World Health Organization (WHO) Coronavirus Press Conference May 27

Dr. Tedros: (00:00) Day for Monday, for Tariq. Thank you. Thank you Tariq. Good morning, good afternoon, and good evening. Yesterday, 40 million health professionals sent a letter to the leaders of each of the G20 nations calling for a healthy and green recovery from COVID-19. I fully support this, the human cost of COVID-19 has been devastating, and the so-called locked down measures have turned lives upside down. But the pandemic has given us a glimpse of what our world could look like if we took the bold steps that are needed to curb climate change and air pollution. Our air and water can be cleaner, our streets can be quieter and safer, and many of us have found new ways to work while spending more time with our families. Dr. Tedros: (01:07) Yesterday, WHO published our manifesto for a green and healthy recovery from COVID-19 with six simple prescriptions. First, protect nature, which is the source of the air, water and food on which human health depends. Second, ensure that homes and health facilities have water and sanitation, access to clean and reliable energy, and are resilient to climate change. Third, invest in a quick transition to clean energy that will cut air pollution so that when COVID-19 has been defeated, people can breathe clean air. Four promote healthy and sustainable food systems to give people access to healthy and affordable food. Fifth, build cities that integrate health into all aspects of urban planning from sustainable transport systems to healthy housing. And sixth, stop subsidizing fossil fuels that cause pollution and drive climate change. Dr. Tedros: (02:27) As some countries start to reopen their societies and economies, the question we must answer is whether we will just return to the way things were or whether we will learn the lessons the pandemic is teaching us about our relationship with our planet. Building back better means building back greener. When I started as director general, almost three years ago, one of the first things I did was to put out a call to all the staff, to contribute ideas for how to transform WHO and make it more effective, and I was asking many of my colleagues saying, "Please generate crazy ideas to transform our organization." Dr. Tedros: (03:18) One of the ways I did that was by instituting open hour, where any staff member can come to talk to me about any issue they want every Thursday afternoon. These ideas became the basis of the transformation process we have been implementing over the past few years, and I would like to use this opportunity to tank all the staff who contributed their ideas that are now changing the face of WHO. At one of the first meetings, a staff member proposed the creation of a WHO Foundation. The idea was to establish a way to generate funding for WHO from sources we haven't tapped before, including the general public. Until now WHO has been one of the few international organizations which has not received donations from the general public. Dr. Tedros: (04:20) I immediately recognized the enormous potential in this idea, thanks to the staff who suggested this idea. It's well documented that one of the greatest threats to WHO success is the fact that less than 20% of our budget comes in the form of flexible assess contribution from member States, while more than 80% is voluntary contributions from member States and other donors, which are usually tightly earmarked for specific programs. In effect, that means WHO has little discretion over the way it spends its funds, almost 80% of its funds. We have been working hard to encourage member States to increase the proportion of flexible funds they give us. And we are very grateful for those countries that have given us greater flexibility in recent years, and there is improvement. Dr. Tedros: (05:37) For WHO to fulfill its mission and mandate, there is a clear need to broaden our donor base and to improve both the quantity and quality of funding we receive, meaning more flexible funding. Since February, 2018, we have been hard at work supporting the establishment of the WHO Foundation, and today after a hard work of more than two years, it gives us enormous pleasure to launch it officially, to launch the WHO Foundation. This is a historic step for WHO, as an integral part of our resource mobilization strategy to broaden the contributor base. Dr. Tedros: (06:36) The WHO Foundation was not ready to launch when the COVID-19 pandemic begun, so with the support of The United Nations Foundation, The Swiss Philanthropy Foundation, and several other partners, we launched the COVID-19 solidarity response fund. In just two and half months. This fund has raised more than 214 million U.S. Dollars from more than 400,000 individuals and companies, including $55 million from the One World: Together At Home, virtual concert. These funds have been used to buy lab diagnostics, personal protective equipment, and to fund research and development, including for vaccines. Dr. Tedros: (07:28) The Solidarity Response Fund is powerful proof of concept for the WHO Foundation. To further promote the Solidarity Response Fund WHO has partnered with the animation studio Illumination to launch a public service announcement today, aimed at children featuring the beloved animated characters, the Minions and Gru, voiced by the actor Steve Carell, to promote ways for people to stay safe from COVID-19. The Solidarity Response Fund will continue to receive donations to support WHO's work on COVID-19, while the WHO Foundation will have to fund all elements of WHO's work and be fully aligned without priorities. Dr. Tedros: (08:23) It now gives me great pleasure to introduce Professor Thomas Zeltner, who is the founder and chair of the board of the WHO Foundation. Professor Zeltner is a Swiss physician and lawyer with a long and distinguished career in public health, including at Director General of the National Health Authority, and as Swiss Secretary of State for Health. Professor Zeltner, thank you for your support and collaboration over the past 18 months, and the floor is yours to speak about the new WHO Foundation which is being born today. Thank you professor. Professor Thomas Zeltner : (09:13) Well, thank you so much Dr. Tedros for welcoming me here in Geneva, and it's really an honor, and I'm very pleased to have the opportunity to speak on this topic today. It is important, and indeed a very important day, and I'm very thrilled to announce the creation, the formal creation of the WHO Foundation. What I will do is address in five key points briefly, the following points. First, what is a WHO Foundation? Secondly, why is it needed? Third, how will it make a difference? Fourth, what is the relation between the Foundation and WHO? And finally, where are we today and what are the next steps? Professor Thomas Zeltner : (10:12) So let me start with the first, what is the WHO Foundation? The Foundation is an independent grant making organization set up under Swiss law. Its primary mission is to address the most pressing global health challenges of today and tomorrow by raising significant new funding for WHO from nontraditional sources, and I stress that, from nontraditional sources. The foundation will work with individual major donors, with the general public and with corporate partners to strengthen the global health ecosystem by supporting WHO's resource mobilization strategy, broaden WHO's donor base, and supporting its five years strategy also known as the General Program of Work. Professor Thomas Zeltner : (11:21) Second, some may ask why is this foundation needed? The creation of the foundation represents a truly innovative approach to diversify WHO's resource mobilization strategy. This new approach is clearly a urgent need as illustrated by the tremendous response of the donation to the COVID-19 Solidarity Response Fund that Dr. Tedros just alluded and showed how important it is. While a pandemic preparedness and response will also be one of the areas of the WHO foundation, the foundation's mission is much broader than this, and will cover all areas of global public health, in which WHO is working. We will do this by supporting global public health's needs from a wide range, from prevention, mental health, to noncommunicable diseases, to emergency preparedness, and to health system strengthening Professor Thomas Zeltner : (12:42) Three, how will this foundation make a difference? The foundation will enhance and compliment, not supplement or something like that, but compliment the global health's ecosystem by providing agility flexibility in receiving contribution and grant making, accelerating WHO led evidence based interventions, and focusing on high impact intervention and partnerships, we will maintain close ties to WHO with ensure synchronization, support and complementarity in all what we do in all areas. All funding of the WHO Foundation will help implement WHO's general program of work. On average, between 70 and 80% of the funds we raise will go directly to the WHO secretariat. The remaining 20 to 30% will be used to strengthen public health globally by working with implementing partners of WHO. What is the relation of the Foundation with WHO. The foundation is an independent legal entity formed under the laws of Switzerland. The name is being licensed on a revocable basis in accordance with terms and conditions stipulated in an agreement between the WHO and the Foundation. The Foundation has been established, and that's a legal requirement, by me as a Swiss citizen in the Canton of Geneva here in close collaboration with WHO and supported by an independent philanthropic consulting firm. WHO will mean maintain close links with the Foundation, in this regard, the Director General will designate a representative to attend the board. Professor Thomas Zeltner: (15:03) ... the representative to attend the board foundation meetings as an observer. WHO also periodically will report to member states on its interaction with the foundation and funds received from it. All funding from the WHO Foundation to WHO will be fully aligned with the program budget decided by member states and given as flexible and predictable as possible. Professor Thomas Zeltner: (15:36) The last point, what are the next steps for the foundation? While we have established a possibility to receive donations right now under a new homepage, whofoundationproject.org, and I invite you to look at it and to feel free to donate, we currently are in the process of forming a secretariat for the foundation and starting the search of a CEO. In addition, we are in the process of expanding the board to include prominent and diverse personalities from all WHO regions. Professor Thomas Zeltner: (16:24) I'm truly humbled and honored to be the founder of this initiative, and thank you, Doctor Tedros, very much for this opportunity, for your confidence, and for all your support in launching this initiative, which has been in the making for two years, as you mentioned. I would also like to thank the advisory group that has helped us in establishing this foundation. Very much thank you, all members of this group. We very much look forward now to engage with individual major donors, with the general public and corporate partners, to tailor partnerships with the ultimate goal of supporting STG3 to help future generations to overcome health challenges of today and to thrive tomorrow. Professor Thomas Zeltner: (17:27) WHO deserves a strong, independent, external advocate who can support and strengthen its impact in the global health ecosystem, and this foundation will do just that. Thank you so much. Derek: (17:49) Thank you very much, Doctor Tedros and Professor Zeltner. Now Professor Zeltner and the Director General, Doctor Tedros, will sign the Memorandum of Understanding between WHO and WHO Foundation. Dr. Tedros: (18:53) Many pages, 'eh? Dr. Tedros: (18:54) Okay. Do you want to do the [inaudible 00:20:36]? Professor Thomas Zeltner: (19:12) Sure. Dr. Tedros: (19:12) Okay. Give me that. Okay. Derek: (20:43) Congratulations to both Professor Zeltner and to the Director General for signing the Memorandum of Understanding between WHO and WHO Foundation. Thank you, and now we will start with our session with journalists on questions and answers. I will remind journalists that they can listen answers and they can ask their questions in 61 languages plus Portuguese, and they can also listen in Hindi, and we would like, if possible, to have short and concise questions. We would start first from our colleague based here in Geneva, [Logan Sierra 00:21:36] from Swiss News. Logan. Logan Sierra: (21:40) Yeah. Thanks, Derek. Can you hear me? Derek: (21:42) Yes, very well. Logan Sierra: (21:44) Thank you, and thank you for taking my question. A question to Doctor Tedros on the new foundation that was just launched. I know that it's an independent foundation, but given the recent tensions with the US on the founding of the organization, do you consider that as a model for future reforms of the funding structure of the organization in order to prevent in the future that one member state could jeopardize the efforts of the organization? Dr. Tedros: (22:15) As I said earlier, this had started more than two years ago and it came from one of our colleagues, actually. As I said, I have this what I call open door, open hour, every Thursday in the afternoon and our staff come and see me to tell me any ideas they have to improve our organization. Dr. Tedros: (22:57) As you know, for any organization to serve the people they serve better, they have to evolve regularly, and in WHO we consider change as a constant. That's why the staff anytime can come not only two, three years ago, but even now they come every Thursday, we have even started virtual now, to talk to me, to give me advice. That's how we got this idea and it's continuing. Dr. Tedros: (23:34) When we started, when this idea came, it really was based on the problems we have been facing and we are still facing. Most of the funding we get, which is 80%, is not flexible. It's earmarked, and our discretion to use it based on other priorities is really limited. That's why we said I think in order to improve flexibility, we need to have additional resources and un-earmarked resources. This is a good solution and we have to pursue. Not only it helps us, of course, to improve the quality of the funding we have, but we also knew that it can address the other problem we face, meaning most of the funding comes from a limited number of donors, especially the voluntary, and it can help us in broadening the base, not only the quality of the funding itself, and having additional resources, especially as Professor said, the funding will come from nontraditional, so it's a plus, a plus, and it increases the sources of funding we get. Dr. Tedros: (25:12) Not only that, we want also additional funding, because based on the transformation we had, we need to invest more in programs, especially if you take the healthy population, one of the pillars we have which is least funded. This idea helps us, the WHO foundation, to increase the volume, too, the quantity, so we can expand our programs. Investing in healthy populations is really key in promoting health. Dr. Tedros: (25:56) We have to actually as WHO focus on keeping people healthy. Our focus should not be in managing disease, but in preventing it from happening and in helping people to lead a healthy life. That's one area, actually, which is least funded, which addresses the root causes of the problem. This is the food we eat, the air we breathe, the environment we live in, and the other factors that can bring ill health or can keep us healthy. Investing in that, investing in promoting health, is very important, and that's why the additional funding we can get through this foundation, and, of course, other sources, can help us also to really invest in this one program, which is least funded, which we identified now based on the transformation as one pillar and the major pillar. Actually, we call it the entry pillar, because that's the healthy populations. Promotion of health, which is the entry pillar and the most important. Dr. Tedros: (27:11) The reform has been completed. The design part by March 2019. This was part of that design and it was already one year in the process last year. This has many benefits, as I said, and it has nothing to do with the recent funding issues, but this is something that started with the transformation that can help the organization, or WHO, to improve the quality of funding, to increase the amount of funding, to serve the people we serve in a better way. Thank you. Derek: (27:54) Thank you very, Dr. Tedros. We will try to go to the next question that comes from Nicola [inaudible 00:28:05] from [inaudible 00:28:06]. Nicola, you would need to unmute yourself. Nicola: (28:11) Can you hear me? Derek: (28:12) Yes, Nicola. Please go ahead. Nicola: (28:14) Great. Thank you very much. Good afternoon. Many African governments are now starting to reopen their economies. What can they learn from countries worldwide who have themselves already started to emerge from lockdown? Are there any cheap or low tech versions of contact tracing that might be available to them, for example, and if not, how should they go about this opening up? Dr. Maria Van Kerkhove: (28:48) Thank you very much for the question. Indeed, there is a lot that all countries can learn from each other as we learn about the virus, as we learn about which control measures work, and how they are implemented, as well as how many of these public health and social measures, or so-called lockdowns, are lifted. Dr. Maria Van Kerkhove: (29:07) What we are learning from all countries that are starting to initiate the lifting of these measures is that the lifting of these measures need to be done in a slow and a staggered way, and it needs to be done using a data-driven approach, meaning do we have the infrastructure in place, the public health infrastructure in place, to know where the virus is? Dr. Maria Van Kerkhove: (29:31) The low tech solutions that you mentioned are people. They are the workforce that needs to be in place to be able to find cases, to be able to test for those cases, to be able to care for individuals who are infected with COVID-19 depending on the severity of their symptoms, and to be able to trace the contacts and quarantine the contacts, and that needs people. It needs a workforce that is educated and trained that can perform those functions. Dr. Maria Van Kerkhove: (30:03) Aided and trained that can perform those functions. There are apps that we have talked about before that can support that, but it doesn't eliminate the need for people. What we are learning from those that are lifting the lockdown, is that the ones that can do this well, the ones that are teaching us, they have the public health infrastructure in place. So in several countries in Asia for example, in countries in Europe, that are lifting these measures, what they're able to do is quickly identify cases and look at the metrics. How many cases are being detected? What do the bed occupancy look like? What are the numbers of deaths over time? What is the reproduction number? There's certain criteria that need to be looked at. And that is something that all countries can do. But the best advice we have seen, we have learned, is that it needs to be done in a slow way. Not all measures can be lifted at once, certainly not nationwide. Taking an approach of looking at where is transmission least and looking at that at a geographic level, but also doing it a slow way. Dr. Michael Ryan: (31:11) I just maybe add here. There's sort of a perception that all technology and all knowledge moves from north to south on this planet. In fact, when we look at something as fundamental to public health and to stopping epidemics as contact tracing, in fact, I think the south is teaching the north or the north is rediscovering just how important core public health infrastructure, workforce, case-finding, contact tracing and simple quarantine measures are, and how central these are to stuffing new viruses, respiratory viruses, other viruses like hemorrhagic fever viruses, for which we don't have treatments or vaccines. Our best protection against diseases for which we don't have treatments or vaccines, for which we understand some part of the transmission dynamic and where we can break the chains of transmission. And we'd like to thank those countries in the south, particularly those countries who've faced these types of epidemics over the last number of years, who really honed the techniques for efficient case finding and contact tracing. And many of those techniques are in fact, being reabsorbed into countries of the north. Dr. Michael Ryan: (32:29) Another issue is we have this perception that the public health part of the equation is the cheap and cheerful part. And then we have the health system part and that's the sophisticated technological part. And that's what costs all the money. This is maybe one of the misconceptions. We have fundamentally under-invested in the public health architecture in all countries, north and south. And many countries have found that when they went looking for the public health system, when they went looking for the public health workforce, when the system needed to quickly find cases, investigate clusters, track contacts, we didn't have that architecture in place, in a lot of countries, north and south. And I think we've learning a fundamental lesson that that inability to aggressively control, contain and suppress infection has to an extent led to the need for much more stringent and broader based public health and social measures and lockdowns. Dr. Michael Ryan: (33:31) And we've seen in countries. And I think one of the analysis we've been doing here, we've been looking at the experience of countries and countries have been coming and working with us. At the different combinations of responses that countries have used. From the surveillance, to the community engagement, to physical distancing, to all of the different measures. And what appears to be successful is not that every country who was successful did everything perfectly. It's that countries that have been successful have moved early and have used a combination of responses, with public health surveillance at its core, case-finding, tracing, testing and those key components of public health response. Dr. Michael Ryan: (34:14) And I think the lesson we need to learn everywhere, it's not what can other countries learn, even in countries who've just had a big epidemic and may have a second wave at some point in the future, we need to be absolutely sure. The public health surveillance architecture, the public health surveillance workforce, that these are core investments we need to make now. We don't have time to wait to build the public health workforce. And we thank those countries in the south, particularly those countries in conflict, who've kept alive the concepts of contact tracing and in which we've learned and honed the techniques for doing that sufficiently Speaker 2: (34:52) Many thanks for this answer to Nicola from [inaudible 00:34:55]. Next question comes from [inaudible 00:04: 58]. Speaker 3: (35:03) Yes hello. Thank you. I have a question for Prof. Zeltner. As of donations and funding of the WHO Foundation, how will you make sure that they will comply with the principles of WHO? Thank you. Prof. Zeltner: (35:23) Well, thank you very much for that point. We will actually apply the principles of FENSA and investigate that there are no conflicts of interest from the money we receive. The second one, that's the first step we'll do. If there are questions and we are not sure whether there may be a conflict of interest, then we actually can consult WHO and we'll talk with WHO whether that is a donation that might be in conflict. And the third step actually is that we're offering a donation of funding, an additional funding. WHO, as a matter of fact, is free to accept it or not. So, even if we think everything is fine, is cleared, WHO still is in a position or the secretary to say, " No, we think there is a problem." So I think we have a couple of hurdles to make sure that we comply with the stringent and rightly set up FENSA principles. Speaker 2: (36:45) Thank you. Thank you very much Professor Zeltner for this answer. Now we will go to Deutsche Welle and we have Rosie with us. I understand the Rosie is not with us right now. So we will try with Economic Times India, where we have Divya. Hello Divia. Divya can you just unmute yourself please? We are trying to get a connection with Economic Times India. You would need just to click unmute. Okay. So we may come back to Economic Times India. Let's try with Brazil now. [inaudible 00:37:34] from Brazil. Speaker 4: (37:40) Hi. Speaker 2: (37:41) Hi. Speaker 4: (37:43) I have a question about prediction of pandemic. Since 2005, WHO predicts that a pandemic could happen and advises members should take prevention measures. Has any country followed the directions? And what could have been done especially in Brazil, which is now the center of the Coronavirus? Dr. Maria Van Kerkhove: (38:09) I can start on this and maybe Mike would like to supplement or DG. So yes. So WHO is always thinking about epidemic and pandemic preparedness. It's one of the foundations of the work that we do and we've been thinking about for a long time. And there are many things that we have put in place in working with through our regional offices and country offices to support member states in terms of pandemic preparedness. The most obvious one is around Influenza pandemic preparedness, where we we have pandemic preparedness plans that are developed at the national level. And we work with countries to develop those plans and get systems in place to be able to activate for a novel influenza pandemic. And there's a whole series of work. And this is based on decades of experience with Influenza, knowing what we know about that pathogen, and knowing how it operates, and the fact that it's not a matter of if, it's a matter of when. Dr. Maria Van Kerkhove: (39:06) In addition to that, we also have a, a program of work where we're looking at emerging pathogens. And many of these pathogens emerge from animals. We work with FAO and OIE, our partner agencies to look at improving surveillance in animals. We're working with them directly to look at surveillance at the animal human interface, for the possibility that there may be a new pathogen that may be detected and may spill over, meaning it transmits from animals to humans and that we can capture that quickly. We work with member states on the developments of surveillance in animals, surveillance in humans, and preparing for rapid response investigations. So it's the workforce that we're talking about. It's this public health infrastructure and workforce ready to do these rapid investigations around the time of a potential emergence. So before this pandemic, my focal point area was around MERS, where we were looking at within the Middle East, all of the opportunities, all of the times where this virus jumped from a camel to a human, to do rapid investigations, to ensure that the virus didn't have an opportunity to transmit further. And we have a number of areas of work. Within our R&D Blueprint, you've heard of what we call Disease X, which is something that was coined several years ago, where we were looking at what is going to be the next pathogen that emerges. Dr. Maria Van Kerkhove: (40:37) And all of these diseases in some respect are Disease X, including COVID-19. And that's getting the systems in place to be able to look at the development of diagnostics, the development of therapeutics, the development of vaccines for the next pathogen. And we use our experiences with Coronavirus, with Influenzas, with thinking of Smallpox, think, if that were to reemerge. And that's the only virus that's been eradicated. Looking at mosquito-borne pathogen, looking at Zika, Chikungunya, Plague. So there's a lot of things that are on our radar. COVID-19 is just one of many emerging diseases that we are constantly looking at even today. But the program of work continues, we work with all countries to build their infrastructure to be able to prepare for an eventuality like this. Dr. Tedros: (41:35) Thank you. Thank you Maria. Just would like to add a couple of lines. Not only WHO was warning about pandemic which is based on the vulnerability of our world actually, not once, but many times. It could be 10 years ago, five years ago, even two years ago, last year. It has been a repeated reminder from WHO. But at the same time, we have been working on transforming the organization. As part of the transformation which I said, which helped actually to now lead into the establishment of the WHO Foundation, we have been investing also in emergency preparedness. And that's why we have the first emergency preparedness division giving more attention to emergency preparedness. And it was really starting to deliver, it's a new division. And the second is we have established an independent body, Global Preparedness Monitoring Board. Dr. Tedros: (42:55) This was in partnership with the World Bank and the president of the World Bank and myself actually co-convene that independent board. And it's co-chaired by our former Director General Dr. Gro Harlem and the former Secretary General of IFRC Dr. As Sy. And they have already released their first independent report last August with a title, The World at Risk, showing the vulnerability and the risk we have in terms of pandemics. And the report underlines that the world is not prepared. Dr. Tedros: (43:40) So these are the two additions from the transformation, but not only that, there are other things we have been doing, especially the focus on countries, working with countries to identify their gaps in terms of preparedness, and preparing a preparedness plan that can address the gaps. One of the challenges we faced actually is although many countries, more than 70 countries have now a plan that identifies where the gaps in terms of preparedness are, but the financing has not materialized. So going forward, I think the world has learned its lessons, we will make sure that the assessments are done again, revise gaps are identified and plans are prepared, and finance those plans. They shouldn't end up in shelves, finance these plans and make sure that countries are better prepared to fight, to finish the current one, but to prepare for the next epidemic which- Dr. Tedros: (45:03) ... for the next epidemic, which may happen because we're still vulnerable. Speaker 5: (45:13) Thank you very much, Dr. Tedros. For this next question comes from John Zarocostas. John, can you please unmute? John Zarocostas: (45:24) Yes. Can you hear me? Speaker 5: (45:24) Yes. John Zarocostas: (45:25) Yes. Good afternoon. My question is to the professor and also perhaps to the director general. You just mentioned earlier, sir, that you'll be following the principles of the FENSA. I was wondering, will your MOU also require you to register as other foundations under the FENSA and be subject to the FENSA scrutiny as all the other charities and foundations and non-state actors participating in WHO? Prof. Thomas Zeltner: (46:03) Well, thank you very much. I mean, you may know and some may know that I have been working actually at the FENSA regulations in another capacity and we will... You know, our basis now is the memorandum of understanding between WHO and the foundation. The foundation remains actually an independent legal entity and WHO and independent legal entity are linked by this contract we just signed. And this contract can always be withdrawn from WHO, if they feel that foundation is not working appropriately. In that respect, the relation between the foundation and WHO is a very different one from what we call engagement of non-state actors. That's the reason why we think that we do not have the same legal quality as a non-state actor. Speaker 5: (47:22) Thank you very much, professor. Now we will try to go back to [Divya 00:47:27] from Economic Times of India. Divya, are we having a better luck now? Divya Rajagopal: (47:33) Hi. My name is Divya Rajagopal from the Economic Times newspaper. I wanted to check if there's a solidarity trial being planned for vaccines on the similar lines as the solidarity drug trial? Thank you. Dr. Michael Ryan: (47:53) At this stage, there are no specific vaccine trials planned. But the WHO approach is to develop standard protocols for vaccine trials, which will allow our member states to effectively put in place the means to carry out their own trials using various vaccine products, either products from their own country, or from other countries. So it puts our member states back in the central position in defining number one, the need for trials, the carrying out of those trials, the regulatory and ethical process around the delivery of those trials. Taking this approach will allow countries to have comparable data, to have standardized approaches and for WHO to invest in the necessary data safety monitoring boards and oversight mechanisms and the technical operational and scientific inputs to ensure that those trials are of the highest possible quality. Dr. Michael Ryan: (48:45) So at this stage, there are no trials planned, but it will proceed in the same way that we've proceeded with the solidarity trials for drugs by involving countries, by involving scientific institutions in as many countries as possible, and thereby democratizing the process and giving countries access to the scientific knowledge, the technical platforms to be able to test vaccines on their own terms, within their own countries. Speaker 5: (49:14) Thank you very much, Dr. Ryan. Let's try to take a question from Will from CNBC. Will, can you hear us? Will: (49:28) Yeah, can you hear me? Speaker 5: (49:29) Yes, please. Will: (49:30) Good. I believe it was Monday the WHO suspended the global solidarity trial hydroxychloroquine. President Trump previously said that he was taking hydroxychloroquine to prevent infection of COVID-19 as a precaution. He since stopped taking it. But my question for the WHO is whether that's advisable for a world leader to be taking hydroxychloroquine to prevent the infection of COVID-19? Dr. Michael Ryan: (50:02) Thank you. WHO has... We've said this at a previous press conference, but I think it's worth repeating. We do not advise the use of hydroxychloroquine or chloroquine for the treatment of COVID-19 outside randomized control trials, or under appropriate close clinical supervision, subject to whatever national regulatory authorities have decided. So in some countries, national regulatory authorities have allowed the use of the drug under close clinical supervision. So from that perspective, I think WHO's advice on this is clear. As you will have noted from previous press conferences, we've temporarily halted the randomization of patients into the hydroxychloroquine arm of the solidarity trials while we, with an abundance of caution, just check on the safety issues around the drug and ensure that we can hopefully continue with that once those checks have been done. Dr. Michael Ryan: (51:06) Important again to reiterate that these drugs are extremely useful drugs in the treatment, and lifesaving drugs in the treatment of other diseases, particularly lupus and malaria as a primary use and other auto-immune disorders. It's extremely important that people on those drugs, and under the appropriate clinical supervision, are continuing to take their prescribed medication and continue to have access to that medication. The concern regarding hydroxychloroquine and chloroquine refers specifically to the use of this drug in the treatment of COVID-19 patients. And as we said, there is no empirical evidence that at this point that these drugs work in this case, either for treatment or for prophylaxis. But again, we look forward to the outcomes of the trials when they are completed. Dr. Maria Van Kerkhove: (51:54) If I could add, it speak to the specific questions about chloroquine or hydroxychloroquine, but just to say that WHO has released updated clinical guidance today. And this is a very detailed document, which is aimed at medical professionals and ministries of health to advise on how to care for patients who are infected with COVID-19, whether it's mild, for symptomatic treatment, whether they have pneumonia, whether they have a severe disease or septic shock, and it's quite detailed. And I just thought it would be a good opportunity to mention that this will be posted today, if it's not posted already right now. But, it is important that anyone that is seeking treatment seeks that treatment with the advice of their doctors. And so while we are able to put out this guidance based on the latest evidence that we have, and as Mike has said, we don't have any specific treatments yet but these clinical trials are underway. There is advice that we do provide for ministries of health and medical professionals all over the world. Speaker 5: (52:51) Thank you very much. We have time for one or two more questions. So let's go to [inaudible 00:07:56], [Anyes Bergegov 00:07:58]. Anyes? Anyes Bergegov: (52:57) Yes, hello do you hear me? Speaker 5: (53:26) Yes. Anyes Bergegov: (53:26) [foreign language 00:08:04] Dr. Michael Ryan: (53:33) Maria will give you a more detailed answer as to the cross-protection of other coronavirus infections with regard to COVID-19. There is certainly some evidence with regard to t-cells that if you have a previous coronavirus infection, you may be able to mount a more rapid response to COVID-19. But there is no empirical evidence that previous coronavirus infectious protects you from infection with COVID-19, the jury is still very much out on that. But it is interesting to note that at least in some of the studies, that if we're getting a more broad based t-cell response, there's more hope than for vaccines and others producing a more long-term immune response. So for me, this information is very important. It gives us hope that we're getting the kinds of immune responses that may be helpful for long-term protection. And we also mean that vaccines have a broader protection but Maria may have more technical detail on the cross-protection issues, because much experience with SARS and MERS and another coronavirus. Dr. Maria Van Kerkhove: (54:34) Thanks, Mike. So yes, no, I mean, this is welcomed news to see this type of research and to see that there are specific studies that are looking at a t-cell response. There are a number of assays that are out there that are looking at the immune response, measuring different elements of that immune response, including neutralizing antibodies, t-cell response. Most of the serologic assays that are commercially available are not looking at a t-cell response, they're looking at IgM, IgG, not even neutralizing antibodies. The assays that can do that are more specialized labs. And so what WHO is doing in our support for seroepidemiology globally, to really understand the immune response, to understand the extent of infection, is three different things. One is we are working with collaborating laboratories globally who have experiences with coronaviruses and with FIND to evaluate the serologic assays that are out there that are available. Dr. Maria Van Kerkhove: (55:34) How well do they work? What are they measuring, and how well do they measure that? And that is something that is ongoing, you've heard me speak about before. The second thing that we're doing is we are working with several researchers globally, and also NIBSC in the UK to develop an international serum panel, which we have recently shipped to a number of labs across the globe to be able to validate and evaluate the essays that are out there and to come up with a standardized serologic assay. Again, that is also in development. And the third thing that we're doing is we've provided these core protocols, similar to the core protocol that we have for the solidarity trial. These are for seroepidemiologic investigations. And we're working with countries to look at the extent of infection as measured by these antibodies. Dr. Maria Van Kerkhove: (56:26) From the available studies that we have, there's two published studies, and there's more than 20 that are available in pre-print. And in many we've received some results through press release. We haven't fully been able to evaluate the assays. And one of the important things is to look at the cross-reactivity with other coronaviruses and see if that is a factor in the immune response that people have. So this is something that is under development, but yes, so the results for the t-cell is welcomed news. And we know that there are a number of labs that are additionally looking at that as well. Speaker 5: (57:04) Thank you very much for this. We will conclude this press briefing here with a special thanks to our special guest Professor Zeltner. We will have an audio file sent to you very soon and transcript will be posted tomorrow as well as a number of announcements and news from different WHO regions and country offices. I wish everyone a very nice evening. Dr. Tedros: (57:28) Thank you. Thank you Tariq, and thank you professor for joining us, and thank you to all online who have joined today. Thank you so much. See you on Friday.