WHO press conference on global health issues - 8 June 2023
00:00:57
MH Hello, everybody. This is Margaret Harris in WHO headquarters, Geneva, welcoming you to our global press briefing on current health issues today, 8th June 2023.
As usual, we will start with opening remarks from our Director-General, Dr Tedros Adhanom Ghebreyesus. I will then open the floor to questions and our very impressive, large panel of technical experts here, both in the room and online, will be available to answer your questions.
As I mentioned, we have a large panel of experts. On Dr Tedros' right we have Dr Michael Ryan, our Executive Director of our Health Emergencies Programme. Next to Dr Ryan is Dr Sylvie Briand, our Director, Epidemic and Pandemic Preparedness and Prevention.
Next to Dr Briand is Dr Janet Diaz, who is the Lead for our Clinical Management Response. Next to Dr Diaz is Dr Teresa Zakaria, our Technical Officer for Emergencies Response. Next to Dr Zakaria is Dr Alain Labrique, our Director for Digital Health Intelligence. On Dr Tedros' left we have Dr Maria Van Kerkhove, Technical Lead for COVID-19, and Dr Abdirahman Mahamud, our Director for Alert and Response Department of our Health Emergencies Programme.
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We also have a large panel of experts online. We recognise that you have many questions. Our work is very diverse and we will call on them as appropriate. But now, without further ado, we will go to Dr Tedros for his opening remarks. Dr Tedros, you have the floor.
TAG Thank you. Thank you, Margaret. Good morning, good afternoon and good evening. Today, Equatorial Guinea declared its outbreak of Marburg virus disease over, 42 days after the last patient was discharged from treatment.
The outbreak was the first of its kind in Equatorial Guinea, with 17 laboratory-confirmed cases, including 12 reported deaths. In addition, 23 probable cases were reported, all of whom died. Four patients recovered and have been enrolled in a survivors programme to receive psychosocial and other post-recovery support.
I thank the government of Equatorial Guinea and the affected communities for their response and the health workers who put themselves in harm’s way to serve others. I honour those health workers who paid the ultimate price for simply doing their jobs.
To support the government’s response to the outbreak, WHO deployed 80 experts in epidemiology, logistics, health operations, risk communications, clinical care and infection prevention and control. We worked with the health authorities to set up a treatment centre, provided medical supplies and trained health workers to support safe care for patients, including emergency use of a promising antiviral.
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WHO also supported authorities in neighbouring Cameroon and Gabon to ramp up outbreak readiness and response. We continue to work with Equatorial Guinea to maintain surveillance and testing to enable prompt action should flare-ups occur.
Now to Ukraine, where the destruction of the Kakhovka Dam has caused widespread devastation and human suffering, leading to severe flooding, displacement of communities and significant infrastructure and environmental damage. The impact on the region’s water supply, sanitation systems and public health services cannot be underestimated.
WHO has rushed in to support the authorities and health care workers in preventive measures against waterborne diseases and to improve disease surveillance. Our team is in the field, continuously reviewing health needs to support those affected. In the coming days, WHO will deliver additional supplies to strengthen access to health services.
Next to Haiti, where the humanitarian situation has been deteriorating. Recent torrential rain, flooding and earthquakes have added to a toxic mix of poverty, hunger, violence and disease. 4.9 million people are expected to face crisis levels of hunger this year.
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With armed gangs controlling large areas, insecurity in parts of the country has reached levels comparable to countries at war. Hundreds have been killed in the violence, and rape and other forms of sexual violence are rampant.
Hunger and disease go hand-in-hand. The cholera outbreak, which began in October last year, continues to simmer with more than 45,000 cases and 700 deaths reported. Other diseases such as TB, measles and polio, present an active risk.
Essential health services such as routine immunisation for children have been severely disrupted. In 2021, only 41% of children had been fully immunised against measles and we expect that number to be even lower now. Children are particularly at risk of the deadly combination of hunger and disease. Severely malnourished children are many times more likely to die of diseases like cholera and measles.
Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services, while health facilities are unable to function normally due to fuel shortages.
WHO is working to address the immediate needs of the population in areas affected by the resurgence of cholera, as well as protecting the most vulnerable groups impacted by violence, insecurity and rising poverty levels. WHO has asked for US$37 million to reach 1.8 million of those in need in 2023.
Haiti is far from the only country where health is imperilled by a lack of access to electricity or to sources of clean energy. A new report this week shows that globally 675 million people still lack access to electricity, most of whom live in sub-Saharan Africa.
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Meanwhile, 2.3 billion people globally, more than one in four, use polluting fuels for cooking, leading to millions of deaths each year. This puts women and children, particularly, at greater risk of chronic diseases, while also contributing to climate change and perpetuating gender inequity.
Cooking with solid fuels such as wood, charcoal, coal, crop waste and kerosene is a huge health burden for more than a quarter of the world’s population, particularly for the most vulnerable populations. WHO is supporting countries to integrate clean cooking into broader energy planning, improving affordability, and devising better delivery mechanisms.
Finally, yesterday marked World Food Safety Day. Every day, an estimated 1.6 million people around the world become sick from eating unsafe food. Over 200 diseases, from diarrhoea to cancers, are caused by eating food contaminated with bacteria, viruses, parasites or chemicals.
Safe food is a primary determinant of human health. To guarantee this right, governments must ensure that food meets safety standards. These standards are developed by WHO and the Food and Agriculture Organization of the United Nations through the Codex Alimentarius, the international standard-setting body for food safety and quality, which this year marks its 60th anniversary.
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Another way WHO is supporting countries to make food safe is by harnessing the power of technologies such as whole genome sequencing. Sequencing the genomes of microbes in food can identify with precision where a germ originated, whether from a food processing facility or a restaurant, pinpointing the source of a food-borne outbreak.
Tomorrow, WHO is announcing new guidance for countries on how to use whole genome sequencing to improve food safety surveillance. Margaret, back to you.
MH Thank you very much, Dr Tedros. I will now open the floor to questions and I'll just make one correction. Dr Alain Labrique is Director for Digital Health and Innovation. My apologies for giving the incorrect title. The first question will go to Yuri Aprelev [?] of RIA Novosti. Yuri, please unmute yourself and ask your question.
YA Thank you for taking my question. My question is about Ukraine. Are you working with the Russian authorities to help the people on the left bank of Dnieper, under Russian control, or do you work only in the territories controlled by Ukraine? And is the WHO's aid intended only for the territories under the control of the Ukrainian army, and if is the case, why? Thank you.
MH Thank you, Yuri. I think we'll start with Dr Teresa Zakaria or Dr Ryan?
MR I can begin and Teresa can give details. In all conflicts, WHO offers assistance to all civilians affected by conflict on whatever side of a conflict they're on and, in the case, we've been obviously working for years in both Ukraine and in Russia on matters related to health.
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The fact that Russia has invaded sovereign territory of Ukraine creates a difficulty in accessing the populations in occupied territories, either through cross-lines or cross-border solutions. We've faced this many times before in Syria. It requires the cooperation of all parties to be able to access civilians in that situation.
In previous situations in the Donbas, before the invasion by Russia, we were able to maintain health interventions on both sides of that conflict with the agreement of all parties. In this particular situation it is more difficult. We continue to offer assistance and certainly, in this acute situation, are offering assistance to all parties because this is an acute emergency affecting the lives of many people on both sides of that river.
But, certainly, in terms of our operational presence, primarily our operational presence is very much on the side of the territories controlled by Ukraine, but there is reason for that. The reason for that is that Russia has invaded Ukraine and it is Ukrainians that are being attacked in this situation and the primary needs and the primary beneficiaries must be those who are most affected. So, in this particular instance, the reason why our presence is greater on the Ukrainian side of the conflict is because that conflict has primarily affected Ukrainians.
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TZ Thank you for your question. Building on what Dr Ryan has mentioned, I think, yes, it is our ultimate principle to make sure that anyone who requires health assistance is provided such regardless of where they may reside and regardless to which party of a war they belong to.
Now, in terms of addressing the needs, the acute health needs of those who are affected by the floods caused by the damage of the dam, indeed we have more presence at the moment and more visibility on needs on the side of the river that is under Ukrainian control.
However, we are monitoring, especially through the leadership of our regional office in Europe, to make sure that all information coming from the other side of the river is also monitored. So, we are aware, even though with less information of assistance being provided, evacuation centres being set up as well on the bank that is controlled by Russian forces.
But assistance is also ongoing and we are continuously advocating for access to make sure that we can access all populations in need so that we can provide equitable assistance to everyone who requires it. Thank you and back to you, Margaret.
MH Thank you very much, Dr Teresa Zakaria and Dr Michael Ryan. The next question will go to Emma Farge, from Reuters. Emma, please unmute yourself and ask your question.
EF Good afternoon. Also a question about Ukraine, please. I was wondering how high you consider the cholera risk to be in the flooded areas and if you are pre-positioning any vaccines. Thank you.
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MH Thank you. I think that will be Dr Teresa again.
TZ Thank you. We have not seen any cases, human cases of cholera since the start of the invasion of Ukraine. Having said this, environmental samples do show that the pathogen exists in the environment, so that constitutes a risk. So, at any given moment, indeed, we could start finding cases.
We have been working very closely with the Ministry of Health of Ukraine to make sure that mechanisms are in place to enable the importation of vaccines as soon as they are required. So, the preparedness activities are ongoing, knowing that the risk of cholera is present.
And with the flooding caused by the damage of the dam, indeed epidemiological surveillance for waterborne diseases is heightened and supplies are being mobilised to make sure that they are as close as possible to those who may require it.
We are trying to address quite a wide range of health risks actually associated with the floods, starting from trauma, to drowning, to waterborne diseases, but also all the way to the potential implications of disruption to chronic treatment, which were are watching also very closely.
00:16:55
So, all of those health risks are being monitored and supplies are pre-positioned to make sure that we would be able to deliver the best care possible, among that cholera and the facilitation of the arrival of vaccines when it is needed. Thank you.
MH Thank you very much, Dr Zakaria. The next question goes to Anadolu Agency, to Muhammet İkbal Arslan. Muhammet, please unmute yourself and ask your question.
MA Thank you for taking my question. As Mr Tedros mentioned, the destruction of the Kakhovka Dam has a big impact on the region. Generally, how many people are affected because of this destruction? Can you give us any number on average? Thank you so much.
MH Dr Ryan? Oh, you were suggesting Dr Briand? Teresa, sorry. Dr Teresa, go ahead.
TZ Thank you. We haven't seen the full impact yet of the destruction of the dam and disease downstream with the consequent flood but also upstream with the disruption of water supplies. I think we are looking at quite a large population potentially being affected.
Upstream, the water that actually comes from the dam does serve a population of up to 700,000 people. Downstream there are over 30 settlements that are at risk of flooding. I think the exact information and the exact extent of the impact is yet to be seen, also because water continues to come downstream. So, we are watching out for it.
00:18:43
Figures at the moment show that initially 16,000 people were immediately at risk of flooding on the river banks. Thousands have been evacuated. We know that this number can only grow, but I think it is difficult and it would imprudent to actually quote one single number at the moment, especially because we are yet to see the full extent of the damage of the dam.
Again, it is multifaceted. There are the populations who are at risk of flood, there are the populations who are at risk of disruption of clean water and then there is even a wider population who are at risk of less access to food in the coming months because agricultural lands are rendered completely obsolete. Thanks.
MH Thank you very much, Dr Teresa Zakaria. The next question goes to Banjot Kaur of The Wire, India. Banjot, please unmute yourself and ask your question.
BJ Thanks for taking my question. I was just wondering if WHO has any information about an ongoing conflict within a state of India called Manipur, and the conflict is ongoing for more than a month now. Is WHO India Office aware of this and do they apprehend certain health problems there also because of the nature of the conflict? Thank you.
00:20:08
MH Banjot, that's not a question for a global health briefing. That will be for our India Office and, certainly, can you send me your question specifically by email and I'll refer it to our India Office? Thank you for attending the press conference. The next question goes to Belisa Godinho, W Magazine, Portugal. Belisa, please unmute yourself and ask your question.
BG Thank you for taking my question. I would like to know if there is any update on measures to be applied by WHO globally on combatting the climate-related crisis and the emergence of new diseases, preventing future pandemics and promoting safe food. Thank you.
MH Thank you very much. We have several people who can answer that question. I was wondering if Dr Briand would like to begin or shall we go to Dr Neira, who is online I understand? Dr Briand, would you like to begin?
SB Thank you very much for this question. At least, I will address your question on the health and climate crisis through the angle of the risk of emergence of epidemics and pandemics. Of course, as you know, climate change has a number of consequences. Some consequences are on the temperature, other consequences are on climate-related disasters.
But to give you an idea of what WHO is really currently working on. We are looking at different diseases that can produce epidemics and pandemics and understanding the factors that are driving the occurrence of these epidemics and pandemics, and what factors are directly related to climate change.
One example is, for instance, vector-borne diseases or diseases that are transmitted by mosquitoes and, as you know, mosquitoes prefer climates that are warmer. So, we are looking at when you have an increase in temperature, the impact this can have on a mosquito population.
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And if those mosquitoes are carrying viruses that can produce epidemics such as, for instance, Zika, chikungunya, yellow fever, dengue, what impact it could have on the populations that are now living under such climatic conditions.
We have developed global strategies to address, for example, those vector-borne risks to make sure that countries that could be affected have the right means to do surveillance and to monitor those risks but also have the right capacities to face those epidemics, also access to the countermeasures, when we have countermeasures, be it vaccines or treatments or any other preventive measures.
This is work in progress because, of course, the epidemiology of those diseases changes due to climate change and so we are just making sure that we can be prepared and ready to face those risks should they occur. Other risks could be linked to water as well, as has been mentioned, especially when the pathogen is in the environment, like for cholera.
Then, you can have also more cholera outbreaks if the climatic conditions are changing. There are many other risks linked to climate crisis but maybe Maria Neira, if she's online, can address the rest linked to pollution and so on. Thank you very much.
00:24:19
MH Indeed, Dr Neira is waiting online. She is director of our department that deals with climate change and health effects and over to you, Dr Neira.
MN Thank you. Thank you very much, Margaret and to complement what Dr Briand was saying, WHO is very much following what climate change might represent for public health.
Clearly, one of the messages that we are looking at is how to reduce the causes of climate change, looking at how we can implement an agenda that will reduce emissions at the beginning and therefore having less problems related to climate change, which is greater now, as you can see problems everywhere related to heat stress, related to spread of infectious diseases, related to water shortages, food shortages as well, people displaced, mental health as well. So, clearly, working upstream, looking at the cost of climate change and reducing those emissions is one of our priorities.
Second, we want to prepare the health systems to be climate resilient. We need to look at those diseases described by Dr Briand, which are climate sensitive and may occur now with more frequency and in places where we didn't see them before. So, we need to make sure that the health systems which are already coping with this increase of those diseases needs to be climate resilient, better prepared, with better epidemiological surveillance.
We collaborate with the World Meteorological Organization, for instance, to make sure that we have a good and strong epidemiological system based on those climate-sensitive diseases. And, of course, we work as well at making sure the vulnerability is reduced and making sure that the health systems are better prepared and are more sustainable, more climate resilient and better equipped to cope with some of those diseases caused by climate change, which is already affecting, very much, our health.
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One of the other parts of the equation on climate change is related to causes of climate change overlapped very much with the causes of air pollution, which is the combustion of fossil fuels. That's why if we mitigate the causes of climate change, not only will it have an impact on reducing all of those diseases with an eventual epidemic potential but we will, as well, reduce the air pollution which is, at the moment, one of the biggest public health problems, representing more than seven million premature deaths every year.
All the natural disasters we are facing right now are linked to climate change and therefore it is very urgent to fight against the causes of climate change to better protect people's health from climate change and from air pollution. Thank you.
MH Thank you very much, Dr Neira, and thank you, Dr Briand. We have only one more journalist with a question, it looks like we've answered your questions well today, and that's Gabriela Sotomayor, from Proceso. Gabriela, could you please unmute yourself and ask your question?
GS Thank you very much, Margaret. Hola, Dr Tedros. I would like your advice and your assessment of the situation that I will refer to. To explain my question, let me tell you that the Minister of Health in Mexico is analysing to eliminate 35 Official Mexican Standards, known at NOMs.
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Among the NOMs that they want to abolish are those that define criteria and procedures for preventing, detecting, diagnosing and treating diseases classified as public health problems such as breast cancer or cervical cancer, similarly regulations setting out strategies for treating diabetes or sexually transmitted infections.
The people in favour of this initiative say that it is not necessary, that there are official criteria to regulate the prescriptions, therapeutics, etc. Others, that are against that, said that this is unacceptable because these NOMs allow thousands of women in Mexico, for example, to have access to the best treatments available and better life expectancy during and after cancer. In general terms, for every country, what is your assessment on these or your opinion, your advice? Thank you so much.
MH Thank you, Gabriela. So, you're asking about the importance of norms and standards, as far as I can see. It's a very general question and I'm looking around to see who might be best answering it. We don't really have a specific person. I think this is one for you to send to Media Inquiries and I will put it to our Norms and Standards Division.
Now, I think we'll wind up the press conference. Oh, we've got one more question, two more questions. Robin Millard, from Agence France-Presse. Robin, could you unmute yourself and ask your question?
RM Thank you. I would just like to ask about the current health situation in Ethiopia, now that aid has been supposedly flown back into Tigray for a period time. It is has been a while since we've spoken about it, so if you could just give us an overview, perhaps, of the current situation. Thank you.
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MH Thank you, Robin. Teresa, is that you to begin with?
TZ Thank you for the questions. The humanitarian emergency in Ethiopia, we still have a very much dedicated team following all of the health risks occurring at the moment in Ethiopia, caused not only by the humanitarian situation in Tigray but also because of the food insecurity in the broader region.
I don't think there was a specific question on any specific diseases but overall WHO has continued maintaining its operation, making sure that the disease surveillance system is working, that public heath events, especially new outbreaks, are detected as early as possible and that there are mechanisms in place to make sure that we can respond accordingly.
This is really to address multiple health risks in the Tigray region, in all parts of the country actually, related to the protracted situation, the conflict, but also because of the food insecurity. Perhaps if there are more, we could have a follow-up on specific issues, specific health risks that you would like to have information on. Thank you.
MH Thank you very much, Dr Zakaria. Dr Ryan?
00:31:40
MR Just a supplement. Certainly, as Dr Tedros said for many, many months the dividend of cessation of hostilities is an improvement in the lives of ordinary people and certainly we've seen humanitarian access, certainly in Tigray, improved but also in other parts of Ethiopia.
But, still, only about 80% of the areas in Tigray are actually accessible. There are still significant gaps in access and West Tigray remains inaccessible since November 2020. So, there are still areas, there are now areas within areas and there hasn't been a complete improvement on that and, as I said, there are still some areas that are not accessible.
There are almost nine million people in need of health assistance in the northern regions, as a whole, and the risks are still there. There is still severe acute malnutrition, there is still malaria, acute respiratory tract infections, acute watery diarrhoea, measles, meningitis, typhoid fever, typhus, dysentery. The threats remain and still dealing with the aftermath of much of the trauma and there have also been some areas that have experienced drought, some areas have experienced heavy rain.
We need to remember that in this situation that an already vulnerable population was exposed to an even worse situation, particularly in Tigray with the blockade, and many other areas have suffered as well, in terms of lack of access to health care. So, these things don't just switch back on. There's still ongoing environmental issues, ongoing issues of insecurity but definitely more access, definitely more access by agencies to be able to assist people.
00:33:35
The provision of essential health services has improved and it has scaled up, particularly in Tigray, but it does remain constrained. There are still acute shortages of adequate medical supplies that continue to be reported and damaged infrastructure, while improved, only 3% of health facilities in Tigray report that they're fully functional.
The vast majority of health facilities still have issues with power supply, water supply or some element of their full functioning is compromised. There is no question that the cessation of hostilities has paved the way for a fragile peace and the slow but steady implementation of the agreement is a cause for hope that has resulted in significant improvement of humanitarian access, but there are still huge numbers of people in need of ongoing humanitarian assistance.
We're continuing to support the recovery, rehabilitation and rebuilding of the health systems right throughout Northern Ethiopia, and there are still issues in areas of the south too that have been deeply affected by drought over a long, long period of time.
So, yes, I would say that we need to further scale up our activities right the way through Northern Ethiopia. There still is a gap in funding, a huge gap in funding to support those activities and programmes, such as the expanded programme in immunisation, the malaria programme, the TB programme, the HIV programme, the pharmaceutical supply chain, still require significant support to come back online.
00:35:11
I think this is part of the challenge we face in all crises. The acute hostility attracts attention, or inattention in this case, and then peace comes and there is a dividend for that. Then, the hard miles begin of rebuilding destroyed infrastructure, rebuilding destroyed lives as the world moves on to the next conflict or to the next zone of human clashes around the world.
But we can't forget the people of Ethiopia and we certainly can't forget the people of Northern Ethiopia and specifically those people in Tigray. We estimate in Ethiopia, as a whole, about 17.4 million people are in need of humanitarian assistance, and this is a country that is now absorbing many refugees fleeing across from Sudan.
Ethiopia in the past has offered a zone of safety and a place of safety for people fleeing many, many conflicts. Again, Ethiopia will require support in carrying out its obligations under international and humanitarian law to provide support to refugees fleeing conflict.
So, a complex situation and one requiring our continued support. I can give you a lot more and we'll be happy to send out more information about our specific activities. I don't know if Dr Tedros wants to comment but I think that's the general assessment of the situation.
MH Thank you, Dr Ryan. Yes, indeed, Robin, if you need more detail we're very happy to provide. We'll provide it via Media Inquiries. The next question goes to Christiane Oelrich, from dpa. Christiane, please unmute yourself and ask your question.
00:36:57
CO Thank you, Margaret. I was happy to get this opportunity at the end of the press conference. I would like to go back to the first question and what Dr Ryan said about access and presence in Ukraine. You explained that WHO is more active on the Ukrainian side because Ukrainians were more affected but, of course, the people in the occupied territories are also Ukrainians.
So, I wonder whether you could be bit more specific whether WHO is present on the east side of the river that is under Russian control or whether there have been specific requests by WHO to Russia for access that were denied or maybe granted. Thank you.
MH Thanks you, Christiane. Over to Dr Ryan.
MR I don't believe we have a permanent presence on the side of the river that you refer to. As I said, in previous times in the Donbas we had access to populations on both sides of that conflict, which was a conflict within the borders of sovereign Ukraine and we were able to access by negotiation people on both sides of that conflict.
Since the Russian invasion, we have focused on being able to support the people to whom we have greatest access and that is has been people on the Ukrainian side of the conflict. We continue to engage with, coordinate with and receive information on a regular basis from Russian authorities regarding the health situation of the people in occupied territories. We're assured by Russian authorities that those people are well-monitored, well-cared for, well-fed, well-supported.
00:38:53
We would be delighted to be able to access those areas and be able to monitor health, as we would in most situations wish to do, but it again will be for the authorities of Ukraine and Russia to agree how that could be achieved. We operate at the invitation and at the behest of our Member States.
If any of you had attended our World Health Assembly you will see just how political these issues are. We stand ready at any time to deploy, to support civilians affected by conflict anywhere in the world but we can only do that with the support and acceptance of the combatants or the conflicting parties in a situation like this. Thank you.
MH Thank you very much, Dr Ryan. Now, we've come to the end of the questions, so I'll close this Q&A part and hand back to Dr Tedros for final remarks.
TAG Thank you. I think Gabriela is not happy because her question was not answered. I fully understand. The reason we couldn't answer the question was, one, it needs some expertise but the second and more important is we don't know exactly what the Minister had done. Based on the question, to really respond could be a bit difficult.
If you agree, Gabriela, we can check what happened with those issues like the elimination of some of the standards that have been followed and then come back to you. So, that's why, otherwise we would be happy to answer any question and that's what we always do. We value your participation and your questions but it would be good for us to understand what exactly happened in order to give you a full response. Do you want to ask again, Gabriela Sotomayor?
00:41:05
MH Gabriela? Yes, go ahead.
GS Thank you very much, Dr Tedros. I appreciate it very much. The thing is that the Minister of Mexico is analysing this but they will eliminate 35 NOMs in Mexico, some of them related to breast cancer and cervical and uterine cancer, and maybe the most vulnerable women in Mexico, the most poor of them will be affected. What is your advice in this situation because the NOM works very well? Why eliminate it right now? We are concerned about that. So, thank you so much. I really appreciate it.
TAG What is the NOM, Gabriela? NOMs?
GS NOMs. These are standards of regulating of health issues.
TAG So, it's a system in Mexico, NOMs, N, O, M, S?
GS N, O, M, S. It is Official Mexican Standards, known as NOMs, N, O, M.
TAG Still, to be honest, we'd be happy to see what they're doing. Maybe they are trying to replace it with a better one, I don’t know, or they may have other reasons. If you can give us some time, then we'd be happy to check this week. Since we do our pressers regularly, then we can give you a full answer.
00:42:58
And, to be honest, we don't see it as answering a question only. If something is happening and there is a need to talk to the authorities, then that's the most important part. We do that, by the way, based on information we get from you or questions. We reach out to understand and help. If there is something that is not being done based on the standard, then we explain what the standard is and ask them if they could stick to the international standard.
Of course, countries have their own national laws. We cannot force them but at least we can advise them and we can give them our support when needed. So, I would be happy to follow-up on this and get back to you, Gabriela. Thank you for your commitment to this. Muchas gracias.
GS Gracias. Gracias, Dr Tedros.
TAG Thank you. With that, thank you to all members of the press for joining us today and see you next time.