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NEWS RELEASE
[New survey results show health systems starting to recover from pandemic](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-r/)
Geneva, 2 May 2023 — After three years of the COVID-19 pandemic, health systems in countries have started showing the first major signs of health system recovery, according to the [WHO interim report on the “Fourth round of the global pulse survey on continuity of essential health services during the COVID-19 pandemic: November 2022–January 2023”](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-y/). By early 2023, countries reported experiencing reduced disruptions in the delivery of routine health services, but highlighted the need to invest in recovery and stronger resilience for the future.
Among the 139 countries that responded to the fourth round of WHO’s pulse survey, countries reported continued disruptions in almost one-quarter of services on average. In 84 countries where trend analysis is possible, the percentage of disrupted services declined on average from 56% in July-September 2020 to 23% in November 2022- January 2023.
Persisting disruptions are due to both demand- and supply-side factors, including low levels of health care-seeking in communities as well as limited availability of health workers and other health-care resources such as open clinics or available stocks of medicines and products.
“It is welcome news that health systems in the majority of countries are starting to restore essential health services for millions of people who missed them during the pandemic,” said Dr Rudi Eggers, WHO Director for Integrated Health Services. “But we need to ensure that all countries continue to close this gap to recover health services, and apply lessons learnt to build more prepared and resilient health systems for the future”.
First notable signs of recovery
In this new survey, fewer countries reported intentionally scaling back access across all service delivery platforms and essential public health functions since 2020-2021 reporting, showing an important step to return to pre-pandemic levels of service delivery and broader system functioning.
By the end of 2022, most countries reported partial signs of service recovery, including in services for sexual, reproductive, maternal, newborn, child and adolescent health; nutrition; immunization; communicable diseases (including malaria, HIV, TB, and other sexually-transmitted infections); neglected tropical diseases; noncommunicable diseases; management of mental, neurological and substance use disorders; care for older people; and traditional and/or complementary care.
The number of countries reporting disruption to their national supply chain system reduced from nearly half (29 of 59 responding countries) to about a quarter (18 of 66 responding countries) within the last year.
Despite signs of recovery, service disruptions persist across countries in all regions and income levels, and across most service delivery settings and tracer service areas. Countries are also dealing with increasing service backlogs – most frequently in services for screening, diagnosis and treatment of noncommunicable diseases – which can lead to negative consequences as people are delayed access to timely care.
Recovering essential health service delivery is critical because disruptions – including to services for health promotion, disease prevention, diagnosis, treatment, rehabilitation and palliation – may have even greater adverse health effects at population and individual level than the pandemic itself, especially among vulnerable populations.
Integrating COVID-19 services into essential health services
In another important step towards system recovery and transition, most countries have made progress in integrating COVID-19 services into routine health service delivery. About 80-90% of countries have fully integrated COVID-19 vaccination, diagnostic and case management services as well as services for post COVID-19 condition into routine service delivery.
Still, most countries (80% of 83 responding countries) reported at least one bottleneck to scaling up access to essential COVID-19 tools (e.g. COVID-19 diagnostics, therapeutics, vaccines and personal protective equipment – PPE), with health workforce issues and lack of funding representing the most common barriers.
Further support needed for recovery, resilience and preparedness
Most countries have started to apply what they have learnt during the COVID-19 pandemic, including through the institutionalization of a number of innovative service disruption mitigation strategies into routine health service delivery. These include deployment of telemedicine approaches, promotion of home-based care or self-care interventions, approaches for strengthening health workers availability, capacities and support mechanisms, innovations in procuring and delivering medicines and supplies, more routine community communications, and partnerships with private sector providers.
Three quarters of countries reported additional funding allocation towards longer term system recovery, resilience and preparedness.
Countries expressed need for WHO support to address remaining challenges in the COVID-19 context and beyond, most frequently related to health workforce strengthening, building the monitoring capacities of health services, designing primary health care — oriented models of care, governance, policy and planning and financial planning and funding.
Note to editors:
In the fourth round of WHO’s global pulse survey, 222 countries, territories and areas were invited to respond to a standardized web-based survey between November 2022 and January 2023. The fourth survey followed up on WHO’s previous 2020 and 2021 pulse surveys: [Round 1 (May-September 2020)](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-j/), [Round 2 (January-March 2021)](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-t/), and [Round 3 (November-December 2021)](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-i/) which showed the extent to which the pandemic was affecting the continuity of essential health services and how countries are taking action. While pulse surveys have limitations such as reporting bias and representativeness, the strength of this effort is that it is comprehensive and delivers information rapidly. The term “country” should be understood to include all countries, territories and areas. Trend analyses was completed based on responses from 84 countries, territories, or areas that responded to at least one survey section in all four pulse survey rounds.
Further information:
See the full report [here](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-d/).
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World Health Organization, Avenue Appia 20, 1202 Geneva 27, Switzerland
WHO urges increased implementation of recommended tools to combat malaria
25 April 2023– Marking World Malaria Day, the World Health Organization (WHO) is issuing a call for increased implementation of new and existing interventions to save lives from malaria. Nearly 1.5 million children at high risk of illness and death from malaria in Ghana, Kenya and Malawi have now received their first dose of the first malaria vaccine, RTS,S/AS01 (RTS,S),thanks to an ongoing pilot programme coordinated by WHO.
The malaria vaccine pilots, launched in 2019, are increasing equity in access to malaria prevention for the most vulnerable and are saving lives. If implemented broadly, WHO estimates that malaria vaccines could save the lives of tens of thousands of children each year.
“We have the tools to drive down malaria, a package of interventions that includes vector control, preventive medicines, testing, and treatment,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “These are joined by a safe and effective malaria vaccine, which could save the lives of tens of thousands children every year. With sustained investment and scaled-up efforts to reach those most at risk, malaria elimination in many countries is in reach.”
World Malaria Day 2023 is being marked under the theme “[Time to deliver zero malaria: invest, innovate, implement](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-p/)”. Within this theme, WHO is urging more effective implementation of available tools and strategies to prevent, diagnose and treat malaria, particularly among marginalized populations.
According to the latest World malaria report, published in December 2022, there were an estimated 247 million new cases of malaria in 2021. The WHO African Region continues to shoulder the heaviest burden of the disease – accounting for an estimated 95% of all malaria cases (234 million) and 96% of all deaths (593 000) in 2021. Nearly 80% of malaria deaths in the African Region were among children under the age of five.
New strategies and tools
Countries have made some progress in expanding access to malaria services for most-at-risk populations. Despite some progress, many people at high risk of malaria still lack access to services that can prevent, detect and treat the disease. Challenges in expanding access to malaria services have been compounded, particularly in sub-Saharan Africa, by the COVID-19 pandemic, converging humanitarian crises, restricted funding, weak surveillance systems, and declines in the effectiveness of core malaria-fighting tools.
To address these threats and support countries in building more resilient malaria programmes, WHO recently published new strategies and frameworks, including:
· a [new strategy](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-x/) to contain antimalarial drug resistance in Africa;
· a [new initiative](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-m/) to stop the spread of Anopheles stephensi in urban environments;
· a [new framework](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-c/), developed jointly by WHO and UN-Habitat, to guide city leaders in urban malaria control.
· a [new toolkit](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-q/) to help countries assess their malaria surveillance systems and identify areas for investment
WHO has also increased the transparency, flexibility and access to its malaria recommendations. The consolidated WHO Guidelines for malaria are now available through two digital platforms: [MAGICapp](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-a/) and the [“Malaria Toolkit” app](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-f/). WHO encourages countries to tailor the recommendations to local disease settings for maximum impact.
Prospects for new interventions
Continued investment in the development and deployment of new malaria vaccines and next-generation tools will be key to achieving the 2030 global malaria targets.
A second malaria vaccine, the R21/Matrix-M (R21) vaccine, if approved, could help close the sizable gap between supply and demand and further reduce child illness and death from malaria. It is a priority for WHO to continue the thorough and efficient expert review of the R21 malaria vaccine once additional key safety and efficacy data from the ongoing R21 phase 3 trial are available and provided to WHO.
Phased introductions of the RTS,S malaria vaccine in additional countries in Africa are expected to begin in early 2024.
In the vector control space, there are 28 new products in the R&D pipeline. Tools under evaluation include, for example, new types of insecticide-treated nets, targeted baits that attract mosquitoes, spatial repellents, lethal house lures (eaves tubes) and genetic engineering of mosquitoes.
Researchers are prioritizing the development of non-ACT treatments in the field of antimalarial medicines due to the emergence and spread of partial artemisinin resistance. The development of next-generation medicines, such as “triple ACTs,” which use a combination of artemisinin and two partner drugs, is underway to reduce the risk of drug resistance.
Notes to the editor:
For more information on the WHO World Malaria Day campaign, visit: https://www.who.int/campaigns/world-malaria-day/2023
Related Links:
[Malaria Fact sheet](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-z/)
[World malaria report 2022 (who.int)](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-v/)
[The WHO Guidelines for malaria](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-e/)
Q&A on RTS,S malaria vaccine [https://www.who.int/news-room/questions-and-answers/item/q-a-on-rts-s-malaria-vaccine](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-s/)
Malaria Vaccine Implementation Programme
[https://www.who.int/initiatives/malaria-vaccine-implementation-programme](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-g/)
Malaria vaccine: WHO position paper – March 2022:
[https://www.who.int/news/item/04-03-2022-first-ever-malaria-vaccine-recommendation-now-published-in-a-position-paper-and-in-the-who-guidelines-for-malaria](https://worldhealthorganization.cmail19.com/t/d-l-zuiltyd-iitylyihjr-w/)
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