The United Nations Office at Geneva
Multimedia Newsroom
UNOG-RUSH-NEWS Briefing Continuity 18JUL2023
/
1:38:36
/
MP4
/
546.5 MB
PRESS BRIEFING BY THE UNITED NATIONS INFORMATION SERVICE
18 July 2023
Immunization services rebounding in some countries
Dr. Kate O'Brien, Director, Immunization, Vaccines and Biologicals, at the World Health Organization (WHO), said that each year WHO and UNICEF issued estimates on national immunization coverage. The 2022 data showed that recovery was under way, but it was uneven with too many countries still falling behind. In 2022, there had been 14.3 million “zero dose” children, who had not received DTP (diphtheria, pertussis, and tetanus) vaccines; the overall coverage of DTP vaccination stood at 89 per cent, informed Dr. O’Brien. All regions except for the Africa region had made progress; in Africa, the coverage was some six per cent lower than in 2019, before the COVID-19 pandemic. Only 83 per cent children in the world had received measles vaccines, lower than 86 per cent in 2019. Promising news included the HPV vaccine, which had been given to 21 per cent of girls in 2022. Backsliding with vaccinations was reversing if we looked at the world as a whole, stressed Dr. O’Brien.
Dr. Ephrem Tekle Lemango, Associate Director of Immunisation at the United Nations Children’s Fund (UNICEF), speaking from New York, stated that the vaccine recovery, while welcome, was uneven, with improvements mostly noted in several large countries, such as India, Indonesia, and Brazil. Low-income countries were struggling the most, because they were often facing other challenges, such as conflict and crises. Countries with steady vaccination rates before the pandemic had shown remarkable resilience during and after the pandemic, noted Dr. Lemango. Fifty-nine countries had reported a total of 80 measles outbreaks in 2022, he warned. In 2022, some countries had shown that vaccination recovery was possible; countries around the world ought to be supported on the same path. UNICEF encouraged governments to build and sustain vaccine confidence.
Responding to questions from the media, Dr. O’Brien emphasized that there was no link whatsoever between measles vaccines and autism. Globally, measles vaccine coverage stood at 83 per cent; the global community was on the road to recovery, but low-income countries were not following suit. As children got older, the sense of urgency on the part of their families to have them vaccinated tended to go down. Ability to conduct outreach activities in low-income countries was the weakest. Dr. Lemango explained that in Africa, stagnation of coverage was observed, with some two out of ten children not reached by DTP vaccines. Some spillover from the scepticism towards COVID-19 vaccines was being observed, but the overall weakness of community health systems across Africa was the primary cause of low vaccination rates. On HPV vaccines, global coverage stood at 21 percent, reiterated Dr. O’Brien. Among the 130 countries administering the vaccines, the coverage ranged from 50 to 67 per cent – still not where it needed to be. The goal was to reach a 90-per cent coverage of all girls by 2030.
Dr. Lemango stressed that in Africa, a significant percentage of children remained unvaccinated; challenges were to reach a higher number of children, but also the continuously growing populations. The main reason children were not getting vaccinated, explained Dr. O’Brien, was the lack of access. Misinformation and disinformation, growing both in size and scope, were also having an impact in some communities.
Vaccination rates per country over time are available here.
Heatwaves
Clare Nullis, for the World Meteorological Organization (WMO), said that many parts of the northern hemisphere were currently affected by extreme heatwaves. If a new temperature record was to be broken, the WMO would need to confirm it first and then inform the public.
John Nairn, Senior Extreme Heat Advisor at the WMO, stated that heatwaves were amongst the deadliest natural hazards, with hundreds of thousands of people dying from preventable heat-related causes each year. Heat was a rapidly growing health risk, due to burgeoning urbanization, an increase in high temperature extremes, and demographic changes in countries with ageing populations. A study published the previous week calculated last summer in Europe alone 60,000 additional people had died due to extreme heat, which was still a conservative estimate.
These events were going to continue and grow in intensity, and the world needed to prepare for it, as it would have a significant impact on human lives and livelihoods. The world needed to broaden its attention beyond maximum temperatures alone, said Mr. Nairn. Minimum (night) temperatures also needed to be taken into consideration, because high night temperatures did not allow human bodies to recover properly. High overnight temperatures carried highest health risks, especially for vulnerable populations.
Mr. Nairn explained that the WMO was supporting protective policies such as heat action plans that incorporated early warning and response systems for urban and non-urban settings. WMO was also supporting its members by updating guidance on heat health warning systems, and working with the World Health Organization and a wide number of partners and governments through the Global Heat Health Information Network. It was also everyone’s personal responsibility to develop their own heat plans, stressed Mr. Nairn.
Panu Saaristo, Emergency Health Unit Team leader at the International Federation of Red Cross and Red Crescent Societies (IFRC), speaking from Budapest, said that heatwaves were an invisible killer. It was not a European phenomenon only; over the past ten years, over 400,000 people had died of weather and climate disasters, said Mr. Saaristo. Infants, the elderly, and people with chronic health conditions were most at risk. Deaths from heatwaves could be greatly reduced with relatively simple solutions. Red Cross societies across Europe were doing exactly that; for example, Italian Red Cross volunteers were checking on elderly people by telephone to make sure that they were fine. The Greek Red Cross Society had been handing out drinking water and reminding tourists to remain hydrated, and the Turkish Red Crescent was responding to forest fires in six provinces across the country. During these times, the most vulnerable people, especially in urban areas, ought not be forgotten. IFRC had created a heatwave guide for cities, to help community leaders to futureproof their communities for further heatwaves. Now was the time for cities to incorporate heat measures.
Answering questions from the media, Mr. Nairn said that there would be interannual variability in temperatures from one year to another. The global trend was continuing to go upwards, so it was difficult to speak of a “new normal”. The temperature record for Europe had been observed in Sicily in August 2021, at 48.8 degrees centigrade; it was not possible to predict whether this record would be broken in 2023. Ms. Nullis emphasized that heat records had to be verified for the sake of scientific accuracy and track keeping; this painstaking process took time. Mr. Nairn explained that El Niño had different effects on different parts of the globe. If the minimum daily temperature was high (usually at night), it would then sustain very high temperatures during the day. Mr. Saaristo stressed the importance of anticipatory, early action. Governments needed to take the lead and get all of their societies on board. These were not the normal weather systems of the past; the changes were happening and would continue for quite some time, until or unless it was repaired. Electrifying everything was a major way to address climate change, said Mr. Nairn.
Situation in Sudan
Xavier Castellanos, Undersecretary-General of the International Federation of Red Cross and Red Crescent Societies (IFRC), speaking from Nairobi, said that the conflict in Sudan was having deep humanitarian consequences in Sudan and its neighbouring countries. IFRC’s appeal had received only 7 per cent to support the affected population. More than 40,000 volunteers were available in the country to provide humanitarian services, he said. Providing adequate financial resources was of great importance, stressed Mr. Castellanos. The rainy season was about to start, increasing the risk of floods and diseases, and making access to people in need ever more difficult. Having spent two weeks in Sudan and Ethiopia, Mr. Castellanos spoke of massive unmet needs of local populations. There were evident but unmet protection needs for women and children. He praised thousands of Sudanese Red Crescent volunteers, many of whom were internally displaced themselves, or had seen their own homes destroyed. Many of these volunteers had ways to deliver aid and reach affected communities, but more resources were needed.
It was very concerning that the sufficient resources were not available and how poorly funded the emergency appeals were. The stress on host families was very high, and reception centers were packed and showing unmet needs. Mr. Castellanos reminded that significant numbers of people were fleeing violence for the second time. IFRC was prioritizing meeting the needs of women, children, and persons with disabilities. Within Sudan, the revised emergency appeal had the focus on protection. Mr. Castellanos emphasized that the whole humanitarian system was doing the best possible under the given circumstances, but the situation needed much more international financial support.
Black Sea Initiative
Alessandra Vellucci, for the United Nations Information Service (UNIS), responding to questions, reiterated that Secretary-General António Guterres deeply regretted the decision by the Russian Federation to terminate the implementation of the Black Sea Initiative – including the withdrawal of Russian security guarantees for navigation in the northwest part of the Black Sea. Thanks for this initiative, the World Food Programme had shipped more than 725,000 tons to support humanitarian operations – relieving hunger in some of the hardest hit corners of the world, including Afghanistan, the Horn of Africa and Yemen. Ms. Vellucci informed that the Secretary-General’s statement was shared with the media as soon as it was possible.
Catherine Huissoud, for the United Nations Conference on Trade and Development (UNCTAD), reminded that UNCTAD Secretary-General Rebeca Grynspan had addressed the media in Geneva several days earlier. Her comments on the Black Sea Initiative news would be shared when they became available. Ms. Huissoud would look for precise, updated data on exports of Russian fertilizers.
Ms. Vellucci stressed that Secretary-General Guterres would not stop, and the United Nations would not stop our efforts to facilitate the unimpeded access to global markets for food products and fertilizers from both Ukraine and the Russian Federation.
Announcements
Alessandra Vellucci, for the United Nations Information Service (UNIS), informed that today at 10 a.m., the Committee against Torture had started reviewing the report submitted by New Zealand; the review would end on 19 July in the afternoon. The review of Romania would begin on 19 July, at 10 a.m.
Today was the Nelson Mandela International Day, informed Ms. Vellucci. On that occasion, the Secretary-General had issued a message.
***
Teleprompter
Good morning, Welcome to the press briefing of the Information Service in Geneva.
Today is the 18th of July and I really want to start this briefing before giving the floor to our guests by reminding everyone that today the international community comes together to celebrate Nelson Mandela International Day.
Nelson Mandela was a colossus of courage and conviction, said the Secretary General in the message that he has issued for this day.
And I know that that's been distributed to you.
I won't read it all, but I'd like to just start this briefing with the words of the Secretary General concluding the the message where you say as we commemorate Nelson Mandela life and legacy, let us be animated by his spirit of humanity, dignity and justice.
Let us stand with women and girls, young people and change makers everywhere and let us take action to build a better world.
I think there are no better world words to start this briefing today here at the UN in Geneva and to walk the talk.
We will start immediately with our two guests from WHO and UNICEF, who have come to tell us about promising signs of immunisation services rebounding in some countries.
We have with us Doctor Kate O'Brien on Zoom.
She is the director of immunisation, vaccine and biologicals of WHO and Ephraim Tecla Limango, who's on Zoom from New York.
And thank you very much, Sir, for waking up so early.
WHO is UNICEF associate director of immunisation.
I don't know who would like to start, maybe Doctor O'Brien to tell us about this promising science and then we will go to Mr Limango and then we'll open the floor to questions.
You have the floor.
[Other language spoken]
Each year, WHO and UNICEF release the estimates of national immunisation coverage, what are called the Woundic estimates, for every 194 WHO Member state.
And last year we rang bells at the historic backsliding that we saw across countries, across regions and across vaccines.
This year we released the 2022 data and from a global perspective, we're recovering.
But that recovery is uneven with too many countries and too many vaccines not seeing an improvement yet.
One of our main measures of immunisation programme performance is how many 0 dose children exist.
And I want to explain what a 0 dose child is.
These are children who do not receive the first dose of the vaccine against diphtheria, tetanus and pertussis.
It means these are children who don't receive any vaccines through the routine immunisation programme.
And in 2022 there were 14.3 million zero dose children.
Now the good news is that that's 3.8 million fewer than in 2021, but it still remains 10% higher than the number in 2019, which was 12.9 million.
So global coverage of the first dose of DTP vaccine now stands at 89% and that's very close to the pre pandemic coverage of 80 of 90%.
But when we look at this global number by region and by income strata, the data is really a lot more nuanced than a simple trajectory towards recovery.
All regions except for the Africa region have made progress in recovery for DTP.
The region's coverage is now 6% lower than 2019 levels and this is the largest gap for any region.
Low income countries made virtually no progress towards recovery.
They have 80% coverage for DTP one which is well below the 89% coverage for low middle income countries.
Only 83% of children received a measles vaccine in 2022, also well below the 86% global value from 2019 before the pandemic.
And for measles vaccine in low income countries, measles coverage has neither improved.
In fact, it has fallen for a third year in a row as of 2022.
In low income countries, coverage for measles vaccine is only 66% compared with 71% in 2019.
But there is some other promising news and that is on global coverage of HPV vaccine.
In 2022, the coverage of HPV vaccine has surpassed the coverage in 2019.
In fact, 21% of girls globally received their first dose of measles of, excuse me, of HPV vaccine, which is up from 19% in 2019.
So this year's data show that though there is serious backsliding in previous years, that backsliding is reversing.
We're not out of the woods yet, but we are making progress.
And I'll turn this over to my colleague, Dr Lamongo.
[Other language spoken]
Thank you, Doctor Lemon.
Thank you very much, Katie, and good morning, colleagues and everyone.
And thank you so much for allowing us to comment from my UNICEF headquarters in New York.
[Other language spoken]
Last year, UNICEF described the backsliding in childhood immunisation coverage as a red alert for child health.
Today you see your hope that this trend is actually reversing.
However, the recovery escape described is uneven, with improvement concentrated in just few countries.
Eight large countries account for about 3.8 million of the four million additional children reached in 2022 and these are countries such as India, Indonesia, Myanmar, Philippines, Brazil, Mexico, Pakistan and Tanzania.
In 2021, we had reported that 73 countries recorded substantial declines which is above 5% coverage decline during the pandemic.
Out of this, just 15 have recovered through pandemic levels to pre pandemic levels and 24 are en route to recovery but the largest number which is 34 of them have stagnated at pandemic levels or continued declining.
Low income countries are struggling the most.
This is because they are facing other challenge such as conflict and crisis, but also because over many years they have not had the resources to build resilient health systems.
The data indicates that countries with steady sustained vaccination coverage in the years before the pandemic have been able to stabilise immunisation services since Regions that suffered long standing declines, such as the Latin America and the Caribbean, have not been as resilient.
This under supports how important it is for governments to make progress in immunisation coverage but also maintain adequate investment to sustain their achievement.
What is at stake in this critical decision of either to make this investment or not is children's lives.
Since coverage levels blind, we have witnessed outbreak of diseases such as measles, yellow fever and diphtheria increase and our efforts to eradicate polio have been as well set back.
59 countries reported a total of 80 measles outbreaks in 2022.
If we don't catch up vaccination of older children that were missed since 2019 quickly and urgently, we will inevitably witness more outbreaks and very be responsible for more child deaths.
In 2022, some countries demonstrated that this recovery is indeed possible.
Let us receive the findings from WHO and UNICEF today at the powerful and urgent call to action and help countries everywhere.
All of this important call to action.
Governments have an opportunity in this moment to primarily double down on their commitment to increase financing to immunisation and also work with the stakeholders to unlock available resources to implement catch up efforts.
This include COVID-19 resources.
Secondly, enable immunizers with children who were born just before or during the pandemic and who are now moving past the eligible age when they would have been vaccinated by communication services.
We also encourage governments to build and sustain vaccine confidence and the acceptance through engagement with communities and health providers.
And most importantly, for countries with stagnant coverage, it is critical that they strengthen primary healthcare services and expand immunisation, including through community health workers.
In that way, we can reach the most marginalised and least served children.
[Other language spoken]
Thank you very much for both these briefings.
I would encourage your colleagues, if possible, to send the journalist the, the notes of what you said as soon as possible.
And I see you already, Lisa, raising your hands.
Maybe it's because of that, because especially from New York, the, the audio was not always perfect.
So if you could just send out the notes that you've used Doctor Limango, that would be really useful.
So I'll open the floor to questions first in the room, but I don't see hands up.
So let's go to the platform.
Lisa Schlein was of America.
[Other language spoken]
Good morning to everybody.
Thank you for this.
I'd like to know, you say that measles vaccination has not recovered.
I'm wondering why particularly this, does it have to do with the connection with autism still?
And in regard to autism, perhaps you could talk about the situation in developed countries as well, whether there's been increased hesitancy on vaccinations, child vaccinations in general.
And if you could elaborate a bit about the situation in Africa, why it remains the continent which has the least vaccination, whether I know inequities has to do with it?
Is it mainly a matter of finances?
Is it conflict, Is it climate change?
Is it all of the above?
If you could deal with that and if you could lastly speak about what the main elements of recovery in your regard.
Money, of course, but what else is needed in order to get more children vaccinated?
[Other language spoken]
[Other language spoken]
I don't know if, Doctor O'Brien, you want to start and maybe then Miss Doctor Levan, go on the children's side.
Yeah, I'll take the measles part of the question and maybe I can turn over to Doctor Limango to address the situation in Africa.
I'll, I'll touch just a little bit on the main elements of recovery.
So on measles, let me just make a couple of points for clarification.
So first and foremost, there is no causal association between measles vaccine and autism.
I just want to make that very clear to all and I know, I know Lisa that what your question wasn't intended to imply that there has been past reports that have been proven incorrect and and there is no link between measles and autism.
So that's the first thing.
Nevertheless, that misinformation stays out there.
And I want to also say that there has been globally some improvement in measles vaccine coverage.
We are at 83% coverage now in 2022, which was up from the low of 81% during the pandemic.
So globally, we have seen an improvement.
It's on the road to a recovery, but it is not fully recovered.
And when you look specifically at low income countries, that's the strata where there has been no recovery at all.
And the reason for that is, first of all, measles is given at nine months of age.
That's when the vaccine is given or 12 months of age.
So it's a different time point in a child's life than when the first dose of the other vaccines are given, which are given somewhere around six weeks of age or two months of age.
And so there are challenges that families face to continuing to bring children for their vaccines.
And we've always seen that measles vaccine is at a lower coverage than the vaccines that are given at 610 and 14 weeks.
As children get older, the the sense of urgency on the part of families for, you know, coming back to return to get more vaccines tends to go down as the child ages and they're out of that biggest, highest risk.
At least perceived by parents.
So it's not news that measles vaccine coverage is lower than DTP coverage, but it means that children who are in the programme get lost out of the programme.
That when the programmes are not adequately following up with children to make sure that they're coming back for that nine month visit or the 12 month visit for measles vaccine.
In particular in low income countries, these are countries that as a as a group tend to be countries where there is conflict, where there's fragility, where health systems are weakest.
And so the ability to do those outreach activities and the things that are needed to get kids to return for their measles vaccine is weakest in those countries.
So that's on the on the measles side of things.
And it is this growing immunity gap.
In other words, for every measles case that occurs, somewhere between 12 and about 20 other cases will occur infected by that individual among people who are not immune.
And the way that children become immune is best done by vaccination, not by actually getting infected and risking severe disease, death or or consequences of measles.
In terms of the main elements of recovery, there are several things that we're really emphasising and that we have seen in countries that have recovered.
First and foremost is political leadership and political commitment and that means usually at the head of state level, at the Ministry of Health level, to be out there expressing not just verbally and it from an advocacy perspective but from a funding perspective, from a health workforce perspective, from a commitment to the immunisation programme to assure that vaccines are procured and there are no stock outs.
Other elements include the number of health workers, the supply chain, the adequacy of supply coming in, the confidence of communities in vaccination.
All of these elements are part of what has resulted in a strong recovery in programmes.
I'll, I'll move it over to Ephraim so he can talk about the situation in Africa.
So over to you.
[Other language spoken]
[Other language spoken]
[Other language spoken]
And keep the question on the African continent generally, what we are seeing in the African continent is a stagnation of coverage as compared to what we had in 2021 whereby the coverage of the first dose of vaccine against deterrent Satanism purchases at this very moment stays about 81%, which means 8 out of 10 children are rich, but two out of 10 children remain unreached and the third dose of the same vaccine is about 74%.
So one child out of four children remain enriched in the African continent.
This varies from subcontinent to subcontinent within that region.
But what is really important is that Africa faces the challenge of limited resources available health facilities in the continent, especially in the countries that have **** unvaccinated number of children.
Access to health facilities, most importantly those delivering immunisation services is very limited.
Number of health workers, really the proportion is quite lower in the African continent as compared to other regions.
And of course, investments in immunisation financing are also limited within the continent.
But this is further exacerbated by increasing number of conflicts and associated fragility.
And the impact of the pandemic had also caused economic fragility in many countries affecting their ability to buy vaccines and avail it to their people.
We have also seen a bit of spillover from COVID-19 vaccination related vaccine confidence challenge which currently is improving across countries.
But a vaccine confidence issue could also be stated as one reason.
But the most important set back in the African continent is the weakness of Primary Health care systems to continuously and sustainably deliver immunisation services.
And that is why we continuously call upon governments and global partners to be able to support countries to strengthen their community health systems.
Which is a means to reach the last mine.
Which is a means to reach children that are reading file from urban areas.
It's also critical to keep in mind even conflict and fragility make the greatest contribution.
We have also significant number of children missed in urban poor areas where social exclusion or inability of these communities to be registered and recognised limit the access to vaccination, in addition to the limited reach to to children who live in remote and rural areas.
Thank you very much.
Thank you very much, Sir.
Indeed, this is important.
So we have a question from John Zarrocostas, France, Van Katherine, English Channel and The Lancet.
Good morning and thank you for the briefing.
I was wondering if you could put some context in all these numbers.
Firstly, if you could tell us if I got it right.
I didn't hear the HPV vaccination rates.
How much are they?
The low rate is linked to the **** cost of the vaccine for many poor countries.
And secondly, what is the overall vaccination rate in some big African countries like Nigeria, Dia, Congo, Ethiopia, where they've got many burdens, including the **** debt burden?
In some countries, I think the amount spent on health is 15 times less than what they pay for their debt servicing.
[Other language spoken]
Maybe on the numbers, Doctor O'Brien, Yeah, I'll start then specific of the countries.
Yeah, I'll start on the HPV side of things and maybe Ephraim can go over to the specific country data.
So on HPV, the global coverage, as I mentioned for the first dose of HPV in girls, which is really our focus because it's a cancer prevention, cervical cancer prevention vaccine.
So we're at 21% globally and that doesn't sound very ****, but I'll give some texture to that.
There are 130 countries that are using HPV vaccine for girls in their routine immunisation programme.
Among countries that are actually using the vaccine, the coverage depending on region or depending on income strata is ranges from somewhere around 55% coverage up to about 67% coverage.
So even in countries that are using the vaccine, the coverage in girls who should be getting the vaccine is still growing and is still not where it needs to be.
So that's one issue.
The second issue is that not every country has the vaccine in their programme yet.
And that's part of the reason why the global number is as low as it is because there are over 60 countries that where the coverage of HPV vaccine is 0.
In other words, it's not in the programme yet.
What's really important is that some of those countries are very large countries.
India, Bangladesh are two examples.
And yet the good news is that between now 2023 and 2025, there are 26 countries that have committed that they will introduce HPV vaccine including those those two countries and those 26 countries make up a very substantial fraction of the remaining cervical cancer disease burden.
And so we do expect that in the coming years we will see very significant progress.
But to give you a point of where we're we're trying to head, the goal for the cervical cancer elimination strategy is that 90% of all 15 year old girls around the world should be vaccinated with HPV vaccine.
And that goal is a 2030 goal.
So presently we're at 21% and we're trying to get to a 90% of all girls vaccinated by 20-30.
[Other language spoken]
That means that more countries need to introduce the vaccine and those countries that are already using the vaccine need to improve their programmes to get higher coverage in the girls in their country.
And you've asked specifically about the price of the vaccine for low and low middle income countries.
This is not a barrier.
And the reason is that those countries are supported by GAVI, the vaccine Alliance, the Funding Agency for low and low middle income countries.
And so countries receive the vaccine with substantial support.
They do have a co-pay for the vaccine, but cost of the vaccine for those countries is not the barrier.
We have in the past faced supply shortages.
Those supply shortages are largely in been relieved with new manufacturers coming in, but we still have to carefully manage the supply that is available to assure that every country that wants to introduce in the time frame they want to introduce can do so.
I'll go over to Doctor Limongo for the question on overall vaccination in Nigeria DRC and thank you very much.
And if you could just give a little bit more concise answers because we have got more questions still.
So Doctor Limongo on the individual countries please.
Thank you very much.
And as a starters for the African continent, which is home to about 12% of the world population, but it's a home to 54% of the UN or under vaccinated children.
So there is a significant proportion of children who remain unraged in the African continent.
And this overall increased number of unvaccinated children is driven by countries that have larger population.
For instance, from the West and Central Africa region it is Nigeria, and from Nigeria and and and Central Africa is the DRC and the Eastern and Southern Africa region.
Large countries like Ethiopia, Tanzania and Uganda contribute to the significant number of improvements or declines in immunisation coverage in 2022.
If you take specific for example, the number of 0 dose children in Democratic Republic of Congo foreign stance, we see that there is an overall increase of about 160,000 zero dose children from the 2019 levels we had in terms of 0 dose children in Nigeria, about over 250,000 additional number of 0 dose children from what we had in 2019 levels.
So this is a significant increment.
But the overall coverage in the African continent is also it has stagnated which means this increase are increases as a result of overall population increase.
So the African continent has two challenges.
One is to reach more number of children but also to improve coverage against increasing number of population.
If you want to look at the specific coverage rates in these countries, for example, antigens such as the search, the circles of vaccine against Dictaria, Titanis and Pertussis for some selected countries like DRC currently is about 65%, which is only 65% of eligible children reached with this important vaccine.
And I'm trying to look at the list.
Nigeria is currently around 62%, which shows that there is a long line to go to be able to reach these children in these countries.
Thank you very much.
[Other language spoken]
It would be really important to have these numbers in writing to the journalist as soon as possible.
James or or Carla, please, John, I see you have a follow up, but I give the floor to Gorky who's being patiently waiting.
And then I come to you for a brief follow up.
And really I like every to ask everybody to be a little bit concise.
[Other language spoken]
Gorkindo is is our correspondent of the sole de de car and continent premiere.
[Other language spoken]
[Other language spoken]
[Other language spoken]
The.
Like, like Briefer is asking whether in the you've spoken about the problem of axes to vaccination, but have you factored in that in many countries there is also some kind of resistance to the vaccine?
He brought the example of the vaccines against COVID that that were received by some countries in Africa in number of sufficient number of doses, but not used because people didn't want to be vaccinated.
So he's asking whether this has been factored in the list of elements that block vaccination, access to vaccination or vaccination in some of these countries.
I don't know if Doctor O'Brien or Doctor Romano want to answer on this.
[Other language spoken]
So, so your question very briefly, the main reason, the very overarching and dominant reason why children don't get vaccinated is around access.
The vast majority of families of mothers of fathers want believe in vaccines.
They understand the value of vaccines.
They've seen the benefit of vaccines.
And this is true around the world.
This is not only true in in the African continent, but the reason why vaccines are not administered are access reasons.
[Other language spoken]
It's difficult to get there.
When you go to a clinic, they may not have the vaccines.
It's around quality of services that that is the overarching reason.
No matter what country or community that we look at, however, it is true that we are very concerned about vaccine confidence and the awareness of families around the benefit of vaccine.
And clearly the information misinformation, disinformation that is growing in size and growing in scope is having some impact in some communities at specific times on the confidence that people have in vaccines.
And so this is, this is not to diminish that.
And certainly part of what we see may be related to that.
But certainly for childhood vaccinations, this is not the same problem as was seen in COVID vaccine, which has many, many attributes to it that created a great complexity.
But I, so I don't want to diminish your your concern or your question, but I do want to emphasise that that is not the main reason why countries have low vaccination coverage.
It's about a system perspective throughout the systems, as Doctor Liamongo has has referenced previously.
Indeed.
And I also see that now has put a link on the, in the chart to the rates of coverage in every country.
So please have a look at the chart.
John, you had a quick follow up and then we go to WMO and IFRC and then Gorky promised at the end.
I'll give you the floor on the Black Sea Green initiative.
John, your follow up quickly because yes, the other, can you hear me there?
[Other language spoken]
[Other language spoken]
[Other language spoken]
Yes, yes, Doctor Brian, even with the Co payment, what is the average paid by a poor country for HPV?
Even with the assistance of GAVI and the Co payment, what is the average cost per vaccine for HPV?
Yeah, I'll get, I'll get you the specific number, but I'm going to give you the range that it is for a GAVI country.
The cost that they pay depends where they are in the graduation phase for Gavi.
But those countries that are fully supported by GAVI pay less than $0.50 per dose for an HPV vaccine.
And I have to look up what exactly the co-pay is.
So we'll get back to you with that specific number.
But it's, it's, it's cents, not not even a not even a dollar a dose, but less than $0.50.
I think it's $0.25, but I have to look it up again.
[Other language spoken]
Is that for WE 2 or for our next speakers?
[Other language spoken]
[Other language spoken]
[Other language spoken]
[Other language spoken]
Oh, yes.
No, it's, it's not for WHO?
It's on the Black Sea Grain Initiative.
OK, we'll speak about the BSGI at the end, please.
We have got several people.
[Other language spoken]
I know that you have questions.
I don't think I have the answers, but I'm happy to try.
But in the meantime, please let's finish with our different guests and then I'll take all your questions about the Black Sea Grain Initiative.
[Other language spoken]
First of all, thanks.
Very thank you very much to Doctor Limango for having waken up so early to brief us on this important issue of immunisation.
Thanks to Doctor O'Brien here in Geneva from WHO again, any follow up we have James with Carla.
We're happy to help the journalist here in Geneva.
And I now turn to our colleagues of WMO and IFRC.
I don't need to say again, how, how, how hot is this room?
We see it every time we meet.
I know some of the journalists.
We've got 60 people connected.
I see that they prefer staying in their room then coming here, which is so hot.
And we do need to speak really about this terrible heat weights.
So we have with us.
Claire Nullis from WMO was brought as John Neer was the senior extreme heat advisor of WMO.
I'm happy to hear that WMO has an extreme heat advisor, Sir.
And we have Pano Saristo, who's on Zoom from Budapest, who is the emergency health unit team leader of the International Federation of the Red Cross.
Tomas de Laronga is here with us also together with Marina Lini Santanam.
Marina, I'm not sure people know you yet.
[Other language spoken]
[Other language spoken]
I don't think you have briefed yet.
[Other language spoken]
So we are here to speak about not only heat waves, but also the impact on health.
And I'll start maybe with Claire and then we will go to John and then to Pan Claire.
Yes, and good morning, everybody.
Many parts of the world, the Northern Hemisphere specifically, are gripped by intense extreme heat waves, many cases long lasting.
The World Meteorological Organisation and our members who are the National Meteorological and Hydrological Services obviously are monitoring the situation very, very closely, issuing many warnings, many alerts.
If a new temperature record is broken, we will advise you of the fact we are posting regular updates on the website, on social media.
So please, please follow us in the, in the coming days.
So I've had briefers in this room the last couple of weeks to talk about the climate aspects of, of, of what's happening today.
We're putting a focus on the impacts and specifically the impacts on health.
So I have John Nairne, who's senior extreme heat advisor.
Also in the room is Joyce Schumacher Gulmo of the joint World Meteorological Organisation, World Health Organisation, Climate and Health Office.
And obviously we're around during summer to most of summer to to answer any questions that you do have.
Over to John.
Thank you, Claire, it's on here.
Good morning and thanks for the opportunity.
Heat waves are amongst the deadliest natural hazards with hundreds of thousands of preventable deaths each year.
It's a rather poorly understood hazard.
Heat is a rapidly growing health risk due to increased, well, rapid urbanisation, the increasing extreme temperatures and an ageing population.
The impacts on people, economies, the natural and built environment are very serious.
A recent study has calculated that in Europe last summer, 60,000 additional people died due to extreme heat.
And that number is considered to be quite conservative by the experts who did the work as well as government.
So, and it's worth noting that that number is for Europe.
And of course, we're seeing extreme heat waves widespread around the world, and Europe has some of the strongest early warning systems and heat health action plans in the world, so you can imagine what the numbers are likely to be globally.
So we are seeing continuing growth in the frequency, duration and intensity of heat waves, and this is entirely consistent with the science of global warming and IPCC reports.
These events will continue to grow in intensity and the world needs to prepare for more intense heat waves.
The recently declared El Nino is only expected to amplify the occurrence and intensity of extreme heat events.
So we're in for a bit of a ride I'm afraid, and they will have quite serious impacts on human health and livelihoods.
One of the noticeable phenomena that we've seen is that the the growth in simultaneous heat waves around the northern hemisphere has increased 6 fold since the 1980s.
This trend shows no sign of decreasing.
It's also worth noting for the current event that July and August are the most critical months for extreme heat waves.
We've already seen them impact Asia, North and Central America, Africa, the Middle East, and now Europe.
[Other language spoken]
It is increasing, but more importantly, we need the world to broaden its attention beyond the maximum temperature alone.
In many locations where the minimum, the maximum is reaching into the **** 40s or higher, the temperature may still be near 40 at midnight.
So in these circumstances, the minimum temperature is more important for health and failing critical infrastructure which supports these people during extreme heat waves.
So repeated **** nighttime temperatures are particularly dangerous for human health because the body is unable to recover from sustained heat.
This leads to increased cases of heart attacks and death.
And it's not the only diseases that we see, but they're the notable ones.
While most of the attention focuses on daytime maximum temperatures, it is the overnight temperature which will have the biggest health risk, especially for vulnerable populations.
So the WMO is continuing to develop its policies, particularly to integrate early warning systems and early action response systems into heat action plans that will protect vulnerable people where they're applied, and also to help sustain critical infrastructure.
WMO is updating guidance on heat health warning systems and works with the World Health Organisation and a wide number of partners and governments through the Global Heat Health Information Network.
And WMO is also standardising terminology and definitions for extreme heat.
We feel that the categorisation of heat wave intensity will standardise our impact forecasts and warnings worldwide and that will have an impact in terms of people's understanding of the phenomena and how to respond to it.
And finally, I'd like to add that it it will be everyone's individual responsibility to have extreme heat plans because in the end, government can only do so much and these events are rather dangerous and you need to have something to fall back on.
[Other language spoken]
Thank you very much.
John Pano, you are the you're leading the emergency as operations of IFRC from Budapest.
You're you have the floor.
Thank you for allowing me to put a spotlight on what the Red Cross societies in Europe are doing to help people to cope with the the effects of heat waves.
Heat waves are really an invisible killer.
We are experiencing hotter and hotter temperatures for longer stretches of time every single summer here in Europe.
And as we heard, it's not a European phenomenon, it's it's everywhere around the globe.
In the past 10 years, more than 400,000 people have died from extreme climate and weather related disasters, according to the World Disasters report that my organisation, the IFRC, is publishing.
And every one of these deaths is a tragedy to the families and loved ones that they leave behind.
As we heard from colleagues, infants, the elderly, people with chronic health conditions are at a particular risk.
Most heat related deaths in these heat waves do not occur because of heat stroke alone, but because of the impact to the heat has on people with pre-existing conditions, cardiovascular, respiratory diseases and so forth.
But deaths from heat waves can be greatly reduced with relatively simple solutions and that is why Red Cross societies around Europe are implementing the simple low cost actions all over Europe to help the population struggling with extreme temperatures.
[Other language spoken]
The Italian Red Cross they are checking up on elderly people via telephones to ensure that the elderly people are safe from extreme heat.
Similarly, Portuguese Red Cross and French Red Cross are sharing practical tips through social media so that you don't leave your children or animals in parked cars.
The importance of using sunscreen, wide brimmed hats when you are exposed to the sun and so forth.
The Hellenic Red Cross The Greek Red Cross Society has been handing out drinking water and reminding the locals and tourists to stay hydrated because once you feel thirsty that's that's already you are already dehydrated.
Romanian Red Cross is doing the same.
Further Spanish Red Cross that has experienced enormous heat waves as several for several years.
They maintain shelters for people impacted now, especially by the La Palma wildfire and they also providing shelters for pets together with the local government.
Spanish Red Cross is also reminding people through social media networks to protect themselves from breathing in the wildfire smoke which can aggravate pre-existing health conditions and be very, very dangerous.
And these **** temperatures lead to very dry vegetation and the combination can create extreme fire danger, which is part of our messaging and and information to the population.
And one more example, the Turkish Red Crescent.
They are also responding to forest fires in six provinces in the country.
And volunteers and staffers of Durkisilai have been providing food and emergency aid since Sunday night because of the fires.
During these times it's crucial to pay attention to the people that face the biggest risk.
They are not only people that are vulnerable because of the health conditions.
Socio economical conditions and living arrangement can also induce risks.
So low income people in the continent cities really bear the brunt of this invisible emergency.
And these heat waves also impact other areas of society through reduced economic output, strange health systems, and and even power outages.
Unsurprisingly, urban areas are among those that are hit the hardest because cities are hotter than the surrounding countryside.
The International Federation of the Red Cross and Red Crescent Societies, the IFRC, has created a heat wave guide for cities.
This guide helps governmental and community leaders to future proof their communities and it can be accessed on our website, ifrc.org.
More than half of the world's population lives in urban areas, but according to the United Nations, this is expected to increase to 2/3 by 2015.
Now is the time for cities to incorporate heat reduction measures in their strategies and plan for more green spaces in their cities.
IFRC is currently engaged in work to better protect some 250 million people from heat, those people that are most ignored by rapidly rising climate risk by 2025 in at least 150 cities and towns.
According to our plan, there's a strong evidence that the frequency and intensity of heat waves are expected to rise around the globe because of the climate change.
Current extreme surface temperatures along the Mediterranean are fueling the heat wave by keeping night time temperatures at uncomfortable levels, worsening the impact of human health as per our climate centre, the Red Cross Climate Centre in the Netherlands.
Preparedness that early warning systems become more and more paramount.
The International Federation Red Cross and Red Crescent Societies is committed with our National Societies around the region and around the globe to combat the deadly effects of heat waves in Europe and around the world.
Together and only together, we can beat the heat.
[Other language spoken]
Thanks to you, Sir.
And I'll open now the floor to question first in the room, Nina, Nina Larson, AFP.
Hi, thanks for taking my question.
I was wondering First off, when it comes to heat records, so you announced yesterday there was a new heat record from 2021.
How likely do you think it is that that might be broken in coming days?
[Other language spoken]
So is this a new normal or is this not even touching the new normal?
If you could say a little bit more about that.
[Other language spoken]
So maybe the the new normal 1st every year we'll have inter annual variability.
It'll be governed by the the way in which the the oceans respond to the changes.
And we see of course that the El Nino is, is kicking in right now.
So as we move through different cycles of the global temperatures, we will see additional pressures or a backing off.
But it is worth noting that even during the LA Nino years, the the global temperatures are now warmer than they were back then, the El Nino's back in the 1980s.
So the global trend is continuing to grow.
So I don't know that we can actually talk about normals because it will keep changing.
[Other language spoken]
Sorry, the first question changing for the worst.
[Other language spoken]
Oh, our records.
I'm not sure what to say about the records.
I'm going to pass that to you.
[Other language spoken]
So yesterday the World Meteorological said that we have recognised a new temperature record for the European continent and that was recorded in Sicily in August 2021 and it was a temperature of 48.8°C.
We don't know yet if that record will be, will be broken if you know, but if there is a new, you know, reported new ****, we will set up a rapid assessment team to, to, to assess this.
But then the actual full and final verification, it does take time.
[Other language spoken]
It's, you know, because we need to, we need to get it right.
But I can't, I can't predict what's going to happen.
And we're still we're still mid-july.
We still have August to go.
[Other language spoken]
And Panel, if you want to add something, just put your hand up so that I know I, I should give you the floor.
[Other language spoken]
And I think this hand is, as you said before, for the other questions.
So I'll go to Jamie.
Jamie Keaton is our correspondent, Associated Press.
[Other language spoken]
Thank you very much.
I wanted to just follow up on the on the question of the methodology, if I could just really quickly, Claire, So what you're saying is that if there is a suspected heat record that you'll call it a preliminary finding?
I mean, could you just tell us because it took you 2 years to confirm the previous one.
So just I just want to make sure that we get the proper phraseology of that.
And then the second thing just has to do with, you mentioned that in the coming days, you're expecting some intensification of records of the of, of the, of the temperatures in Europe, it seems.
Could you just tell us if that's obviously maybe not with the El Nino factor?
What makes you think that we're going to see an intensification in the next few days?
So on the procedures, if you look on our website, we posted quite a detailed story yesterday.
And this is a quote from the World Meteorological Organisation Weather and Climate extremes rapporteur.
He's a Professor Randall Sevigny.
He's based at the University of Arizona.
And he said climate change and temperature increase has spurred a surge in reports of record weather and climate extremes, especially for heat.
We have to make sure that these records are verified for the sake of scientific understanding and accuracy because we are seeing an increase in reports.
We've now got A2 level procedures.
So we have a sort of fast track rapid assessment which will initially say yes, you know this new reported temperature record is feasible.
There are no evident faults with the, with the recording equipment.
It was, you know, recorded and then in the right place.
We will then, and so we can do that fairly quickly.
We will then go on to and this is Professor Cerveny and his, his team of volunteers, and I stress they are volunteers.
They, they have day jobs, which is another reason these things take take time.
They will then conduct A detailed evaluation.
So for instance, in the case of the record in in Sicily, they actually had to, you know, examine the all, all the equipment in involved.
We've got 2 ongoing investigations into temperatures which were recorded in, in Death Valley in, in the United States in both 20/20/20 and 2021.
Now the sensors which recorded both of those temperatures, they had to be sent away to be, to be examined just to make sure that everything, every, everything is working right.
So yes, it is a very slow, very painstaking process.
But we, you know, we want to get it right.
We're not, we're not doing this for fun.
You know, we need to get it right.
It's it's not just a case of, oh, you know, hey, we've got another record for the Guinness Book of Records.
It's, you know, it really builds up an understanding of, of, of our climate and and the extremes we're seeing.
[Other language spoken]
If you want to add something, just raise your hand.
I have Jeremy launch radio France international.
[Other language spoken]
[Other language spoken]
I, I, I would like to, to have maybe a comment on what you said earlier.
You, you, you mentioned places in Europe where the temperature is around 40° at midnight, if I understand correctly.
I would like to know what are those places exactly We're talking about Italy, for instance.
And then you, you, you mentioned that the, the, the risk that people have when you have those kind of temperatures at night.
Does it mean that you actually have more risk to die because of heat waves at night because of exactly what you said?
Do you have more death occurring at night because of heat waves?
And then the second question is, is about what's coming next.
You mentioned, of course, Aminio, but that doesn't mean that still, since we don't have the effects of Aminio in Europe right now, does it mean that can we take it for granted that next year in Europe will already be worse than what we have right now, John?
So I might work my way backwards from the El Nino.
Of course, it has different effects according to where you are on the globe.
So Europe tends to be more affected through the Mediterranean, I believe.
I'm trying to pull it from my memory at the moment, but probably the the bigger effect would be earlier heat.
[Other language spoken]
So it's quite likely that you would see an earlier start to heat.
[Other language spoken]
The reason why I mentioned minimum temperatures is because we're trying to understand how sustained that the **** temperatures are through the day and into the night.
So if the minimum is ****, the temperatures will kick in sooner in the day and reach a **** temperature sooner and be sustained longer into the day and further into the night.
So the idea that you could have very **** 30s temperatures around midnight is not unusual when you have an extreme heat wave where the minimum is ****.
So the focus on what the maximum will reach is an extreme temperature question is not an extreme heat question.
The extreme heat is a function of how long those temperatures are staying higher.
And so that's why I urge people to have a look at how **** those minimums are staying because that's an indicator of how **** the temperature will be near midnight.
I don't have precise locations for you at this stage.
I just know from my investigations into past heat waves, when you have have **** minimums, you all have very **** minimum temperatures near midnight.
[Other language spoken]
And we were only discussing an an American heat wave where the temperatures were 105 at midnight.
I try to remember the city, but I can't quite remember it.
But, and then they had a storm and the power was knocked out.
So you've got a location where they've had very **** temperatures to midnight.
They're relying upon air conditioning.
The air conditioning fails.
And what do you do?
You know, you've got a very hot night ahead of you.
So, and it's not just that we're talking about countries that have these resources to call upon to call themselves.
We've got many countries where this this calling infrastructure doesn't exist and these people are exposed all the time.
So we could probably supply locations in the past where those temperatures have occurred.
But the the Mediterranean heat wave, it is big, but it's nothing like what's been through North Africa and it's it's developing into Europe at this stage.
We're in the early phases of this heat wave with forecasts that are not very pretty.
Hello, yeah, if I could and I can send out more details.
One specific example is is Phoenix, AZ, which is a major city in the US, which has seen an extraordinary spell of temperatures above 110°F in the daytime.
But what's worrying people, it's just that, you know, these nighttime temperatures are just not going down when.
And as John said, that's when the body needs to recover.
But I can, I can send you some more specific specific examples that would be appreciated.
[Other language spoken]
I'm wondering if Europe is better prepared than last year when 60,000 extra people died.
And could you say a few words about how much pressure the European healthcare system is under currently and what sort of health emergencies we're we're seeing and where?
[Other language spoken]
Maybe this is more a question for fun.
I don't know if you want to take this one.
Well, I can speak for the Red Cross and Red Crescent network.
We have clearly taken tried to learn from last year and from the **** death rates and tried to prepare our national societies with with the knowledge bridging, sharing best practises and also providing funding from our disaster relief emergency fund, which we can quickly allocate to national societies in an anticipatory manner for the National societies to take immediate action.
And it's also a question of focusing it, it need the focus needs to be on the most vulnerable and those settings that are after in climate adaptation so that we can reach and inform and include those people that are most at risk.
And we are definitely focusing on reducing risk of these climate related disasters.
And we encourage the authorities who are more responsible for the the healthcare sector, the hospitals that that take the brunt of the the increased healthcare needs to also to do the same.
The anticipatory and early action is really important because it reduces the impact of this type of slow onset climate disaster.
[Other language spoken]
I might just add that health alone can't solve the problems with hate.
We've had our workshops with the G7 and also a round table in Washington with all the health experts who have been tackling this problem for some time.
And they're getting good at what they do.
But they're calling out that they can't do it on their own and that governance is a key issue.
And the actual, the actual process of reaching out beyond health as the responsible agency to deal with heat is 1, where we can build resilience across our infrastructure.
We can't have power failing and have health systems with people at home on medical equipment relying upon that equipment.
Who's responsible?
Is it health?
It's governments that need to think through these issues and build stronger governance issues that pull in all of society to help solve the problem.
[Other language spoken]
Thank you very much.
[Other language spoken]
Yes, I do just want to really quickly, I mentioned a question earlier about, you know, how do you know that this intensification is going to happen and how do you know, how do you know you, Mr Nairn, you said earlier that that you know that this is just the early phases of of the heat wave in Europe that we're seeing right now.
If I understood you correctly, how do you know that and how much is this is tied to climate change if you, I don't think we've made that specific connection there, at least not I mean you mentioned IPCC, but just if you could say and finally, just, I mean, how does this compare just for the for the average person on the street?
How does this compare to what we've seen in previous years?
Are you concerned, very concerned that we're seeing a worsening, a greater worsening in intensification of these heat waves generally?
[Other language spoken]
[Other language spoken]
Look, the the story that since the 80s we've got a six fold increase in simultaneous heat waves is there in the data and the trend line isn't changing.
We're seeing the global oceans exhibiting greater thermal anomalies, which is helping to drive these higher temperatures.
You're seeing the loss of global ice.
We talk about the three poles, the North Pole, the South Pole and the Himalayas or the permanent ice on, on the continents.
Those are critical for the weather systems that we rely upon to give us stable weather patterns.
Now in the Northern hemisphere in summer, they are too stable.
The jet stream is wandering around like there's expressions I won't use.
But anyway, it's, it's very wobbly and it ends up with parked weather systems that accumulate a lot of sunshine and, and, and heat in one location that moves extremely slowly.
These are not your normal weather systems of the past.
They have arrived as a consequence of climate change in the North Pole ice.
And that is reinforcing that mechanism.
It will continue and it will continue for some time.
You, you have to reverse it.
You have to do climate repair to change it.
So it is global warming and is going to continue for some time.
Thank you very much, John.
That was absolutely clear.
Lisa Schlein VS American in the chat is asking IFRC to send the notes and Thomas was here and is nodding.
It will come.
By the way, James, if you're still on the line, it seems UNICEF has not yet sent the notes on immunisation and they will appreciate receiving them.
So thank you very much.
You, you, you should have received our notes.
[Other language spoken]
Sorry.
There's still, I see a hand from **** Pedrero, also AFP.
[Other language spoken]
[Other language spoken]
[Other language spoken]
Good morning everybody.
Thank you for taking my question.
So WMO and in general every organisations are alerting those days about those heat waves and records.
We we only heard about that every day and about how we have to adapt.
The the question that we that sometimes I think people would like to understand is what they can do at their personal level, not to adapt to this climate change because that we have heard, but how to reverse that climate change, what they can do and not expecting that countries would take their engagement.
And I think this this it's part of the story is really not heard or at least for my part, for my side.
So what what you can do and say to to those people, what they can do to reverse this climate change.
And because I think people is hearing every day that they are records.
They know that and they believe that.
[Other language spoken]
And yes, I think the, I mean, it's, there are a number of things that I think not only the, the agencies, but everybody, at least in the United Nations, first and foremost, the Secretary general are saying and has been saying for a very long time on what we can do to, to reverse, as John said, restates climate.
I just invite you to have a look at the, at the statement that we have distributed to you the other day when it was in Brussels speaking about the issue of SDG and climate change and how people can really act on, on, on this, even at the personal level.
But of course, he has been insisting a lot on the issue of fossil fuels and the need to stop and revert this issue, this this exploitation and including, of course, all the implications at the financial level.
I don't know if John, you have a specific advice to give maybe or panel, but really there there is, there is a lot we have been saying and we can give you again all the numbers and all the actions that people need to look at and implement if we want to do something at the personal level and of course at the national.
And I I think the simplest thing is electrify everything.
[Other language spoken]
It means stop carbon fuels still electrify everything.
It'll make a lot of difference.
[Other language spoken]
Yeah, exactly.
[Other language spoken]
I think it's one of the key words.
[Other language spoken]
So thank you very much.
Thanks to Maso for answering the request of notes.
I was thank also, of course, Panosaristo for being with us on Zoom from Budapest.
John, Claire and their colleague to be here to tell us about this incredibly important phenomenon.
And now let's go to our last speaker who is also from the IFRC Serbia Castellanos, who is the Under Secretary General of IFRC for Operations Serbia.
You are coming to us from Nairobi for a briefing on Sudan.
You have the floor.
[Other language spoken]
Thank you very much and good afternoon to to everyone.
Let me start by saying that this conflict has deep humanitarian consequences in in Sudan and as we saw in Ukraine also is having consequences in neighbouring countries.
People from Sudan have fled to chat with Ethiopia, to CAR to South Sudan, to Egypt.
But this conflict lacks concerningly of financial resources and this deepens the humanitarian consequences.
The IFRC appeal, just to give an example, has received 7% of 60 million Swiss francs to support to the affected population in a country where more than 40,000 volunteers remain in capacity to provide humanitarian services.
Where 2000 of them are actively every single day in the affected areas, responding and doing it's level best to support a humanitarian community in providing humanitarian services.
This is an example of how concerning the financial resources to support people in need we are facing right now.
We know that more than 3 million people have now been displaced, but also the millions that are in the middle of the conflict who have had no other option than staying in their homes.
It's about a conflict happening in a country that was already affected by the flood, by the food insecurity and by socio economic impacts due to compounding crisis affecting Sudan.
As we all know, the rainy season is about to start, bringing the risk of floods and increasing diseases and added difficulties in getting access to people in need.
The previous session was about heat, heat waves in Europe.
I just returned from Sudan where the temperature was around 41°, where communities are in conditions that obviously are not the ones that we are expecting if we want to deliver services and to maintain the lives and living condition of the people in in a good shape.
So coming from the field also, I visited Topia, Ethiopia and Sudan where I spent two weeks in Metema at border location with Sudan.
The unmet needs are obvious.
People from Sudan may take days or weeks until until they are able to enter to Ethiopia.
Until that process takes place, they have no other option but to stay between the two borders in in in improvised huts.
Others may stay under a tree, sheltering from the weather or even sleeping on the roads avoiding ***** bites.
There is a worrying number of arrivals that have reported being of sexual and gender based violence on the route from Sudan towards Ethiopia.
Women and children show evident needs of protection and limited health services in the area as well are evident.
One of the persons I spoke with said to me, we demand to be treated with respect and dignity.
I am a woman with a child that the only available tent in the area requires that I sleep in the same place that men are staying.
I am AI and she said I am a Muslim and a woman do not sleep in the same place as where men are.
Sudan The Sudanese Red Christian Society has been on the ground since the fighting erupted on 15th of April 2023.
Through its branches and units, the Sudanese Red Crescent Society has a presence in 18 states of Sudan and volunteers have continued to respond throughout the conflict with its neutral status meaning it's able to gain access across both sides.
Over 400,000 volunteers has this national society that are being trained with the skills, with the knowledge and from those 400 person, at least 10% of them have been activated across the country and in the completely affected areas.
2000 every single day, 2000 of them every single day are responding across the states providing humanitarian services, including Khartoum and Darfur.
Estaban volunteers count also as ID PS and are also victims of the conflict.
Some of them reported that their houses have been looted, taken or affected by the crossfire.
Nevertheless, they are actively involved in dead body management and dignified burials, providing first aid, distributing any advice whenever are available.
More than 100 of them are supporting in clinics in in Khartoum, in hospitals, in health centres.
Many others are providing psychological first aid, distributing food with an agreement we have that the national society has made with work food programme.
The Sudanese Red Christian Society has access access to the food and the volunteers and the staff are the ones to negotiate with the parties or the conflict to access access to distribute supplies to the stranded communities in the same way as as I described before, a negotiate to provide dignified burials.
Such a difficult role to play in the middle of a conflict.
All of them has expressed that they can do more if resources were available.
But the sad reality for this conflict is resources are scarce.
At least the eye foresee and answer to the national society is something that really represents an issue of concern.
The world is turning away.
The needs are enormous and mountain daily.
The biggest strategy is how poorly funded our emergency appeals are.
As I mentioned, I was in Sudan.
I went to Port Sudan and visited several reception centres where I heard the same thing from the affected communities.
The Sudanese red Crest of society told me before we need food, we need medicine, we even we even more for cases of chronic diseases, we need cash to be able to cover our needs.
All people were clearly under huge stress and we'll need mental health support by by everyone.
The the situation is is very clear what they are going to need in terms of mental health.
A host family typical receives up to three displaced families and will and and demonstrate great solidarity with the Sudanese population.
The stress on host families is **** in reception centres are packed.
Those we reception centres that have a room available can host in each room up to 15 people.
Some some centres are better off than others, but all of them are showing clear clearly the men and met needs.
In one of the centres, the administrator administrator showed me the food that was available for the rest of the week.
It was just two boxes with vegetables and a bag of flour.
And he said this is the only thing I have left for more than 120 people that were hosted there.
I do not and he said I do not know what I will do tomorrow.
I have to say we couldn't answer him how we can help him without having the resources with us.
This is a crisis impacting already vulnerable people.
Please remind that 11.7 million people in Sudan have existing acute humanitarian need priority.
The majority of those forced to flee are women and children and a significant number of people are fleeing violence for a second time, having been displaced in the camps in Sudan.
Red Cross Red Christian societies are prioritising the needs of women, children, all people and people with disabilities who are disproportionately impacted.
The IFRC Regional Emergency Appeal support National Societies working with those who have fled to the six neighbouring countries with one of the major focus that focuses that are protection, gender and inclusion within Sudan.
The revised emergency appeal also has a focus on protection and it's humanitarian service provision, in particular women, children, older people and people with specific needs.
Finally, to say that all the humanitarian ecosystem is doing its level best, but my plea is that we will need to put in the minds and hearts of the international community that this conflict requires the financial resources that are needed in order to really address the humanitarian needs of the people and especially dignify the lives of the people affected by this conflict.
Thank you very much.
Thank you very much, Mr Castellanos, for this extensive briefing.
Is there any question on Sudan in the room I don't see any hand up or on the platform I don't see any hand up.
So thank you very much for having spoken to us about this dire situation.
And I also remind the journalist that over the weekend, we have issued a statement by Martin Griffiths and the Secretary General for Humanitarian Affairs and Emergency Relief Coordinator, also on the three month mark of the conflict in Sudan, an incredibly difficult situation for Sudanese civilians as also described by Mr Castellanos now.
So I would like now to give the floor to the two journalists with us for it, for questions, for other questions.
And I'll start with Gorky.
[Other language spoken]
[Other language spoken]
[Other language spoken]
Swish Invented.
[Other language spoken]
Mudon santima detro fluid gel empreso dupree le moenaj Selimmen Discord de marsonge com de prejudge de Carter de Zeta de for sofola.
[Other language spoken]
[Other language spoken]
I'm deeply disappointed decision.
The grass as a project initiative and when you push the Milton Milton and support the depression humanitarian and particularly.
[Other language spoken]
Andrew Poor, LeMond Afani.
[Other language spoken]
We continue opposite the Jirak.
Emma, I see Amma has their hand up, but I had promised the the floor to Yan.
So if Yan is still with us, yes, go ahead Yan Yes.
[Other language spoken]
Many thanks for giving me the floor.
Yes, on the grain initiative 2 points yesterday we got the media advisory on the SG statement only 10 minutes ahead of his statement.
That's, that was really quite short.
And I would like to ask you to give us more time in advance to prepare.
It was I think 4:30 in the afternoon was quite late for the print editions.
So I couldn't use the SGS forwards in, in my version for my print edition, Tiger Spiegel and, and, and other papers, I couldn't use it anymore.
That's was not very comfortable.
And secondly, I was wondering, why don't we have a briefing with the secretary general of Antet on the grain initiative?
She's key in negotiating with Russia on the memorandum of understanding.
But as far as I remember, she hasn't briefed us for months on this issue.
And this is really worldwide news, and we don't hear anything from anted.
That's really quite astonishing.
So I would like to ask you to organise a briefing with Madame Greenspan on this issue.
[Other language spoken]
Yeah, and thank you very much.
So let me explain how you went yesterday.
[Other language spoken]
When the news came of the letter that had been, that had been given to the JCC with the announcement of the termination of the rush participation in the memorandum of Understanding.
This came at the moment when New York was sleeping.
We of course immediately started having question from the journalist.
We couldn't do much more than wait for New York to wake up.
We had, I answered thanks to our colleagues in New York who were up very, very early.
We gave some, some information to the journalist that consulted us to say that we were expecting a, an announcement or a statement from the secretary General, which indeed came.
And you have to think that it came at 10:30 New York time.
The Secretary General had the speaking engagement at the **** level political forum just before or that he could not change.
So he did the statement as soon as he had finished the other engagement.
And we have distributed to you under embargo his remarks as soon as they came from New York.
So it was really one of those cases where indeed things happened here on another time zone and we had to wait for New York to wake up.
But we tried to support the journalist Swed out as much as we could.
And again, the information on the statements came at a certain time when they woke up and we gave it to you immediately.
So I understand that it was not very convenient for this time, this time zone, but it happened as soon as humanly possible, really.
We immediately informed you when we had this, this information ourselves.
And the Secretary General gave the statement as soon as he could.
So this is on your first point, on the point of a briefing by Mrs Greenspan, I can only turn to Katherine, who is online and give her the floor.
But I'd just like to remind you that Mrs Greenspan has participated to the the press conference that the Secretary General gave together with the Executive director of ESCAP a few days ago on the latest briefing of the **** level group that she chairs.
And she answered questions also on the situation of the Black Sea Green Initiative.
But I let Catherine answer on this.
[Other language spoken]
Good morning, everyone.
Thank you Alison Haff for reminding that she spoke to you a few days ago.
I have forwarded the request for her to comment and she will do so when she thinks it's it's relevant.
So we are working on on that and we will let you know in due course when she will be commenting.
[Other language spoken]
[Other language spoken]
Yes, also on the Black Sea, please, we're using the word terminated and copy.
I'm, I'm wondering, is it really over from the UNS point of view or are there any efforts at all behind the scenes to revive it?
And I guess that's for for you, Alessandra or or for for Catherine.
Is it over from your point of view?
Well, again, I think the secretary chair has been very clear.
The letter that came to the GCC used the word terminate, so I think it is pretty clear what it means.
Terminated is terminated and of course, as the Secretary General said, we are very mobilised to continue looking for solutions.
The the two agreement is such have terminated doesn't mean that they we will not find some other way either practical or through agreements to solve the the dire situation that this termination has created.
But the word used, I can confirm, was terminated.
Gorky merci bucco Alessandra.
What tante de response?
The total Yeah.
[Other language spoken]
Then they say dear they shows continent a local, a reality.
They say so total more different.
They shows put like **** of the speech the school.
[Other language spoken]
The man of politics, the universe, for example.
National Review.
The.
Is Juan Corky this still a hand up with by John?
[Other language spoken]
Can you hear me there?
[Other language spoken]
[Other language spoken]
Yes, My question is concerning following up to Jan's comments on the Black Sea grain issue.
I'm interested in the remarks by the Secretary General.
He was citing 2 Russian exporter groups for the grain data and the fertiliser data exported from Russia.
Is it possible to get some data sets from UN agencies closely involved in these negotiations, either from UNCTAD or FAO or the Secretary General's Office?
Surely there must be clear data that the UN has other than grain associations exporters which are not as reliable as the data where is collected at the receiving end of the importing country.
This is basics and I was stunned to see now official data in the Secretary General's report.
[Other language spoken]
I'd like to of course Catherine answer on on that side.
There is a lot of information, sorry, on the website of the coordinator, the UN coordinator for the Black Sea Green Initiative.
We have sent you, I think it was yesterday, the day 25, a note from that office from our good friend and colleague Ismi Paladet.
I'm sure you you remember where there were some numbers, but also the links at the bottom of a number of resources.
I have not gone too much too deeply into it, but I would like to invite to, to have a look first at this because there were really a lot of information and is mini is available also to answer questions.
I know Anka has also another array of data and maybe I'll pass the, the floor to Catherine on this.
Yes, it's, it's difficult to have the to have all the data on fertilisers.
But I will ask again, you, you know very well, John, that we've tried to provide you with this type of data and let me check again and I'll get back to you.
[Other language spoken]
I'm aware of the excellent work done by the UN office in Istanbul, but my question was with reference what the SG said concerning the Russian MOU data set.
The staff die, JCC concerns the MOU between Turkey, Ukraine, Russia and so yes, I'm aware of the other data set, but I'm interested more in getting more reliable data collected by the importing countries receiving goods from Russia.
Thanks very much.
I think Catherine has taken good note of this.
And really this was the size of the Memorandum of understanding, which was mainly looked at by Ankit.
So she will come back to you.
[Other language spoken]
I was wondering what is the way forward now in terms of the initiative is, is the UN launching a new attempt to revive the two the two agreements and especially are there is an initiative to approach Russia on this matter?
[Other language spoken]
Look at the only thing I can tell you is that, as the Secretary General said, the United Nations as an entity will continue to do whatever we can to ensure that these fertilisers and food gets to the market.
Because this is really critically important for everyone, for the world, not just for, as we said before, for some vulnerable countries, but for every country.
How this is going to take place, obviously I cannot tell you today.
The discussions already started yesterday.
The spokesperson of the Secretary General said during the noon briefing that it is we have not been losing 1 moment and already started to try and re and and and and, and with the contact that has been established with the work that has been done until now to look at ways to ensure that these products gets on the market.
So I cannot tell you how exactly now, but the let me confirm that we've already started working on this matter.
And this sorry, concludes the questions.
I have already spoken to you today, Africa, about the Africa Day.
I'm just looking for the last announcement here that I had for you and it was that about the Committee Against the Torture that will start reviewing as as started with the time that is now reviewing the report submitted by New Zealand and the next country to be examined by this committee will be Romania.
That concludes the announcement I had for you.
I thank you for having followed this extremely long briefing, but very, very interesting.
I wish you a cool as much as you can day and I'll see you on Friday.
[Other language spoken]