we push this forward of course this pieces of the P will have to fit together and and we count on everyone on that all parties all parties we will count on them over to you thank you so much uh Dr peper corn Dr tedras yeah just uh one line I think uh Rick has already covered it very well um what I would like to say is first of all we welcome the POS and second and we hope all parties will respect that but at the same time uh we don't think that POS is enough and we still insist on a ceas fire because ultimately the best medicine and the best vaccine is actually peace that's just what I would like to add and Fila back to you thank you Dr Tedros for the second question of Emma I would like to invite Dr mongi to to answer this question on the emergency use listing for uh empx vaccines over to you thank you f as uh the DG mentioned two companies submitted completed their submission of applications to who for emergency use listing review on the 23rd and these are Bavarian noic from Denmark and C biologics from Japan there are some other companies that are in discussions but these are still under screening and we have not yet confirmed their actual acceptance of their submission so those at the moment we are not in position to discuss thank you thank you so much I would like now to invite anas pedero from a France press to ask to ask the next question an yes yes hi uh good afternoon everybody it's a question also on empo vaccines um I wanted to ask you if you could be more specific on how many pledges uh were uh for DRC where has been made for DRC and when do you think the first empo vaccines uh could arrive in DC because I I heard that um before you say that the plages would materialize in two three months would that be uh not too late maybe I don't know and um once the the vaccines are available what kind of uh Logistics difficulties you think uh the distribution and transportation will face thank you uh thank you anas I would like to invite timen to answer this question Tim oh thank you so um to be clear on some of these pledges uh we are are in discussion with the partners that are actually uh donating uh some of this vaccine and we have an overview around some of these uh quantities that will be uh available in the coming days uh once the country is also ready to receive and Implement these so what we understand right now is from uh Hera that they have procured 175,000 doses of mvn vaccine in addition the man Bavarian Nordic is uh donating another 40,000 doses uh to these quantities that makes up about 230,000 doses that we understand are immin uh available to be dispatched uh to uh affected regions and then as we look further subsequently there are other pledges but we understand that still needs a couple of weeks for them to be agreed on the final uh administrat processes to turn pledges into donations over thank you I think that Dr vov would like to elaborate on this yeah thanks so in addition to what Tim was saying about the numbers of Doses and when they can get into countries we're also working um with our regional colleagues our country off office colleagues the Ministry of Health on the vaccine delivery as part of the response so there are detailed plans that are being developed this is based on the epidemiology of what's happening in the DRC um there are different modes of transmission there are different populations that are affected uh depending on where we are talking about in the country and of course it's not only the DRC so the plans to use these vaccines in a targeted way are currently being developed there are plans that exist but I also want to highlight there's a lot of questions about vaccines and I anticipate many journalists will will continue to ask about the vaccines but as the DG has pointed out and as we we point out in our Global strategic preparedness response plan as is being highlighted in the Continental plans vaccines are only one part of the solution we were I was fortunate to be with uh the director General in DRC yesterday um where we met with the UN country teams as he mentioned and almost as much as they asked about vaccines they asked about strong clear communication about prevention about preventing the spread how can we have the right messages targeted to the people who are at risk and so our our teams are working with UNICEF we're working with many different partners um I shouldn't mention one if I don't mention them all because as who we we work in Partnership um with not just International agencies but Civil Society local Partners to make sure that those messages Reach people who are at risk um and so there's a lot of work that's happening there and I just want to emphasize that right now even when vaccines aren't available and it's going to take some time for the vaccines to reach those who are most at risk the right messages can be reaching the right as risk atrisk populations so we're working to make sure that those messages are Target targeted they're tailored focusing on prevention focusing on preventing the spread in the complex context in which these empo outbreaks are happening Dr Ted yeah thank you uh thank you so on on the vaccines um as you have heard from du um one thing that has to be clear is the um for the eul we need complete information and the information submitted until last Friday was partial and last Friday we got from both companies the additional information we were asking for so we couldn't issue eul before all the information arrives because we have to um have all the information required before we proceed uh on top of that I think um since since we have now the complete information the eul can be ready uh in the next two weeks because it's already a week now since we have received the complete information so but still um we don't need to wait you know until two weeks before we proceed with procurements and that's why gab and UNICEF are proceeding with procurements side by side with the process of the eul so I think that has to be clear and then on the vaccines um some of the vaccines as team said will arrive in the next few days in the RC uh while I was in kinasa I met with Minister kba and also with Jean Casa the um DG J Casa of Africa CDC and the things that should be done from Africa CDC side from the country side from wh side uh and other partners side has been done and we hope to have the first um delivery in the next few days and then it will build up um and that's why the October issue that you said um but it's not um I don't think anybody said you know the vaccines will arrive in October the the part part of the shipment will arrive actually in the next few days and then will will will will build up but considering the number of case and so on most of the allocation of course will be in in the RC and I would like this opportunity to thank the donor countries and uh institutions for for for for the vaccines and that will help in our response but it's not just vaccines alone we already uh implementing the other methods which are very very important so vaccine is one among the tools and we are not just waiting for the vaccines while Expediting the vaccines we're doing uh what should be done under the leadership of the government and the leadership ownership and Leadership of government is important be DRC or or other countries which I have already outlined that reported uh empo uh and not only the ownership and Leadership by the government but Community Partnership is also Central because as we all know outbreak start and end in communities so government's ownership and Leadership strong Community involvement and partnership is important and then the implementation or use of all the tools that we have at hand including vaccines one thing that I really commended is the leadership by the DRC government especially the president because um he put already 10 million us do on the table to respond without waiting for uh donors to to to move and that's an indicator of ownership and and and Leadership and that is very very important to put the resources required while mobilizing Partners to to supplement to supplement to that that's a major indicator of ownership and and Leadership and I hope uh all countries reporting empo will do the same thing it's only through ensuring government leadership and ownership that we can stop this virus of course coupled with that I said um strong Community mobilization and appropriate use of uh the tools while vaccines would be the additional tool Vila uh thank you I would like now to invite uh Gabrielle Emmanuel from NPR to ask the next question Gabrielle hi thank you very much um I I guess I had a bit of a broader question one is that as we all know there's been a lot of frustration about um the time it's taken to get vaccines um empx vaccines and I've heard a lot of people make this analogy that to covid and and the lack of resources then that were in Africa and I wanted to kind of get a sense of how we're making sure we're not falling into the same uh pitfalls and hurdles of from back then um also and not just related to back scenes but also related to diagnostic tests and other other mechanisms to to to care for what's happening and and then a more specific question I'm curious you mentioned about the rising cases I was wondering if that's happening in specific populations um in in addition to the countries you mentioned thank you very much so thanks I I can start with that question so I we're not in the same situation we were in when covid began um the capacities that countries have um particularly around the world but particularly in Africa for uh diagnostic capabilities PCR based capabilities surveillance um case finding contact tracing clinical Care Emergency operation centers across the entire pillars of of the response that they expanded and strengthened during covid they're using for empo they're using for chalera they're using for uh suspect VHF uh viral hemorragic fever outbreaks so we're not in the same situation with regards to vaccines um there 's a lot of work that is happening that needs to continue um it was emphasized during Co to make sure that we we not only address access uh we not only address delivery um and and Equity but looking at production capacity making sure that we have these hubs we have the MRNA hubs that were started Tech transfer uh works so that more production can be made for vaccines so we're not in the same situation that we were having said that moox is not a new disease this virus has been circulating for decades ades we went through a global Public Health Emergency of international concern 2022 to 2023 based on the clay 2 outbreak we have a new Public Health Emergency of international concern largely due to this 1B this new CLA um and there's a lot of work that we're ha that's happening to not only look at access but delivery um another area of strengthened capacity across Africa is vaccine delivery what countries put together to vaccinate large numbers of people Young through the Epi programs but all the way through older adults through with covid vaccine through that life course can be utilized for empo there's a lot of experience in the DRC itself doing vaccination for Ebola all of that can be leveraged for the use of vaccines for empo but again I want to highlight that the use of vaccines as part of this response is part of the response in a targeted way we're not talking about Max vaccination programs we're talking about protecting populations at risks our health workers context context of context um and again using those vaccines as soon as they can arrive in country so I think we need to shift this narrative a little bit and talk about also not only the challenges but the strengths that exist across the continent of Africa there's a lot of leadership as the DG just said within the country itself the ownership of this the capacities in those countries we are here for support but this response is led by the ministry it's led by the government it's but it's um driven by local communities and we are here to support that implementation of any interventions that are brought [Music] in for for [Music] the 9,715 meeting of the Security Council is called to order the provisional agenda for this meeting is threats to International Peace and security the agenda is adopted the United Kingdom has requested for the floor I give them the floor thank you Mr President sorry to interject early um uh we understand an invitation is to be extended to Marley to participate under rule 37 we of course accept the ruling of the presidency on this and we're happy to hear what Marley has to say but just for the record in case it's misinterpreted under the wording of rule 37 we do not accept the premise that Marley's interests are specially affected by West weapons transfers to Ukraine thank you I thank the distinguished representative United Kingdom for the statement the Russian Federation are requested for the floor I give them the floor thank you live service this is the primary audio circuit for the Reuters live service after the environmental samples purpose that we specifically focus on that and that's and that's how we uh we came with this three uh case this three suspected polio cases of which one uh was confirmed routine imization was always incredibly strong in Gaza at coverages of of 90 95% even over 95% of course when this crisis erupted Etc the routine administation also did integrated who I would say again the Ministry of Health health workers who UNICEF and partners we focusing on that and over the last quarter I mean reach coverage is reach actually coverage of almost 90% we have to get better in the data on the denominator Etc but there a lot of focus how do we get routine immunization uh improved now that links me to the to the following topic this is of course all an environment with an a disintegrated ated Health sector where you talk about a hospital functionality of 70 out of 36 hospitals which are partly functional 58 of of 132 Primary Healthcare partly fun functional in addition five field Hospital partly in full for uh fully and and we've seen many an enormous spread of infectious diseases and when you look at that for example acute respiratory infections and those are under reporters speak people have lack of access to these Primary Healthcare facilities we see more than a million acute respiratory infections more than 600,000 diarrheal diseases 25 times what is normally there during these kind of periods a lot of scabas are Li 105,000 skin diseases 70,000 cases and Incredibly worrying what we call the hug JIS syndrome hepatitis A over 105,000 cases a lot of this related to the the incredibly poor water and sanitation conditions everywhere in in in Gaza so yeah we and it's really I'm glad that you asking this question because we focus now of course Very Much on polio and a polio campaign but we deeply concerned about the overall health situation I talked about the health functionality and I want to add also another point that uh over the last week we over the last week wh last two weeks we planned for six missions to the north to bring fuel to bring medical supplies to the hospitals in nor only two were approved to deliver those Fuel and medical supply and with huge troubles I mean incredibly lengthy missions one of our teams only returned late at night completely unnecessary day before yesterday so reached the Indonesian Hospital with fuel and also part of fuel and to come out at one but uh other hospitals in the North like Al hospital they face zero St fuel stocks and that has of course implication for all the service the maternity Services the daily surgeries which they do the the the hod dialysis patients etc etc and other hospitals Halu hospitals International hospitals facing same problems and it it really pains me that in the 11 months of this prices we still have to discuss this basic these Basics kind of missions of fuel and medical supplies bringing teams and merg medical teams in bringing patients in and out and that we still struggle with that and related that to that also another topic is medac the medical evacuation incredibly needed we estimate that 10,000 critical patients should leave Gaza they should get treatments elsewhere outside G and since the Rafa Crossing closed 6 May 6 May the only substantial metac was organized with great support from the UAE and who managed and organized to uh actually uh facilitate the metac of 85 patients and I think 65 companions but that's of course a Dr in the ocean what is needed and and we urgently we request and I want to do this again today we request the establishment of medical corridors first and foremost to restore the traditional referral path from Gaza to East Jerusalem and West Bank hospitals are ready in the West Bank and East Jerusalem to receive gazan patients to receive their Palestinian Brothers assistance then also uh to get a medical Corridor operated to Egypt and to uh and and and and and to and to Jordan so this is just some of these issues thank you over to you uh thank you Dr peeper corn I can see that Dr Hamid Jafari wants to add uh some details Dr Jafari you have the floor thank you for the land just to supplement what Rick has said um in terms of the impact uh and I think for polio we have to actually think about the potential impact the current outbreak has so we know that this virus came into Gaza probably around September October of last year and it has been circulating in Gaza since then and just the genetics uh genomic uh signatures on the virus and that it has been detected in multiple sites and now we have a unfortunate paralytic case of polio we are assuming that this virus is circulating all across Gaza um and the conditions that Rick and others have described of lack of clean water overcrowding extensive uh sewage contamination are ideal for intense polio virus transmission so the potential for this to continue in Gaza spread to surrounding countries uh Israel has communities that are reluctant to vaccinate for religious reasons Lebanon is going through a crisis there are issues in in Syria so there is a fair amount of vulnerability in the surrounding countries and so the potential for international spread and that's why folio I want to remind everybody remains a public health emergency of international concern under the IH so I think we we need to think about this as what are the potential impacts of more paralytic cases in Gaza and then International spread with with other countries having to despair uh to declare Public Health emergencies and and uh stopping outbreaks and preventing paralytic cases uh within their own borders back to you Fila thank you thank you Dr jaffari I would like now uh to ask if other colleagues want to add anything maybe Dr Zakaria thank you Fila um just to highlight that it has been 11 months of continued violence and so we're seeing now polio but this is along with many other diseases for which our Collective capacity to prevent detect and respond to continue to be um disrupted severely disrupted uh we have not been able to implement the most basic Public Health interventions for the entire population of Gaza and people continue to be displaced people continue to not having access to sufficient and good quality food uh especially for the younger children who depend on much more than food commodities getting into Gaza so we're seeing polio but we're also show that many other pathogens are spreading under detected and it's a matter of time until we see a surge and and much many more diseases spreading really out of control what we wish though is for this PO vaccination campaign to be successful which would also be then an important milestone for us to know that yes humanitarian operations can be scaled up for the entire population of Gaza and the vaccination against polio for Gaza should then set the example for how we can do better and significantly increase humanitarian assistance for all sectors for the entire population of Gaza and also the West Bank and the region thank you thank you so much I realize that we haven't answered one of the question from uh Gabrielle Emmanuel from NPR on Rising cases of empo we have with us Dr uh Rosamund Lewis um and uh Rosamund is our technical lead for empo Dr Lewis do you want to take uh NPR question on do we have Rising cases of empo sure thank you very much uh yes it's a certainly a valid question and uh there are a rising reports Rising number of cases being reported in different parts of the country so you've heard of course that there's the cases in the emic areas largely affecting children young children and Adolescence as well and then we also have the um a fairly rapidly spreading outbreak in uh the eastern part of the country which is now also in Burundi uh with cases in Rwanda Uganda and Kenya um so there uh there is suggestion that of course uh these outbreaks are continuing to spread and the true um virus for example in the eastern part of the country it really started in one Health Zone called kamituga and then it spread to 10 Health zones in South kuo and then it spread to North kibo and then it's so it's clearly the virus is on the move and those are those are true cases um another factor is uh for example notably well in both both outbreaks emic areas as well as in the outbreak that began in eastern central Africa is uh the attraction to improving Health Services part of you've heard Dr Van Co say that we we support the countries on many aspects of the response one of them is providing essential medicines kits uh for clinical care uh particularly for children but also um for adults um for hospitals and health centers and so as the population realizes that they in fact have access to um better Optimal Care they will also come to the health centers and so more cases are detected you also have an increase in access to Diagnostics you also very specifically mentioned that um while the emergency use listing has been triggered uh three weeks ago and the uh Public Health Emergency of international concern two weeks ago of course we've been supporting the country ever since they first declared uh well even before that naturally but remember Democratic Republican of Congo declared their epidemic of uh empo as long ago as December 2022 so since that time we've been bringing support and notably over the last uh eight to 10 months in Diagnostics including uh increasing the capacity for diagnostics from One National Lab to eight provincial Labs uh two National Labs that can now do prary Chain Reaction PCR and uh eight provincial Labs or seven provincial Labs that can also do um PCR but through a smaller unit called Gene expert which is provided to provincial Labs um so diagnostic capacity has increase a lot which means again people have better access to diagnosis uh and uh access to um care because of that and Confirmation which also increases the number of cases reported so there are many things that are contributing to increase number of cases so better surveillance better Diagnostics better clinical care um actual circulation of the outbreaks which continues um and uh and with all of that we work we're working also with the country to improve case definitions so for example in the early days when the outbreak first began in South kibu and one-third of the cases uh were in fact among sex workers at that time um trans sexual transmission of empo was only just becoming recognized in the country and so it took some time to also recognize that genital lesions for example could be empo as opposed to herpes or syphilis so quite a number of factors are are in contributing to a greater recognition of disease and as we continue uh to support the country in all these areas of work of course we do expect the number of cases to continue possibly to rise although we've done a lot already um and then with time as the interventions take U more and more uh effect and and better hold um we fully expect the number of cases to begin to come down again um thanks uh Dr vov yeah I just wanted Roseman was was reminding me of um she's made some great points I just want to highlight a couple of things here so when you see these Maps um we've seen these maps online that show cases and circulation they basically color the whole map um and what we're trying to do with the detailed epidemiology and working with the different teams is really looking at a more granular level about what's happening so as Roseman was saying it's very complex there's a lot of different groups that are affected but not all the same groups are affected in the same areas there's different clayes that are circulating we have some information on occupation we see different AG age profiles and so what we're hoping to be able to do um through the strengthened IMS in country working with the ministries of Health working with Partners is to have more details of that epidemiology um because the more precise we can be the more targeted we could be in the in tailoring the interventions um everything from enhancing the surveillance that we're doing through the risk communication and the targeted messages there through the use of those vaccines so I just wanted to highlight that point that the surveillance aspects that's that's been pointed out already are really critical and the upsurge of Staff in people uh Workforce in the DRC um led by the Ministry of Health led by the government part of that is really trying to get that detail so we're really grateful for all of the the the extra hands on deck um that have a lot of experience with surveillance in the country to help us really detail this out because that Precision is what we need to really um stop this outbreak in the next six months uh thank you so much I would like now to invite for the last uh question Haley OT from CBS can you hear me hello thank you um my question is about the polio vaccine in Gaza health workers in Gaza have raised concern over the cold chain the Palestinian Ministry of Health says there will be mobile Refrigeration units I was wondering if you could give us any more information about those and how they would work and how the the coal chain would be maintained and managed during vaccine delivery and distribution thank you thank you um maybe Dr Jafari can take this question I can start and then and then Rick can provide additional details so the way the cold chain is organized is that this is largely a fix siiz vaccination with some Outreach um so uh there was a shortage of cold chain and so additional freezers and refrigerators have been imported by UNICEF and and deployed into into into Gaza from these freezers the vaccine is then put into cold boxes and brought closer to the vaccination site where then it is transferred to a large number of uh vaccination teams in what we call vaccine carriers to maintain the Integrity of the uh po chain so the the planning and positioning of Po chain is part of what we call micr planning for this campaign which has been which has been uh completed and then of course a very important tool that exist is the vaccine vial monitor which is on every vaccine vial of polio that tells the the vaccinator and health workers about the viability of the vaccine that monitor is a very strong tool so Rick I don't know if you want to add any particular specifics on on how this is being managed in Gaza yes thank you uh yeah I would like to add some points and and and thanks thanks for this um question so first of all I think that we described the number of vaccines which which have arrived in Gaza and actually all the cool chain equipment including including I I would say generators and related to that so it's it's all part of that and and you talk for example about 500 vaccine carriers Etc I mean that's an it's a hamit describes already the the the fix SES and I want to again point that out we we we talk about uh almost 20 2, 200 2, 1880 health workers community outreach workers which have been trained and will support implementing of this campaign and we talk about 392 fixed points I mean and and and they are there so that the vaccines Co chain is one issue that talk about fuel for example that it is needed to make sure that this all works that all been arranged with all kind of difficulties we discussed a number of of days the way we actually going to implement the campaign the three days per Zone plus we needed another one the the mobile teams and just the the word micr planning is sometimes a bit U yeah I think it's it's it's it doesn't do justice the microplanning is the most important part of any polio campaign and and seems easy it's actually very complex so it's just like area by area small area by area how what's the analysis where are the children how do we vaccinate what's the best way forward and this is constantly be updated and adapted and when we talk about because I think I was not even clear enough how complex it is even in place like a relatively small environment as Gaza the total number of teams is 513 there we fixed teams 174 fixed team out reached 252 we talk about Community points 33 Community to 252 mobile teams special teams special 48 Transit teams as we call it 39 Transit teams and backup teams 40 now that shows a little bit about the complexity of this operation and I also want to stress that it's also part of vulnerability of this operation and and we have to make sure that's all part of all the puzzles I mean everybody calls talks always about the vaccine and the cold chain which is very important the microp planning and everything related to that is probably the most important uh part of a of a successful campaign and and this brings me back and and and that we we need of course we need definitely that that all all the parties all the parties actually that we stick uh stick to the agreement we have the humanitarian pulses to ensure that people can move that they can bring their children that all those teams can do their work uh we talk about hiring Vehicles hiring truck trcks motorcycles Etc uh it's all part of the uh part of the campaign when this is all linked I think we have a good chance to actually get a successful uh campaign so again we called on all parties to help ensure that this happens as it has been planned and and agreed on over to you uh thank you Dr Jafari and thank you Dr peper corn we have come to the end of our press conference thank you so much for your participation we will be sending you the audio uh files and DG uh Dr tedos remarks right after this briefing uh and of course you can reach out to the W2 media team if you have any followup question uh with this over to you Dr tedos for your closing remarks thanks thanks Fila and thanks to all uh members of the press for joining us today and see you next time e