00:00:40 TJ Hello to everyone from Geneva, WHO headquarters. My name is Tarik and I welcome you to this regular COVID-19 press briefing. It's not so regular because today is International Migrants' Day and Dr Tedros will say more about that as well as our guests. Before I give the floor to Dr Tedros, just to remind journalists, this press briefing has simultaneous translation into six UN languages plus Portuguese plus Hindi. We will open the floor to questions immediately after the opening remarks. We would ask journalists to be brief and ask one question at a time. I would also like to use this opportunity to thank our interpreters who are helping us with the interpretation for today. I will briefly say who is in the room here and then I will also later announce who is online to answer any questions. In the room we have Dr Tedros, WHO Director-General. We have also our special guest who Dr Tedros will introduce a little bit more in detail; it is Mr Antonio Vitorino, Director-General of the International Organisation for Migrations. We have Dr Mike Ryan, who is our Head of the Emergency Programme. We have Dr Maria Van Kerkhove, Technical Lead for COVID-19. We also have Ms Jacqueline Weekers, who is the Director of the Migration Health division with IOM and we have Dr Santino Severoni, who is our Director at WHO of Migration and Health. Bruce Aylward is also with us, who is working with the ACT Accelerator. I'll give the floor to Dr Tedros for his opening remarks and then we will introduce other experts who are online with us. TAG Thank you. Thank you, Tarik. Good morning, good afternoon and good evening. On Monday I ended our press conference by sending my best wishes to UNHCR, the UN refugee agency, for its 70th birthday and today is International Migrants' Day and I'm delighted to be joined by Antonio Vitorino, Director-General of the International Organisation of Migration. Welcome to him. IOM is our next-door neighbour here in Geneva and our very close partner. In recent years we have witnessed the largest population movements and displacement since the end of the Second World War. Too often migrants and their families remain outsiders in their adapted communities even years after migrating. 00:03:39 They face discrimination, social exclusion and lack of access to health services and yet migrants make enormous contributions to our societies with new ideas that drive economic and social innovation. That's also true in the COVID-19 response. It was Turkish migrants to Germany who founded the company that developed the first COVID-19 vaccine to be approved and rolled out. It was a nurse from the Philippines who administered the first dose of that vaccine in the UK. All around the world many health workers are migrants, especially women, who account for 70% of the global health workforce. When the World Health Assembly designated 2020 as the International Year of the Nurse and the Midwife none of us had any idea how much we would rely on nurses, midwives and other health workers to keep us safe in the face of a global pandemic. We all owe a huge debt of gratitude to the nurses and midwives who are often the first and only health professionals present to treat and comfort the sick and dying and bring new life into the world. 00:05:04 Together with Women in Global Health, the International Council of Nurses, the International Confederation of Midwives, the United Nations Population Fund and Nursing Now we yesterday launched a list of 100 outstanding women nurses and midwives from around the world who have made an exceptional contribution to nursing and midwifery. They represent millions of nurses and midwives who use their knowledge and expertise on a daily basis to protect the health and lives of others, at times putting themselves in harm's way to do so. To better understand the impacts of COVID-19 in refugee and migrant populations WHO and the research consortium led by Ghent University and the University of Copenhagen has conducted a global survey called Apart Together. The survey was supported by several partners and included almost 30,000 migrants and refugees in almost all WHO member states. 00:06:17 It shows that people living on the streets and in asylum centres are less likely to seek care if they have symptoms of COVID-19. Of those who reported not seeking healthcare 35% said it was because of financial constraints and a further 22% said it was fear of deportation. More than half of those surveyed said that COVID has caused them depression, worry, anxiety and loneliness. These findings paint a bleak picture but they also point the way forward. There are several measures countries can take to include refugees and migrants in response plans and public health measures. Access to care must not be linked to legal status. Improving internet access for migrants is also important for improving access to information and most crucially we call on all countries to remove financial and other barriers to care for migrants as part of their journey toward this universal health coverage. Health for all means all including migrants. That means increasing investments in health, especially in primary healthcare to create health systems that are sensitive to migrants' needs, their language and their health problems. 00:07:56 These include reproductive and child health, mental health, trauma from injuries, violence, sexual abuse and assault, investing in the health of migrants is not just the right thing to do; it also has long-term benefits for social cohesion and economic development. Exclusion is costly in the long run but inclusion pays off for everyone. It's also vital that migrants and refugees are included in plans for the roll-out of vaccines against COVID-19. As you know the ACT Accelerator, which includes the COVAX facility, was established to ensure access to vaccines for the world's poorest and most vulnerable people, many of whom are migrants. Earlier today WHO and our COVAX partners, GAVI, CEPI and UNICEF announced that we have secured agreements for access to a billion doses of several promising vaccine candidates. I would like to thank Canada and Prime Minister Trudeau for committing to share surplus doses of COVID-19 vaccines. These unprecedented agreements mean that all 190 countries and economies participating in COVAX will be able to access vaccines to protect vulnerable groups in their populations during the first half of next year. 00:09:34 This week I have spoken with CEOs of pharmaceutical companies and met with European Commission President Ursula and President Charles Michel in Brussels to ensure that we start vaccination as soon as possible in the new year. WHO and our COVAX partners are working non-stop to start vaccination as soon as possible in the new year and WHO remains committed to working closely with IOM and many other partners to support countries in improving the health of migrants during the pandemic and their end [?] after it's over. It's now my great pleasure to introduce Antonio Vitorino, Director-General of the International Organisation of Migration, to say a few words. Antonio, mi fratelo, you have the floor. AV Thank you so much, Tedros. It's a great pleasure for me to be here today with you not just as a neighbour but as a close partner in International Migration Day. Because of all the reasons that you have just mentioned it is indeed critical that we join forces to ensure that the most vulnerable including, as you have said, migrant refugees, asylum seekers, internally displaced persons and in general people on the move are not left out of our global efforts to fight back against COVID-19. 00:11:10 I must say that, contrary to the political rhetoric, most of these forcibly displaced persons live in low and middle-income countries which tend to have weaker health systems and struggle to meet the health needs of their own population. Access to health is a human right. It's a human right of migrants too but the list of barriers and difficulties that migrants face in assessing healthcare is far too long. That said, I believe that in some countries being a regular migrant is a prerequisite to access to healthcare. But this lives quite a large number of irregular migrants, stranded migrants, migrants who cannot return back home and we estimate that we have three million stranded migrants all over the world, and leaves also migrants in detention uncovered. Too often health information is not given in a language that is understood by migrants. Last but not least, as you have mentioned, migrants are particularly prone to anxiety, to insecurity, to mental health and psychosocial problems and especially women and girls who are particularly vulnerable. 00:12:44 To be honest, what I have found particularly intolerable in this current crisis is that while being so often left behind migrants have also been on the front line of the response to the pandemic, taking personal risks for everyone's well-being. This is across many critical sectors, not just the healthcare sector but also transport, food, retail, research, IGN and homecare; you name it. So I'm happy to be able to tell you that many countries have understood the importance of universal health coverage. Already before the pandemic about 43% of all countries offered health coverage to all migrants no matter their legal status and in this year of public health emergency several host countries have temporarily introduced new policies or relaxed requirements to grant access of migrants to healthcare. But this is not enough. One of the crucial issues is that migrants sometimes are suspicious to look for healthcare because they're afraid that, contacting health services, they might be detained or even deported. 00:14:12 Building a mutual trust relationship between public health services and migrants will be crucial, especially now as we are going to have a true test case. As we collectively gear up for one of the world's largest vaccination campaigns I believe that we must be vigilant and ensure that access to the vaccine is fair and equitable. I praise the efforts of WHO in the COVAX environment and the WHO partners, GAVI and the Vaccine Alliance on this front. Therefore I want to take this opportunity to call on governments to count and include all migrants present in their territories no matter their legal status in their national vaccination plans. Let me be very clear; as governments prioritise health workers on the front lines they need to ensure that migrant front-line health workers are also vaccinated. As governments prioritise people above a certain age then all migrants above that same age should be prioritised in the same way. It's not a question of creating any preference or privilege to migrants; it's guaranteeing access to the vaccination on an equal footing with the nationals. 00:15:47 It remains vital that migrants in vulnerable situations have access to immunisation and essential primary healthcare services including mental health in humanitarian settings as much as in urban slums or border communities. From our side, Tedros, you can count on IOM engagement and support for the efforts to guarantee a successful vaccination process so that we finally defeat the virus. Thank you. TAG Thank you so much, Antonio. Tarik, back to you. TJ Thank you very much, Mr Vitorino and Dr Tedros, for these opening remarks on this very important day. Before I start calling on journalists for questions, just to let you know, we have online also Dr Soumya Swaminathan, who is the WHO Chief Scientist. We also have Kate O'Brien, Director for Immunisation, and we have Mariangela Simao, who is Assistant Director-General for Access to Health Products and Medicines. With that I will start with the Philippines, Philippines Daily. We have Yovik Yi online with us; I think it's the first time we've had Yovik with us. Yovik, please unmute yourself. YO Hi. Can you hear me? 00:17:28 TJ Yes. Please. YO Hi. I would just like to ask about the public's preference for some candidate vaccines. Pfizer, Moderna and AstraZeneca earlier released the efficacy data on their vaccines which naturally excited everyone but of course these firms can't be expected to supply the entire world with their vaccines. So my question is, what can WHO say to those people who might be questioning or having doubts about their governments' decision to enter into deals with manufacturers that have yet to release their data or are still completing their phase-three trials? Thank you. TJ Thank you, Yovik. The line was not really the best. If we were able to hear, it's about candidate vaccines and data, in particular about the AstraZeneca vaccine. If Dr Swaminathan is online maybe you can try to answer this if you heard the question correctly. SS Thank you, Tarik. Actually I couldn't hear the question very clearly. Is it possible to repeat it? 00:18:52 TJ I think the question was about the data that we are getting from different manufacturers and I think there was a question about the AstraZeneca vaccine in particular. Yovik, if I'm wrong please correct me because we were not able to hear correctly. YO Hello, can you hear me now? TJ Yes, please try again. YO My question is, I would like to ask about the public's preference for some candidate vaccines because Pfizer, Moderna and AstraZeneca have already released their efficacy data but of course these firms can't be expected to supply the entire world with the vaccine. So my question is, what can WHO say to those people who might be questioning their governments' decisions to enter into deals with manufacturers that have yet to release their data or are still completing their phase-three trials? Thank you. SS Okay, I think that was clearer. I can start and Mariangela or Kate or Mike might want to come in. The first thing I would like to say is that the WHO really wants to support as many vaccine candidates as possible to go through clinical trials because, as you just pointed out, there are a number of different properties or characteristics of a vaccine that may make it more or less suitable for different settings. 00:20:26 Ideally one would like to see a vaccine that's a single dose, that can be stored at room temperature, that gives long-lasting protection, that's safe, effective and is also manufactured easily and can be scaled and is affordable. So that would be a really ideal vaccine and there are so many candidates in development including innovative products like a combined influenza and SARS-CoV-2 vaccine. There's a measles platform, there's an intranasal vaccine, a couple of them that are coming along. So we would like to support the research and development and we'd like to support companies and countries and encourage them to continue with clinical trials. I think that's the first message. The second is about the question of when is a vaccine good enough to be used and again there are very clear criteria which we've laid down that regulatory agencies like the FDA and the EMA have laid down. 00:21:25 These criteria have benchmarks for both efficacy as well as safety as well as things like the quality of manufacturing, which needs to be checked before WHO or any of the regulatory agencies would endorse a vaccine either through an emergency use listing or ultimately through a full licensure or a pre-qualification as the case may be. So I think the criteria are clear. Now it's up to regulatory agencies in countries to make the decisions and they make decisions based on benefits and risks because in a situation... When you're in a pandemic there's obviously an urgency and a need to get vaccines out to people and therefore one has to weigh the benefits and the risks at a particular time. WHO will examine all the dossiers that are submitted to WHO. Mariangela's division is accepting these on a rolling submission basis so that we are up to speed, we can move quickly and we would provide either emergency use authorisation or pre-qualification as the case may be based on the data that we're able to examine. Thank you and maybe somebody else would like to add. 00:22:43 TJ Thank you, Dr Swaminathan. I understand Dr O'Brien would like to add something. Dr O'Brien. KOB Yes, just very briefly. Because of the supply situation most countries are likely going to have to use more than one product and so we do need multiple products in the marketplace, they do need to meet efficacy and safety and manufacturing standards but most countries are going to have to be juggling more than one product and getting that supply security is really important. I think those are just elements from a delivery perspective that we also have to keep in mind. Thank you. TJ Thank you, Kate. I understand also Dr Aylward and Dr Ryan would like to add something. Dr Aylward, Senior Advisor to the Director-General. BA Yes, just a very quick response. Recognising this challenge WHO right at the very beginning of the pandemic and very early on established what we call our target product profile which says, these are the standards that a vaccine should hit. These were published broadly, it's what all the vaccine manufacturers have been working toward and as countries are assessing vaccines they're looking at, do they hit these standards. 00:24:01 Then we have also put in place, of course - to the specific question about what WHO is doing; we have a whole pre-qualification/emergency use listing process that looks in detail at all of the detail that companies generate as part of these trials to ensure that they meet the necessary standards. These standards as well as the criteria are published on our website where again the general public can look and say what are the kind of standards, how do we ensure that these are hitting these standards, what is the process to get there. All of that is laid out very clearly, very transparently. This aligns very, very closely as well with what what we call the stringent regulatory authorities around the world are also using as they assess the vaccines. So when you ask about the general public, the general public should have great confidence in products that have been looked at by stringent regulatory authorities and the WHO process because they take those through all of those measures systematically; the efficacy, the safety, the quality of the product but also the programmatic suitability to make sure that this is something that is going to suit the circumstances in which these are going to be used. 00:25:21 MR Bingo, Bruce. I'd say something very similar. I think it's important that when citizens are looking to governments now and saying, we're not getting the vaccine and there's vaccine in some countries and governments have made choices; they've been looking at price and the profile of the product, the production capacity of the product and their access to it because of that. I think it's an important moment for us all. There are going to be many vaccines coming on-stream at different times. Some will have advantages over the others; some can be used at higher temperatures, Bruce, and some will be produced in higher volumes. Countries will be more used to working with a single product over a long period of time so where you may lose in a certain part of the early part you may gain in speed and you may gain in effectiveness later. 00:26:06 So I don't think we should be seeing this as a game of winners and losers right now. We're at the beginning and, yes, the products that are coming through now are in low volume. They're very expensive products but they're low-volume. They've come through first but other products will come through, we hope, early next year. So I think this idea of talking about good or bad vaccines or better or worse approaches and we start to hold or judge governments against one another; I think governments, COVAX, partners have been negotiating in good faith with manufacturers to make the best deals they can against what Bruce has laid out very clearly, against things like the profile of the product, the production capacities, the state of data available about the product and its likely performance and ultimately about the price of that product. These are complex decisions and I think it could be very disruptive for us all to transition to some kind of nationalistic foot race to who does what. We all have to get there together. We simply have to finish this race in a line together and someone getting there first doesn't necessarily help everybody else. 00:27:18 So I think we're all going to have to just be a little bit patient and a little bit tolerant that things are going to move at slightly different paces in different situations and that we don't politicise this. Again we've seen this again and again in this pandemic; issues that should be about collective responsibility and moving forward together turned into comparisons and turned into, he did good, she did bad... This is not the way, quite frankly, that we need to move forward right now. We need to move forward in solidarity to find these solutions. Science has delivered. Now we need solidarity to deliver the ultimate solution which is to stop this virus transmitting and killing the people we love. TJ Science, solidarity and solutions. The next question, Bayram from Anadolu News Agency; Bayram. BA Thank you, Tarik, for taking my question. My question is for Mr Antonio Vitorino but Mr Tedros can also add something on it. According to official UN figures Turkey continues to host the largest number of refugees worldwide. Turkey currently hosts some 3.6 million registered Syrian refugees and 370,000 persons of other nationalities. 00:28:38 Of course Turkey had lots of challenges during the COVID-19 pandemic, maybe more than any other country as they host millions of migrants and refugees. So today, Mr Vitorino, will you call on European or Western, rich countries to open their borders to migrants and to share the burden of Turkey? Thank you very much. AV The answer is, absolutely, we think that there is a shared responsibility of the international community to support countries that have the responsibility of hosting large numbers of refugees, asylum seekers and migrants. The good news I have for you is that fortunately in most of the refugee and migrant camps all over the world the virus has been contained. The number of casualties in camp settings, which was my worst nightmare, has fortunately been rather low, sometimes even lower than in the host communities. But that does not mean that there is no need for a specific approach to the vaccination when it comes to the people in the camps because the camps are... You cannot have social distance in the camps; let's be honest. 00:30:03 People wear masks and that's very positive but social distance is impossible so the efforts of IOM and other UN partners - WHO, UNHCR and other agencies - are precisely to deliver health support and health services to these populations and to help host countries in dealing with the challenge that represents, guaranteeing that those migrants and refugees are safe, are screened, are traced, are quarantined and now beginning next year are vaccinated. Thank you. TJ Thank you very much, Mr Vitorino, for this. We will go to our next question. It comes from Adrian, who works for Sumedico. Adrian, I think it's also the first time you're with us. Adrian. Can you please unmute yourself, Adrian? TR Hello. In Mexico City an emergency's been declared, as well as in other cities in the country and there's been a high amount of infections and deaths. What has Mexico done to end up in this situation? 00:31:35 TJ I think we were able to hear your question about Mexico and the latest situation in Mexico. MR Yes, Maria may add; I don't have the Mexico numbers with me today but we have spoken about Mexico in the last number of days and Brazil and other countries in Central and South America and we have seen worrying increases. In fact Mexico, like other countries in North America, never really exited its first surge or first wave; it managed to get some degree of control and the disease has surged again in many places and we've seen that same phenomenon happen in other countries like Brazil as well; the United States. Over three-quarters of the cases we're seeing globally now are occurring in the Americas. It's a very, very high and intense period there and it really does come back to being able to implement all of the measures that are needed, having strong co-ordination and governance, having a do-it-all approach in terms of both public health and social measures, advice to people on wearing masks and personal hygiene and having a very strong focus on surveillance and testing and having a health system that can cope with the cases when they do occur. 00:33:00 It's been tough for all countries but where countries have not been able to implement a comprehensive strategy and sustain that over time and gain the buy-in and support of their population and provide that support back to their population it's been tough for many countries to get through their first and second surges or waves of this disease. We've said that here too; vaccine is on the way, it is a source of great hope and we should celebrate that vaccines are coming but the next three to six months are going to be tough. Countries that currently have intense community transmission are likely for that transmission to intensify. Countries that have had good control on the disease may struggle to maintain that control of the disease and you've seen that in a number of countries. Even in East Asian countries that have done well up to now they are really having difficulties in containing certain particularly urban outbreaks at the moment. 00:33:59 So past success is no guarantee of future success; past failure is no guarantee of future failure. It is really what you do now and what everyone does now. We have to bring vaccines in as a tool that puts an end to this virus but the vaccines alone won't do it and we don't have these vaccines at a level yet that they can actually affect the transmission dynamics of this organism. So Mexico's no different to other countries; many, many countries are facing up a very serious mountain again at a very difficult time with the prospects for increased transmission. Other countries are maintaining their capacity to control the virus and some are struggling even at that. We've been saying it here for a very long time so at the risk of repeating ourselves again and again, there is no magic to this, there are no unicorns here, it is a very simple commitment to just doing very simple and direct things that need to be done and continuing to do that. They're very hard miles; it's a very difficult thing to do. Sustaining government effort, sustaining cohesion, sustaining community compliance and participation; they sound easy. They're the hardest things to do in public health and we're sorting out the sciency bits but we're really not doing well at sorting out the social bits, the leadership bits and the co-ordination and the support we need to our communities to be able to contain this virus. Maria, you may wish to add something. 00:35:36 Thanks, Mike. Just looking at the numbers, we are seeing an increasing number of cases being reported from Mexico over the last three weeks. We're seeing a stabilisation of the deaths over the last three weeks with more than 4,000 deaths being reported each week. When we look at the numbers - and what we're seeing from the data from Mexico is that there is detail that's being provided at the sub-national level and I think that's a really important factor. If you look at things at a national level you miss the details of what is actually happening in terms of transmission in specific geographic locations. If you have the systems in place, the surveillance in place, the testing in place, the data management in place you can not only find the virus and take the public health actions to keep people safe in terms of isolation, clinical care, contact tracing, cluster investigation, supporting quarantine then if you know where the virus is you know how you can use your resource and your capacities to the best of their ability. 00:36:34 So if we look at some of the breakdown we can see that there are differences in transmission based on different parts of the country and this is true for Mexico but it's true for every other country. It's breaking down the problem into actionable interventions that can be targeted, can be tailored and using the resources wisely. So it's not just about the comprehensive approach; it's about using that in the most appropriate way based on the situation that you have at hand. We are seeing that but unfortunately we are seeing an increase in cases across Mexico but you have the tools at hand right now that can turn it around. I think that's what's really critical right now. Again, as Mike has said and as the team keep saying, we have vaccines and more importantly vaccination that is starting to come online but it will take some time to reach everyone so please know that there are tools that you have now. Each one of us has a role to play as well as leaders at political level or community leaders or youth leaders to take the necessary steps to not only know where the virus is but take the necessary steps to lower your risk of exposure, which will lower your risk of infection. 00:37:44 So stay the course, use the measures that you have at hand in the most appropriate way you can and you will get through it. TJ Thank you very much, Dr Van Kerkhove and Dr Ryan, for this. Now we will go to Agence France Press. We have Nina Larsson with us. Nina. NI Hi, thank you for taking my question. I wanted to ask you about the international mission going to China next month, which has been announced is going to happen next month. Could you tell us specifically when the experts will go if you have the dates and where they'll be going in China, under what conditions they'll be working, if they'll be under Chinese supervision and if they'll need to quarantine before starting work, which will obviously impact, I guess, how long they have to stay? Thank you. MR Maria can provide more of the details. We still don't have a take-off date. We're working on the logistics around visas and flights but we do expect the team to leave in the first week of January. 00:39:03 There will be quarantine arrangements; obviously, as ever, we will have to comply with whatever the arrangements are for risk management in travel and on arrival in China itself. The team will visit Wuhan; that's the purpose of the mission. Clearly the team will pass through and by Beijing, as is the necessary part of any mission that's considered to be a joint approach and we will show good courtesy to our colleagues in China in doing that. But the purpose of the mission is to go to the original point at which human cases were detected and we fully expect to do that. The question regarding the team; the team is a WHO team, it's a team of international experts of international renown who will work with our Chinese colleagues. They will not be, as you say, in quotes, supervised by Chinese officials. I sometimes wonder at some of the language that some of our journalistic colleagues use and how things tend to be characterised through the question, not through the answer that's given. We will operate as we would operate in any member state; at their invitation, with gratefulness for their support to that and with the full intention of pursuing the scientific principles that his organisation has always stood for. We will continue to do that and provide all the support necessary for the international team that we have brought together in order to find and learn more about the origin and source of this virus. TJ Many thanks, Dr Ryan. The next question is from Radio France International, Jeremy Launch. Jeremy. Jeremy, if you hear us please unmute yourself. We don't have Jeremy on the line now so let's go to Simon Ateba. Simon. SI Yes, thank you for taking my question. This is Simon Ateba from Today News Africa in Washington DC. My question is about seriousness in Africa and it goes to Dr Tedros. Do you think the African continent continues to take COVID-19 seriously? I know that Africa is not one country; 55 countries, 1.3 billion people, 2,000 languages. But it seems to me that the social distancing, use of masks and the rest are no more the way they were months ago. Thank you. 00:41:59 MR I can start. Yes, Africa is a very diverse continent and, Simon, it's great that you recognise that; many don't. It tends to be seen as one amorphous continent, which never ceases to irritate me. The reality is that Africa is not out of the woods yet and we've seen South Africa continue to battle higher numbers; we've seen countries around; Eswatini; I think we've seen in Namibia, we've seen Botswana, we've seen southern Africa has had a continued issue. We've seen small but... The trajectory in West Africa and in parts of East Africa is actually upwards; the trajectory in South Africa. So while the absolute numbers may not be huge the trajectory is worrying so Africa does need - countries in Africa need to maintain their vigilance. There is no question about that but it's also a very, very long road and many people in Africa live in a situation where they have to work to live, they have to work to eat and therefore there are more limited choices for people in that situation. They don't necessarily have government structures that can put aside trillions of dollars to pay people to stay at home and therefore people don't have the same choices. 00:43:20 I have seen a pretty high compliance with mask wearing and other stuff in Africa. We've seen some excellent examples of surveillance and investigation. Our colleagues in South Africa have been tracking the evolution of this virus and genetic variations and state-of-the-art work and I keep saying that; that surveillance in Africa is, in terms of the ability to do contact tracing... Some of the work done in Nigeria by Nigeria CDC is global state-of-the-art work; in Rwanda and other places. So Africa is actually showing the way, showing the way in community engagement, showing the way in community-based approaches. It's showing the way in keeping this disease, as you said, in terms of migrants and in terms of refugee camps and other places and remembering that the vast majority of migrants and refugees in the world are being hosted in countries who don't necessarily have the resources that others do. There are millions and millions of refugees and migrants hosted in Africa and on the African continent and without the terrible complaints we hear from others about hosting hundreds or thousands. 00:44:26 So from my perspective, yes, Africa is not out of the woods but Africa is also leading, on the leading edge of this response and showing the way for how you can deal with one of many emergencies at a single time. I think at one point last month Sudan was dealing with ten different epidemic emergencies at the same time - imagine if that was the case in other countries - and doing it with a high level of quality. So, yes, as there are in every country, there are things that we'd like to see more of and very clearly Africa's not out of the woods and there's every chance that things can get worse on the African continent. Therefore it's really important that we also make sure that vaccines and other interventions, new diagnostics and new therapeutics, are shared equitably across the world based on risk and on vulnerability. DG, you may wish to add. TAG Thank you. I think the seriousness of Africa was clear from the start, Simon. Many countries - the majority of them - started their actions as early as possible, their social measures and so on. You remember when many countries, when they didn't even have any cases, were taking serious measures. I think that prevented serious problems from happening in many countries in the continent. 00:46:10 You can actually see the situation not only from the specific country early preparedness but the continental action they were taking. I remember having a meeting with the Ministers of Health in February, March, preparing the continental strategy and the political leaders, the AU Commission, Musa Faki and the current President of the African Union, the Chair of the African Union, heads of state, also President Ramaphosa co-ordinating the overall response. So not only the immediate or early action by individual countries but the continental strategy and the co-ordination of the leaders to implement the continental strategy; I think that really helped. If you see the major - the countries that are contributing the most, 12 countries globally, none of them is from Africa in terms of cases or in terms of deaths. Of course there could be not only the early response but other reasons to explain this but we believe that Africa has really done its best. The seriousness you said is there and we hope that will continue. 00:47:56 As Mike said, there is good hope now for vaccines and that's an additional tool but all countries should continue to do the basics and follow a comprehensive approach in order to defeat the pandemic. So because of vaccines which are still rolling out now we shouldn't lower our guard and we should continue to be very vigilant and implement all the measures we need to implement based on the toolbox that we have been implementing. Thank you. TJ Thank you very much, Dr Tedros. We received a question; you mentioned South Africa; we received a question about news from a South African scientist on a new variant of the virus so maybe Dr Van Kerkhove can comment on that, please. MK Yes sure. Thanks, Tarik, for the question. Yes, we are aware that South African researchers have identified some virus variants from sequencing of patients across the country and I should first and foremost say that South Africa has worked incredibly hard to increase sequencing capacity across the country, which is really commendable. We are seeing increases in the ability of sequencing all over the world so that's first and foremost; that's really important. 00:49:30 So yes, we're in touch with researchers and scientists from South Africa who've identified some virus variants. The variants have mutations in them and, as you know, this is a virus that mutates; all viruses mutate, all viruses change over time and these mutations are expected but having the ability to sequence will allow them to actually look at those changes. So what they're doing right now - and we are working with our SARS-CoV-2 virus evolution working group; they're growing the virus in the country and they're working with researchers to determine any changes in the behaviour of the virus itself in terms of transmission; does this virus transmit more easily than the others, are there any differences in severity, are there any differences in the ability of a person who is infected with these variants to develop antibodies and are there any differences in the diagnostics or therapeutics or vaccines? 00:50:31 So far we have no indication that there are any changes in the virus' behaviour but these studies are underway and so that's what's really important; that South African researchers as well as researchers in the UK - because there are other mutations that are identified in the UK; there have been mutations identified in other countries - there's a system in place, there's a process in place to evaluate each one of these mutations, each one of these variants so that we understand what is their importance in terms of the virus' behaviour. These are studies that take some time to be conducted in a lab and we have the mechanisms, the trust, the collaborations that are in place with the researchers in South Africa and in other countries to work on to determine if there are changes and what those changes mean. As soon as we learn anything about this we will let you know. South Africa had a press conference, I believe, at the same time as we were doing this press conference here providing the information openly and this is a good sign. This is what we need to see but the more opportunity this virus has to spread the more opportunities this virus has to change so it's really important that we do everything that we can to minimise the spread now with the tools we have. We can't emphasise that enough so we thank our colleagues in South Africa as well as colleagues in the UK and Denmark who alerted us to mutations that they've identified and who are carrying out the scientific studies to help us understand the implications of these. 00:52:07 MR Maybe a shout out too to those who work in the likes of Genbank and GISAID and others who accept and post all of these sequences as well and thanks to those who continue to do that. Keeping this information in the public domain is really important and having all scientific eyes on that to look for any changes that are significant. It's really important; this is a collective process, this is collective intelligence that's applied to a complex problem and it requires a lot of people to have input so it's great to see this kind of collective intelligence put to work. TJ Many thanks. We are getting close to the hour so let's try one or possibly two questions. Stephanie from Reuters; Stephanie. Stephanie, you will need to unmute yourself. 00:53:10 ST Sorry, I had my hand up to ask about the same issue about the South African variant, which Maria has already addressed so unless she has something more to say about it I think we're good. Thank you. TJ Okay. That's very good, that we managed to answer your question in advance. With this we will conclude today's press briefing. Big thanks to our guests, Mr Antonio Vitorino, Director-General of the IOM, and Jacqueline Meekers from the Migration Health Division of IOM and to our WHO guests. The last word as always goes to Dr Tedros. TAG Thank you. You have said what I wanted to say, to appreciate my fratelo, DG Vitorino and also director Jacqueline for joining us today and look forward to working even more closely. Thank you for your partnership and friendship. Grazie mille. Thank you also to all who have joined us today and bon week-end. See you next week. 00:54:32