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World AIDS Day 2020 – WHO calls for global solidarity

WHO (30.11.2020) – https://bit.ly/2Jt8f8z – On 1 December WHO is calling on global leaders and citizens to rally for “global solidarity” to maintain essential HIV services during COVID 19 and beyond – and to ensure continued provision of HIV services for children, adolescents and populations most at risk for the disease. The Organization also calls on countries to provide health workers with greater protection and support so they can continue their work safely during the pandemic.

 

Protecting people from HIV during the pandemic, and ensuring they can maintain treatment, is critical. Researchers are currently investigating whether people with HIV have an increased risk of poor outcomes with COVID-19. Preliminary evidence of a moderate increased vulnerability of people with HIV makes it even more urgent that people with HIV have access to antiretrovirals (ARVs)  and treatments for co-morbidities – such as treatment for non communicable diseases (NCDs), chronic obstructive pulmonary disease (COPD), diabetes and tuberculosis.

 

WHO and partners sounded the alarm earlier this year, concerned at the impact of reported disruptions in service delivery. But now, thanks to the unstinting work of health and community workers, the number of countries reporting disruptions in HIV services has declined by almost 75% since June. Only 9 of the 152 countries surveyed are still reporting disruptions (maps: June 2020November 2020); and in June, 24 countries reported less than 3 months supply of ARVs, while now only 12 report a critically low stock.

 

This is mainly due to the implementation of existing guidelines, including providing multi-month dispensing (MMD) of ARVs for 3-6 months to patients who did not have access to health facilities; strong WHO-led global, regional, country, manufacturer and partner coordination to ensure adequate supply of drugs stocks, and sustained provision of facility-based essential health services and community delivery mechanisms.

 

But countries have also introduced a number of effective adaptations and innovations in service delivery during COVID-19. These include:

 

  • In many countries in sub-Saharan Africa, testing for COVID-19 has heavily relied on the laboratory systems built and developed by HIV and TB programs. Devices have been shared across programs as well as infrastructure, sample transport systems, and highly skilled staff.
  • In Thailand, PrEP services have been delivered through key population led health services providing multi-month dispensing, telehealth, Xpress service, self-sampling, and counselling.
  • In Bulgaria, a demonstration project showed strong community demand for HIV self-testing which also led to expansion of testing services to reduce inequalities between rural and urban areas.

 

“On World AIDS Day 2020, we pay tribute to the communities and countries who have shown resilience and innovation – often spearheaded by people themselves living with HIV,“ says Dr Meg Doherty, Director of WHO’s Department of Global HIV, Hepatitis and STI Programmes. “This is vital, because while we focus on fighting this new pandemic, we must not drop our guard on a twin pandemic that has been with us for 40 years and which is far from over.”

 

Progress towards global targets for diagnosis and treatment has slowed down considerably this year.

 

New data shows that an estimated 26.0 million people were on antiretroviral treatment as of mid-2020, up only 2.4% from an estimate of 25.4 million at the end of 2019. This increase is too slow by comparison to last year where treatment coverage increased by an estimated 4.8% between January and June of 2019.  Among 24 countries with monthly data reported to UNAIDS and WHO, people currently on treatment have been supported and maintained, but testing has declined in all and newly enrolled on treatment has been halved. In the last few months; however, there positive signs of rebound in testing and treatment services.

 

WHO hopes that some of the innovative approaches adopted during COVID-19 can help the world catch up and accelerate progress towards our new 2025 targets and the SDG goals of ending AIDS as a public health threat by 2030.





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COVID-19: Key Questions for the World Health Organization

If the WHO is to remain a credible international organization, it must answer these questions – publicly and in detail (See HRWF comment at the end)

– World Health Organization Director General Tedros Adhanom Ghebreyesus and China’s President Xi Jinping

The American Interest (23.04.2020) – https://bit.ly/2VwJ48b – In view of ongoing controversies surrounding the World Health Organization’s response to COVID-19, we have isolated the most important questions that need to be answered in order to form an objective assessment of the organization’s record. These questions have been formulated after research of Chinese and other open sources.

When did the WHO receive information about COVID-19?

According to the pro-Beijing South China Morning Post, owned by Jack Ma (owner of the firm Alibaba and a member of the Chinese Communist Party), the first case of COVID-19 in Wuhan, China, was confirmed on November 17, 2019. But according to the official website of the WHO, it first received a report from China about the virus outbreak on December 31.

Before that date, did the WHO receive or discover any other information about the outbreak? If so, what was the organization’s reaction? What did Chinese authorities say in their first report to the WHO? Can the public see that report? If not, why not?

Was the WHO aware of China’s suppression of research and information about COVID-19?

On January 1, 2020, the day after China’s report, Hubei province health authorities ordered the company that first identified and sequenced the virus to stop testing, destroy all samples, and keep information secret. According to press reports, two days later, central health authorities issued a similar official order to testing facilities across the country. If the WHO was aware of these things, how did it react to China’s cover-up?

What did the WHO do with information received from Taiwan about the risk of human-to-human transmission of COVID-19?

It is now well-known that on December 31, Taiwan alerted the WHO about the risk of human-to-human transmission of the new virus. What is less known is what the WHO did upon receiving the alert from Taiwan. Did the organization pass on the concerns to other countries?

Was the WHO aware of Chinese doctors becoming infected with COVID-19, even as the organization denied that the disease could be transmitted between individuals?

Like the Chinese government, the WHO officially denied until January 20 that COVID-19 could be transmitted from human to human. But between January 1 and January 11, at least seven doctors contracted the virus. The WHO was presumably aware that infected doctors are the most telling indicator of human-to-human transmission. Was the WHO aware of doctors infected in China during this time? Or did Chinese authorities not inform the WHO of these cases?

Why did the WHO continue to deny human transmission after confirming a case of COVID-19 in Thailand on January 13, 2020?

The WHO official timeline records that on January 13, “Officials confirm a case of COVID-19 in Thailand, the first recorded case outside of China.” Why then did the organization continue to claim at its January 14 press conference that there was no evidence showing human-to-human transmission, and no case of doctors infected in China or Thailand?

Why didn’t the WHO visit Wuhan hospitals where COVID-19 patients were being treated?

On January 20 and 21, a day before the Wuhan lockdown was declared, WHO experts from its China and Western Pacific regional offices conducted a brief field visit to Wuhan. The delegation visited the Wuhan Tianhe Airport, Zhongnan Hospital, the Hubei provincial Center for Disease Control (CDC), including the BSL3 laboratory in China’s CDC. Why did the delegation not visit Wuhan Central Hospital, Jinyintan Hospital, or Wuhan Pneumonia Hospital—that is, the main hospitals treating infected patients? Did the WHO request such visits?

Did the WHO receive information from Zhongnan Hospital head Dr. Wang Xinghuan about the spread of COVID-19?

On January 19, the day before the WHO delegation’s visit, top Wuhan public authorities came to inspect Zhongnan Hospital, and instructed the hospital administrators and professionals to be “mindful of political implications about what you are going to say to WHO.” The hospital head Dr. Wang Xinghuan responded that, “I must tell them the truth. Have we learned any lesson from SARS? Saving lives is the biggest politics, so is telling the truth.” That night, worried that Wang would reveal what he knew, the city government sent an official “friend” to talk to him.
Wang told the “friend” that political integrity “requires us to stand with the people, which is good for the Party’s overall image.” Can the WHO reveal what Dr. Wang told the delegation on January 20?

Given the massive evacuation from Wuhan during the week of January 20, why did the WHO wait until January 30 to declare the outbreak a public health emergency of international concern (PHEIC)?

BBC health reporter James Gallagher’s January 18 report begins: “The number of people already infected by the mystery virus emerging in China is far greater than official figures suggest, scientists have told the BBC. There have been more than 60 confirmed cases of the new coronavirus, but UK experts estimate a figure nearer 1,700.”
During the WHO delegation’s visit in Wuhan, residents desperate to avoid the virus were scrambling to leave the city for destinations in China and throughout the world. Wuhan Mayor Zhou Xianwang confirmed at a January 26 press conference that more than five million Wuhan residents had left in the past week. Was the WHO delegation aware of this mass evacuation? Why was a PHEIC declaration not made at the WHO’s meeting on January 22-23?

What took place when the WHO’s Director-General met with Communist Party General Secretary Xi Jinping and other top Chinese leaders on January 28?

On January 28, a senior WHO delegation led by Director General Tedros Adhanom Ghebreyesus traveled to Beijing to meet China’s leadership, learn more about China’s response, and offer technical assistance.

Tedros met with Xi Jinping and Foreign Minister Wang Yi, but did not meet with the official head of the Chinese government’s response, Premier Li Keqiang. Did Tedros request a meeting with Li? What did Tedros learn in China? Was his trip political or professional in nature?

Given China’s suppression of information, failure to contain the COVID-19 epidemic, and delays in reporting on the nature of COVID-19, why did the WHO’s Director-General praise the Chinese response and, indeed, the Chinese “system”?

In January 30, at the WHO news conference to declare the outbreak a PHEIC, Tedros hailed the CCP system, Xi Jinping’s leadership, and China’s response: “As I have said repeatedly since my return from Beijing, the Chinese government is to be congratulated for the extraordinary measures it has taken to contain the outbreak, despite the severe social and economic impact those measures are having on the Chinese people.” He went on to note that the speed with which China detected the outbreak, isolated the virus, sequenced the genome, and shared it with WHO and the world are very impressive, and beyond words. So is China’s commitment to transparency and to supporting other countries. In many ways, China is actually setting a new standard for outbreak response, and it’s not an exaggeration.

At the same conference, he said, “Let me be clear. This declaration is not a vote of no confidence in China. On the contrary, WHO continues to have the confidence in China’s capacity to control the outbreak.” He seemed to feel the need to add later: “I’ll repeat this. Let me be clear. This declaration is not a vote of no confidence in China. On the contrary. WHO continues to have confidence in China’s capacity to control the outbreak.”

Given the facts laid out above, why did the WHO’s Director-General make such false claims? If the WHO was unaware of these facts at the time, does it now still stand by what Tedros said at the news conference? Does he still believe China was committed to “transparency”? Why did Tedros praise and defer to China?

Why didn’t Tedros recommend restricting Chinese travel and trade on January 30?

At the January 30 conference, Tedros repeatedly stressed that the WHO did not recommend—and indeed opposed—any restrictions on Chinese travel and trade. Given the above information, and especially the Wuhan Mayor’s admission on January 26 that more than five million Wuhan residents had escaped the city, why was Tedros opposed to restrictions on Chinese travel and trade? Does the WHO now admit that this judgment was incorrect?

Why did the WHO continue to oppose restrictions on Chinese trade and travel through the end of February?

As agreed by the two sides, China and the WHO convened Chinese and foreign experts to form a joint mission to investigate epidemic prevention and control in China. Starting on February 16, the joint mission visited Beijing, Guangdong, Sichuan, and Wuhan of Hubei province successively, ending on February 24.

The team leaders of the joint mission—Dr. Bruce Aylward, former WHO Assistant Director-General and senior advisor to the Director-General, and Dr. Liang Wannian, head of the Expert Panel on COVID-19 Response of China’s National Health Commission—held a press conference in Beijing before Aylward left China. At the press conference, Aylward continued to oppose restrictions on Chinese travel and trade. In retrospect, does the WHO think this was sensible?

Why didn’t the joint China-WHO mission inspect the infected areas of Wuhan?

At the end of the February 24 press conference, Washington Post Beijing bureau chief Anna Fifield asked the WHO’s Dr. Aylward why he was not in quarantine after staying in Wuhan over the weekend. Aylward said he didn’t go to any “dirty” areas in Wuhan and that he had been tested for the coronavirus that morning. He left China immediately without quarantining himself for 14 days. It is obvious that by “dirty areas,” Aylward meant infectious areas.

Why did the WHO experts on the mission to study and investigate the viral outbreak not go to the infected area?
(The WHO delegation visiting Wuhan on January 20-21, 2020, also does not seem to have gone to “dirty areas.”) Did the WHO experts on the mission have freedom to choose where they went, what hospitals they studied, and what people to talk to—doctors, the infected, relatives of the deceased, or people on streets for that matter? Or was the mission itinerary and agenda dictated by the Chinese authorities?

Why did the WHO’s Dr. Aylward lavish praise on China’s putative success in containing COVID-19?

At the same press conference, and without having personally seen infected areas of Wuhan and other places in China, Aylward lavished praise on the government’s success in containing the virus. But when a BBC reporter asked him to what extent he thought a cover-up and censorship played a role in allowing the virus to accelerate at the rate that it did, he replied, “I don’t know, frankly, didn’t look at that. I’m just being completely honest. . . .”
One purpose of the press conference was to make recommendations for a global response. Why, then, did an expert charged with that task not consider whether China or any country had made mistakes? Why did Aylward try to avoid that question? Does the WHO now think this approach was appropriate?

Why did the WHO wait until March 11 to declare COVID-19 a global pandemic? Why did Dr. Aylward continue to minimize the scope and threat of COVID-19?

At the press conference, Dr. Aylward also said, “Because every day we stopped to think about this disease and make decisions, should we do it or not, this virus will take advantage and almost double the number of cases. We have to move fast.” This shows that he understood the vital importance of speed. By March 4, as the number of cases and death toll soared in many countries, it had long met the criteria of transmission between people, high fatality rates, and worldwide spread. Yet on March 4, in an interview with New York Times reporter Donald McNeil, he said, “We don’t have a global pandemic.”

Has the WHO run models to estimate how many lives could have been saved if it had acted more quickly to declare COVID-19, respectively, a public health emergency of international concern and a global pandemic?

Finally, does the WHO believe it has a duty to coordinate all affected countries to form a credible, independent scientific team to conduct an investigation into the origin of COVID-19?

The origin of the novel coronavirus has been at the center of a maelstrom of debate of accusations between countries. This is a first-order of question, and one that concerns all the citizens of the world. The question is ultimately a scientific one, and consistent with the organization’s mandate. Can the WHO deliver?

Jianli Yang is founder and president of Citizen Power Initiatives for China. Aaron Rhodes is president of the Forum for Religious Freedom-Europe, human rights editor of Dissident Magazine, and the author of The Debasement of Human Rights (Encounter Books, 2018).

HRWF Comment

Peng Liyuan, the wife of Xi Jinping (General Secretary of the Communist Party of China and President of the People’s Republic of China), is one of the five WHO Goodwill Ambassadors. A key position for lobbying/

Directly after the Tiananmen Square protests of 1989 in June 1989, Peng Liyuan sang for the martial-law troops. A photo showing the scene in which Peng, wearing a green military uniform, sings to helmeted and rifle-bearing troops seated in rows on Beijing’s Tiananmen Square, was swiftly scrubbed from China’s Internet before it could generate discussion online.

In June 2013, the American Foreign Policy magazine’s article Why Michelle Obama Shouldn’t Meet With Peng Liyuan, approved the First Lady of the United States Michelle Obama’s choice not to meet with Peng Liyuan who allegedly sang in support of Chinese troops in Tiananmen Square in 1989, following a crackdown on protesters on 4 June 1989.


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