29 May 2024, Aden, Yemen – Nearly US$ 9.5 million in funding has been secured for critical health projects in Yemen – a pivotal step in strengthening the country’s health system. WHO signed the significant agreement with the King Salman Humanitarian Aid and Relief Centre (KSrelief) at the opening of the Seventy-seventh World Health Assembly in Geneva, Switzerland.

The projects funded under the agreement will target 12.6 million people in Yemen across various governorates. Projects will focus on improving access to safe water, preventing the spread of infectious diseases and enhancing the health system’s capacity to respond to outbreaks. These efforts are expected to significantly reduce morbidity and mortality rates and enhance the overall resilience of Yemen’s health infrastructure.

The agreement reflects the ongoing commitment by WHO and KSrelief to address Yemen’s pressing health needs. It was signed by Dr Tedros Adhanom Ghebreyesus, WHO Director-General, and His Excellency Dr Abdullah Al Rabeeah, Supervisor General of KSrelief, in the presence of Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean.

“This agreement signifies a strong partnership and a shared vision for a healthier future for Yemen,” said Dr Arturo Pesigan, WHO Representative to Yemen. “The funding from KSrelief will be invaluable in strengthening our efforts in water, sanitation and hygiene services; acute watery diarrhea response; and measles surveillance and response. This funding will make a substantial difference to the lives of those people most in need.”

Mr. Saleh Al-Theebani, Director of KSrelief's Aden branch, appreciated the partnership between KSrelief and WHO aimed at providing life-saving interventions for the Yemeni people. He emphasized that this new funding is part of the Kingdom of Saudi Arabia's ongoing support to alleviate suffering and ensure access to essential health services across the country

KSrelief has been a steadfast supporter of Yemen for years, providing vital resources and expertise to address the country’s health challenges. Through its cumulative contribution of US$ 320 million to WHO, KSrelief has played a key role in supporting humanitarian and health response operations in Yemen.

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About WHO

Since 1948, the World Health Organization (WHO) has been the United Nations agency dedicated to advancing health for all, so that everyone, everywhere can attain the highest level of health. WHO leads global efforts to expand universal health coverage, direct and coordinate the world’s responses to health emergencies and connect nations, partners and people to promote health, keep the world safe and serve the vulnerable.

About KSrelief

The King Salman Humanitarian Aid and Relief Centre (KSrelief) is a humanitarian aid organization established by the Kingdom of Saudi Arabia. KSrelief is dedicated to coordinating and providing international relief to alleviate suffering and provide essential services to those in need.

Entomological surveillance workshop for malaria in Socotra. Photo credit: M. Al Amoody 25 April 2024, Socotra Island and Tehama region, Yemen – Despite persistent efforts to prevent and control malaria in Yemen, about two thirds of the population remain at risk of the disease.

With World Bank support via the Emergency Human Capital Project (EHCP), WHO implements key interventions to deliver a tailored approach to malaria management at country level in line with the burden of disease. This includes capacity-building for malaria focal points and the rollout of indoor residual spraying campaigns for affected communities and those at risk.

WHO supported an indoor residual spraying campaign in the Tehama region, to cover Yemen’s 2310 highest malaria-burden neighbourhoods, in February 2024. The campaign directly protects more than 540 000 people from malaria and dengue, across 86 000 homes sprayed. It also indirectly protects more than 2 million people in targeted and neighbouring districts.

More than 780 spraying workers, 160 team leaders and 93 field supervisors carried out the campaign. This intervention builds on the last spraying campaign conducted by WHO under EHCP in the same region in November and December 2022.

Some areas of the country, such as Socotra Island, have made tremendous progress, and are working towards the goal of having no local malaria transmission. Socotra started working towards malaria elimination in 2000, with no local cases reported since 2005.

In March 2023, WHO conducted a pre-elimination assessment on the island, in line with WHO guidelines to identify any gaps and boost readiness in case malaria is imported from other parts of the country or abroad. This is a particular risk due to the frequency of tropical cyclones affecting Socotra, as well as the impacts of climate change and the humanitarian situation in Yemen and nearby countries.

>Following this assessment, a training of trainers session was conducted, in February 2024, for 20 malaria staff from Hadhramaut, Marib and Socotra governorates. This sought to enhance their skills in surveillance, diagnosis, case management and vector control.

Soon after the training, in Socotra, reports were received of an imported suspected malaria case. The trained staff moved quickly to implement active case detection – based on the protocol learned at the session – including clinical diagnosis, rapid diagnostic testing, and laboratory confirmation. The case tested positive, having recently travelled to Socotra from Hudaydah, a high-burden governorate. The individual was provided a course of treatment and was followed up until fully recovered.

25 April 2024 – As long as a single child is infected with polio, all unvaccinated children are at risk of contracting the disease. In fragile and conflict-affected contexts, such as Yemen, children can be especially vulnerable. From 2021 to 2023, Yemen reported 237 variant poliovirus type 2 cases – from both circulating vaccine-derived poliovirus type 2 (cVDPV2) and vaccine-derived poliovirus type 2 (VDPV2).

“We didn’t know we were supposed to take [our children] to the hospital to get vaccinated, and I wasn’t aware of the seriousness of these diseases or thinking that any of my children would get sick,” said a mother whose child contracted polio in 2021 and is now paralysed.

One in 4 children in Yemen cannot receive all the recommended vaccinations on the national routine immunization schedule. Indeed, 17% of Yemen’s children are considered zero-dose children – they have received no doses of vaccine. Low vaccination coverage, and increased vaccine hesitancy among parents are among the many factors that contribute to this situation.

Early on 25 February 2024, about 6700 fixed and mobile vaccination teams set out to reach nearly 1.3 million children aged under 5 years with the novel oral polio vaccine type 2 (nOPV2). Working from health facilities and on the streets of the 12 target governorates, the teams were determined to give children the 2 drops of vaccine needed to protect them from the debilitating disease.

Fig. 1. Geographic distribution of laboratory-confirmed variant poliovirus type 2 cases (2021–2023)

Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

Carrying vaccine coolers, the vaccination teams travelled the roads of the targeted cities, their crumbling alleys a sign of the decade of conflict that has affected Yemen. Some areas were easy to access, but others involved arduous journeys to reach vulnerable children.

On the outskirts of cities, congested camps of internally displaced people reflect the impact of the protracted conflict. Dwellings are made of boards and old rugs, and access to safe water, sanitation and hygiene is lacking. Many of the families in the camps once had settled homes; their future is now uncertain.

Mobile vaccination teams find many deprived children as they go door to door, but sometimes the biggest challenge is to convince parents to vaccinate their children. Parents and caregivers are usually positive when teams approach them. But there is increased vaccine hesitancy and refusal among families affected by misinformation coupled with limited health literacy. This has left many children unprotected.

There is no cure for polio; it can only be prevented. The impacts of the conflict and adverse socioeconomic conditions have left many children in Yemen susceptible to the disease.

It is only thanks to parents who wait in long lines at health facilities and vaccination teams who travel long distances to vaccinate children that Yemen’s polio outbreak is not more widespread.

Yemen's Ministry of Public Health and Population carried out the polio immunization activities as part of a national immunization campaign funded by the Global Polio Eradication Initiative and supported by WHO and the United Nations Children’s Fund (UNICEF).

In total, the campaign reached 1.29 million vulnerable children across the 12 governorates. Teams delivered the polio vaccine to the doorstep of every home, shelter and camp in fragile communities to protect children’s health and future. The independent post-campaign monitoring data show that 91% of targeted children were reached during the supplementary immunization activity, with coverage by governorate ranging from 86% to 99%. Refusal was the main reason for children missed during the campaign.

Fig. 2. Immunization coverage rate in targeted governorates (25–28 February 2024)

Multiple doses of polio vaccine offer the best protection to children, especially those living in fragile and conflict-affected settings. The Ministry, WHO and partners will take the lessons learned from this campaign and work with health workers to deliver another vital round of polio vaccine to these same communities in the coming months.

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