Iranian President Ebrahim Raisi and the country’s foreign minister were found dead Monday hours after their helicopter crashed in fog, leaving the Islamic Republic without two key leaders as extraordinary tensions grip the wider Middle East.

Supreme Leader Ayatollah Ali Khamenei, who has the final say in the Shiite theocracy, quickly named a little-known vice president as caretaker and insisted the government was in control, but the deaths marked yet another blow to a country beset by pressures at home and abroad.

The decision by the country’s highest court, the Constitutional Court, may still be appealed. It ruled that Zuma is only eligible to serve as a lawmaker five years after his 2021 sentence for contempt of court was completed.

Zuma is now the leader of a new party, uMkhonto weSizwe Party, and is campaigning against the long-ruling African National Congress he once led.

Analysts say the ANC, which has comfortably held power since Nelson Mandela became the country’s first Black president in 1994, might receive less than 50% of votes in next Wednesday’s election and lose its parliamentary majority.

That would be the ANC’s worst electoral performance since it came into power in South Africa at the end of apartheid.

One reason the ANC is under pressure is Zuma, who stepped down as president in 2018 amid a swirl of corruption allegations and now threatens to draw more support away from the ANC.

Globally, the number of new weekly cases reported during the week of 12 to 18 December 2022 was similar (+3%) to the previous week, with over 3.7 million new cases reported. The number of new weekly deaths was 6% lower than in the previous week, with over 10 400 new fatalities reported. In the last 28 days, over 13.7 million cases and over 40 000 new fatalities were reported globally – a 36% increase and 2% decline, respectively, compared to the previous 28 days. As of 18 December 2022, over 649 million confirmed cases and over 6.6 million deaths have been reported globally.

WHO has updated its living guideline on COVID-19 therapeutics to include convalescent plasma. For non-severe COVID-19 patients, WHO recommends against its use, while it should only be used within clinical trials for severe and critical COVID-19 patients.

Convalescent plasma is a transfusion of blood plasma from someone who has recovered from COVID-19.

Current evidence shows that convalescent plasma does not improve survival or reduce the need for mechanical ventilation, while it has significant costs.

An independent panel of experts, the guidelines development group, looked at pooled data from 16 randomized controlled trials, including 16 236 patients with non-severe, severe, and critical covid-19 infection.

While the evidence that convalescent plasma has no benefit in non-severe patients was certain, it was less so in the case of severe and critically ill patients. So, randomized clinical trials for these subgroups should continue.

• Working with COVAX, African Vaccine Acquisition Trust and other partners – world can and must meet WHO targets to vaccinate 40% of the population of all countries by the end-2021 and 70% by mid-2022
• Vaccine supply gaps to COVAX must be closed immediately for countries to reach the 40% year end target
• United Nations Secretary-General and WHO Director-General call on countries and  manufacturers to make good on their commitments without further delays 

The World Health Organization has today launched the Strategy to Achieve Global Covid-19 Vaccination by mid-2022 (the Strategy) to help bring an end to what has become a two-track pandemic:  people in poorer countries continue to be at risk while those in richer countries with high vaccination rates enjoy much greater protection.

WHO had set a target to vaccinate 10% of every country, economy and territory by the end of September but by that date 56 countries had not been able to do so, the vast majority of these are countries in Africa and the Middle East.

The new strategy outlines a plan for achieving WHO’s targets to vaccinate 40% of the population of every country by the end of this year and 70% by mid-2022.

“Science has played its part by delivering powerful, life-saving tools faster than for any outbreak in history,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “But the concentration of those tools in the hands of a few countries and companies has led to a global catastrophe, with the rich protected while the poor remain exposed to a deadly virus. We can still achieve the targets for this year and next, but it will take a level of political commitment, action and cooperation, beyond what we have seen to date.”

“This is a costed, coordinated and credible path out of the COVID-19 pandemic for everyone, everywhere,” said United Nations Secretary-General Antonio Guterres. “Without a coordinated, equitable approach, a reduction of cases in any one country will not be sustained over time. For everyone’s sake, we must urgently bring all countries to a high level of vaccination coverage.”

To achieve the global vaccination targets, there should be a three-step approach to vaccination, with all older adults, health workers, and high-risk groups of all ages, in every country vaccinated first, followed by the full adult age group in every country and lastly extended vaccination of adolescents.

Vaccinating 70% of the global population requires at least 11 billion vaccine doses.   By the end of September, just over 6 billion doses had already been administered worldwide.  With global vaccine production now at nearly 1.5 billion doses per month, there is sufficient vaccine from a supply perspective to achieve the global vaccination targets provided that there is equitable distribution of those doses. 

Substantial financing has already been invested to procure most of the required vaccine doses for low- and lower-middle-income countries through COVAX, the African Vaccine Acquisition Trust (AVAT) and bilateral contracts.  There needs to be additional investment to secure the remaining vaccine doses for these countries as well as investment to support in-country delivery.  

The Strategy outlines the priority actions needed from the different actors to achieve the targets.

All Countries must:

• Establish updated national COVID-19 vaccine targets and plans defining dose requirements to guide manufacturing investment and vaccine redistribution, and financial and programmatic resource needs to guide internal planning and external support;
• Monitor vaccine demand and uptake carefully to rapidly adapt services and ensure continuity of vaccine supplies;
• Commit to equitable distribution of vaccines in line with the WHO three-step approach;
• Revise national vaccination strategies, policies and prioritization as needed to harness emerging evidence to maximize the impact of existing, modified and new vaccines.

Countries with high vaccine coverage must:

• Swap vaccine delivery schedules, with COVAX and AVAT to enhance coverage in countries in need;
• Fulfil and accelerate vaccine dose-sharing and donation commitments to COVAX in the near term, for those with existing pledges;
• Establish new dose-sharing commitments to facilitate progress toward the 70% coverage target in every country.

Vaccine-producing countries must:

• Allow the free cross-border flow of finished vaccines and raw materials;
• Enable diversified vaccine production, both geographically and technologically, including through non-exclusive, and transparent licensing and sharing of know-how to allow transfer of technology and scale-up of manufacturing.  

COVID-19 vaccine manufacturers must:

• Prioritize and fulfil COVAX and AVAT contracts as a matter of urgency;
• Provide full transparency on the overall monthly production of COVID-19 vaccines and clear monthly schedules for supplies to COVAX, AVAT and low and low-middle income countries, to enable proper global and national-level planning and optimal use of scarce supplies;
• Actively engage and work with countries that have high coverage and that have contracted high volumes of vaccines to allow the prioritization of COVAX and AVAT contracts, including through delivery schedule swaps, and facilitate rapid and early dose-sharing;
• Commit to share know-how more rapidly, facilitate technology transfer and provide transparent non-exclusive voluntary licenses, to ensure that future vaccine supply is reliable, affordable, available, and deployed to every country in volumes and timing that achieves equitable access.

Civil society, community organizations, and the private sector must:

• Advocate locally, nationally and internationally for equitable access to COVID-19 vaccines, tests and treatments, calling for and monitoring in particular the specific actions required of manufacturers, governments and multilateral actors;
• Mobilize and empower communities, including through social media and community networks, to generate strong vaccine demand and address misinformation and misperceptions that contribute to vaccine hesitancy;
• Provide support to the in-country delivery of vaccination programmes and services.

Global and regional multilateral development banks and institutions must:

• Enable countries to more rapidly access the capital and external support needed for in-country vaccine delivery, prioritizing low-income settings and especially targeting support to the technical, logistics and human resources required;
• Engage fully with COVAX/ACT-Accelerator and AVAT, with integrated operations and real-time sharing of information to truly support equitable access;
• Support international procurement and allocation mechanisms to enable all countries to equitably, efficiently and rapidly achieve the COVID-19 vaccine targets;
• Support vaccine distribution plans and a campaign to convey the life-saving importance of approved COVID-19 vaccinations.

For their part, WHO, Gavi, UNICEF and CEPI must work in close collaboration with World Bank, World Trade Organization, International Monetary Fund, Africa CDC, AVAT, and other key partners to monitor progress, identify changes needed to resolve bottlenecks, coordinate information and prioritize actions; continue to co-lead and manage the COVAX Pillar of ACT-Accelerator; support the equitable allocation of available vaccines, particularly to low-, lower-middle-income and lagging countries; directly support countries to develop and sustain rapid, effective, high-quality COVID-19 vaccine delivery programmes that can achieve the global targets; address key research, policy, safety and regulatory issues that will optimize vaccine impact including effective supply, dosing and vaccine schedules, mixing and matching of products, protection against variants, and other issues; and monitor and report monthly on progress towards the global COVID-19 vaccination goals.

The number of adults aged 30–79 years with hypertension has increased from 650 million to 1.28 billion in the last thirty years, according to the first comprehensive global analysis of trends in hypertension prevalence, detection, treatment and control, led by Imperial College London and WHO, and published today in The Lancet. Nearly half these people did not know they had hypertension.

Hypertension significantly increases the risk of heart, brain and kidney diseases, and is one of the top causes of death and disease throughout the world. It can be easily detected through measuring blood pressure, at home or in a health centre, and can often be treated effectively with medications that are low cost.

The study, conducted by a global network of physicians and researchers, covered the period 1990–2019. It used blood pressure measurement and treatment data from over 100 million people aged 30–79 years in 184 countries, together covering 99% of the global population, which makes it the most comprehensive review of global trends in hypertension to date.

By analysing this massive amount of data, the researchers found that there was little change in the overall rate of hypertension in the world from 1990 to 2019, but the burden has shifted from wealthy nations to low- and middle-income countries. The rate of hypertension has decreased in wealthy countries – which now typically have some of the lowest rates – but has increased in many low- or middle-income countries.

As a result, Canada, Peru and Switzerland had among the lowest prevalence of hypertension in the world in 2019, while some of the highest rates were seen in the Dominican Republic, Jamaica and Paraguay for women and Hungary, Paraguay and Poland for men. (See notes to editors for country breakdowns/rankings).

Although the percent of people who have hypertension has changed little since 1990, the number of people with hypertension doubled to 1.28 billion. This was primarily due to population growth and ageing. In 2019, over one billion people with hypertension (82% of all people with hypertension in the world) lived in low- and middle-income countries.

What to do to keep yourself and others safe from COVID-19

• Maintain at least a 1-metre distance between yourself and others to reduce your risk of infection when they cough, sneeze or speak. Maintain an even greater distance between yourself and others when indoors. The further away, the better.
• Make wearing a mask a normal part of being around other people. The appropriate use, storage and cleaning or disposal are essential to make masks as effective as possible.

Here are the basics of how to wear a mask:

• Clean your hands before you put your mask on, as well as before and after you take it off, and after you touch it at any time.
• Make sure it covers both your nose, mouth and chin.
• When you take off a mask, store it in a clean plastic bag, and every day either wash it if it’s a fabric mask, or dispose of a medical mask in a trash bin.
• Don’t use masks with valves.

• For specifics on what type of mask to wear and when, read our Q&A and watch our  videos. There is also a Q&A focused on masks and children.
• Find out more about the science of how COVID-19 infects people and our bodies react by watching or reading this interview.
• For specific advice for decision makers, see WHO’s technical guidance.

 How to make your environment safer

• Avoid the 3Cs: spaces that are closed, crowded or involve close contact.
  • Outbreaks have been reported in restaurants, choir practices, fitness classes, nightclubs, offices and places of worship where people have gathered, often in crowded indoor settings where they talk loudly, shout, breathe heavily or sing.
  • The risks of getting COVID-19 are higher in crowded and inadequately ventilated spaces where infected people spend long periods of time together in close proximity. These environments are where the virus appears to spread by respiratory droplets or aerosols more efficiently, so taking precautions is even more important.
• Meet people outside. Outdoor gatherings are safer than indoor ones, particularly if indoor spaces are small and without outdoor air coming in.
  • For more information on how to hold events like family gatherings, children’s football games and family occasions, read our Q&A on small public gatherings.
• Avoid crowded or indoor settings but if you can’t, then take precautions:
  • Open a window. Increase the amount of ‘natural ventilation’ when indoors.
  • WHO has published Q&As on ventilation and air conditioning for both the general public and people who manage public spaces and buildings.
  • Wear a mask (see above for more details).

Don’t forget the basics of good hygiene

• Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water. This eliminates germs including viruses that may be on your hands.
• Avoid touching your eyes, nose and mouth. Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and infect you.
• Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately into a closed bin and wash your hands. By following good ‘respiratory hygiene’, you protect the people around you from viruses, which cause colds, flu and COVID-19.
• Clean and disinfect surfaces frequently especially those which are regularly touched, such as door handles, faucets and phone screens.

What to do if you feel unwell

• Know the full range of symptoms of COVID-19. The most common symptoms of COVID-19 are fever, dry cough, and tiredness. Other symptoms that are less common and may affect some patients include loss of taste or smell, aches and pains, headache, sore throat, nasal congestion, red eyes, diarrhoea, or a skin rash.
• Stay home and self-isolate even if you have minor symptoms such as cough, headache, mild fever, until you recover. Call your health care provider or hotline for advice. Have someone bring you supplies. If you need to leave your house or have someone near you, wear a medical mask to avoid infecting others.
• If you have a fever, cough and difficulty breathing, seek medical attention immediately. Call by telephone first, if you can and follow the directions of your local health authority.
• Keep up to date on the latest information from trusted sources, such as WHO or your local and national health authorities. Local and national authorities and public health units are best placed to advise on what people in your area should be doing to protect themselves.

• Amid a global pandemic, unprecedented needs and growing insecurity, aid workers and health-care responders are staying and delivering to the world’s most vulnerable people.
• Last year was the most violent on record for humanitarians, with 483 attacked, 125 killed, 234 wounded and 124 kidnapped. The UN condemns all attacks on humanitarians.
• OCHA and partners present the inspiring stories of humanitarian #RealLifeHeroes who are stepping up to meet the challenges.

Today, World Humanitarian Day, the world honours all humanitarians – many working in their own communities – who are going to extraordinary lengths in extraordinary times to help women, men and children whose lives are upended by crises and the global COVID-19 pandemic.

The dedication, perseverance and self-sacrifice of these real-life heroes represent the best of humanity as they respond to the COVID-19 crisis and the massive increase in humanitarian needs it has triggered.

First responders are often people in need themselves — refugees, members of civil-society organizations and local health workers. They bring food, shelter, health care, protection and hope to others amid conflict, displacement, disaster and disease.

But humanitarian workers are being tested like never before, struggling with unprecedented movement restrictions and insufficient resources as needs are outpacing funds.

And all too often, they risk their own lives to save the lives of others.

In recent weeks alone, despicable attacks have killed aid workers in Niger and Cameroon, and since the onset of the pandemic, scores of health workers have come under attack across the world.

According to Humanitarian Outcomes’ Aid Worker Security Database, major attacks against humanitarians last year surpassed all previous years on record. A total of 483 relief workers were attacked, 125 killed, 234 wounded and 124 kidnapped in 277 separate incidents. This is an 18 per cent increase in the number of victims compared to 2018.

This is the eleventh World Humanitarian Day, designated by the UN General Assembly. It falls on the day of the attack on the UN compound in Baghdad on 19 August 2003, which claimed the lives of 22 people including the Secretary-General's Special Representative for Iraq, Sergio Vieira de Mello. Since then, nearly 5,000 humanitarians have been killed, wounded or abducted, and the 2010-2019 decade experienced a 117 per cent increase in attacks compared to 2000-2009.

A surge in attacks against health workers was recorded in 2019, including strikes against medics in Syria and shootings of Ebola workers in the Democratic Republic of the Congo (DRC).

Most of the attacks occurred in Syria, followed by South Sudan, DRC, Afghanistan and the Central African Republic. Mali and Yemen both saw a doubling of major attacks from the previous year. The UN condemns these attacks, and it calls for accountability for perpetrators and justice for survivors. Relief workers cannot be a target.

Mark Lowcock, the Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, said: “To humanitarian workers everywhere doing important, courageous work on the front lines we say Thank You. You are saving lives every day, and as new challenges and crises are piling on to existing ones, your perseverance is an inspiration. Your protection is also paramount to making sure we can deliver to people most in need. The best way to pay tribute to humanitarian workers is by funding their work and ensuring their safety.”

This year's World Humanitarian Day comes as the world fights the COVID-19 pandemic. To pay tribute to the efforts of humanitarians, OCHA and its partners present the personal stories of some of the #RealLifeHeroes who are stepping up to meet the challenges, particularly local humanitarian workers.

They include refugees who as health workers are playing essential roles in the pandemic response; Ebola health workers who are stepping in to fight COVID-19; and doctors and nurses who continue to provide critical health care to women and children.