World Health Organization Briefing April 6: Lady Gaga Joins the Press Conference

Lady Gaga: (00:00) 68 corporate leaders, from some of the world's biggest and most generous companies. And I asked them to join my corporate kindness list, as there have been many corporations and philanthropists that have been very, very generous during this time. Since then, we have also been calling on philanthropists around the world as well, and tech companies included. Lady Gaga: (00:21) Again, I'd like to reiterate our deep gratitude to the medical community. My heart is very, very achy and warm for those who are ER doctors, as well as nurses who are sleeping in cars, to make sure that they don't infect their families or their patients. What you are doing is putting yourselves in harm's way to help the world. And we all salute you, and you are triumph, truly. Lady Gaga: (00:50) I am proud to say that, over the past seven days, we've raised a total of $35 million for the solidarity fund. This money will [inaudible 00:00:59] essential PPE supplies and testing kids around the world, and will help improve lab capacity to rapidly process tests. It will also coordinate research development. Lady Gaga: (01:11) It is so important to think globally and to support the World Health Organization, to curb the pandemic and prevent future outbreaks. I know Dr. Tedros is particularly concerned about Africa and so are all of us. We also need to act locally, by supporting local charities and initiatives. So that the frontline healthcare workers, and those in immediate need, have the resources they need to survive during this time. Lady Gaga: (01:36) It has been an honor to help with this huge broadcast event, which will take place on April 18th, where we need to tell the stories of and celebrate the frontline community healthcare workers and their acts of kindness. We will be on different networks, many networks actually. And I wanted to talk a little bit broadly about what we're going to be doing. Lady Gaga: (01:59) What's very important is three things happen for all of us, that we celebrate and we highlight the singular, kind, global community that is arising right now. Two, we want to highlight the gravity of this historical, unprecedented, cultural movement. And, three, we want to celebrate and encourage the power of the human spirit. Lady Gaga: (02:22) I would like to, on behalf of the World Health Organization and Global Citizen, thank Dr. Tedros, as well as everyone that has donated so far. We are going to continue fundraising. But I would like to also let you know that this broadcast [inaudible 00:02:40] not actually a fundraiser. We all wanted to raise the money before we went on air. So when we do air live on April 18th, put your wallets away, put your credit cards away, anything away that you need to, and please sit back and enjoy the show that you all very much deserve. And I'd like to pass this now to Hugh Evans. He's been a wonderful partner of mine. Hugh, thank you so much, and thank you Dr. Tedros. Hugh Evans: (03:13) Well, good morning, good afternoon, good evening. And thank you Dr. Tedros, and thank you Lady Gaga, your excellencies, ladies and gentlemen. Lady Gaga, Dr. Tedros, you've both demonstrated extraordinary leadership at an unprecedented moment, when our society is being challenged like never before. And we are so thankful for your leadership. Hugh Evans: (03:37) I'd like to echo Lady Gaga's sentiment, and commend the incredible acts of bravery demonstrated by the frontline community health workers around the world. And I hope that we, as a shared humanity, emerge from this moment forever grateful for the work of doctors, nurses, teachers, grocery store workers, and all of those who are the backbone of our communities. Hugh Evans: (04:07) Global health is at the very core of the Global Citizen mission. And we must ensure that the world's poorest and most marginalized people have access to resources to cope with and tackle this health crisis. Through One World Together At Home on April 18, we will be calling on philanthropists, corporations, and governments to fund critical global COVID-19 response efforts, including distribution of resources and PPE to critical frontline healthcare workers. Hugh Evans: (04:45) In our partnership with the WHO and United Nations, Global Citizen is committed to driving action, to help ensure our global health systems are strong enough to stop a future pandemic before it happens. April 18 is going to be a moment of global unity, connecting the world through a historic global broadcast. Hugh Evans: (05:10) We are bringing together the greatest artists in the world, under the passionate and extremely talented curation of Lady Gaga. In alphabetical order, some of the artists we'll be announcing today include Alanis Morissette, Andrea Bocelli, Billie Eilish, Billie Joe Armstrong of Green Day, Burna Boy, Chris Martin, Sir David Beckham, Eddie Vetter, Sir Elton John, Finneas, Idris and Sabrina Elba, Jay Balvin, John Legend, Kacey Musgraves, Keith Urban, Kerry Washington, Lang Lang, Lizzo, Maluma, Sir Paul McCartney, Priyanka Chopra Jonas, Shah Rukh Khan, Stevie Wonder, and many more to be announced over the coming weeks from all corners of the globe, under the passionate and extremely talented curation of Lady Gaga. We are grateful to all of you for participating and supporting this critical effort. One World Together At Home will be broadcast live on Saturday, April 18th, 2020, at 5:00 PM PDT, 8:00 PM EDT, and 12:00 AM BST, airing on ABC, NBC, Viacom, and CBS networks, iHeartMedia, and Bell Media networks and platforms in Canada. Internationally, BBC One will run the program on Sunday, April 19. And additional international broadcasters include BN Media Group, Multi-choice Group and RTE in Ireland. Hugh Evans: (07:18) The digital broadcast will celebrate and support brave community health workers who are doing lifesaving work on the frontline. And we've all seen the limitations of world leaders around this world to step up and face this extraordinary challenge. And we want to do our bit to support the essential work of the World Health Organization, driving action and raising critical funds. Thank you again, Dr. Tedros. And thank you Lady Gaga for your leadership. Thank you all. Speaker 1: (07:50) Thank you very much flow to our guests for their remarks. And, Dr. Tedros, I guess you would like to take them too. Dr. Tedros: (08:18) Once again, I would like to thank Lady Gaga and Hugh Evans for their partnership. We had a call last week, and I was so amazed by the energy and passion of Lady Gaga. It's incredible commitment to humanity. And that's when I said I think what she has planned can happen. Let's bring the world together, to improve our awareness, and to mobilize resources to fight the pandemic. So I thank her for her incredible passion and commitment and leadership. And also to my friend Hugh Evans, for connecting all the dots, and for his leadership. Dr. Tedros: (09:17) We all look forward to joining you for the One World Together At Home concert on the 18th of April. And the pandemic continues to recognize that individuals and governments want to do everything they can to protect themselves and others, and so do we. We understand that some countries have recommended or are considering the use of both medical and nonmedical masks in the general population, to prevent the spread of COVID-19. Dr. Tedros: (09:56) First and foremost, medical masks must be prioritized for health workers on the front lines of the response. We know medical masks can help to protect health workers. But they're in short supply globally. We're concerned that the mass use of medical masks by the general population could exacerbate the shortage of these specialized masks, for the people who need them most. In some places, these shortages are putting health workers in real danger. Dr. Tedros: (10:38) In health care facilities, WHO continues to recommend the use of medical masks, respirators, and other personal protective equipment for health workers. In the community, we recommend the use of medical masks by people who are sick, and those who are caring for a sick person at home. WHO has been evaluating the use of medical and nonmedical masks for COVID-19 more widely. Today, WHO is issuing guidance and criteria to support countries in making that decision. Dr. Tedros: (11:21) For example, countries could consider using masks in communities where other measures, such as cleaning hands and physical distancing, are harder to achieve, because of lack of water or cramped living conditions. If masks are worn, they must be used safely and properly. WHO has guidance on how to put on, take off, and dispose of masks. What's clear is that there is limited research in this area. We encourage countries that are considering the use of masks for the general population to study their effectiveness, so we can all learn. Dr. Tedros: (12:06) Most importantly, masks should only ever be used as part of a comprehensive package of interventions. There is no black or white answer, and no silver bullet. Masks alone cannot stop the pandemic. Countries must continue to find, test, isolate and treat every case and address every contact. Mask or no mask, there are proven things all of us can do to protect ourselves and others. Keep your distance, clean your hands, cough or sneeze into your elbow, and avoid touching your face. Less than 100 days since WHO was notified about the new coronavirus, research has accelerated at incredible speed. The viral genome was mapped in early January, and shared globally, which enabled tests to be developed and vaccine research to start. More than 70 countries have joined WHO solidarity trial to accelerate the search for an effective treatment. And about 20 institutions and companies are racing to develop a vaccine. Dr. Tedros: (13:43) WHO is committed to ensuring that, as medicines and vaccines are developed, they're shared equitably with all countries and people. I want to thank the medicines patent pool and unit eight for the initiative they announced last Friday, to include medicines and diagnostics for COVID-19 in their licensing pool. Dr. Tedros: (14:09) I also want to thank the president of Costa Rica, president Carlos Alvarado, and the health minister Danielle Salas, for their proposal to create a pool of rights to tests, medicines, and vaccines, with free access or licensing, or reasonable and affordable terms for all countries. Muchas gracias, Mr. President. I support this proposal. And we're working with Costa Rica to finalize the details. Dr. Tedros: (14:44) Poorer countries and fragile economies, it's time to face the biggest shock from this pandemic. And leaving anyone unprotected will only prolong the health crisis and harm economies more. I call on- Dr. Tedros: (15:03) Economies more. I call on all countries, companies and research institutions to support open data, open science and open collaboration so that all people can enjoy the benefits of science and research. Finally, we are nearing the end of the Ebola outbreak in the Democratic Republic of the Congo. This is one good news. If there are no more cases, the government of the Democratic Republic of Congo could declare the outbreak over as early as this Sunday. We're not there yet, and we remain on full response mode. We're continuing to investigate alerts and to test samples. This would not have been possible without the incredible health workers who have put themselves at risk for more than 18 months to stop this outbreak, just as health workers are putting themselves in danger to save lives from COVID-19. Health workers in DRC faced the double threat of fighting a deadly virus in one of the world's most dangerous and unstable regions, exposing themselves to Ebola and bullets. Dr. Tedros: (16:48) Tomorrow, as you know, is WHO's birthday, a day we celebrate each year as World Health Day. This year, we're paying tribute to the incredible contribution of all health workers, especially nurses and midwives. Nurses and midwives are the backbone of every health system. They're there from the first moments of life to the last. Tomorrow we're publishing our first report on the state of the world's nursing, which highlights gaps and makes recommendations for all countries. One of the lessons I hope the world learns from COVID-19 is that we must invest in health workers, not only to protect lives but also to protect livelihoods. I thank you. Tariq: (17:55) Thank you very much, Dr. Tedros. Also, as always, we have Dr. Mike Ryan and Dr. Maria Van Kerkhove who will be answering questions. So we will now open the floor. I will go to one question that I received by email this morning and I promised to answer. That's Ankit Kumar from India today, and Ankit is asking that we have recently seen a spike in cases caused to religious gatherings in India. In fact, almost a third of new cases were linked to one gathering in India. We have also seen incidents of violence against health workers due to fear and misinformation. Is WHO concerned with these developments? What is WHO's message to religious and community leaders as their followers? Dr. Mike Ryan: (18:55) First and foremost, the idea of violence against health workers is driven by fear and it's driven by misunderstanding, but it's really, really unacceptable, and we ask everyone in every community to see our health workers as our heroes and to support them in every way we can. With regard to gatherings of any type, be they religious or be they for other purposes, there are always risks associated with such gatherings in the midst of a major epidemic and WHO has issued guidance on that. Many of these gatherings are now postponed or canceled. We've been working very, very closely with religious and faith based organizations all over the world, including groups from the Islamic tradition, Christian traditions and others, and continue to work through faith based organizations to communicate using our epi wind platform. Dr. Mike Ryan: (19:56) We're also continuing to develop guidance specifically for the Holy month of Ramadan and are working through our Eastern Mediterranean regional office to be able to advise governments and religious institutions on how best to manage the risks associated with such Holy events. But it's very important, again. Having COVID-19 is not anybody's fault. Every case is a victim and every case needs to be treated with sensitivity as the health workers who treat them. So it's very important that we not profiling COVID-19 along racial, along religious, along ethnic lines. This is not helpful. Tariq: (20:40) Thank you very much. So this was a question from Ankit Kumar from India today. Now we will go to journalists online. We will start with Jamie from Associated Press. Jamie, can you hear us? Jamie: (20:53) Hi. Yes. Can you hear me? Tariq: (20:54) Yes, please go ahead. Jamie: (20:56) Great, thank you very much. Well I wanted to just ask you about, over the weekend, Dr. Anthony Fauci mentioned that as many as, if I understood it correctly, as much as 50% of transmission could be asymptomatic, and just sort of aligned with that, if you could just give us a little bit more about what you're thinking about the fact that, I'm sorry, hold on, that some countries have said that this outbreak is more infectious than influenza, as much as the CDC is saying that it's up to three times more infectious than influenza. So what do you have to say about that? Thanks. Dr. Maria Van Kerkhove: (21:48) I'll start and perhaps Mike or DG would like to supplement. So the modes of transmission and the way in which this virus is transmitted is of significant interest to all of us. And what we are doing is we are working with member states, we're working with everyone that's affected by this, looking through the research and trying to understand when most transmission is happening, when any transmission is happening. And what we know from reports, what we know from published literature is that the predominant way in which transmission is occurring is amongst symptomatic individuals. And these are people that can be symptomatic very early on in symptoms, even when they start to feel a little bit unwell. And this is supported by some data that actually tries to attempt to capture virus from individuals who are symptomatic. We also know that it's possible that people can transmit in the few days before they become symptomatic or in their presymptomatic phase. Dr. Maria Van Kerkhove: (22:44) There have been some studies that have come out, and we learned about this when we were on mission in China back in January and early February, that there are individuals that can shed virus one to three days before they develop symptoms. However, it's very important to know that even if you are pre-symptomatic or even if you don't have any recognized symptoms, you still have to transmit through droplets. You still have to have these infectious particles that come out of your nose and your mouth. And so while we know that that is possible, we do not believe that that's a major driver of transmission. Dr. Maria Van Kerkhove: (23:17) Now, we've also seen modeling estimates that suggest that there's large numbers of unrecognized transmission, and I used unrecognized on purpose because I'm not saying asymptomatic. I'm saying that we may be missing people who are out there who are infected, but we're missing them because of current surveillance strategies. And that is certainly possible in many parts of the globe. Whether or not those individuals are asymptomatic, we will have to wait until we see results of serologic studies, which we hope we'll be seeing in the coming days if not weeks. And so what we can say is that most people are transmitting this virus while they are symptomatic. Dr. Mike Ryan: (24:00) Hi Jamie. Just in addition to, because I think we have, I would never in any way contradict my good friend, Tony Fauci, he's such an eminent man. There are many different estimations of what might represent asymptomatic transmission or other infections in the community. And we do know and everyone accepts that when the sero-epidemiology studies do come online, we will probably find more people who've been infected unknowingly. There's no question of that. Dr. Mike Ryan: (24:33) The thing we need to address in all of this is very often the idea of severity versus infection, and there is a huge association between the dose of exposure and the severity of infection. We see this in many other infectious diseases. So we also probably need to look at who is getting sick or very sick and is the dose and the type of exposure they're getting different to those who may be exposed and sero-convert in the community. So it's not just a matter of looking at how many people in the community are infected, but are there specific elements of exposure that cause individuals to have a higher dose of exposure or a specific route of exposure that causes a more severe infection? Dr. Mike Ryan: (25:18) There's also that concept of infectious dose when we talk about the different types of transmission. If somebody is exposed to a high dose from another individual directly or from a surface that's heavily contaminated, you can imagine a large dose. In other circumstances, individual particles of virus particles potentially floating through the air, it can be demonstrated that that may happen in certain circumstances, certainly in healthcare settings. But is that significant in terms of driving infection? Is that significant? Does that produce an infectious dose that can successfully infect another individual? And these are all very important things that still need to be studied. Again, we're only a number of weeks into this. I think we need to have the sero-epi studies. I think we need more information on what is the infectious dose, and particularly the relationship between the dose of exposure or infection and the severity of the disease subsequently, which has been seen in many, many other diseases in the past including Colera, Ebola and others. Tariq: (26:27) Thank you very much Mike and Maria. We'll go now to our next question. That's [inaudible 00:11:35]. Can you hear us? Speaker 2: (26:36) Yes, Tariq. Thanks a lot for taking my question. So I just wanted to ask about the global push to try and find a pre-exposure prophylaxis or postexposure prophylaxis. I understand there's several trials going on, and most of them with chloroquine or hydroxychloroquine. I was just wondering whether you can speak a little bit to what role this could potentially play. And of course also there's a lot of smaller studies going on. Is there any way to make sure that they all lead to results that can be pooled in the end? Dr. Mike Ryan: (27:09) Maria can give you more detail, but certainly one of the solidarity trials, I think solidarity three or four, we have one of the trials under design which will be a multicenter study which will look at prophylaxis in healthcare workers to see whether there's evidence that giving lower doses of drugs like chloroquine or hydroxychloroquine to help workers would reduce their risk of becoming infected in a healthcare environment. Those studies are certainly underway. And again there are a number of those studies underway in smaller studies around the world, but again as WHO, we're trying to bring together a larger set of collaborative studies that will give us the answers we need. Dr. Mike Ryan: (27:52) In terms of postexposure prophylaxis, I don't believe we have at the moment studies planned, but Maria can speak to that. But there is certainly evidence for the use of, not proven evidence of effectiveness, but there are a number of studies underway and trials underway that use hyperimmuneglobulin in the treatment of disease. In other words, they use the purified plasma of recovered individuals to give an antibody boost to people who are suffering the disease. Similar approaches have been used in postexposure prophylaxis for other diseases, but Maria may be aware of studies underway in that area. Dr. Maria Van Kerkhove: (28:34) Only to add that we have, as you mentioned, there are a number of smaller studies that are happening globally and across a large number of countries. We have teams through our science division and through GORN, through the Global Outbreak Alert Network, who are pulling together available literature on a number of topics, one of which is actually looking at different types of therapeutics and drugs. And the idea is until we can actually have a study that pulls together enough of a sample size to get these answers to these questions, we're trying to evaluate every piece of evidence that is published so that we could look at the way in which these studies were done, we can look at the strengths, we can look at the limitations, so that can help guide us closer towards an effective treatment for COVID-19 Tariq: (29:22) Thank you very much. Next question is from [inaudible 00:14:28]? Is it Kate who is from [inaudible 00:29:30] with us? Kate: (29:32) Ah, yes. Hi. Good evening or good morning. I'm actually from BSM radio Malaysia. My question is that many countries around the world, they have imposed lockdowns or some sort of restrictions of movements of, so I was just wondering what WHO's guidance would be. What's the sweet spot, so to speak, the kind of data that governments need to consider before lifting or relaxing some of these lockdowns? Thank you very much. Speaker 3: (30:04) Thank you very much. Dr. Michael J. Ryan: (30:05) Thank you. It is a difficulty for governments right now, because the lockdowns in many situation are proving effective in dampening the flames of this epidemic in those countries, but those lockdowns are also causing great economic hardship and everybody, especially in the developing world, needs to get to a more sustainable way of managing this epidemic and controlling COVID-19 without continuing to damage economic and social life. The transition strategy out of lockdown requires a calibrated, stepwise approach. It will be probably very inadvisable just to lift a complete lockdown, all of the measures, because lockdowns are a general term that include closure of schools, closure of churches, stay-at-home orders, closure of workplaces. It's a mixture of different things, and I think each government needs to break out: what does our lockdown actually constitute? What are the elements of our lockdown? Where is that happening in the country? Do we now understand the epidemiology of the disease in each area of which we have an element of lockdown or shutdown? Dr. Michael J. Ryan: (31:19) And then, to chart a path out, you have to build strong public health capacity to take over from the lockdown. In other words, the lockdown is pushing the disease down by putting people back in their homes, by separating communities. Once you raise the lockdown, you have to have an alternative method to suppress the infection. The way to do that is active case-finding, testing, isolation of cases, tracking of contacts, quarantining of contacts, and strong community education and participation and ownership around normal physical distancing, hygiene, and giving communities the power to control infection by, in effect, managing their own physical distance, managing their own capacities to support the response. Dr. Michael J. Ryan: (32:08) In that situation, if you have strong public health capacity, if you've got a community that's mobilized and empowered, and if you've strengthened your health system, then you're potentially in a position to start unlocking or unwinding the lockdown. The specific parameters you need to be looking at are things on two sides: one is it will be very inadvisable to lock down if the number of cases coming through the hospital are already at a level where your occupancy of beds is nearly at 100%. You need to be in a position where you now have free beds in your system so that you're managing and coping with the caseload, and that means you have some absorption capacity left. Dr. Michael J. Ryan: (32:52) You need to look at things like the doubling rate: how many days does it take for the number of cases to double? You need to look at positivity rates: what proportion of all samples that we test are positive? You'll see in somewhere like Korea, they're testing 2-6% of their samples they test are positive. Last week, in New York, 37% of tested samples were positive. So you need to carefully look at what proportion of people I test are positive, you need to look at the number of contacts that are generated per case. And it goes on and on, and WHO will be issuing a guidance to countries that is much more specific around the parameters they should be looking at. There are no absolutes here, there are no answers, there are no numbers that say "if this number is this, then you do that." That doesn't exist. Dr. Michael J. Ryan: (33:40) But what we can do is offer countries very specific measurements that they need to look at to chart the path out of lockdown, and that stepwise approach of unlocking somewhat and then waiting to see, I think you need to say "we will stop doing this element of the shutdown, and then we will wait and we will look at the data. If that works, we go to the next stage, and the next stage." So a careful, calibrated, stepwise exit from lockdown, with putting in place public health capacities, putting in place community capacity, building the capacity of the health system to cope should the disease bounce back up. Dr. Michael J. Ryan: (34:20) That's the safe path out of lockdown. We want to achieve it as quickly as possible, and we want to avoid many countries going into that circumstance, and we still have many countries around the world who are not in a lockdown situation. In fact, their epidemiology would suggest they can avoid the worst of this. We need to support them to avoid them going into that situation. The most damaging lockdowns are in many developing countries, where people, as the D.G. has said many times, can live from hand to mouth. Not from paycheck to paycheck, but from day to day, and we have to find adapted solutions around lockdown and around disease control in vulnerable, peri-urban populations living in poverty, in poor, rural communities. We have to find other ways to manage, alternative, adapted ways to manage lockdowns or slow-downs or shutdowns in those situations. Speaker 3: (35:17) Thank you very much. This was Kate from BFM Radio from Malaysia. Now we will go to Nigeria, to MetroStar, and it's Innocent. Innocent, can you hear us? Innocent: (35:32) Thank you. Can you hear me? Speaker 3: (35:34) Not very well, but we will try. Please go ahead. Innocent: (35:38) Okay. Thank you for taking my question. I have two questions to ask. One, how will WHO assess our Africa country? What have you done concerning the lockdown and management of COVID-19? And then the second one, there is a news going around that vaccines are to be tested on African when you develop. How true is that? And is there a window of, is there a window that's in the near future, vaccine will be developed for COVID-19? Thank you. Innocent: (36:27) Hello? Speaker 3: (36:27) Yes, we are trying to make sure that we understood the questions. We will try. Dr. Michael J. Ryan: (36:33) I think this is Nigeria, is it? Maria may answer the question on vaccine development. With regard for our general assessment on lockdown, the director general may wish to comment on this, because he's been speaking with many leaders in Africa and, I believe, spoke with the whole of the African union leadership and countries late last week, so therefore is in a much better position than me to speak about that. We would characterize, so far, Africa's actually doing well in this response thus far. Countries have essential capacities for testing, many countries are taking strong action and want to really focus on finding cases and doing contact tracing and trying to stop this disease becoming much more extensive, given the fact that health systems are not as strong in many countries. Dr. Michael J. Ryan: (37:35) They need support in that, though. They need support in testing, they need support with protective gear, and they need to be given the resources to be able to mount those types of responses. So I would characterize that Africa has not suffered the worst of this pandemic so far; the worst of it can be avoided with very, very swift action to support those countries in Africa who really do want to take a comprehensive approach to this disease, and with the many vulnerable people, including refugees and migrants who live in those countries, it is our responsibility to provide that support. Dr. Michael J. Ryan: (38:14) D.G., you may wish to speak about your interactions with the African union countries. Dr. Maria Van Kerkhove: (38:22) I'll answer the question around vaccines: what we can say is that there are a number of vaccines that are in development. Vaccines will be tested through clinical trials with all ethical considerations in place in whichever populations are under study with informed consent, with open and transparent communication. This is of the upmost importance; not only do we have strong, robust scientific evidence, but we ensure that all of the studies that are done are done with appropriate and the highest level of ethical considerations. Dr. Maria Van Kerkhove: (38:58) One thing, if I could just mention on the first question around Africa, is that there are a number of countries in Africa right now which have very few cases. Mike has alluded to this in his earlier response, very few cases. Some only have imported cases, and there is an opportunity here, this window of opportunity that the D.G. has spoken about, exists in many countries still. There is an opportunity to prevent the worst from happening in a number of countries across Africa and across countries that are still seeing their first case in some island countries, and we need to support those governments, those countries, all of the people in those areas to prevent the worst from happening, to prevent these individual cases from becoming clusters, these clusters from becoming community transmission. Dr. Maria Van Kerkhove: (39:51) I think that's where we need to put a lot of emphasis on and a lot of support on so that we can prevent countries from reaching a point where they need to put in these very restrictive movement restrictions. Dr. Tedros: (40:08) Thank you, thank you for that question, my brother from Nigeria. On the situation, as Mike said, of course when you see the number of cases, the African continent has the lowest number of cases so far. But that doesn't mean that the situation will not deteriorate. It may. So Africa should do everything to prevent this situation from getting worse, and that's why African leaders are doing their best. I had a chance to participate in a meeting, a leaders' coalition, which was arranged or invited by the chairperson, the current chairperson of the African Union, the president of South Africa, President Ramaphosa, and many leaders from all corners of the continent have actually participated. Dr. Tedros: (41:23) The main agenda is to have a continental strategy, and also make sure that that continental strategy helps the national strategy. But in addition to a coalition of political leaders or the heads of states and government, they have also agreed to have business leaders, coalition of business leaders. Business leaders in Africa are also getting together, because Africa will need resources. Dr. Tedros: (42:04) One of the major problems that was identified during the discussion was especially shortage of equipments, starting from medical equipments, test kits, PPM test kits and so on. The leaders have agreed to look for concrete solutions to address the problem. They also believe that, considering the number of cases we have in the continent, testing cases and tracing contacts and isolating them, meaning using the comprehensive approach, will actually help. They believe that lockdowns alone may not help, or the physical distancing alone cannot help. They have agreed to do everything to follow the comprehensive approach. Dr. Tedros: (43:14) From WHO side, we have been supporting, and we increased, improved the testing capacity in Africa significantly in the past two months, and many countries in Africa have now testing capability, although we may have shortage of test kits. But we're working on that, too. And we're finding different ways of addressing the gap, but we will support the African Union, we will support the Africa CDC, and also we will continue working through our regional office in Congo, Brazzaville, WHO original office, and continue to support and fight the pandemic together. Dr. Tedros: (44:03) Then, on the vaccines issue, there was, I think, a comment last week from some couple of scientists who said the testing ground for the new vaccines will be Africa. To be honest, I was so appalled, and it was a time when I said, when we needed solidarity, this kind of racist remarks actually would not help. It goes against the solidarity. Africa cannot and will not be a testing ground for any vaccine. We will follow all the rules to test any vaccine or therapeutics all over the world, using exactly the same rule whether it's in Europe, Africa- Dr. Tedros: (45:03) Exactly the same rule, whether it's in Europe, Africa or wherever, we will use the same protocol. And if there is a need to be tested elsewhere, to treat human beings the same way equally. And the hangover from a colonial mentality has to stop and WHO will not allow this to happen. And it was a disgrace actually and appalling to hear during the 21st century from scientists, that kind of remark. And we condemn this with the strongest terms possible, but we assure you that this will not happen in Africa and will not happen elsewhere in any country. Proper protocols will be followed and human beings will be treated as human beings because we are all human beings. Dr. Tedros: (46:12) Then after saying this, the vaccine development, we're addressing two issues and we will be announcing as soon as possible, hopefully during this week a big initiative to accelerate the research and development and production of vaccines and also design mechanisms for equitable distribution of the vaccines. While we're looking for vaccines, unless we break the barriers to equitable distribution of the products, whether it's vaccines or therapeutics, we will have a problem. Dr. Tedros: (47:01) So we need to address the problem ahead of time. We need to address the problem of access or challenges to access ahead of time and that's why we will put together a mechanism and we will appoint senior people from the north and south that will work out the details on how they can accelerate production, but at the same time how they can ensure equitable distribution. Dr. Tedros: (47:37) And solidarity is very important here. When a vaccine or a medicine is ready, we have to be able to deliver it to all over the world. There should not be a divide between the haves and the have-nots. If we say solidarity, solidarity should be in its full form. And I hope each and every individual, each and every human being will go for that kind of solidarity. I thank you. Speaker 4: (48:20) Thank you very much, Dr. Tedros. We'll take a couple of more questions. We go to [Yung 00:48:26] from Xinhau News Agency. Yung, can you hear us? Yung: (48:34) Can I hear you? Dr. Tedros: (48:35) Yes, we can hear you. Please go ahead. Yung: (48:38) Okay. As the World Health Day is approaching, what do you have to say to the frontline medical workers in China and around the world in the global antivirus efforts? And this question is for Dr. Tedros, thank you. Speaker 4: (49:00) Did we understood, well the question is what is the message to health workers in China and around the world? Dr. Tedros: (49:06) The question is not clear. If he can- Speaker 4: (49:08) Maybe you can repeat a question please. One more time please. Yung: (49:12) Okay. As the World Health Day is approaching, what [inaudible 00:49:17] to say and what kind of message do you want to deliver to the frontline medical workers in China and around the world in the global antivirus effort? Dr. Tedros: (49:34) Yeah, I think I have said it earlier. As you know this is the year of the nurse and the midwife 2020. And we were ready to celebrate it in a big way and it was the main event actually, was supposed to be a main event in our assembly in mid-May. Unfortunately, we're in this situation but we will be launching a report tomorrow. This is the first of its kind. It's a report on the state of nursing. We will launch it tomorrow, that's during the World Health Day. Dr. Tedros: (50:36) But while launching that report, although it's about nursing, we will celebrate all health workers, midwives, pharmacists, doctors, you name it. I think the world is now seeing the importance and the central role that health workers play. People, when they're asked of course to choose, they would say health first because it's only when you're healthy that you can aspire anything. Whether it's wealth or fame or anything, it doesn't matter if you're not healthy. If you're not healthy, the first thing you ask for is to get back your health. And our health workers are making sure that happens and they're central and very important for any individual. Dr. Tedros: (51:51) So not only during COVID, but during other times too, health professionals are very important because they are safeguarding that very important aspect of life. That's health. So we have to celebrate them every day. Of course, during COVID, we can see to what extent they are sacrificing. We have lost many of them. They're dying while saving lives. So my message first is to the public at large, that each and every individual should recognize whether it's during normal times or pandemics like now, to recognize the role of health professionals and to help them, to protect them. To really appreciate and respect what they're doing. Dr. Tedros: (52:56) And to the health workers, although you're doing, especially during COVID pandemic, although you're working in a difficult situation, you should know that your work is the most blessed one. Your work is something special to the extent of losing your life while helping others to live. And we respect you and appreciate you for that. And we also believe in you and that you will do everything to control this pandemic, but you should know that you have and the world understands, the most important job. Dr. Tedros: (53:57) We can see the humility which is coming from some leaders because of this pandemic. I know they're seeing, starting from their own life and the whole world from a different prism. And they will also see your role. But the most important is not the recognition from the public or from leaders, but the internal commitment and passion you have in believing that you are doing the most blessed thing. And you have all our respect and appreciation and we believe in you that together we will finish this pandemic. And all the respect and appreciation we have to you, the greatest respect and appreciation ever. Thank you. Speaker 4: (55:02) Thank you very much Dr. Tedros. I think this important message will be heard from everyone and we will conclude this press briefing with this important words from Dr. Tedros. We will have a audio file available in minutes to come and we invite you for our next briefing on Wednesday. Thank you. Dr. Tedros: (55:33) And see you on Wednesday. Tomorrow actually, for the launching. Yes, see you tomorrow.