WHO joins individuals, organizations and UN partners worldwide in marking the International Day of Zero Tolerance for Female Genital Mutilation (FGM)

FGM has no health benefits, and it harms girls and women in many ways. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. Despite this, a number of myths and misconceptions about FGM persist, which support the perpetuation of this harmful practice.

One such myth that families and individuals often wrongly believe, is that FGM would be safer if carried out by a health care provider. Some health care providers are also under the misconception that by carrying out FGM they are preventing harm to girls or women. This could not be further from the truth. There is no medical justification for FGM, and medical practitioners carrying out FGM on girls and women are causing only harm.

• Myths about FGM
  7 infographics about FGM

A woman social worker (centre) speaks about the dangers of FGM to a girl and her mother at their home, Egypt

UNICEF/Pirozzi

Evidence shows that FGM performed anywhere and by anyone causes harm. Beyond the immediate risks, FGM can cause life-long trauma and pain for survivors – including urinary and vaginal problems, scar tissue and keloid, sexual problems (including pain during sex), increased risk of childbirth complications, and psychological problems such as depression, anxiety, post-traumatic stress disorder, and low self-esteem.

Fact sheet

• Female genital mutilation
  Updated January 2018

Working towards zero tolerance for female genital mutilation in Sudan

Today, more than 1000 communities in Sudan have abandoned the practice which has no health benefits and continues to violate the human rights of 200 million women and girls in Africa, the Middle East and Asia.

Unfortunately FGM is increasingly being performed by health care providers across the world – a so called ‘medicalisation’ of the practice. By rejecting harmful myths and misconceptions however, health workers who refuse to carry out FGM can help to safeguard the human rights of girls and women. They can even help to bring about positive change by being part of more widespread abandonment of the harmful practice.

FGM includes all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. More than 200 million girls and women alive today have been cut in 30 countries in Africa, the Middle East and Asia where FGM is concentrated. This is a global problem however, which affects girls and women worldwide.

WHO guidelines on the management of health complications from female genital mutilation

WHO is working to equip health care providers with the information and skills to be able to provide high-quality medical care and counselling to girls and women who have been subjected to FGM. To supplement the WHO guidelines on the management of health complications from female genital mutilation, WHO is now working on strengthening the health sector response to FGM with a new practical tool, to be launched later in 2018. WHO is also working on building evidence on the causes, consequences and costs of FGM, as well as developing and testing interventions to prevent health care professionals from carrying out the practice, how to eliminate it, and how to care for those who have experienced FGM. WHO continues to work with other UN agencies and other partners as part of a decades-long and ongoing effort to eliminate FGM, and to advocate for the end of this harmful practice.

• Publications on FGM

Source: http://www.who.int/reproductivehealth/topics/fgm/zero-tolerance-fgm/en/?utm_source=WHO+List&utm_campaign=2d63687114-EMAIL_CAMPAIGN_2018_01_18&utm_medium=email&utm_term=0_823e9e35c1-2d63687114-266698981

WHO List of epidemic-prone diseases that need more R&D investment

The World Health Organization (WHO) finalized its list of priority pathogens that have a potential to cause a public health emergency and which have no, or insufficient, countermeasures. These diseases urgently need R&D to develop treatments and vaccines. Crimean-Congo haemorrhagic fever (CCHF) Ebola virus disease and Marburg virus disease Lassa fever Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS) Nipah and henipaviral diseases Rift Valley fever (RVF) Zika Disease X

2018 annual review of the Blueprint list of priority diseases

For the purposes of the R&D Blueprint, WHO has developed a special tool for determining which diseases and pathogens to prioritize for research and development in public health emergency contexts. This tool seeks to identify those diseases that pose a public health risk because of their epidemic potential and for which there are no, or insufficient, countermeasures. The diseases identified through this process are the focus of the work of R& D Blueprint. This is not an exhaustive list, nor does it indicate the most likely causes of the next epidemic.

The first list of prioritized diseases was released in December 2015.

Using a published prioritization methodology, the list was first reviewed inJanuary 2017.

The second annual review occurred 6-7 February, 2018. Experts consider that given their potential to cause a public health emergency and the absence of efficacious drugs and/or vaccines, there is an urgent need for accelerated research and development for*:

• Crimean-Congo haemorrhagic fever (CCHF)
• Ebola virus disease and Marburg virus disease
• Lassa fever
• Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS)
• Nipah and henipaviral diseases
• Rift Valley fever (RVF)
• Zika
• Disease X

Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown “Disease X” as far as possible.

A number of additional diseases were discussed and considered for inclusion in the priority list, including: Arenaviral hemorrhagic fevers other than Lassa Fever; Chikungunya; highly pathogenic coronaviral diseases other than MERS and SARS; emergent non-polio enteroviruses (including EV71, D68); and Severe Fever with Thrombocytopenia Syndrome (SFTS).

These diseases pose major public health risks and further research and development is needed, including surveillance and diagnostics. They should be watched carefully and considered again at the next annual review. Efforts in the interim to understand and mitigate them are encouraged.

Although not included on the list of diseases to be considered at the meeting, monkeypox and leptospirosis were discussed and experts stressed the risks they pose to public health. There was agreement on the need for: rapid evaluation of available potential countermeasures; the establishment of more comprehensive surveillance and diagnostics; and accelerated research and development and public health action.

Several diseases were determined to be outside of the current scope of the Blueprint: dengue, yellow fever, HIV/AIDs, tuberculosis, malaria, influenza causing severe human disease, smallpox, cholera, leishmaniasis, West Nile Virus and plague. These diseases continue to pose major public health problems and further research and development is needed through existing major disease control initiatives, extensive R&D pipelines, existing funding streams, or established regulatory pathways for improved interventions. In particular, experts recognized the need for improved diagnostics and vaccines for pneumonic plague and additional support for more effective therapeutics against leishmaniasis.

The experts also noted that:

• For many of the diseases discussed, as well as many other diseases with the potential to cause a public health emergency, there is a need for better diagnostics.
• Existing drugs and vaccines need further improvement for several of the diseases considered but not included in the priority list.
• Any type of pathogen could be prioritised under the Blueprint, not only viruses.
• Necessary research includes basic/fundamental and characterization research as well as epidemiological, entomological or multidisciplinary studies, or further elucidation of transmission routes, as well as social science research.
• There is a need to assess the value, where possible, of developing countermeasures for multiple diseases or for families of pathogens.

The impact of environmental issues on diseases with the potential to cause public health emergencies was discussed. This may need to be considered as part of future reviews.

The importance of the diseases discussed was considered for special populations, such as refugees, internally displaced populations, and victims of disasters.

The value of a One Health approach was stressed, including a parallel prioritization processes for animal health. Such an effort would support research and development to prevent and control animal diseases minimising spill-over and enhancing food security. The possible utility of animal vaccines for preventing public health emergencies was also noted.

Also there are concerted efforts to address anti-microbial resistance through specific international initiatives. The possibility was not excluded that, in the future, a resistant pathogen might emerge and appropriately be prioritized.

*The order of diseases on this list does not denote any ranking of priority.