WHO/Europe Health Emergencies Newsletter - Issue No.36: 29.02.2024
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Health Emergencies Newsletter
Issue No.36
29.02.2024
TOP STORY
As Ukraine marks 2 years of full-scale war, WHO Regional Director for Europe Dr Hans Henri P. Kluge reflects on how the country’s health system has coped, with WHO support, and what lies ahead. Despite over 1 500 attacks on health facilities, infrastructure and personnel in 2 years, the health system has proven remarkably resilient.
While the road ahead is fraught with challenges, the right investments can ensure a better future.
UKRAINE EMERGENCY
Joint statement by Dr Jarno Habicht, WHO Representative in Ukraine, and Munir Mammadzade, UNICEF Representative to Ukraine, Kyiv, 7 February 2024
“We are deeply concerned about the recent drastic increase in attacks impacting civilians and civilian objects across Ukraine, in particular health and education facilities.
Deadly attacks have continued unabated as the full-scale war reaches the end of its second year. Since February 2022, WHO has documented 1 552 attacks on health, impacting health providers, supplies, facilities, warehouses and transport, including ambulances. They have claimed at least 112 lives, including health-care workers and patients, and injured many more. These attacks have reportedly damaged or destroyed more than 3 800 schools in Ukraine, according to the government."
As we mark a grim 2-year anniversary since the onset of the full-scale war in Ukraine, it becomes increasingly evident that effective risk communication, community engagement and infodemic management (RCCE-IM) are indispensable in navigating humanitarian emergencies. Since the escalation of conflict in February 2022, the critical role of RCCE-IM in shaping responses has become ever more apparent, underscoring the imperative of prioritizing these measures in humanitarian efforts.
When the long-running conflict in Ukraine escalated into full-scale war in February 2022, millions of people nationwide were confronted with situations that they had never experienced. Many people found themselves at a new location within or outside of Ukraine, often in distress due to family separation or the experience of violence. Their need for clear information from trusted sources, guidance on maintaining their health, and feeling engaged in the co-design of response activities increased. Tailored RCCE-IM interventions can improve the ability of displaced people to navigate and access hosting health systems for treatment and prevention, but also give people a sense of orientation and belonging, thus increasing their well-being.
"We feel that we are not forgotten, and our work is visible. These trainings provide us also with moral support.”
These are the words of Dr Halyna Shyshova from the Donetsk Regional Centre for Disease Control in Ukraine. Dr Shyshova completed various WHO-supported courses during 2023 and 2024 as part of a transformative 3-year EU-funded project implemented by WHO/Europe. A main aim of this initiative is to enhance the immunization-related knowledge and skills of health-care workers.
Facing exceptional challenges in her daily work, operating in a region mostly under occupation, and with a front line near the city of Sloviansk that is regularly shelled, Dr Shyshova remains steadfast in her resolve.
In a significant step towards enhancing public health in Ukraine, WHO and the Government of Ukraine have jointly released the WHO Country Cooperation Strategy, Ukraine 2024–2030. The Strategy was published following a joint planning session where the parties also agreed on the key focus areas for 2024.
This ambitious plan will focus on health system strengthening and financing, and European Union (EU) accession. It aims to build a resilient, people-centred health system capable of delivering high-quality care to all residents, regardless of their ability to pay, and to navigate the complex health challenges posed by the ongoing war and corresponding public health threats.
Two years into Europe's most significant crisis in decades, Ukraine's challenges and its remarkable adaptation have a lot to teach.
WHO has been an active partner to Ukraine, navigating the complexities of delivering health support in a war-torn country. Our journey has unfolded lessons of immense value, not just for Ukraine but for the global health community. As we mark this grim anniversary, it is crucial to reflect on these insights and how they shape our collective path forward.
MEASLES OUTBREAK
2023 saw a sharp increase in measles cases in the European Region, putting millions at risk. Updated data from 2023 are driving home the urgency of a swift and concerted response to measles outbreaks in the WHO European Region, underpinned by the need to protect everyone who remains vulnerable to the disease.
Last year, more than 58 000 people in 41 of the 53 Member States in the Region – straddling Europe and central Asia – were infected with measles, resulting in thousands of hospitalizations and 10 measles-related deaths.
The latest numbers from 2023 represent a rapid increase compared to the previous 3 years, and a risk for anyone in the Region who is not protected. Sustained efforts are clearly needed to prevent measles cases from continuing to rise in 2024.
Measles continues to spread in the WHO European Region, with over 42 200 cases reported by 41 Member States for 2023. Among the countries most affected in the Region, Kazakhstan has recorded the highest incidence with 13 677 cases in 2023, which corresponds to over 639 cases per million population. There have been over 11 300 reported cases among children under 14 years of age in the country, with 70% of them being unvaccinated against measles.
As in other countries of the Region, the virus is spreading rapidly and the outbreak is attributed largely to an accumulation of susceptible children who missed routine immunization doses during the COVID-19 pandemic; 65% of the reported measles cases in Kazakhstan have been children under 5 years of age.
COVID-19 AND RESPIRATORY VIRUSES
Türkiye unveiled a draft National genomic surveillance strategy (GSS) at the PHA4GE (Public Health Alliance for Genomic Epidemiology) conference 2023, reflecting its commitment to global public health genomics. In partnership with the Ministry of Health, the delegation also presented research showcasing the nation’s proactive response to the COVID-19 pandemic, underscoring its contribution to global health security.
Along with Dr Süleyman Yalçın, head of the National Molecular Microbiology Reference Laboratory, Türkiye emphasized the importance of a national GSS under the EU-funded Strengthening national capacities against COVID-19 project. Recommendations included establishing a formalized network of global health genomics professionals, capacity-building workshops for low- and middle-income countries, cross-sector partnerships, ethical frameworks for data sharing, and a standardization of protocols.
Infodemics occur when too much information, including false or misleading information, is available in digital and physical environments. This can pose a big health risk, which is often exacerbated during emergencies. To mark the publication of a new toolkit, Cristiana Salvi, WHO/Europe’s Regional Advisor on Risk Communication, Community Engagement and Infodemic Management, explains the importance of addressing dangerous health narratives.
TÜRKİYE EARTHQUAKES
The initial 7.7 magnitude earthquake was the most powerful recorded in Türkiye in 84 years. Its impact was devastating across a huge area: 11 provinces in Türkiye were affected, more than 50 000 people lost their lives (including over 7000 refugees, many of whom were Syrian), more than 100 000 were injured, and approximately 1 million people lost their homes.
The earthquakes caused massive destruction and suffering, creating new and urgent health needs in the communities affected, including both host and refugee populations. The disaster disrupted access to health services, including maternal and newborn health care, vaccination, noncommunicable disease management, mental health support, disability and rehabilitation services, and health information.
EMERGENCY PREPAREDNESS
Noncommunicable diseases (NCDs), such as cardiovascular disease, cancer, chronic respiratory disease and diabetes, are responsible for 75% of deaths worldwide. People affected by humanitarian emergencies are at increased risk of NCDs. It is estimated that strokes and heart attacks are up to 3 times more likely following a disaster. However, care and treatment for NCDs are often not included as a standard part of humanitarian emergency preparedness and response, which focus on the most immediate needs.
To support integration of essential services for NCDs into emergency preparedness and humanitarian response, the World Health Organization (WHO), the Kingdom of Denmark, the Hashemite Kingdom of Jordan, the Republic of Kenya, and UNHCR, the UN Refugee Agency, are jointly convening a global high-level technical meeting on NCDs in humanitarian settings on 27-29 February in Copenhagen, Denmark.
Hans Kluge, Regional Director, Europe, World Health Organization (WHO)
Europe has faced an unprecedented number of emergencies in recent years, including disease outbreaks, conflict and extreme weather events.
When a disaster hits, the World Health Organization has learned, it is generally those who are already vulnerable who are the most likely to be at risk.
Here's why we must better plan for the ‘invisible’ impact of emergencies and disasters on health, particularly for those with noncommunicable diseases.
A long-standing partnership on issues as varied as climate change, digital health, antimicrobial resistance and the health and care workforce, all firmly based on mutual goals of improved public health in Europe, is about to become even stronger.
The agenda was packed when European Commissioner for Health and Food Safety Ms Stella Kyriakides, the European Commission’s Director-General for Health and Food Safety Ms Sandra Gallina, and WHO Regional Director for Europe Dr Hans Henri P. Kluge met, along with their respective teams, on 1 February in Brussels, Belgium. Together they reflected on further strengthening their strategic collaboration in the light of current key issues in public health.
When emergencies strike, it is crucial to ensure availability of and access to functioning hospitals. Hospitals help those affected by emergencies while also handling the normal everyday flow of patients, such as those who have had accidents, have a chronic illness or are giving birth. Hospitals play a paramount role in providing health care, but they also help to maintain the population’s trust in the health-care system and state structures.
With all of this in mind, as part of its Safe Hospital Initiative, WHO has been conducting trainings using specially designed guidance and tools that support hospital staff to address issues of hospital safety and response coordination in times of crisis. Recently, trainings, policy and technical advice, and strategy and guideline development in Lithuania and Bosnia and Herzegovina have helped build resilience into these Member States’ health facilities.
