flu vaccination. the then minister of health dr. tawfiq bin fawzan al-rabiah received a global award on behalf of the kingdom for combatting smoking through social awareness, treatment, and application of regulations. the award was presented as part of the 72nd session of the world health assembly, held in geneva in may 2019. after becoming one of the first nations to ratify the who framework convention on tobacco control in 2005, it plans to reduce tobacco use from 12.7% in 2017, to 5% in 2030. youth health healthcare in schools until recently fell under the stewardship of the ministry of education. in 2018, the council of ministers transferred healthcare in schools to the health ministry. following this, a thorough check was carried out into the processes at schools for children's health, and health checks for 339,825 pupils in 5,570 schools were implemented. in 2018, this was transferred across to the health ministry. following this move, a thorough check was carried out into the processes at schools for children's health. it was decided that reform on health checks was required and subsequently implemented that all pupils in chosen grade intervals would have health checks. as a wider move to improve health infrastructure in the kingdom, the minister opened a number of new cardiac centers, both for operations and research. the new facilities totaled six by the end of 2018, with performance indicators suggesting heart operation success was up to 96%. due to the kingdom's growing population, the moh launched the newborn screening program, which includes hearing tests and heart examinations, covering up to 96% of the kingdom's babies. other highly specialized services are offered in parallel with the screening program. vision 2030 healthcare and health infrastructure were a key performance indicators for saudi arabia's vision 2030, a program to increase standards across the kingdom in a number of fields. following its introduction in 2013, a number of major milestones were reached. the development of remote health meant that the 937 call center received a total of 3 million calls in 2018, this more than doubled from the 1.4 million the year prior. as part of the ongoing efforts to transform the digital interaction patients have in the country, a new app 'mawid' was introduced to centralize health bookings. 10 million bookings have been made since its introduction, with five million using the app last year. seha was also a success, allowing patients to speak remotely to a doctor or medical professional. it is believed that 300,000 people used the app in 2018 alone. raising the levels of productivity, efficiency, and quality of performance in the provision of health services in hospitals, the ministry is implementing the program «health performance - ada'a» towards achieving the saudi vision 2030, and currently includes 98.8% of hospitals, where more than 40 indicators are used to measure performance in 7 service hubs, wherein positive results were achieved in reducing waiting periods in emergency and outpatient clinics. enhancing traffic safety is one of the kingdom's goals in its 2030 vision. the minister of health is part of a ministerial committee overlooking the implementation of many initiatives and projects in all aspects of traffic safety dimensions, which focuses on enforcement, engineering, education, and emergency response. these efforts resulted in the reduction of fatalities by 33%, injuries by 21%, and motor vehicle accidents by 34% in the last two years. fatalities per 100,000 had been reduced from 28.8 in 2016 to 17.7 in 2018. the kingdom is aiming to be the best in class in road safety by 2030. to strengthen the role of the private sector, the moh has introduced electronic licensing services for medical facilities. prior to the introduction of this license, the process used to take 120 days in many cases. the moh has also enabled the sector to monitor itself through the self-assessment service, followed by inspections of health establishments to ensure that they are free of harmful health practices. alternative care healthcare services in saudi arabia are provided by several public and private agencies. however, the ministry is the major planner and provider of these services. 937 call center in line with the saudi vision 2030, the saudi ministry of health introduced the 937 call center, which uses a toll-free number to provide medical services. the center provides high-quality and immediate emergency assistance to patients as it fulfills their medical needs and requirements. the 937 number was an instant success in the kingdom and by 2017 had reached a million annual medical calls. as the service grew, so did the quality of the medical feedback, with satisfaction ratings increasing 25% in less than one year. once the call center passed one million annual calls, it continued to grow, processing 80,000 calls a week by the end of 2018. the call center can also process and book appointments with a medical professional should it be required, which can be now done digitally since the introduction of a centralized booking system, known as mawid. the system can also be used for referrals for the first time, so physicians can refer patients to a hospital for a specific reason using the system. the most notable thing about this is not the technology, but that it is provided free of charge to saudi arabian citizens. when compared to us services, many similar offerings are privatized and operated by for-profit companies, such as webmd. seha virtual hospital in line with the saudi vision 2030, the saudi ministry of health launched the first virtual hospital in the kingdom. the svh aims to promote virtual healthcare, achieve innovation in the health sector, develop resources and achieve sustainability in addition to achieving institutional excellence. specialized services in the svh include emergency and critical advice, specialized clinics, multidisciplinary committees, medical support services, and home care services. ministry's response to covid-19 by the end of december 2019, china witnessed a widespread of acute pneumonia cases, later known as coronavirus disease 2019 covid-19. thereafter, countries around the world started preparedness and response efforts, in different ways at different times, in an attempt to limit the spread of covid-19. the kingdom of saudi arabia was one of the first countries that started precautionary and preventive measures and anticipated the danger of this disease, which turned into a global pandemic within a short period of time. the kingdom did not limit its efforts to curb covid-19 to the local level, as it also expanded them to the international level, given its political, strategic, and economic roles. these are evident with the kingdom's leadership role during its presidency of the g20 for the year 2020. moreover, several international bodies and media channels praised the kingdom's efforts at the national and international levels to strengthen response, develop a treatment, and ensure the availability of preventive equipment, as well as its $500 million contributions to support global efforts to curb the pandemic. this support is part of the kingdom's commitment to fund international organizations according to the agreements announced at the g20 extraordinary summit initiated by the kingdom. the kingdom of saudi arabia participated in the pledging conference hosted by the european commission and led by the world health organization (who) to advance the work of access to covid-19 tools (act) accelerator, as a member and one of the founders of this landmark global initiative, which espouses the shared commitment of all partners to equitable global access to innovative tools for covid-19 for all. the launch of the act accelerator has catalyzed an unprecedented level of the partnership of key actors and relevant stakeholders across sectors, to align and coordinate efforts in pursuit of the accelerated development, production, and equitable access to new covid-19 diagnosis, therapeutics, and vaccines, thus ensuring that in the fight against covid-19, no one left behind. owing to the experience that the kingdom accumulated over the years in risk management and assessment to secure national and global health, ensure the security and the safety of hajj and umrah pilgrims every year, and develop a highly efficient health system, and to its previous experience in curbing the middle east respiratory syndrome (mers-cov); the kingdom took several early, evidence-based precautionary measures at the highest levels. the kingdom's success in "flattening the epidemic curve", is thanks to the strict measures it took early based on scientific evidence and previous experiences, the attack rate in the country was 9 cases per 1,000 population, tests were conducted at a rate of 13,000 tests per 100,000 population, and the case fatality rate was at 1% compared to 3.47% globally, as of august 23, 2020. although covid-19 has the same origins as mers-cov and the severe acute respiratory syndrome (sars), the development of covid-19 is not yet fully clear. the kingdom's leadership relied on its previous experience with the spread of the mers-cov to take a series of proactive and precautionary measures to curb covid-19 before the first case was confirmed in the country on march 2, 2020. these measures included activating command and control centers (cccs), suspending travel to china, and suspending entry to the kingdom using tourist visas. on 28 february, the minister of foreign affairs of saudi arabia announced the temporary suspension of entry for gulf cooperation council (gcc) citizens to mecca and medina. citizens of the gcc who had been in saudi arabia for more than 14 consecutive days and didn't show any symptoms of the covid-19 would be excluded from this rule. after the first case was confirmed in the kingdom, firm and effective precautionary measures were taken to impose social distancing, and strengthen key capabilities and resources on several fronts for virus containment, prevention, preparedness, detection, and treatment, as part of an integrated national approach to combating the pandemic. some of these measures included the suspension of umrah, education, and all international and domestic flights; the launch of mass field testing; and the expansion of laboratory capacity to conduct over nine million covid-19 tests. on 19 march, saudi arabia suspended the holding of daily prayers and the friday prayers in and outside the two mosques in mecca and medina to limit the spread of coronavirus. similar measures were carried out across the country during the same week. on 20 march, saudi arabia suspended entry and praying to the general public at the two holy mosques in mecca and medina to limit the spread of the coronavirus. other measures included a partial then total curfew in various regions of the kingdom, and the decision to treat all citizens, legal and illegal residents for free without any consequences. the kingdom's position among the g20 countries while the kingdom, chair to the g20 summit for 2020, many of these countries are still recording varying numbers of covid-19 confirmed cases and deaths. the kingdom had the lowest covid-19 case fatality rates at lower than 1%, while italy and france had the highest rate at 15%, and china had a rate of 5%. risk assessment since the beginning of the pandemic, the kingdom has based its decisions on the risk assessment of the covid-19 spread at the international and domestic levels. the "jeddah tool" was used to conduct a strategic assessment of the health risks of umrah and hajj due to the pandemic. this assessment revealed that the risks of umrah were "extremely high". accordingly, a recommendation was made and a decision was issued to suspend umrah. "salem covid tool" was used to assess the health risks of covid-19 in mass gatherings and events, which resulted in the cancellation and suspension of many events before a curfew was imposed. "jeddah" and "salem covid" tools are scientific risk assessment tools that the ministry of health's global center for mass gatherings medicine (gcmgm), a who collaborating center, developed based on scientific methods and reviewed and studied its application several times. precautionary measures the ministry announced several precautionary measures for the general public to limit the spread of covid-19, such as: avoid going out unless necessary stay at home if one suspects having covid-19 symptoms self-isolate at home and report anyone who has symptoms provide educational materials for the community suspend all gatherings and promote the "we are all responsible" campaign ban gatherings in residences, workplaces, and businesses. hajj 2020 - a success story in a success story, hajj for the year 1441 ah (2020g) was organized with great efforts and cooperation of