A new report, entitled “Relationality in community engagement: its role in humanizing healthcare and achieving quality integrated health Services” has been developed in collaboration with the Qatar Foundation for Education, Science and Community Development (QF) and launched at the Seventh edition of the World Innovation Summit for Health (WISH) taking place in Doha on 13–14 November 2024.In the aftermath of the COVID-19 pandemic, community engagement has further resurfaced as a necessary condition, and a shared responsibility within health systems, for emergency preparedness, response and recovery efforts in global public health. The new report introduces the background and current policy context for community engagement across different WHO regions. It presents an Integrated Change Framework (ICF) to embed and strengthen community engagement processes in health system functions and activities; explores eight selected country case studies, highlighting common success elements incorporated into the ICF; and concludes with recommendations for applying the ICF to improve health system performance.Relational community engagement emphasizes improving relationships among health and care workers, between them and with the people they care for. To enable this, governments are encouraged to focus on the following aspects.1. Promote relational leadership, management, and governanceInvest in adaptive, transformative leadership models to drive whole-system learning.Develop political commitment to adopt a relationship-focused approach to community engagement as an inherent way of working in health systems and across sectors.Engage the health and care workforce and civil service across sectors to develop a renewed vision for public sector values and ways of working.2. Strengthen relationship-building capabilities in health systems Strengthen communication and collaboration in health systems, setting relational competency benchmarks and invest in local capacities of communities to address power imbalances. Develop participatory skills in multi-disciplinary teams and interprofessional practice. Integrate social and contextual data in health service design and delivery.3. Invest in transdisciplinary research and practice development Fund research using the Integrated Change Framework (ICF) to foster collaboration across the sciences, technology, and the arts. Relationality in community engagement is critical for improving today's health systems, since it represents a powerful way of enhancing patient care; promoting collaboration, connection and belonging; addressing the social determinants of health; improving equity; and integrating lived experience and holistic knowledge systems through community-centred approaches to health and well-being.  

The ceasefire and the cessation of hostilities took effect on 27 November, offering temporary relief for the millions of civilians caught in the conflict in Lebanon. But Lebanon’s suffering did not end amid staggering unmet health needs. Bordering Syria and Israel, Lebanon’s overburdened health system is reeling from the impacts of an economic crisis, political deadlock, refugee crisis and now war. The country is host to 1.5 million Syrian refugees: inevitably, events in Syria impact Lebanon and WHO operations. Syrian nationals are entering Lebanon at the same time as Syrian refugees are returning to Syria from Lebanon."An already decimated health system remarkably withstood this latest storm, but it has been further weakened. The challenges are complex and call for specialized, sustained support," said WHO Representative to Lebanon Dr Abdinasir Abubakar.A rocky road aheadThe road ahead for Lebanon‘s health system is rocky and the future uncertain. Lebanon’s cumulative real GDP has shrunk by 38% since 2019, according to the World Bank, with the war being the latest of many blows. As of today, more than 1 million people displaced by hostilities have returned to southern Lebanon where the physical and health infrastructure is in tatters. Several health facilities remain closed and most hospitals are running below capacity due to financial restraints and shortages of staff, long-standing challenges in Lebanon.More than 530 health workers and patients have been killed or injured in attacks on health care and thousands of health workers have been displaced or have emigrated leaving the hospitals and the health centres grappling to meet the health needs of the populations. In order to keep hospitals running, the need for health workers is dire.Water and sanitation systems have been severely disrupted, compounding the risk of disease outbreaks. With nearly 7% of buildings in ruins in the two southern governorates that were hardest hit, thousands remain on the move and won’t be able to return home anytime soon. Those who have returned face the risks posed by explosive remnants of war, as well as greater overall health risks. Growing need for specialized trauma careSince 8 October 2023, more than 4000 people were killed and 17 000 injured in Lebanon alone. Since the ceasefire took hold and conflict-impacted areas have become more accessible, the death toll continued climbing as more bodies are found in the 16 000 buildings that have been partially or completely destroyed, leaving an estimated 8 million tonnes of debris."The physical destruction is similar to what you see after an earthquake – and that has resulted in complex injuries, open wounds and fractures. And since the treatment provided during the war was often not optimal, the injured end up needing multiple surgeries to prevent complications and disabilities,  " said Dr Ahmad Alchaikh Hassan, WHO Trauma Technical Officer.One in 4 people with life-changing injuries will need long-term rehabilitation and, in some cases, assistive technologies and prosthetics. Specialized support will be required as the technical capacities in Lebanon cannot cope with the increasing numbers of people in need for these services and commodities."This need for specialized health care will persist for months and years to come. Lebanon needs reconstructive surgeons to treat the severely injured, eye doctors to treat the thousands of people injured in the pager attack, physiotherapists to start rehabilitating amputees and prosthetists to assist users of assistive devices," said WHO Representative Dr Abubakar.WHO’s responseEnsuring a sufficient number of trained health workers with expertise in war-related trauma and plastic reconstructive surgery is a priority. Three weeks into an 8-week ceasefire, WHO and the Ministry of Public Health are working on replenishing medical supplies and restoring health services country-wide."WHO and national health authorities have carried out several mass casualty management trainings across Lebanon – resulting in stronger, more life-saving assertive responses.  Without these timely interventions, the outcomes would be unconscionable," said Dr Hassan, WHO's Trauma Technical Officer.The ongoing WHO operations include scaling up trauma care capacity, training surgeons on specialized trauma care in conflict areas, providing mental health trainings to health workers, capacity building for rehabilitation in post-conflict settings, replacing damaged equipment, identifying gaps in health coverage, and preparing for future scenarios and the subsequent health impact.WHO also provided 5000 contingency blood bags and reagents to blood banks and developed awareness material on unexploded ordinances and other health risks for first responders and civilians. WHO and the Ministry of Public Health run strong country-wide surveillance for disease outbreaks which pose a heightened risk in post-conflict settings."The road to recovery will be long and windy. Our aim is to assist the health system to bounce back, and be resilient and prepared. We are grateful to our many partners who have supported this response but this is not the end of it. This is the start and the need for technical and financial support has never been greater," concluded WHO Representative Dr Abubakar.

The WHO Academy in Lyon, France, officially opened its doors today with a high-profile inauguration ceremony. The Academy aims to tackle the growing global shortage of health and care workers, projected to reach 10 million by 2030, by training thousands of health professionals each year.

The 2024 Global Heath Expenditure Report by the World Health Organization (WHO) shows that the average per capita government spending on health in all country income groups fell in 2022 from 2021 after a surge in the early pandemic years. The report entitled, “Global spending on health Emerging from the pandemic” has been published in alignment with the Universal Health Coverage (UHC) Day campaign marked annually on 12 December. The campaign’s focus for 2024 is on improving financial protection for people everywhere to access health services they need.Government spending on health is crucial to delivering UHC. Its deprioritization can have dire consequences in a context where 4.5 billion people worldwide lack access to basic health services and 2 billion people face financial hardship due to health costs.“While access to health services has been improving globally, using those services is driving more and more people into financial hardship or poverty. Universal Health Coverage Day is a reminder that health for all means everyone can access the health services they need, without financial hardship,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.Who’s paying for healthcare?Protecting people from financial hardship due to out-of-pocket health costs is fundamental to achieving health for all. Yet, WHO’s report shows that out-of-pocket spending remained the main source of health financing in 30 low- and lower middle-income countries. In 20 of these countries, more than half of total health spending in the country was paid for by patients out of their pocket, which contributes to the cycle of poverty and vulnerability.The challenges posed by the lack of financial protection for health are not limited to lower-income countries. Even in high-income countries, out-of-pocket payments lead to financial hardship and unmet need, particularly among the poorest households. Most recent health accounts data show that in over a third of high-income countries, more than 20% of total health spending was paid out-of-pocket.On the occasion of UHC Day, WHO is calling on leaders to make UHC a national priority and eliminate impoverishment due to health-related expenses by 2030. Effective strategies to strengthen financial protection include minimizing or removing user charges for those most in need, including people with low incomes or chronic conditions, adopting legislation to protect people from impoverishing health costs and establishing health financing mechanisms through public funding to cover the full population.Public funding needs to budget for an affordable package of essential health services – from health promotion to prevention, treatment, rehabilitation and palliative care – using a primary health care approach.Lessons from the pandemicDuring the COVID-19 pandemic in 2020–2022, public spending on health – mainly via government health budgets –enabled health systems to respond quickly to the emergency. This reflects the advantage of government budgets in financing public health functions, in particular population-based public health interventions, versus other health financing schemes, during times of health emergencies. Government funding ensured that more people were protected and more lives were saved.  Emerging from the pandemic, countries are at a crossroads. Governments face difficult decisions as they work to strengthen the resilience of health systems against future health threats while addressing their populations' healthcare needs in a challenging economic environment.Twenty-five years of WHO tracking global health spendingThe key to making better choices on future health investments is timely and reliable evidence on the level and pattern of health spending. For 25 years the WHO Health Expenditure Tracking programme  has had a major influence on how critical information on health spending is compiled and reported at the country level and globally.Among its most notable achievements are the establishment of the Global Health Expenditure Database – the world’s richest source of health expenditure data covering more than 190 countries since 2000--and the Global Health Expenditure Report, which has been published annually since 2017. These global public goods drive informed policymaking, transparency and accountability worldwide.WHO and partners advance efforts for UHC impactThis year’s UHC Day also provides a platform for a milestone discussion in WHO’s efforts to advance support and collaboration with countries in reorienting their health systems to advance UHC and achieve health security in countries, regions and globally. From 11–13 December, national health representatives, heads of WHO country offices, and health policy advisers from over 125 countries are meeting in Lyon, France to take stock of progress and challenges, agree on priority areas and working methods, and set the agenda for the next phase of the UHC Partnership from 2025-2027.The UHC Partnership is WHO’s flagship initiative on international cooperation for UHC, which brings WHO and partners together to support concrete actions to achieve UHC. It is funded by the European Union, Belgium, Canada, the French Ministry for Europe and Foreign Affairs, Germany, Irish Aid, the Government of Japan, and the United Kingdom - Foreign, Commonwealth & Development Office.

Around 846 million people aged between 15 and 49 are living with genital herpes infections – more than 1 in 5 of this age-group globally – according to new estimates released today. At least 1 person each second – 42 million people annually – is estimated to acquire a new genital herpes infection.Most of the time, these infections cause no or few symptoms. However, for some people they lead to painful genital sores and blisters that can recur throughout life, causing significant discomfort and often requiring multiple healthcare visits. According to the estimates, more than 200 million people aged 15 to 49 suffered at least one such symptomatic episode in 2020. The authors of the study, published in the journal Sexually Transmitted Infections, say that new treatments and vaccines are needed to reduce adverse health effects of the herpes virus and control its spread.“While most people with a genital herpes infection experience few symptoms, with so many infections genital herpes still causes pain and distress for millions globally and strains already overburdened health systems,” said Dr Meg Doherty, Director of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes at WHO. “Better prevention and treatment options are urgently needed to reduce herpes transmission and will also contribute to reducing the transmission of HIV.”Currently, there is no cure for herpes, although treatments can relieve symptoms. In addition to sores, genital herpes can also on occasion lead to serious complications, including neonatal herpes – a rare condition most likely to occur when a mother acquires the infection for the first time in late pregnancy and then transmits the virus to her baby during childbirth. There are two types of the herpes simplex virus (HSV), known as HSV-1 and HSV-2, both of which can lead to genital herpes. According to the estimates, 520 million people in 2020 had genital HSV-2, which is transmitted during sexual activity. From a public health perspective, genital HSV-2 is more serious since it is substantially more likely to cause recurrent outbreaks, accounts for around 90% of symptomatic episodes, and is linked to a three-fold increased risk of getting HIV.Unlike HSV-2, HSV-1 primarily spreads during childhood through saliva or skin to skin contact around the mouth to cause oral herpes, with cold sores or mouth ulcers the most common symptoms. In those without previous infection, however, HSV-1 can be acquired through sexual contact to cause genital infection in adolescence or adulthood. Some 376 million people are estimated to have had genital HSV-1 infections in 2020. Of these, 50 million are estimated also to have HSV-2 as it is possible to have both types at the same time.While the 2020 estimates show virtually no difference in the prevalence of genital HSV-2 compared to 2016, estimated genital HSV-1 infections are higher. Over recent years, several countries have observed changing patterns of transmission in HSV-1, with adult genital infections increasing as childhood oral infections decline. Reduced oral spread during childhood may be linked to factors like less crowded living conditions and improved hygiene, which then increases susceptibility to the virus at older ages. The authors note that these increases may also partially reflect changes in methods and additional data sources. “Stigma around genital herpes means it has been discussed too little, despite affecting millions of people globally. Not enough has been done to address this common infection,” said Dr Sami Gottlieb, an author of the report and Medical Officer within WHO’s Department of Sexual and Reproductive Health and Research including the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP). “Expanded research and investment in developing new herpes vaccines and therapies, and their equitable use, could play a critical role in improving quality of life for people around the world.”While they are not fully effective at stopping its spread, correct and consistent use of condoms reduces risks of herpes transmission. People with active symptoms should avoid sexual contact with other people, since herpes is most contagious when sores are present. WHO recommends that people with symptoms of genital herpes should be offered HIV testing and if needed, pre-exposure prophylaxis for HIV prevention. In line with its Global Health Sector Strategy on HIV, viral hepatitis and sexually transmitted infections for 2022-2030, WHO works to increase awareness about genital herpes infections and related symptoms, improve access to antiviral medications, and promote related HIV prevention efforts. It is also working to advance research and development of new tools for the prevention and control of herpes infections, such as vaccines, treatments and topical microbicides. Earlier this year, a new study showed that genital herpes infections not only cause significant health impacts but also major economic costs – amounting to an estimated US $35 billion a year worldwide – through health care expenditures and productivity loss. Editor’s noteThe study, Estimated global and regional incidence and prevalence of herpes simplex virus infections and genital ulcer disease in 2020: Mathematical modeling analyses, updates the 2012 and 2016 WHO estimates. It was authored by experts from WHO, HRP, the WHO Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections and Viral Hepatitis at Weill Cornell Medicine-Qatar as well as the University of Bristol. Based on comprehensive regional systematic reviews and meta-analyses of HSV-1 and HSV-2 prevalence for all WHO regions, the study estimates the prevalence and incidence of genital HSV infection and HSV related genital ulcer disease in 2020 globally and by region.