2022-04-25-世界卫生组织-COVID-19,_Ukraine_Other_Global_Health_Issues_Virtual_Press_conference_transcript_-_26_April_2022_19页_157kb

Childhood Acute Hepatitis (Unexplained):

• (Trend/Concern) At least 169 cases reported from 11 European countries and the US (ages 1 month to 16 years). Symptoms include abdominal pain, diarrhea, vomiting, jaundice, and severe hepatitis. Liver enzyme levels are elevated.
• (Investigation/Diagnosis) Common causes of viral hepatitis (A, B, C, E) and bacterial gastroenteritis ruled out; adenovirus detected in ~74 cases. Exact cause under investigation globally, involving testing infectious and non-infectious factors across all affected countries (approx. 12). No clear link to COVID vaccines or widespread lockdown suppression suggested.
• (WHO Action) Collaborative investigation with ECDC and affected countries, supporting additional lab testing. Existing cases and new reports from other nations are being assessed.

Ebola Outbreak (DRC):

• (Event/Severity) Confirmed in Mbandaka (NW DRC) 1 week prior; first case reported during press conference, second case identified the same day (patient died). Initial response slow due to weekend passing, linked to political calendar.
• (WHO Action) Strong support for DRC government to scale up testing (has been ongoing), contact tracing, public health measures, and vaccination ring operations.
• (Tools/Readiness) Ebola vaccines pre-positioned (being transported from Goma/Kinshasa to Mbandaka). Support includes diagnostics and clinical management. Emphasis on speed of detection and response, leveraging improved sequencing capabilities. Containment dependent on robust contact tracing and infection prevention control within healthcare settings.

Global COVID-19 Situation:

• (Situation) Reported global cases and deaths continue to decline, but this trend must be approached cautiously (Weekly deaths were 15k+).
• (Challenge) Declining testing levels may be obscuring transmission patterns and viral evolution. Virus persists, spreads, changes, and kills.
• (WHO Action/Call) Continue urging all countries to maintain robust surveillance, including sequencing. Seize opportunity presented by declining caseload to accelerate pandemic preparedness and response mechanisms. Vaccines offer protection but don't replace surveillance or post-COVID care understanding.

ACT Accelerator:

• Vaccines Pillar:
  • (Progress) Largest/complexest global vaccine rollout. 44% of low-income country residents vaccinated with >=2 doses. Unprecedented deals for oxygen suppliers (>120 LMICs). COVAX allocated ~1.9 billion doses, delivered ~1.4.
  • (Challenge/Bottleneck) Hurdles include low access in LMICs (vast majority), need for prompt/accurate testing to access oral antivirals (e.g., Paxlovid). Contingent financing facility (Pandemic Vaccine Pool) initiated but not fully funded. Global vaccine equity gap still wide (~60% of global population vaccinated primary course, only 11% of low-income countries vaccinated).
  • Tools Pillars:*
    • Therapeutics: WHO recommends Paxlovid (85% reduction in hospitalization) for high-risk, mild/moderate COVID. 5 outpatient oral drugs (2 oral, 3 IV) have evidence. Test access complicated by low testing, bilateral deals lack price transparency. Generic versions pending, access funding required (e.g., Global Fund for therapeutics + prep for generics $2.3 billion needed).
    • Diagonistics: Dramatic price reductions for PCR/rapid tests. Advanced global genomic sequencing capacity (Botswana/South Africa lead). Exceeded demand significantly, critical local capacity now exists in several countries (Brazil, Senegal, South Africa, India). Dropped July-September 2021 testing rates by ~70-90% globally due to lifting of restrictions, hindering tracking of virus evolution/surges - caution against discontinuing testing.
    • Health Systems/Response: Coordinated financing (approx $12B) complements ACT-A funding. Partnerships pool resources for training, PPE, community outreach and CE. Strong coordination (bill Rodriguez points out irony of strength now vs. initial panic). Avoid repeating mistakes like halting testing prematurely (Bill Rodriguez referencing his professor's quote). Need to maintain/further strengthen global response mechanisms post-pandemic.

Who Needs Vaccines?