By Dr Ahmed Al-Mandhari

June 30 marked six months since WHO received the first reports of a cluster of cases of pneumonia of unknown cause in China The six-month mark of the outbreak coincides with reaching 10 million cases and 500,000 deaths world-wide.  Although many countries have made some progress, globally the pandemic is speeding up.

A few days ago, our Region passed its own significant and concerning milestone, with more than one million people now infected with COVID-19. The number of cases reported in June alone is higher than the total number of cases reported during the four months following the first reported case in the Region on 29 January.

Today, three countries make up more than 50% of the total number of cases reported in the Region: Iran, Saudi Arabia, and Pakistan. Recently, increasing numbers of cases are also being reported from Iraq, Libya, Morocco, the occupied Palestinian territory, and Oman. Almost 87% of all deaths reported are from five countries: Iran, Iraq, Saudi Arabia, Egypt and Pakistan.

All countries in the Region are experiencing cluster or community transmission. While fewer cases are being reported from countries facing complex emergencies such as Syria and Yemen, we are working on the assumption that the virus is widespread, and are concerned about the ability of their weakened health system to detect and control its spread.

There are several reasons for this sharp increase over the space of just a few weeks. First, many countries now have more testing capacity than they did at the start of the pandemic, which is leading to more cases being detected. Second, easing of social measures in some countries during and after the month of Ramadan led to an increase of cases in the following weeks. Third, weakened health systems in conflict-affected countries are creating challenges in proper detection, testing and treatment of cases.

In recent weeks, countries have started relaxing lockdowns to resume some economic and social activities in an effort to find a balance between controlling the outbreak and protecting livelihoods. As public spaces begin opening up, there is a real risk that we will continue to see an increase in cases, even in countries where the situation now seems to be stabilizing.

We are at a critical threshold in our Region. Easing of lockdowns does not mean easing of the response or easing of social responsibilities. Governments must aggressively scale up the proven public health measures that we know control the spread of the virus - detection, testing, isolation, treatment and contact tracing - now more than ever before. As airports and border crossing open gradually, governments must continue to apply precautionary measures by enhancing surveillance at points of entries.

Individuals leaving their homes for the first time in months must be more cautious and vigilant, and adopt protection measures recommended by the health authorities. Every decision made by a single person affects us all collectively and can have irreparable consequences.

Our health systems are overwhelmed, our health care workers are exhausted, a large number of people in our region are still vulnerable. There is no option to fail. We must succeed, not just in dealing with this pandemic, but also in responding to other health risks that have plagued our region for years. Six months into the pandemic response, it is more critical than ever that essential services such as immunization programmes and health services for mothers and children continue and are able to properly function without interruption.

WHO is fully committed to our vision of protecting the health of all people, everywhere. And we need to see even more concrete commitments and action from governments and the public as we work together as one to fulfil this goal.