Accomplishments in 2021: Celebrating milestones with our donors and collaborators

At the beginning of 2021, COVID-19 continued to highlight the importance of strong health information systems that provide timely, reliable, and actionable data.

In February, we released the SCORE global report on health data systems and capacity, 2020 – the first ever assessment to analyse these areas using data from 133 countries representing 90% of the world’s population. SCORE, which stands for Survey, Count, Optimize, Review, and Enable, is a technical package developed in close collaboration with partners and Member States. As a one-stop-shop of more than 90 essential tools and interventions, the SCORE for Health Data Technical Package guides countries to invest in priority areas that will have maximum impact.

When the SCORE assessment is repeated in 2025, our goal is for every country to have strong surveillance, complete civil registration and vital statistics, and optimum routine health information systems that drive data reporting and use for policy design.

In March we released another important resource package together with the Health Data Collaborative, WHO programmes, and external partners: the Harmonized Health Facility Assessment. This assessment supports countries to conduct standardized surveys that evaluate the availability and quality of their health facility services. This information is crucial to achieve universal health coverage by promoting high-quality, affordable primary health care.

In April, WHO hosted an expert consultation on the new World Health Survey Plus (WHS+): a multi-topic, multi-mode, multi-platform survey system with 21 modules that aim to fill essential data gaps by adapting to countries’ unique needs. As part of the ‘Survey’ element of SCORE, WHS+ supports data collection and routine public health surveillance to guide effective policy design and action. Anyone is free to view session recordings and access the data and tools via the WHS+ website.

COVID-19 mobile phone surveys launched in seven countries in 2021 – Brazil, Ecuador, India, Jordan, South Africa, Spain, and Sweden – with analytical reports coming soon. Mobile phone surveys are a more cost-effective and safer way to gather population health data, especially when COVID-19 presents new risks for face-to-face interaction. Developed in collaboration with partners, these surveys include a COVID-19 question bank that can be filtered by survey type or topic area. Going forward, we plan to update this resource with a focus on small island developing states.

Complementing this work, we focused on gathering all the relevant tools needed to close the equity gap in global health – a crucial step for delivering on our commitment to leave no one behind. This included the release of a new data repository as part of updates to the WHO Health Equity Assessment Toolkit and WHO Health Equity Monitor. The Health Equity Monitor is one of the largest and most diverse databases in the world, tracking disaggregated data for 115 countries. This was followed later in the year with an online course on Inequality Monitoring in Immunization – the first in an upcoming series of courses on monitoring inequalities in health.

Together, these resources support countries to address long-standing inequalities that have been exacerbated by COVID-19. Inequalities that stand in the way of reaching the most vulnerable on the path to 2030 and beyond.

Leading up to the 74th World Health Assembly in May, WHO released its flagship World Health Statistics 2021 report. As an ‘annual check-up on the state of the world’s health’, this report presented the latest data for more than 50 health-related SDG and Triple Billion target indicators. The 2021 edition also included insights on the human toll of COVID-19 and highlighted the importance of disaggregated data to monitor inequalities.

That same month, we presented a paper to the Assembly on the Strengthening of health information systems. This paper outlines achievements, challenges, and new commitments to address the data gaps exposed by COVID-19 – gaps that must be closed in order to monitor progress towards the Triple Billion targets.

We also delivered the third progress report on Implementation of the 2030 Agenda for Sustainable Development. In addition to tracking implementation of the health-related SDGs, this report presents progress on the 46 indicators that make up WHO’s results framework and proposes a new delivery approach to accelerate progress towards 2030 as part of the UN ‘Decade of Action’.

This includes actions taken by the Global Action Plan for Healthy Lives and Well-being for All (SDG GAP) – a multilateral mechanism of 13 agencies to better align country support to meet the SDGs. As part of this mechanism, WHO co-chairs the data and digital accelerator together with UNFPA.

Alongside these reports, we released updates to the International Classification of Diseases, eleventh edition (ICD-11)¹. The ICD provides a common language that allows health professionals across the world to share standardized information. With around 17 000 unique codes for injuries, diseases, and causes of death – including emergency codes for COVID-19 – this landmark revision truly brought ICD into the 21st century with a fully digital and multilingual interface. Later in the year, WHO held a technical meeting on the ICD-11 traditional medicine chapter reflecting the continued importance of traditional medicine in many parts of the world.²

¹ICD-11 was adopted at the World Health Assembly in May 2019 and Member States have committed to using it for mortality and morbidity reporting starting in 2022.

²See also: WHO establishes the Global Centre for Traditional Medicine in India, 25 March 2022.

Following the World Health Assembly, WHO’s Data, Science, and Emergencies Preparedness and Response Divisions jointly hosted the first ever Health Data Governance Summit. This two-part summit, with the second part taking place in September, convened Member States, partners, and the public from over 150 institutes and more than 68 countries to review best practices in research data sharing, public health and disease surveillance, and legal and ethical considerations.

The resulting Summit Statement calls for the effective, ethical, and equitable use of health data as a global public good in line with the UN Secretary General’s data strategy, with further outcomes captured in a Summit report.

Following this summit, the WHO Data Governance Committee approved the Organization’s Personal Data Protection Policy – a crucial investment that aligns WHO with international best practices in personal data sharing and protection.

October welcomed the annual meeting of the WHO-FIC Network. Experts from more than 80 countries gathered to discuss the indispensable task of maintaining and developing the WHO Family of International Classifications. These serve as an encyclopedia of health data standards designed to ensure health data is accessible, comparable, and actionable the world over.

In December, we released two important publications: the State of inequality in HIV, TB and malaria with the Global Fund and the UHC Global monitoring report with the World Bank. The former assesses the state of inequality across these three diseases and compares current trends to a decade earlier using the latest available data for 28 indicators across 176 countries. The latter is a biennial progress report on universal health coverage and highlights the impact of COVID-19 on access to essential health services and catastrophic health spending.

Current estimates from the WHO Triple Billion dashboard suggest that we will be 730 million people short of achieving universal health coverage for an additional one billion people by 2023. This rises to 840 million when accounting for setbacks from COVID-19. With the pandemic pushing millions into poverty due to social and economic disruptions, all countries must rapidly adopt evidence-based policies and recommendations such as those outlined in the UHC report to halt and reverse these trends.

Closing out the year, the Health Data Collaborative (HDC) convened the second annual Global Partners Group meeting, co-hosted by the Institut Pasteur de Dakar in Senegal and KEMRI Wellcome Trust in Kenya. The collaborative is made up of seven constituencies³ and seven multi-agency technical working groups.⁴ The donor constituency – which includes bilaterals, foundations, philanthropic foundations, and global health initiatives – helps align investments with country priorities to support the adaptation and implementation of technical products.

In 2022, the collaborative will focus on increasing the number and diversity of its members, building regional platforms and country coordination teams, advancing communications and advocacy, and making an investment case for RHIS.

³Countries, donors, global health initiatives, academia and research, civil society, multilaterals, and the private sector.

⁴CRVS, community data, logistics management and information systems, digital health and interoperability, data and digital governance, public health intelligence, and routine health information systems.

While the COVID-19 pandemic has been an immeasurable tragedy, it has also created new opportunities for innovation and collaboration – ones that embrace bold thinking to tackle long-standing barriers and blind spots. As Dr Tedros stated, “too often, health has been viewed as a cost, but it has never been clearer that health is an investment in the economy, society, and security.”

As part of his agenda for renewal and recovery, Dr Tedros has outlined the following five priorities for 2022:

1. A radical shift towards promoting healthy lives and well-being and preventing disease by addressing its root causes
2. An urgent reorientation of health systems towards primary health care as the foundation of universal health coverage
3. Strengthening systems and tools for epidemic and pandemic preparedness and response at all levels
4. Accelerating progress towards the SDGs through science and innovation, data and delivery, and digital tools
5. Strengthening WHO’s leading role at the centre of the global health architecture

WHO remains focused on addressing data gaps, focusing on results, and delivering measurable impact in countries as outlined in the Thirteenth General Programme of Work. These renewed commitments underscore the importance of working with Member States and partners to strengthen data systems and monitor progress.   

Tying all this work together is the World Health Data Hub. Set to release a beta version in 2022, the Hub will be an interactive digital destination and trusted source for global health data. For the first time, it will harmonize all datasets and databases from across the WHO digital ecosystem to provide complete, transparent, secure, and open data as a global public good.

This will include inputs from sources like the WHO Mortality Database – a historic dataset dating from 1950 with over seven decades of global mortality and cause-of-death statistics. In the first part of 2022, this database was migrated into a modern, interactive portal that provides unparalleled insight, accessibility, and relevance to all end users.

The next update to WHO’s Global Health Estimates will also be released in 2022. These estimates provide the latest available data on deaths and disability at the global, regional, and national level and are a powerful resource for policymakers and the public. In addition to disaggregated data by age, sex, and cause-of-death, the 2020 GHE will include a comprehensive assessment of the direct and indirect impact of the COVID-19 pandemic on mortality, morbidity, and healthy life expectancy.