We start with a few events from late last week (and weekend).
ACT-Accelerator update (26 June)
HPW - Massive Mobilization Of US $31.3 Billion Required For COVID-19 Diagnostics, Drugs & Vaccines Accelerator
https://healthpolicy-watch.news/massive-mobilization-of-us-31-3-billion-required-for-covid-19-diagnostics-drugs-vaccines-accelerator/
From late last week. “
The World Health Organization aims to raise a whopping US $31.3 billion to fund the ambitious goals of the Access to COVID-19 Tools (ACT) Accelerator; a multi-stakeholder initiative that aims to develop and deploy diagnostics, drugs, and vaccines to control the virus. But so far, only $US 3.4 billion has been pledged towards the initial goals. And US $13.7 billion is ‘urgently needed’ in order to cover immediate needs, according to an investment case released by WHO on Friday. …. The funding will go toward: Scaling up development and delivery of 500 million diagnostic tests to low- and middle-income countries (LMICS) by mid-2021; Delivering 245 million courses of treatments to LMICs by mid-2021; Delivering 2 billion vaccine doses, of which 50% will go to LMICs by the end of 2021….”
The Four Investment Pillars Require Urgent Funding. As a reminder, the ACT Accelerator operates under
four main pillars –
diagnostics, therapeutics, vaccines, and the health systems connector.
“ A
massive effort led by the World Health Organization (WHO) to fast-track the development of COVID-19 vaccine, treatments, and diagnostics—and make them available to countries that need them most—released its production targets today and the price tag needed to produce and deliver the items, which totals $31.3 billion….” As well as
timelines.
(as a reminder), “
The WHO, backed by several world leaders and global health groups, first launched the COVID-19 countermeasure scale-up effort on April 24 in response to a call from G20 leaders in March. Known as the Access to COVID-19 Tools (ACT) Accelerator, the effort was backed by several countries and regional organizations, as well as groups including the Bill and Melinda Gates Foundation. However, several big countries did not participate, including the United States, China, India, and Russia. … … … At a technical meeting today, the ACT-Accelerator published its investment case, which is to speed development, equitable allocation, and scaled up delivery to low- and middle-income countries (LMICs) of 500 million diagnostic tests by the middle of 2021, 245 million treatment courses by the middle of 2021, and 2 billion vaccine doses—half to LMICs—by the end of 2021….”
“…
ACT-Accelerator activities are led by partner organizations and are grouped under four pillars. For example, the diagnostics pillar is led by the Foundation for Innovative and New Diagnostics (FIND) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, the therapy one is led by Unitaid and Wellcome Trust, and the vaccine one by Coalition for Epidemic Preparedness Innovations (CEPI) and GAVI, the Vaccine Alliance….”
“…
the World Health Organization and key partners unveiled a plan Friday to purchase 2 billion doses of Covid-19 vaccines for the highest risk populations of the world. The plan anticipates that by the end of 2021, the doses could be delivered to countries to vaccinate high risk individuals, likely including health care workers, people over the age of 65, and other adults who suffer from conditions like diabetes. The WHO and its partners — the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi, the Vaccine Alliance — estimate it will cost $18.1 billion to deliver on the plan. The effort is one pillar of the WHO’s effort to ensure all countries have access to Covid-19 vaccines, therapeutics, and diagnostics, called the ACT Accelerator, short for Access to Covid-19 Tools….”
Key links:
WHO -
ACT-Accelerator Investment Case (26 June)
WHO - Act-Accelerator update
https://www.who.int/news-room/detail/26-06-2020-act-accelerator-update
WHO’s press release on the published
investment cases.
Couldn’t find an investment case for the (fourth) “health systems” pillar, though…
Covid-19 Pledging summit (27 June)
Reuters - Global COVID-19 fundraising meeting raises $6.9 billion, leaders want vaccine for all
https://uk.reuters.com/article/uk-health-coronavirus-eu-vaccine/global-covid-19-fundraising-meeting-raises-6-9-bln-leaders-want-vaccine-for-all-idUKKBN23Y0RZ
“
A global fundraising meeting on Saturday raised 6.15 billion euros ($6.9 billion) from the United States, the European Commission and numerous countries to fight COVID-19, with many participants stressing that an eventual vaccine should be available to anyone who needs it. The Commission together with the European Investment Bank pledged 4.9 billion euros ($5.50 billion), the United States $545 million, Germany 383 million euros, Canada C$300 million ($219 million)and Qatar $10 million. Forty governments took part in the summit….”
For a full
breakdown of the pledges, see
the EC -
Coronavirus Global Response: Breakdown of the pledges made today in the ‘Global Goal' Summit
Good to know perhaps: “…
over $1.5B in Cash Grants and $5.4B in Loans and Guarantees for a Total of $6.9B Pledged for COVID-19 Relief. …” Ahum.
See also
Global Citizen -
'Global Goal: Unite for Our Future' mobilized over $6.9 billion to help the world’s most vulnerable.
Et pour la petite histoire, « The Rock » (Dwayne Johnson) was hosting the event. See a
Devex analysis ahead of the pledging event -
Rockers and The Rock unite to boost COVID-19 funding momentum.
Kristof Decoster (blog) - “Global health” is wasting the corona moment
http://kdecoster.blogspot.com/2020/06/global-health-is-wasting-corona-moment.html
My assessment of the current corona moment and how global health, so far, fails to seize it. See also the intro of this week. Our “global health financing toolbox” still seems, by and large, stuck in the neoliberal/Third Way MDG era. Anybody who believes that will suffice to deal with the challenges of the 21
st century (not the least the climate emergency & widespread populism) can raise his/her hands. PS: that would include the fans of ‘Team Europe’.
Covid key news – 6 months, more than 10 million cases, half a million deaths, still accelerating… and “the worst is yet to come” (Tedros)
With among others, a focus on pandemic trends and key messages from WHO this week, but also some of the other key UN & other updates.
Cidrap News - Global COVID-19 cases pass 10 million, deaths top half million
https://www.cidrap.umn.edu/news-perspective/2020/06/global-covid-19-cases-pass-10-million-deaths-top-half-million
From earlier this week (29 June): “
Global COVID-19 numbers crossed two grim thresholds yesterday, with cases passing 10 million and deaths topping 500,000, with cases still rising in a number of hot spots and countries that have controlled their outbreaks battling pockets of resurgence…. ”
For recent
data visualizations, see also the
FT tracker :
Among others, "
Latin America now accounts for 52% of average global deaths from #Covid19"
And a more
recent global update from Cidrap News (July 1) -
Huge daily jump pushes global COVID-19 total past 10.5 million
“
With the world total now topping 10.5 million COVID-19 cases, pandemic activity continues to accelerate, with more than 160,000 cases a day reported each day this past week, the head of the World Health Organization (WHO) said today. Global cases have risen to 10,538,577, and 512,689 people have died from their infections, according to the Johns Hopkins online dashboard. As a media briefing today, WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said 60% of the world's COVID-19 cases have been reported in the past month. …”
Telegraph – 'Long, hard road' ahead on Covid-19 for many countries, WHO warns
https://www.telegraph.co.uk/global-health/climate-and-people/long-hard-road-ahead-covid-19-many-countries-warns/
“"Some countries have not used all the tools at their disposal and have taken a fragmented approach," Tedros said. "These countries face a long, hard road ahead." … …
Presenting figures demonstrating once again that the virus is only accelerating as it spreads to new parts of the globe, around six months after it first erupted in China, Dr Tedros …”
PS: and via
the Guardian - The World Health Organization has warned that the Middle East is at a “critical threshold” in the pandemic after the region reached 1 million cases. See also
Cidrap News on the situation in the Middle East.
And
M Ryan on what it means ‘to learn to live with Covid 19’
: “Every person needs to look at their #COVID19 risk.””
Economist Briefing – Covid-19 is here to stay. The world is working out how to live with it
https://www.economist.com/international/2020/07/04/covid-19-is-here-to-stay-the-world-is-working-out-how-to-live-with-it
“People will have to change their behaviour to prevent second waves of the virus.”
Reuters - WHO sending team to China to investigate origins of coronavirus
https://uk.reuters.com/article/uk-health-coronavirus-who-origins/who-sending-team-to-china-to-investigate-origins-of-coronavirus-idUKKBN2402DC
“
The World Health Organization is sending a team to China next week to investigate the origins of the novel coronavirus, its head Tedros Adhanom Ghebreyesus told a briefing on Monday.”
But as
Yanzhong Huang said on Twitter, don’t expect too much, it’s probably just ‘health diplomacy’.
More detail on (the background of) this story via
HPW -
World Health Organization Will Send Mission To China To Investigate COVID-19 Origins
Telegraph - No excuse for poor contact tracing, says WHO, as pandemic reaches grim six-month milestone
https://www.telegraph.co.uk/global-health/science-and-disease/no-excuse-poor-contact-tracing-says-pandemic-reaches-grim-six/
“
Pandemic is "not even close" to being over, warns WHO chief.” (see also
Reuters )
“
Describing contact tracing as difficult is a "lame excuse", World Health Organization chief Dr Tedros Adhanom Ghebreyesus said, as he warned many countries were not doing enough to get a handle on the virus six months on. The WHO director general pointed to the rigorous contact tracing that was carried out in the North Kivu region of Democratic Republic of Congo during its Ebola outbreak, which was declared over last week. At one point this active conflict zone saw more than 25,000 contacts reached each day. Dr Tedros told a press briefing: “Trust me, there is no excuse for contract tracing. If you can do contact tracing in that situation, doing contact tracing in stable countries should not come as such an issue.”…”
“However, so far only a handful of countries have managed to pull off contact tracing successfully, said Dr Michael Ryan, Executive Director of the WHO Health Emergencies Programme….”
WHO - WHO Director-General's opening remarks at the media briefing on COVID-19 - 29 June 2020
https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---29-june-2020
He
listed the five priorities that every country must focus on to save lives.
And also:
On the
updated timeline: “Today, we are
publishing an updated and detailed timeline of WHO’s response to the pandemic on our website, so the public can have a look at
what happened in the past six months in relation to the response….”
And a sobering remark: “…
We all want this to be over. We all want to get on with our lives. But the hard reality is: this is not even close to being over. Although many countries have made some progress, globally the pandemic is actually speeding up. We’re all in this together, and we’re all in this for the long haul….”
WP - The coronavirus is jeopardizing a ‘very, very finite’ workforce: Africa’s doctors and nurses
https://www.washingtonpost.com/world/africa/africa-coronavirus-doctors-nurses-health-care-workers/2020/06/25/ebf19256-b4ac-11ea-9b0f-c797548c1154_story.html
“
The coronavirus pandemic has tightened its grip on much of Africa, where reported cases have more than tripled over the last month, jeopardizing overstretched medical teams as the need for care soars. … Now African health officials and medical professionals are raising concerns about cracks in a crucial armor: Infections among health-care workers have shot up 203 percent since late May, according to the World Health Organization’s Africa arm, following a spike in community transmission and a drop in access to protective gear. … … The trends have alarmed epidemiologists at the Africa Centers for Disease Control and Prevention, who warned in a June report that most countries face a “catastrophic shortage” of medical professionals. … … Africa carries a disproportionately small fraction of the world’s caseload, though testing remains limited in some areas. But with infections on the rise, health leaders say medical staffs are up against growing obstacles to fend off worst-case scenarios — particularly in West Africa. Funds are often tight….”
PS: Via the Guardian –
WHO Afro (Mrs Moeti) -
WHO official says no large hidden toll in Africa
“
The World Health Organization has said it does not believe African countries are harbouring a significant number of unrecorded coronavirus infections, though it said there may be underestimates in some places….”
WP - Latin America’s coronavirus crisis is only getting worse
https://www.washingtonpost.com/world/2020/06/26/latin-america-coronavirus-crisis/
Focus on
overall picture in Latin America, with Brazil & Mexico, obviously but also other countries in the region (including the rapidly deteriorating situation in Chile).
And a link -
Telegraph Latin America’s flu season has started. Could there be a ‘double whammy’ of Covid-19 and influenza?
“
So far, Covid lockdowns have also limited the spread of flu. But there are concerns that, once lifted, influenza infections will spiral.”
Guardian - More young people infected with Covid-19 as cases surge globally
https://www.theguardian.com/world/2020/jun/26/more-young-people-infected-with-covid-19-as-cases-surge-globally
“…
The age profile of new infections in the coronavirus pandemic appears to be younger following resurgences in countries such as the United States, Israel and Portugal linked to greater social contact among under 40s following the loosening of restrictions. … … The trend has been most marked in the US and noted by scientists at the World Health Organization, who have also seen infections of younger people in the developing world contributing to the shifting demographics….
… While some of the change can be explained by better and more extensive testing picking up more mild cases, other experts suggest that while older age groups have remained more cautious about shielding that has not been reflected in the behaviour of younger people….”
Stat News- New journal will vet Covid-19 preprints, calling out misinformation and highlighting credible research
https://www.statnews.com/2020/06/29/new-journal-vet-covid-19-preprints/
“…On Monday, the MIT Press is announcing the launch of an open access journal that will publish reviews of preprints related to Covid-19, in an effort to quickly and authoritatively call out misinformation as well as highlight important, credible research…..”
“…The closest similar effort went live in April at Johns Hopkins University, where epidemiologist Emily Gurley and pathologist Kate Grabowski launched the 2019 Novel Coronavirus Research Compendium. Its 50 volunteers, mostly from Hopkins, include experts in mathematical modeling, diagnostics, vaccines, and related fields. Using keyword searches, they select new studies, both preprints and those published in journals, that they think contain important information for clinicians and policymakers. Postdoctoral fellows and graduate students summarize the paper’s findings, and flag its strengths and limitations. Two Hopkins faculty members vet and edit the reviews, which recently passed 220….
UN News - Hard times forecast for global job recovery in 2020, warns UN labour agency chief
https://news.un.org/en/story/2020/06/1067432
“The impact of the COVID-19 crisis on jobs has been much worse than expected initially, the head of the UN labour agency said on Tuesday, in an appeal to Governments, workers and employers, to agree on a sustainable economic recovery plan to reduce inequalities laid bare by the pandemic….”
UN News - Pause before sharing, to help stop viral spread of COVID-19 misinformation
https://news.un.org/en/story/2020/06/1067422
“The UN is asking people to make the same judgement calls they’ve been applying to social distancing, to social media, and take extra care before sharing. That’s the latest message from the United Nations’ Verified initiative, which wants people around the world to pause before sharing emotionally charged content on social media….”
UNGA - Omnibus Resolution on the COVID-19 Pandemic
https://www.un.org/pga/74/2020/06/23/omnibus-resolution-on-the-covid-19-pandemic/
The Office of the President of the #UN General Assembly has released the revised version of the Omnibus Resolution on the #COVID-19 Pandemic.
For some analysis, see also
South Centre - The UN General Assembly Resolutions on COVID-19: Solemn Assurances for Access to Health Technologies without an Action Plan
UN News – Stalled Security Council resolution adopted, backing UN’s global humanitarian ceasefire call
https://news.un.org/en/story/2020/07/1067552
“The Security Council on Wednesday echoed the Secretary-General’s call for a worldwide ceasefire, to combat the coronavirus pandemic that has already claimed more than half a million lives. The UN chief welcomed the long-awaited move, calling for countries to "redouble their efforts for peace". Unanimously adopting resolution 2532 (2020) on Wednesday, the 15-member peace and security body demanded “a general and immediate cessation of hostilities in all situations, on its agenda.”…”
Better late than never.
Devex - Look to WHO, experts say, as US Senate searches for pandemic response solutions
https://www.devex.com/news/look-to-who-experts-say-as-us-senate-searches-for-pandemic-response-solutions-97603
“As the Trump administration continues to consider withdrawing from the World Health Organization, the Senate Committee on Foreign Relations heard from experts about how the U.S. should approach pandemic response. Their message: Stay and reform WHO….”
“President Donald Trump has said that the U.S. will terminate its relationship with WHO. The latest reports are that the administration intends to move forward with withdrawal and is believed to be drafting a letter to that effect. Proposals from the administration and Congress have proposed potential new entities to tackle global health security, but most of the experts at the hearing said the U.S. should avoid trying to create any parallel structures and rather look to reform WHO and improve its response capabilities. They also recommended that the U.S. take a measured approach to internally reorganizing efforts to ensure that implementing agencies retain control and appropriate significantly more funding….”
Do read also how the experts perceive WHO’s Health Emergency Program, and the need for a lot more funding for WHO.
WP - Everyone will be affected by the U.S.'s withdrawal from the WHO
Dr. Tedros;
https://www.washingtonpost.com/opinions/2020/07/01/everyone-will-be-affected-by-us-withdrawal-who/
In an op-ed, Dr. Tedros hopes “
the United States will keep working with the WHO so we can jointly continue the important progress we have made. There is so much more we can do together.”
Cfr a tweet B Meier: “
With millions of lives depending on @WHO, it is inspiring to see @DrTedros fighting to engage the US in #InternationalCooperation for #Health — in the #COVID19 response & across #GlobalHealth efforts.”
WHO’s 2nd research & innovation Forum (Wednesday)
UN News -
https://news.un.org/en/story/2020/07/1067562
“
WHO convened its second research and innovation forum on Wednesday, bringing together more than 1,000 scientists from all over the world to take stock of the progress made so far, discuss new research questions and knowledge gaps, and to define research priorities, going forward. Research and innovation have played a vital role since the beginning of the pandemic – and even before, said the WHO chief: “We have a shared responsibility to ensure that all people have access to the tools to protect themselves, especially those who are most at risk.”…”
“
Among the takeaways from a large COVID-19 research and innovation meeting led by the World Health Organization (WHO) this week, the vaccine pipeline is healthy and scientists are eager to learn more about the impact of social distancing and other nonpharmaceutical interventions….”
Quote: “…
the conference also found that bulk of the research was taking place in high income countries, Swaminathan said. There was recognition that research must be geared towards low and middle income countries, while also involving researchers and institutions from these countries….”
Other updates/analysis on Covid access to vaccines, medicines, oxygen…
Devex - COVID-19: Countries race to strengthen compulsory licensing legislation
https://www.devex.com/news/covid-19-countries-race-to-strengthen-compulsory-licensing-legislation-97595
“
Given the uncertainty over access to treatments for COVID-19, several countries have been laying the legislative groundwork to issue compulsory licenses for products that patent holders refuse to make accessible. … … Ecuador and Chile have taken initial steps, though compulsory licensing is not only a tool of low- and middle-income countries. Germany, Canada, and France are also preparing to make issuing compulsory licenses easier, if that becomes necessary, and Israel has already issued one to allow the country to import a generic coformulation of lopinavir and ritonavir, an early COVID-19 treatment candidate that has since been proven ineffective. … … The goal now, said Sergey Golovin, intellectual property and access lead with the International Treatment Preparedness Coalition in Eastern Europe and Central Asia, is to convince governments of low- and middle-income countries that do not have critical legislation in place to begin the process of drafting or adopting it…..”
… Compulsory licenses are not the only flexibilities identified by trade agreements. In South Africa, the activist group Section 27 is calling for the introduction of an examination board that is authorized to use strict criteria for evaluating whether a new patent on an existing product is merited and, if not, to reject a local application. … … Countries could also begin establishing parallel importation schemes, which allow officials to import and resell patented drugs from another country where they may be on sale for less than the price set by the patent holder — because of competitive pressures or subsidies, for example. ….”
Devex - Crafting a framework for Africa's COVID-19 vaccine access
https://www.devex.com/news/crafting-a-framework-for-africa-s-covid-19-vaccine-access-97578
Excellent report and analysis of the
virtual vaccine summit (24-25 June) last week. Must-read.
“
The African Union hosted a virtual conference on the continent's leadership role in developing a COVID-19 vaccine, with equity and accessibility at the forefront of conversations.”
“…
Drastic measures to contain the spread of COVID-19, such as strict lockdowns, are not sustainable on many parts of the African continent because of crowded living conditions and the need to keep economies afloat. That’s why an effective vaccine is one of the best chances African countries have to return to normalcy, experts said this week. … … “A COVID vaccine would allow member states to return to a fully functional economy and society,” said Dr. John Nkengasong, director of the Africa Centres for Disease Control and Prevention, during a virtual two-day conference focused on the role the continent hopes to play in the development, production, and distribution of future coronavirus vaccines.
… “Unless we act now, Africa is at risk of being left behind in the global vaccine,” Nkengasong said.
Some of the challenges leaders on the continent face include raising funds to pay for vaccines, strengthening local manufacturing, increasing the number of local clinical trials, and ensuring communities actually want to be vaccinated. … … The conference, attended by government ministers, African Union and World Health Organization officials, researchers, private sector representatives, among others, was a first step toward creating a continent-wide framework on vaccines. The African Union plans to launch its official strategy in the coming weeks.
… … There are several global mechanisms in place to increase access to future COVID-19 vaccines. This includes WHO’s ACT Accelerator, which is an end-to-end effort to hasten the development of vaccines, and its COVID-19 Technology Access Pool. There is also the COVID-19 Global Vaccine Access Facility, headed by Gavi, the Vaccine Alliance, which aims to pay pharmaceutical companies upfront for doses of future vaccines. The facility would allow for pooled procurement of vaccines between high-, middle- and low-income countries, allowing for equitable distribution. But these mechanisms still don’t have the widespread support they need to ensure equitable access once vaccines are available, so African nations should also mobilize capital from global donors, as well as domestic resources, to secure an adequate supply of vaccines, Nkengasong said. They should also negotiate directly with manufacturers or countries that have the adequate manufacturing capacity, such as China or the United States.
The African Export-Import Bank is also in discussions with major donor agencies about providing market availability guarantees to help ensure equitable access to vaccines, said Benedict Oramah, the bank’s president….”
Geneva Health Files - WHO’s Allocation Framework on COVID19 health products
P Patnaik;
https://genevahealthfiles.wordpress.com/2020/06/27/whos-allocation-framework-on-covid-19-health-products/
Must-read analysis. Priti Patnaik zooms in on the
WHO Allocation Framework (released last week by WHO), and had a related
Q&A with Achal Prabhal, expert on access to medicines issues.
Science News - The line is forming for a COVID-19 vaccine. Who should be at the front?
https://www.sciencemag.org/news/2020/06/line-forming-covid-19-vaccine-who-should-be-front
“
U.S. and World Health Organization are already debating how to prioritize the initial distribution of a coveted vaccine.”
Cfr a tweet Soumya Swaminathan (WHO): “
Initial supply of #COVID19 vaccine is going to be limited - the world must agree on a fair and equitable distribution mechanism, to reduce mortality & protect the vulnerable.”
Telegraph - More than $8.5bn committed to finding drugs and vaccines to fight coronavirus
https://www.telegraph.co.uk/global-health/science-and-disease/85bn-committed-finding-drugs-vaccines-fight-coronavirus/
“US government is biggest funder of research but breakthroughs are likely to take some time.”
“Nearly $8.5 billion has so far been committed to finding diagnostics, treatments and vaccines to battle Covid-19, the fastest ever scale-up of research and development to fight an infectious disease. “
“The Covid-19 R&D tracker, put together by the global health think tank Policy Cures Research, has identified more than 850 product candidates in development to fight the virus with by far the greatest investment being made in vaccines. …. Some $4.9bn has been committed to vaccines, compared to $1bn for therapeutics and $731m for diagnostics. The rest of the funding is not specified. Governments are the major funders with the single biggest donor to R&D efforts being the United States government which has pledged nearly $3.4bn. This is followed by Germany which has committed just over $1bn. The UK is the third largest funder and has committed just over $700m. The UK’s biggest single donation is of $49m which has gone to the Covid-19 Therapeutics Accelerator, which is aiming to speed up the development of new drugs. … … China has committed nearly $300m but the tracker also reveals that many smaller, low and middle income countries have also committed to fight the virus.
… for drugs and treatments the picture is less promising, the tracker reveals. So far only one anti-viral - remdesivir - has been conditionally approved by a regulatory authority, and most of the drugs being studied are existing treatments….”
TWN - COVID-19 vaccines: EU prioritises preferential access, paying lip-service to global solidarity
https://twn.my/title2/health.info/2020/hi200609.htm
Analysis by S Shashikant et al.
TWN - COVID-19: Global Concern that Gavi’s Vaccine Initiative Promotes Inequitable Access
https://www.twn.my/title2/health.info/2020/hi200611.htm
More analysis by S Sashikant (TWN). “
The proposal by Gavi, the Vaccine Alliance to create a facility that will enter into advance purchase agreements with pharmaceutical companies guaranteeing the purchase of vaccines, has generated significant global concerns about its impact on equitable access for populations especially in developing countries….”
GAVI Q&A with Seth Berkley – What is the Covax Pillar, why do we need it and how will it work?
https://www.gavi.org/vaccineswork/gavi-ceo-dr-seth-berkley-explains-covax-pillar
Seth Berkley on 6 questions.
Economic Times - Over 100 global leaders appeal to declare covid-19 vaccines a common good
Economic Times;
“Over 100 global leaders, thinkers and industrialists … …have joined Nobel peace prize winner Muhammad Yunus in an appeal to declare Covid-19 vaccines a global common good so that the vaccines can be produced and distributed for free.”
“About 18 Nobel winners, 32 former chief of state and governments, political leaders, international NGOs and institutions have signed the call initiated by Yunus Centre of Bangladesh….”
Reuters - CanSino's COVID-19 vaccine candidate approved for military use in China
https://www.reuters.com/article/us-health-coronavirus-china-vaccine-idUSKBN2400DZ
“China’s military has received the greenlight to use a COVID-19 vaccine candidate developed by its research unit and CanSino Biologics (6185.HK) after clinical trials proved it was safe and showed some efficacy, the company said on Monday. The Ad5-nCoV is one of China’s eight vaccine candidates approved for human trials at home and abroad for the respiratory disease caused by the new coronavirus. The shot also won approval for human testing in Canada. China’s Central Military Commission approved the use of the vaccine by the military on June 25 for a period of one year, CanSino said in a filing. …”
With some early comments & analysis, via Twitter:
Tweets Helen Branswell (Stat):
- China gives first emergency use approval for a #Covid19 vaccine, allowing CanSino's adenovirus vectored vaccine to be used by the military. There is already evidence this vaccine may not work that well in some people. (see next tweet)
- The Phase 1 trial of the CanSino #Covid19 vaccine showed a problem experts expected was indeed an issue with this vaccine. A lot of people have pre-existing immunity to the adenovirus used as the backbone of this vaccine. They don't get as good a take.
- Former @US_FDA head @ScottGottliebMD assesses the thought process behind China's decision to deploy the CanSino #Covid19 vaccine in the military based on data to data: Some protection is better than none. “ China's goal was always shots in arms. Their bet is that even a partially protective Covid vaccine is going to be sufficient to restore confidence and restart economic activity. It's a huge risk given the unknowns about not just efficacy, but safety.”
- Another thought on why use China would use the CanSino #Covid19 vaccine in the military from @dho — it could serve as a priming vaccine, followed up by a booster with another vaccine later.
Tweet Mara Pilinger
“Hot take: This is a giant Phase III trial, even if China isn’t calling it that. But could force US & other countries to weight decisions about how to prioritize vaccine distribution in scary ways.”
FT - Gilead to charge governments $2,340 for Covid-19 treatment remdesivir
https://www.ft.com/content/4969b0a6-9e70-4135-a703-eac438d8ef50
There’s no business like “Big Pharma Business”. “
US drugmaker releases proposed pricing for one of most promising coronavirus medicines.”
“…
Gilead Sciences has said it will charge governments $2,340 for a course of remdesivir, a drug that has been shown to shorten recovery times in Covid-19 patients. The US biotech group said government healthcare programmes in developed markets globally would be charged a flat fee of $390 per vial for the drug. A five-day treatment uses six vials….”
HPW – Medicines Access Experts Challenge US $2340 Per Remdesivir Treatment Course Price Set By Gilead For Developed Countries
https://healthpolicy-watch.news/gilead-to-charge-us-320-per-vial-of-remdesivir-in-developed-countries/
“…
the price is still high compared to the cost of manufacturing, according to medicines access experts, who say that remdesivir could be produced for below a dollar a day….”
“
Private insurers in the United States will pay US $3,120 for a five-day course, or $520 per vial. Out-of-pocket payments will be determined by individuals’ coverage plans. In 127 developing countries, Gilead has allowed generics companies to manufacture the drug, pricing a five-day course at about US $600. …”
“Cost of production for the drug can be as low as US $0.93 per day, according to a paper by Dr Andrew Hill, a senior visiting research fellow at the University of Liverpool, and his colleagues. “Gilead will turn a nice profit with its set price. Especially considering that the company has benefitted from significant government financing for the development of the drug; which apparently has not been discounted,” Ellen t’Hoen, director of Medicines, Law and Policy, told Health Policy Watch. … … The company could turn a US $2.3 billion profit on the “blockbuster” drug this year alone, according to a blog by Ellen t’Hoen….”
Guardian - US buys up world stock of key Covid-19 drug remdesivir
https://www.theguardian.com/us-news/2020/jun/30/us-buys-up-world-stock-of-key-covid-19-drug
“The US has bought up virtually all the stocks for the next three months of one of the two drugs proven to work against Covid-19, leaving none for the UK, Europe or most of the rest of the world. Experts and campaigners are alarmed both by the US unilateral action on remdesivir and the wider implications, for instance in the event of a vaccine becoming available. The Trump administration has already shown that it is prepared to outbid and outmanoeuvre all other countries to secure the medical supplies it needs for the US….”
See also
the Telegraph - US move to buy global supply of remdesivir sets 'dangerous precedent' for pandemic response, experts warn
“There are concerns that the decision undermines global unity in tackling Covid-19 and heightens concerns about "vaccine nationalism".” With quotes by Devi Sridhar, among others.
“
The European Commission is in talks with Gilead Sciences, the US pharmaceuticals business, to reserve doses of the drug remdesivir to combat coronavirus after Washington announced that it had bought up much of the global supply. Stella Kyriakides, health commissioner for the 27-country EU, has held a series of negotiations with the company, including over its production capacity, Brussels said. “Commissioner Kyriakides has been in multiple discussions with the manufacturer, Gilead, including on their production capacity,” the commission said. “The commission is also currently in negotiations with Gilead to reserve doses of remdesivir for EU member states.”…”
Looks like ‘Team Europe’ isn’t just into ‘global solidarity’ & ‘People’s vaccines’.
“
The American pharmaceutical giant Gilead Sciences is coming under scrutiny for agreements that activists say will restrict global access to remdesivir, an experimental antiviral drug that has shown promise in treating COVID-19. The Foster City, Calif.-based company has signed confidential licensing deals with nine pharmaceutical manufacturers — including seven in India — that would prevent the generic version of the drug from being distributed in dozens of countries, including the U.S., that account for nearly half the world’s population. Although the terms of the licenses have not been publicly disclosed, Gilead has said they allow for a cheaper, generic form of remdesivir to be distributed in 127 countries, including nearly all of the world’s poorest nations. But the agreements exclude countries with some of the worst coronavirus outbreaks — including the U.S., Brazil, Russia, Britain and Peru — leading to allegations that Gilead aims to sell only its much costlier, name-brand version of the drug in middle-income and wealthy nations that are desperate for the treatment. “
SMCH - Oxygen shortage looms as virus cases head to 10 million
SMCH ;
See also last week’s IHP news. “
The world faces a shortage of oxygen concentrators as the number of worldwide cases of coronavirus infection nears the 10 million mark, according to the World Health Organisation….”
“… The WHO has purchased 14,000 oxygen concentrators from manufacturers and plans to send them to 120 countries in coming weeks, Tedros said. A further 170,000 concentrators — valued at some $US100 million ($146 million)— will be potentially available over the next six months. … … A few companies dominate 80 per cent of the global medical oxygen market, and in much of the world, the commodity is expensive and hard to get, highlighting lethal inequalities both between and within countries….”
PS: Some are calling on WHO & other global health stakeholders to negotiate a
#COVID19 plan with big oxygen in same way they work with big pharma on vaccines/meds.
FT - Pandemic reopens wounds on IP rights
https://www.ft.com/content/9ed5ca5e-9360-11ea-899a-f62a20d54625
“
The ethics of pharmaceutical monopolies are under scrutiny.”
“The race to develop vaccines and treatments for Covid-19 has been described by many world leaders as the greatest challenge of our lifetimes. But the coronavirus pandemic has reignited a longstanding debate about intellectual property protection and wider public access to medicines, as well as whether some protections should be temporarily overridden to deal with a global pandemic….”
And a link:
AP - Brazil signs deal to produce experimental virus vaccine
“The Brazilian government announced on Saturday an agreement with Oxford University and pharmaceutical company AstraZeneca to produce a promising coronavirus vaccine that is undergoing tests. Brazilian Health Ministry authorities said at a news conference that the country will pay $127 million and receive material to produce 30.4 million doses in two batches in December and January, which would allow it to quickly start inoculation efforts if the vaccine is certified to be safe and effective. They said the total deal is for 100 million vaccines for a country of about 210 million residents….”
Covid funding, debt relief, …
Project Syndicate - Making Multinationals and the Wealthy Pay
J A Ocampo et al ;
Project Syndicate;
“The poor and vulnerable are already suffering the most from the COVID-19 pandemic; they must not be left to carry the economic burden of rescue packages as well. It is time for those who have the most – and have long avoided paying their fair share – to start pulling their weight.”
A few excerpts:
“It
is impossible to say how far global tax revenues will fall as a result of the COVID-19 crisis. But, between tax breaks for corporations and falling incomes, it is safe to assume that the decline will be much larger than the 12% drop during the 2007-09 global financial crisis.”
“Clearly, governments need to find a way to increase their revenues. Cutting taxes for corporations isn’t it. Nor is raising taxes on ordinary workers, which would exacerbate already-widening income and wealth inequality. As we argue in the latest report of the Independent Commission for the Reform of International Corporate Taxation, governments should focus instead on boosting corporate tax revenues, including by introducing more progressive tax systems and putting a floor under tax rates, in order to curb competition….”
Potential new tax revenues obviously exist. … The op-ed also provides an update on the BEPS reform.
For the
report, see
The global pandemic, sustainable economic recovery and international taxation
“The report lists five steps governments can take to tackle tax avoidance ―which has left governments with fewer resources to meet critical priorities in the wake of the pandemic― end the era of tax havens and the ‘race to the bottom’ on corporate taxation. …”
CNBC - ‘Enormous bias’ clouds international approach to African debt relief, experts say
https://www.cnbc.com/2020/07/01/enormous-bias-clouds-international-approach-to-african-debt-relief-experts-say.html
Interesting analysis.
“
African governments spend more on servicing debt than on health care, and calls for debt forgiveness have been leveled at international institutions, individual nations and private creditors amid the coronavirus crisis. Elizabeth Rossiello, founder and CEO of Kenyan cross-border payments and trading platform AZA Finance, told a webinar on Friday that the international perception of African debt markets is tinged with “bias.””
And a quote by an investment management expert: ““
One of the dangers of talking about a blanket debt relief is you damage the potential growth of capital markets at a time when African corporates in particular need access to capital probably more than ever before, and that’s partly because the African continent is performing much more strongly than it did 20 years ago,” said Rohm.” He also argues that disparity between the debt profiles of individual African nations meant that international treatment of African debt should be approached on a sovereign by sovereign basis.
Global Policy - Breaking Out of the Double Squeeze: The Need for Fiscal and Policy Space during the COVID-19 Crises
https://www.globalpolicyjournal.com/blog/26/06/2020/breaking-out-double-squeeze-need-fiscal-and-policy-space-during-covid-19-crises
“Kevin P. Gallagher and Richard Kozul-Wright call on international financial institutions to adopt a series of measures to give developing countries the space to fight and recover from COVID-19.”
CGD (blog) - As the Pandemic Surges in Poor Countries, Why Does the IMF Still Forecast a Milder Economic Crisis for Them?
Justin Sandefur et al ;
https://www.cgdev.org/blog/pandemic-surges-poor-countries-why-does-imf-still-forecast-milder-economic-crisis-them
“
Last week, the IMF revised the post-COVID growth forecasts it had made originally in the April World Economic Outlook (WEO). The April growth forecasts numbers projected a significantly more optimistic outlook for EMDEs compared with advanced economies. It turns out that the latest June forecast maintains this relative optimism for EMDEs.” The authors wonder whether this is right.
Covid science
Starting with this assessment: “
Around 90 per cent of the world’s population is still susceptible to the coronavirus, the WHO’s chief scientist has said. “
Science News - One U.K. trial is transforming COVID-19 treatment. Why haven’t others delivered more results?
https://www.sciencemag.org/news/2020/07/one-uk-trial-transforming-covid-19-treatment-why-haven-t-others-delivered-more-results
“Clinical study has been helped by a simple design, a centralized health care system, and lots of infections.”
Karolinska Institutet - Immunity to COVID-19 is probably higher than tests have shown
Karolinska;
“
New research from Karolinska Institutet and Karolinska University Hospital shows that many people with mild or asymptomatic COVID-19 demonstrate so-called T-cell-mediated immunity to the new coronavirus, even if they have not tested positively for antibodies. According to the researchers, this means that public immunity is probably higher than antibody tests suggest. The article is freely available on the bioRxiv server and has been submitted for publication in a scientific journal….”
Telegraph – Exposure to common cold could provide immunity to Covid-19
https://www.telegraph.co.uk/global-health/science-and-disease/exposure-common-cold-could-provide-immunity-covid-19/
“
T-cells not antibodies may be the key to fighting off the virus, study shows.”
“
Exposure to the common cold could provide some measure of immunity to Covid-19, a new study suggests. The key to this immunity lies in T-cells, a type of white blood cell that helps the immune system fight off viruses, which experts believe may have just as important a role to play as antibodies in fighting off the virus. Researchers at Tubingen University in Germany compared blood cells from patients who had recovered from Covid-19 with those that had not had the disease.
Their research, published on the pre-print server Research Square and not peer reviewed, showed that 81 per cent of the 185 people they tested who had not had the disease had a T-cell response to Sars-Cov-2, the virus that causes Covid-19. And this immune response was linked to previous exposure to common cold coronaviruses, the researchers found….”
WP - This coronavirus mutation has taken over the world. Scientists are trying to understand why.
https://www.washingtonpost.com/science/2020/06/29/coronavirus-mutation-science/?arc404=true
Excerpts: “…
A change in the virus was appearing again and again. This mutation, associated with outbreaks in Europe and New York, eventually took over the city. By May, it was found in 95 percent of all the genomes Ozer sequenced. … At a glance, the mutation seemed trivial. About 1,300 amino acids serve as building blocks for a protein on the surface of the virus. In the mutant virus, the genetic instructions for just one of those amino acids — number 614 — switched in the new variant from a “D” (shorthand for aspartic acid) to a “G” (short for glycine). “G” hasn’t just dominated the outbreak in Chicago — it has taken over the world. Now scientists are racing to figure out what it means.
“At least four laboratory experiments suggest that the mutation makes the virus more infectious, although none of that work has been peer-reviewed. Another unpublished study led by scientists at Los Alamos National Laboratory asserts that patients with the G variant actually have more virus in their bodies, making them more likely to spread it to others. … … The mutation doesn’t appear to make people sicker, but a growing number of scientists worry that it has made the virus more contagious.
“The epidemiological study and our data together really explain why the [G variant’s] spread in Europe and the U.S. was really fast,” said Hyeryun Choe, a virologist at Scripps Research and a lead author of an unpublished study on the G variant’s enhanced infectiousness in laboratory cell cultures. “This is not just accidental.” …the switch occurred in the part of the genome that codes for the all-important “spike protein” — the protruding structure that gives the coronavirus its crownlike profile and allows it to enter human cells the way a burglar picks a lock. And its ubiquity is undeniable. Of the approximately 50,000 genomes of the new virus that researchers worldwide have uploaded to a shared database, about 70 percent carry the mutation, officially designated D614G but known more familiarly to scientists as “G.”
Telegraph - Alarm in Indonesia over high number of Covid-related deaths among children
https://www.telegraph.co.uk/global-health/science-and-disease/alarm-indonesia-high-number-covid-related-deaths-among-children/
“Widespread pneumonia and malnutrition make children more vulnerable to the virus, experts warn.”
“… Last week the Indonesian Paediatric Society (IDAI) reported that more than 200 children, including newborns and infants under five years old, were suspected to have died from the coronavirus outbreak that has strained the country’s fragile health system to breaking point. …”
… Infants were also at higher risk because of the disruption to essential health services, including “maternal and child health, family planning, nutrition services, diarrhoea management and immunisation,” she warned….”
Gates Open Research – Younger ages at risk of Covid-19 mortality in communities of color
K Klugman et al ;
https://gatesopenresearch.org/articles/4-69/v1?utm_source=AuthorEmail&utm_campaign=GORArticleMilestone&utm_medium=Social
Younger people are dying from #Covid19 in Africa.
“
in South Africa initial data suggest that the majority of deaths from Covid-19 are under 65 years of age. These observations suggest significant potential for increased Covid-19 mortality among younger populations in Africa and South Asia and may impact age-based selection of high-risk groups eligible for a future vaccine.”
Cidrap News - Worrisome details noted in kids with COVID inflammatory syndrome
https://www.cidrap.umn.edu/news-perspective/2020/06/worrisome-details-noted-kids-covid-inflammatory-syndrome
“
Today the New England Journal of Medicine published two studies spotlighting the serious manifestations of COVID-19–related multisystem inflammatory syndrome in children (MIS-C), the first involving 186 kids in 26 states and the second involving 99 patients in New York. … … Both studies revealed the same high level of intensive care: 80%....”
Telegraph - ‘Second wave’ is an unhelpful concept, top infectious disease expert warns
https://www.telegraph.co.uk/global-health/science-and-disease/second-wave-unhelpful-concept-top-infectious-disease-expert/
“… Dr Tom Frieden, who served as director of the US Centers for Disease Control and Prevention (CDC) for eight years under Barack Obama, told The Telegraph that the term “implies that this [virus] will act as the flu acts”. “We don't know that - it might, but it might not,” he said. “Basically we will have outbreaks as long as there is exposure.” Instead he advocated a surfing analogy - peaks and troughs in cases should be described as “riding a wave”. …”
Boston Review - The Shape of Epidemics
D Jones et al ;
http://bostonreview.net/science-nature/david-s-jones-stefan-helmreich-shape-epidemics
Neat essay.
“Waves have taken pride of place in the COVID-19 crisis, serving not just to predict but also to persuade. As new infections soar in the United States, their special blend of mathematical and moral messaging will help to shape the future of the pandemic.”
“…This essay sketches this backstory of epidemic waves, which falls roughly into three eras: waves emerge first as a device of data visualization, then evolve into an object of mathematical modeling and causal investigation and finally morph into a tool of persuasion, intervention, and governance. …”
Guardian - Covid-19: risk of death in UK care homes 13 times higher than in Germany
https://www.theguardian.com/world/2020/jun/28/covid-19-risk-of-death-in-uk-care-homes-13-times-higher-than-in-germany?CMP=share_btn_tw
“
Care home residents were more likely to die of Covid-19 in the UK than in any of the major European countries apart from Spain, analysis of global data has revealed. The proportion of residents dying in UK homes was a third higher than in Ireland and Italy, about double that in France and Sweden, and 13 times higher than Germany. The analysis of official statistics was carried out by academics at the London School of Economics as part of the International Long Term Care Policy Network….”
NYT - How the Coronavirus Short-Circuits the Immune System
https://www.nytimes.com/2020/06/26/health/coronavirus-immune-system.html
“In a disturbing parallel to H.I.V., the coronavirus can cause a depletion of important immune cells, recent studies found.”
“…The findings suggest that a popular treatment to tamp down the immune system in severely ill patients may help a few, but could harm many others. The research offers clues about why very few children get sick when they are infected, and hints that a cocktail of drugs may be needed to bring the coronavirus under control, as is the case with H.I.V….”
FT - Coronavirus produces ‘sinister’ tentacles in infected cells
https://www.ft.com/content/2690623a-6824-4837-a36d-73519b77aa7a
“Highly unusual structure raises hopes for use of cancer drugs to treat the disease.”
“Scientists have discovered that the virus behind Covid-19 causes the infected cells to grow stringy protruding branches — a highly unusual structure that allows the virus to attack several cells at once. … … The discovery has highlighted a number of drugs that could be deployed against the disease, most of which were previously being developed to treat cancer. Prof Krogan said cancers, HIV, or Sars-Cov-2 were all searching for the “Achilles heel of the cell”. “It totally makes sense there’s an overlap in anticancer drugs and an antiviral effect,” he said. …”
Guardian - Make masks compulsory in public in UK, says virus expert
https://www.theguardian.com/world/2020/jun/30/make-masks-compulsory-in-public-says-virus-expert-peter-piot?CMP=share_btn_tw
“
Face masks should be compulsory for adults in all public and enclosed spaces, such as shops, according to a leading infectious diseases expert” .
Peter Piot, that is.
Piot also weighs in on some other issues related to the Covid-19 pandemic, including faultlines revealed by the pandemic etc.
Quote: “…We need to realise – and it’s sobering – that
we are at the beginning of what may be a multi-year type of epidemic.”…”
Plos Med (Editorial) – Will COVID-19 be evidence-based medicine’s nemesis?
T Greenhalgh; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003266
“Trisha Greenhalgh asks if during a pandemic evidence-based medicine can deliver the rapid responses needed in public health medicine.”
Concluding: “…
In the current fast-moving pandemic, where the cost of inaction is counted in the grim mortality figures announced daily, implementing new policy interventions in the absence of randomized trial evidence has become both a scientific and moral imperative. Whilst it is hard to predict anything in real time, history will one day tell us whether adherence to “evidence-based practice” helped or hindered the public health response to Covid-19—or whether an apparent slackening of standards to accommodate “practice-based evidence” was ultimately a more effective strategy.”
GAVI – First African trial of a COVID-19 vaccine
https://www.gavi.org/vaccineswork/first-african-trial-covid-19-vaccine
“With trials in Brazil and the UK already underway,
South Africa becomes the first country in the continent to begin a clinical trial of a COVID-19 vaccine.”
GAVI – The latest in the covid- 19 vaccine race
https://www.gavi.org/vaccineswork/covid-19-vaccine-race
(update as of 30 June). With also a great map of the vaccines in the pipeline & stage.
“The race is on to find a vaccine to stop the spread of the COVID-19 virus, with countries around the world researching different vaccine technologies that might halt the pandemic. Of the 148 candidate vaccines that researchers are working on, 17 are now in human clinical trials.”
Covid analysis
From various angles.
Lancet Offline: It's time to convene nations to end this pandemic
R Horton;
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31488-4/fulltext
“…
COVID-19 is the greatest threat to peace and security since World War 2. Since 1948, there have been ten Emergency Special Sessions of the UN General Assembly—… … Surely this pandemic is serious enough to warrant similar political attention. An Emergency UNGASS can be convened within 24 h when international peace and security are threatened. …”
“…For those of us working in global health, COVID-19 has been devastating, and not only because of the toll of avoidable human loss. This pandemic is dismantling the foundations for protecting and advancing health. The right to health, health equity, and social justice form a trinity of values that animates the daily practice of global health. These values, underpinning first the Millennium Development Goals and, since 2016, the Sustainable Development Goals, have accelerated progress in women's and children's health, the control of epidemic diseases, and health system strengthening. But these achievements are now threatened by COVID-19, a pandemic that has still not reached its peak worldwide. Global health has entered a period of rapid reversal. De-development is the new norm. Yet no plan is in place, or even being proposed, to address this global regression in human health….”
Horton goes on to give some very dire stats of what lies ahead, among others by the Global Fund.
Covid19 Health diaries - Triple Crisis of Private Health 2/3
Owain Williams;
https://covid19healthdiaries.com/diary?did=288
Without any doubt, one of the must-reads of the week. Second in series of three blogs.
“…
This is the second part of the thread on market failure and the private hospital and healthcare sector, having posted part 1 on the 19th June. This post picks up and examines the details of the triple crisis of market failure in private sector health, particularly in private hospitals during the pandemic. …. … The triple crises of private hospital and healthcare are now widespread across many countries, both north and south, with this piece illustrating just how far-reaching the market failure is by means of country examples drawn from emerging data, press reports, NGO and multilateral opinion pieces and so on….”
Some of our favourite quotes: “…
there seems to be a major crisis in legitimacy of the token and illusory public-private partnership model, with market failure exposing the emptiness of calls to harness the private sector for delivery of healthcare or even Universal Health Coverage. …“
“… attempts to sustain the case for the private in health and hospital care are emerging in high-level policy discourses, much centring on the efforts of the International Financial Institutions and the WHO to maintain and legitimise the public-private partnership model that has occupied global health policy for over 10 years….”
And another excerpt: “…
It seems that the World Bank and WHO study cited above is accurate in its representation of a huge systemic crisis in private health and hospital care across many LMICs. While clearly significant for the future of that private system after the pandemic, the real immediate concern is that financial collapse will imperil the ability of countries to respond to COVID and have capacity at the systems level. In Africa and Asia most countries are heavily dependent on the formal private sector which accounts for average of 40% of healthcare in these regions, this figure rising to over 80% in countries such as India, Bangladesh and Nigeria. If the private sector suffers even modest collapse and closures, then capacity will be a problem in the pandemic. …”
The conclusion
: “… In conclusion, we have seen a huge financial crisis unfold in private hospital and healthcare in countries where the market model and financialization have been left to run riot over recent decades. COVID is clearly an exceptional crisis, but it has exposed the dangers in weighting health services to profit and business models where elective health has triumphed over essential and universal services. In the next of these threads I will look at the response of the private sector to COVID in a range of countries, above and beyond closure and bankruptcy, as well as the state and multilateral crisis of governance that is centring on the viability of the private in health both within and beyond this pandemic.”
TGH - All Bets Are Off for Measuring Pandemic Preparedness
S Crosby, J Dieleman et al;
https://www.thinkglobalhealth.org/article/all-bets-are-measuring-pandemic-preparedness
Absolute must-read:
“Three standard measures don't predict how countries fare in COVID-19—so how do we better prepare for the next pandemic?”
One of their explanations: “…
Joint External Evaluations, the Global Health Security Index, and measures of universal health coverage are not meant to predict health outcomes but are intended to be tools for identifying gaps in capacity and mobilizing financial and political support to fill those gaps….”
See also this
Twitter thread by co-author
Tom Bollyky .
“#
COVID19 has revealed that we don't yet understand how best to measure countries' capacity to respond effectively to severe pandemic threats…”
Project Syndicate - How Inequality Fuels COVID-19 Deaths
J Sachs;
https://www.project-syndicate.org/commentary/inequality-fuels-covid19-mortality-by-jeffrey-d-sachs-2020-06
“
High inequality undermines social cohesion, erodes public trust, and deepens political polarization, all of which negatively affect governments’ ability and readiness to respond to crises. This explains why the United States, Brazil, and Mexico account for nearly half of the world's reported deaths since the start of the pandemic.”
Guardian - Covid-19 intensifies elder abuse globally as hospitals prioritise young
https://www.theguardian.com/global-development/2020/jun/30/covid-19-intensifies-elder-abuse-globally-as-hospitals-prioritise-young?CMP=twt_a-global-development_b-gdndevelopment
“
Older patients turned away or left untreated, while domestic abuse is also rising, leading charity reports.” HelpAgeInternational, that is. “…
Discrimination against older people has been on the rise since the pandemic, according to the organisation. It has heard reports from many countries of older people left to die from Covid-19 as younger patients are prioritised – or simply refused treatment amid fears they would infect others….”
Lancet Digital Health (Viewpoint)- Applications of digital technology in COVID-19 pandemic planning and response
S Whitelaw;
https://www.thelancet.com/journals/landig/article/PIIS2589-7500(20)30142-4/fulltext
“With high transmissibility and no effective vaccine or therapy, COVID-19 is now a global pandemic. Government-coordinated efforts across the globe have focused on containment and mitigation, with varying degrees of success. Countries that have maintained low COVID-19 per-capita mortality rates appear to share strategies that include early surveillance, testing, contact tracing, and strict quarantine. The scale of coordination and data management required for effective implementation of these strategies has—in most successful countries—relied on adopting digital technology and integrating it into policy and health care. This Viewpoint provides a framework for the application of digital technologies in pandemic management and response, highlighting ways in which successful countries have adopted these technologies for pandemic planning, surveillance, testing, contact tracing, quarantine, and health care.”
CGD (blog) – Healthcare Technologies and COVID-19: Speed is Not Always a Good Thing
K Chalkidou et al ;
https://www.cgdev.org/blog/healthcare-technologies-and-covid-19-speed-not-always-good-thing
«
With a focus on tests, treatments, and a vaccine, we take a look at the emerging global clinical and economic evidence-base underpinning some of these technologies, the mechanisms (mostly global) for financing these commodities, and, finally, the decision-making processes for selecting technologies. This includes identifying the right subpopulations and negotiating a cost-effective tiered price across countries and regions. »
CGD (blog) – Beyond Lockdown—Sustainable COVID Control for Low-Income Countries
Peter Baker, J Konyndyk et al;
https://www.cgdev.org/blog/beyond-lockdown-sustainable-covid-control-lmics
“
Following precedents applied first in wealthy states, more than 140 countries have applied some form of lockdown restrictions to slow their COVID-19 epidemics, but can control measures be made sustainable in low-income countries?”
“….With lockdown measures proving difficult to sustain, many countries are now relaxing their lockdown measures; 58 of the 115 (50.4 percent) countries with remaining lockdown measures are imminently preparing to begin phasing them out. Wealthier countries have relaxed their policies first, utilising a four-layered strategy of social distancing, shielding of the vulnerable, contact tracing and public communication. Low-income countries, however, have material differences that change both the feasibility of these strategies and their cost-benefit calculus. In this blog we look at these four layers and assess their feasibility in low-income countries. We recommend that social distancing measures will need to be limited and carefully adapted, focusing on those that are sustainable for 6-12 months and strengthened with hygiene measures. Measures to shield the vulnerable needs to be community driven and piloted to test feasibility. Contact tracing must be adapted to be low cost and scalable, and public communications must focus on building trust with all communities….”
F2P blog - Optimistic or pessimistic about Covid-19? No need to choose
By
Jordy Vaquer (Open Society Foundations)
https://oxfamblogs.org/fp2p/optimistic-or-pessimistic-about-covid-19-no-need-to-choose/
With
4 possible quadrants. Back to (new) normal; Democratic Renewal; Authoritarian winter; Downward Spiral.
Recommended article.
Guardian - Progress on gender equality at risk from Covid-19 jobs crisis, says ILO
https://www.theguardian.com/world/2020/jun/30/gender-equality-covid-19-jobs-ilo?CMP=Share_iOSApp_Other
“
UN body says pandemic a bigger blow to employment than it previously feared.” “Modest progress in workplace gender equality risks being reversed by the disproportionate impact of the deepening global jobs crisis caused by the Covid-19 pandemic, the International Labour Organisation has said. The Geneva-based ILO said its latest update showed restrictions on activity during the second quarter had led to an even bigger blow to employment than it previously feared, and that women had been hit harder than men….”
ECFR - Europe’s pandemic politics: How the virus has changed the public’s worldview
https://www.ecfr.eu/publications/summary/europes_pandemic_politics_how_the_virus_has_changed_the_publics_worldview
With focus on
European public opinion, but probably also with broader relevance.
“
As covid-19 raged, speculation grew that the crisis would restrengthen public support for the state; faith in experts; and both pro- and anti-Europeanism. New research reveals these all to be illusions. Instead, the crisis has revolutionised citizens’ perceptions of global order – scrambling the distinctions between nationalism and globalism. One group – the DIYers – sees a nineteenth-century world of every nation for itself; the New Cold Warriors hear echoes of the twentieth century and look to Trump’s America to defend them from China; the Strategic Sovereigntists foresee a twenty-first-century world of blocs and regions. This last group are the largest and represent a new form of pro-European who believe Europe will need to support its own sovereignty through joint foreign policy, control of external borders, and relocalised production. … … Rather than a ‘Hamilton moment’ of proto-federalisation, we are instead living through a ‘Milward moment’ of strong nation state identities searching for protection in a dangerous world.”
See also
The Guardian on the same report -
Europeans' trust in US as world leader collapses during pandemic
NPR - 'I Will Kill You': Health Care Workers Face Rising Attacks Amid COVID-19 Outbreak
NPR;
“…
According to Insecurity Insight, a research group that documents violence against aid workers, there have been more than 400 reported global incidents of COVID-19-related violence affecting health care workers and facilities since January. Insecurity Insight tracks attacks on health workers, including threats, assault, arrests and detention, kidnappings and conflict-related violence, along with a number of other types of attacks. Its researchers comb through incident reports from the World Health Organization and groups such as the Aid Worker Security Database and Physicians for Human Rights, along with media reports….”
And that’s almost certainly a huge underestimate.
Guardian - 'Evil forces': how Covid-19 paranoia united the wellness industry and rightwing conspiracy theorists
https://www.theguardian.com/commentisfree/2020/jun/05/wellness-advocates-used-to-talk-about-bali-trips-and-coconut-oilnow-its-bill-gates-and-5g
On a recent but worrying trend.
Excerpt: “…
What was going on? How and why did the largely progressive and left-leaning proponents of wellness merge with rightwing conspiracy theorists and Donald Trump supporters? Such unlikely allegiances were termed “fusion paranoia” in a 1995 New Yorker article by the journalist Michael Kelly, who saw leftwing and rightwing activists coalesce around the anti-war and pro-civil liberties movements that shared common traits of anti-government views and belief in conspiracy theories. Such a tight alliance (or fusion paranoia) between the wellness industry and the far-right would have been unthinkable to me a year ago. But the connection between the alt-right, conspiracy theorists and sections of the wellness community have strengthened and bonded during global lockdowns. The messages of the different groups are remarkably the same: the virus is a cover for a plot of totalitarian proportions, designed to stifle freedom of movement, assembly, speech and – to the horror of some in the wellness industry – enforce a program of mass vaccinations. A popular, multitrillion-dollar sector, the wellness industry’s huge reach and influence has the power to bring people into the conspiracy that previously would not have had any contact with the alt-right….”
Newsweek – Politicizing and Polarizing the Pandemic Pinned America As Global Epicenter
https://www.newsweek.com/pandemic-coronavirus-politicizing-polarizing-1513405
Focus on the US but with lessons for many countries in the world.
“…
the uptick in COVID-19 cases may, in part, be due to politicization of the pandemic, with a failure to coordinate a unified response across the country. In a study published in Science Advances, a team of political scientists analyzed over 30,000 tweets from members of the U.S. Congress. They found rapid politicization and polarization of the pandemic. "
CGD (blog) - A Framework for Identifying the Sources of Indirect Health Effects of COVID-19
Y-Ling Chi et al ;
https://www.cgdev.org/blog/framework-identifying-sources-indirect-health-effects-covid-19#.XvxvZ5TIUKU.twitter
“…
In a policy paper released today, we introduce a framework for mapping out these indirect health effects at the country level, and show how it can shape our understanding of how COVID-related policies reverberate across all aspects of health. As we explain here, the framework can help policymakers move to a holistic COVID-19 response that accounts for the impacts of the pandemic and the measures implemented to fight it….”
Devex - How COVID-19 has advanced the case for procurement reform
https://www.devex.com/news/how-covid-19-has-advanced-the-case-for-procurement-reform-97588
“
The pandemic put procurement, where 1 in every 3 dollars of public money is spent, in the spotlight, said Gavin Hayman, executive director at the Open Contracting Partnership. … … Hayman said COVID-19 has elevated the issue of procurement to the highest levels of government: “People are asking ‘Why don’t we know?’ for the first time,” he said. “…”
Telegraph - Women more willing to comply with lockdown, Panama's sex-segregation experiment suggests
https://www.telegraph.co.uk/global-health/climate-and-people/women-willing-comply-lockdown-panamas-sex-segregation-experiment/
“Males and females were allowed out on alternate days in the Central American country with shops quieter on women-only days. “
“… In response to the Covid-19 pandemic, a small number of countries in Latin America introduced gender or sex-segregated mobility policies. However Panama was the only one to introduce a nationwide policy that held throughout the entirety of the lockdown period and has been seen as a success - the country had just over 30,000 cases and around 1,000 deaths. In what has been considered one of the most aggressive responses to Covid-19 in Latin America, Panama's lockdown was based on an individual’s sex, as listed on their national identification card or “cedula”. Women were allowed to leave their homes on Mondays, Wednesdays and Fridays whereas men were allowed to go out on Tuesdays, Thursdays and Saturdays….”
“… Using anonymised GPS data from the country between February 15 and May 29, researchers at the London School of Economics found that there was less public movement on women’s days. The study, not yet published, recorded engagement with five major categories: retail and recreation, grocery and pharmacy, transit stations, parks and the workplace. While public mobility was lower on women’s days in all areas compared with men’s, this difference was particularly prevalent in visits to grocery and pharmacy stores - a result that researchers found surprising, and at odds with media accounts from Peru highlighting longer queues outside supermarkets on “female” days.”
“… “We came up with a range of hypotheses for why this might be – is it that women are better at following public health guidance than men? "Is it that actually, going to the grocery store becomes this new desired activity, when there’s nothing else you’re allowed to go out for, and thus represents a new source of bargaining between couples, and the fact that men ‘win’ this bargain reveals the perpetuity of gender norms and the patriarchy,” she told the Telegraph. “
WB (working paper) – COVID-19 Age-Mortality Curves Are Flatter in Developing Countries
G Demombynes;
http://documents1.worldbank.org/curated/en/701441593610141326/pdf/COVID-19-Age-Mortality-Curves-Are-Flatter-in-Developing-Countries.pdf
“
A greater share of reported COVID-19 deaths occur at younger ages in low- and middle-income countries (LMICs) compared to high-income countries (HICs). Based on data from 26 countries, people age 70 and older constitute 37 percent of deaths attributed to COVID-19 in LMICs on average, versus 87 percent in HICs. Only part of this difference is accounted for by differences in population age structure. … … It reflects some combination of variation across countries in age patterns of infection rates, fatality rates among those infected, and under-attribution of deaths to COVID-19. The findings highlight that experiences with COVID-19 in wealthy countries may not be generalizable to developing countries”.
“In the rich countries, people ages 70-79 are 12.6 times as likely to die as those ages 50-59. In the low- and middle-income countries, this ratio is 3.5.”
Global Health Research & Policy (Commentary) - The need for COVID-19 research in low- and middle-income countries
M Gupta, D Peters et al ; https://ghrp.biomedcentral.com/articles/10.1186/s41256-020-00159-y
“…
In the early months of the pandemic, most reported cases and deaths due to COVID-19 occurred in high-income countries. However, insufficient testing could have led to an underestimation of true infections in many low- and middle-income countries. As confirmed cases increase, the ultimate impact of the pandemic on individuals and communities in low- and middle-income countries is uncertain. We therefore propose research in three broad areas as urgently needed to inform responses in low- and middle-income countries: transmission patterns of SARS-CoV-2, the clinical characteristics of the disease, and the impact of pandemic prevention and response measures…”
Lancet Global Health – In the COVID-19 pandemic in Brazil, do brown lives matter?
H Ribeiro et al;
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30314-4/fulltext
“In The Lancet Global Health, a pioneering study by Pedro Baqui and colleagues confirms in Brazil findings observed in other countries hit hard by COVID-19: that mortality rates from the pandemic differ by geographical region and ethnicity, with disproportionate impact for Black populations and other ethnic minorities. We can discuss these findings in the context of the social protests occurring in the past few months against structural racism and to the slogan “Black lives matter”. However, in this Comment, we go beyond ethnicity, focusing on social and environmental determinants of health for about 50% of Brazilians….”
BMJ GH (blog) - Social media and the spread of COVID-19 in Nigeria
E Togun;
https://blogs.bmj.com/bmjgh/2020/06/28/social-media-and-the-spread-of-covid-19-in-nigeria/
“This article discusses the influence of social media in the Nigerian COVID-19 pandemic across three broad themes….”
And a link:
BMJ GH (blog) -
Mental health, COVID-19 and primary healthcare in Guinea : a tale of stigma and solidarity (by A Sow et al)
Our World in Data in-depth studies
With 3 new in-depth studies by “Our World in Data”.
Emerging COVID-19 success story: Vietnam’s commitment to containment
Emerging COVID-19 success story: Germany’s strong enabling environment
Emerging COVID-19 success story: South Korea learned the lessons of MERS
Covid impact on other global health programs
Immunization economics - Conducting campaigns during the COVID-19 pandemic
http://immunizationeconomics.org/recent-activity/2020/5/15/conducting-campaigns-during-the-covid-19-pandemic
With info on the
additional operational cost of conducting immunization campaigns during the COVID-19 pandemic.
“
With support from the Bill & Melinda Gates Foundation, ThinkWell has estimated the added cost per dose of several potential precautionary measures: personal protective equipment (PPE) for vaccination teams, additional infection prevention and control (IPC) measures at immunization sites, extra staff and supplies to ensure physical distancing and triaging at campaign sites, additional per diems due to potential changes in delivery strategies, and estimates of an increase of other operational cost components (such as additional social mobilization and training). The analysis uses data from 10 studies on the cost of conducting an immunization campaign to model each scenario at a low, medium and high intensity level, as well as the combined effect on the cost per dose.”
“All protective measures and operational changes combined could increase the operational cost of a campaign by 49% in the low scenario up to 154% in the high scenario.”
Lancet Comment - After COVID-19, a future for the world's children?
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31481-1/fulltext
By the WHO/UNICEF/Lancet Commissioners. With a number of very sensible ways forward.
“
In February, 2020, the WHO–UNICEF–Lancet Commission's report A Future for the World's Children? examined threats facing children—from climate change and related crises of poverty, migration, and malnutrition; commercial marketing of harmful substances; and across all sectors, from unsafe roads and hazardous housing to inadequate education and social protection. The COVID-19 pandemic is exacerbating many of these threats, jeopardising child welfare gains, and causing a global economic crisis in which children will be prime casualties. Yet recovery and adaptation to COVID-19 can be used to build a better world for children and future generations….”
SRHM – Series of Commentaries on SRHR in the era of Covid-19
http://www.srhm.org/sexual-and-reproductive-health-and-rights-in-the-era-of-covid-19/
Do check them out.
GAVI board meeting
Gavi – Short report of latest board meeting
https://www.gavi.org/news/media-room/gavi-board-calls-global-access-covid-19-vaccines
Short but recommended read. “
Gavi Board shows support for continued work on COVAX Facility: a global, coordinated mechanism designed to ensure rapid and equitable access to safe and efficacious COVID-19 vaccines to as broad a global population as possible; The Board also discussed the role Gavi will play in an expansion in cold chain capacity in developing countries to deploy COVID-19 vaccines, as well as potentially diagnostics and treatments; New flexibilities and measures put in place to help countries deal with unprecedented impact of COVID-19 on immunisation programmes, as well as revised gender policy to guide Gavi’s programmes.”
On the
COVAX Facility: “…
The COVID-19 Vaccines Global Access Facility (COVAX Facility) aims to pool demand and resources toward securing access to future supply of COVID-19 vaccines. All countries are invited to participate in the COVAX Facility. Gavi is continuing to work closely with stakeholders to complete the design of the Facility, including ways to raise the necessary funding. The Board was encouraged by what has been achieved so far, putting together the building blocks of the Facility, and raised points around equity, risk and financing that will be incorporated into the design, as well as governance that will be finalised in the summer….”
And a link
– GAVI - Overview of Covid-19 situation in GAVI-supported countries and GAVI's response.
UNAIDS board meeting
UNAIDS - UNAIDS Board discusses UNAIDS’ work on COVID-19 and HIV and UNAIDS’ next strategy and its transformative agenda
https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2020/june/20200626_pcb
Good summary of the UNAIDS board meeting. “
The 46th meeting of the UNAIDS Programme Coordinating Board (PCB) has concluded in Geneva, Switzerland. The PCB, which met from 23 to 25 June 2020, was held for the very first time as a virtual meeting because of the COVID-19 pandemic. The PCB, chaired by the United States of America, had decided that it would be important to demonstrate that the intergovernmental process can continue to work effectively during the COVID-19 pandemic. During the meeting, a series of crucial decisions were taken on the future of the HIV response and on the transformation of UNAIDS, while the interconnectedness between the twin pandemics of HIV and COVID-19 was discussed and reflected upon….”
GFF
Wemos – Is it time for a refresh of the Global Financing Facility?
https://www.wemos.nl/en/is-it-time-for-a-refresh-of-the-global-financing-facility/
“
Wemos critically follows the developments and outcomes of the Global Financing Facility (GFF) for Reproductive, Maternal, Newborn, Child and Adolescent Health and Nutrition. It is currently under the process of a ‘strategy refresh’, planned to be launched around September 2020. With our new fact sheet, we looked into the implications of a potential shift from the GFF’s current structure as a Multi-Donor Trust Fund towards a Financial Intermediary Fund.” (7-pager)
(pre-print S&RM) - Is the Glass Half-Full or Half-Empty? A Content Analysis of Adolescent Sexual and Reproductive Health in Global Financing Facility Country Plans
Asha George et al;
https://www.researchsquare.com/article/rs-38707/v1
“…
As momentum builds for the GFF, we examine the initial efforts of the GFF in addressing adolescent health. …. We undertook a content analysis of the first 10 GFF Investment Cases and Project Appraisal Documents available on the GFF website. The countries involved include Bangladesh, Cameroon, Democratic Republic of Congo, Ethiopia, Guatemala, Kenya, Liberia, Mozambique, Nigeria, Tanzania and Uganda. …”
Financial crisis PAHO
Lancet Letter - Financial crisis at PAHO in the time of COVID-19: a call for action
A King et al;
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31489-6/fulltext
“On May 21, 2020, at a special session of the Executive Committee of the Pan American Health Organization (PAHO), WHO Regional Office for the Americas, Carissa Etienne, Regional Director, declared that due to non-payment of Member States' contributions, PAHO stands on the brink of insolvency. As of April 30, 2020, most of the non-payment is attributable to the USA (67%); however, late payments are outstanding from Brazil, Venezuela, Mexico, Argentina, Colombia, Chile, and others, to a total of US$164·6 million. This includes an unprecedented $63·8 million (57%) of 2019 assessed contributions. This financial crisis could not have occurred at a worse time…”
“…Health security in the western hemisphere would be severely threatened without a functioning PAHO. Reserve funds will be exhausted by September, 2020….” “This is a call to action to countries of the Americas to pay their outstanding contributions and avoid a financial crisis with known and unknown consequences.”
World Zoonoses Day (July 6)
Lancet Editorial – Zoonoses: beyond the human–animal–environment interface
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31486-0/fulltext
“World Zoonoses Day on July 6 marks the day, in 1885, when a young boy received the first vaccine against rabies—a zoonosis, a disease caused by a pathogen transmitted from animals to humans. Rarely is a World Zoonoses Day so relevant to consider these diseases and their disruption of societies….”
“Sounding the alarm about the risk of zoonotic pandemics has largely been the preserve of a handful of scientists and global health experts. Until now. COVID-19 has coalesced the research community around calls for establishing broad transformational change. This pandemic is a sobering warning against exploiting the natural world without pause, and that zoonoses affect not only health but the whole fabric of society. COVID-19 will not be the last, and perhaps not the worst, zoonotic pandemic. Climate change has shown how an existential threat to human civilisation can galvanise a sense of urgency in a whole-of-society response. Tackling zoonoses needs exactly the same.”
Planetary health
Lancet Letter – Time for WHO to declare climate breakdown a PHEIC?
A Harmer, R van de Pas et al;
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31289-7/fulltext
I would say it past time already. In fact, I think WHO should declare a “super-PHEIC” or sth like that.
The authors conclude: “
By declaring a PHEIC, WHO would protect and respect its mandate, global public health, the planet, and the wellbeing of present and future generations; mobilise political will and funding needed for climate action; and convey a sense of urgency. If ever there was a PHEIC, it is climate breakdown. WHO should declare it as such.”
Guardian - US to join summit on global green recovery from Covid-19 crisis
https://www.theguardian.com/environment/2020/jun/29/us-joins-summit-on-global-green-recovery-from-covid-19-crisis
“
The US is to join with other major powers including China, India and the EU in formulating plans for a global green recovery from the coronavirus crisis, in the only major international summit on the climate emergency this year. The idea of a green recovery to prevent a dangerous rebound in greenhouse gas emissions to above pre-Covid-19 levels has been gathering steam, but few governments have yet committed to plans. If they fail to do so in the next few months, the economic recovery from the Covid-19 crisis risks locking in high carbon emissions that would lead to climate catastrophe. Next week, the International Energy Agency (IEA) will host an online summit for the world’s biggest economies as well as developing countries, covering 80% of global emissions. It aims to set out plans for boosting renewable energy, energy efficiency and other emissions-cutting projects that would generate tens of millions of “shovel-ready” green jobs around the world to replace those lost in the pandemic….”
“…The IEA summit on 9 July will be the only major meeting of governments to discuss the climate crisis this year, because the UN Cop26 summit has been postponed to next year due to the pandemic. US participation is crucial, because the White House is pulling out of the Paris agreement, with effect from 4 November, the day after the presidential election….”
See also
HPW - Fateful International Energy Agency Meeting Could Set Course For Climate Friendly COVID-19 Recovery… Or Not.
The Monthly - Witnessing the unthinkable
J Gergis;
https://www.themonthly.com.au/issue/2020/july/1593525600/jo-lle-gergis/witnessing-unthinkable#mtr
By an Australian lead author involved in writing the physical science basis of the “
Sixth Assessment Report” of the United Nations’ Intergovernmental Panel on Climate Change (IPCC).
“
New climate modelling suggests planetary crisis is coming much sooner than previously thought.”
HPW – Swelling Indian National Opposition As Modi Plans To Expand Coal Mining
https://healthpolicy-watch.news/swelling-indian-national-opposition-as-modi-plans-to-expand-coal-mining/
“Prime Minister Narendra’s Modi’s ambitious plan to use coal to power India’s economic revival after his government’s strict lockdowns flattened the wrong curve, bringing economic growth to a halt even as the infection epidemic-curve continued to rise, seems to have run into significant opposition from unexpected quarters. Since the launch of his plan earlier this month, state after Indian state has expressed disagreement with the Centre’s plan to commercially auction coal mines to the private sector, including international players. The latest to join the clamour of opposition by the states of Chhattisgarh, Jharkhand and Maharashtra, where more than half of the 41 mines are located – is the politically powerful chief minister of West Bengal, Mamata Banerjee. Indian environmentalists have also decried a seemingly desperate announcement by the government to auction off 41 Indian coal mines, opening a largely government-controlled sector up to all private investment for the first time ever – and thus greatly accelerating domestic coal production….”
Guardian – Revealed: development banks funding industrial livestock farms around the world
https://www.theguardian.com/environment/2020/jul/02/revealed-development-banks-funding-industrial-livestock-farms-around-the-world
“Two of the world’s leading development banks have pumped billions of dollars into the global livestock sector, despite warnings that reducing meat and dairy consumption is essential for tackling the climate crisis. The International Finance Corporation (IFC) – the commercial lending arm of the World Bank – and the European Bank for Reconstruction and Development (EBRD) have provided $2.6bn (£2.1bn) for pig, poultry and beef farming, as well as dairy and meat processing, in the past 10 years….”
SDGs
IISD - SDG Index Measures All Countries’ Progress Since 2015
IISD;
“The Sustainable Development Solutions Network (SDSN) has released the 2020 edition of the Sustainable Development report, focusing on ‘The Sustainable Development Goals and Covid-19.’ The annual report tracks the performance of all UN Member States on the 17 SDGs, measuring the distance remaining to achieve each target. The 2020 report focuses on ‘The Sustainable Development Goals and Covid-19’….”
“The report released on 30 June 2020 was written by lead author Jeffrey Sachs and a team of independent experts working at the SDSN and Bertelsmann Stiftung. It includes the SDG Index along with interactive dashboards to visually represent countries’ performance by SDG. … … Presenting key report findings on 25 June 2020, Guillaume Lafortune, SDSN, said COVID-19 is negatively affecting several Goals: SDG 1 (no poverty); SDG 2 (zero hunger); SDG 3 (good health and wellbeing); SDG 8 (decent work and economic growth); and SDG 10 (reduced inequalities). In other areas, the ultimate effects of the pandemic remain unclear. …”
As a reminder: “
The SDSN annual report is one of several SDG assessment reports that are released annually prior to the High-level Political Forum on Sustainable Development (HLPF) meeting, which takes place in July (7-16 July). The UN Secretary-General’s ‘
2020 SDG Progress Report‘, which was released in May, identified areas of progress up to the end of 2019 as having included declining global poverty, falling rates of maternal and child mortality, increasing access to electricity, and the development of more national sustainable development policies. “
And a link: IISD
Tools Support Policy Makers’ Efforts to Prioritize Multiple Goals
AMR
Stat - Pharma giants to unveil major $1 billion venture to push novel antibiotics
https://www.statnews.com/pharmalot/2020/06/29/antibiotics-merck-lilly-pfizer-who/
(gated)
“
Amid escalating concerns over antibiotic resistance, several big drug makers are creating a new $1 billion for-profit venture to acquire or invest in small antibiotic companies and their nascent products, according to two people familiar with the plans. The effort will be announced on July 9 by the chief executive officers at Pfizer, Merck, Eli Lilly, Novo Nordisk, Boehringer Ingelheim, Bayer Pharmaceuticals, and Merck KGaA, among others. Also on hand will be government officials from Germany, Sweden, the U.K., and France, as well as representatives from Wellcome Trust and Pew Charitable Trusts…”
SRHR & GBV
UNFPA - Five things you didn’t know about practices that harm girls
https://www.unfpa.org/news/five-things-you-didnt-know-about-practices-harm-girls
“
Every day, hundreds of thousands of girls around the world are harmed physically or psychologically, with the full knowledge and consent of their families, friends and communities. And without urgent action, the situation is likely to worsen. These are the findings of UNFPA’s flagship 2020 State of World Population report, released today. The report examines the origin and extent of harmful practices around the world, and what must be done to stop them. It identifies 19 harmful practices – ranging from breast ironing to virginity testing – that are considered to be human rights violations. But it focuses on three practices in particular that are widespread and persistent, despite near-universal condemnation: female genital mutilation (FGM), child marriage and son preference. Below are five unexpected, and critical, takeaways from the report….”
BMJ (blog) - Will covid-19 be the catalyst for a “new deal” for the health and wellbeing of women, children and adolescents?
Helen Clark (chair of PMNCH Board);
BMJ blog;
“
This week, I joined online with over 1700 delegates from 120 countries for Lives in the Balance: A covid-19 summit to explore ways of improving and increasing investment in health systems and social protection policies for women, children, and adolescents as the world rebuilds in the wake of the pandemic….”
“PMNCH consulted widely across its partnership, and has developed a seven-point Call to Action on covid-19, urging governments to strengthen political commitment, policies and financing to support:…”
Lancet Letter – US Global Gag Rule increases unsafe abortion
T McGovern; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30921-1/fulltext
“The Trump administration issued the Protecting Life in Global Health Assistance policy in 2017. This policy is an expansion of the Global Gag Rule that blocks US global health assistance to foreign non-governmental organisations that provide, counsel on, refer to, or advocate for abortion services; even if they do so with their own funding and in countries where abortion is legal. Following an additional policy expansion in 2019, foreign organisations that comply with the policy must now attach it to all subgrants that they give to other foreign organisations, including those that do not involve US global health assistance. Researchers have found three crucial effects of the policy: decreased stakeholder coordination and reduced discussion related to sexual and reproductive health and rights; reduced access to contraception with accompanying increases in unintended pregnancy and induced abortion; and negative outcomes beyond reproductive health, including weakening of health-care system functioning. These consequences are all associated with adverse maternal health outcomes….”
Lancet - Comprehensive sexuality education to address gender-based violence
R Rollston et al ;
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31477-X/fulltext
“
The COVID-19 pandemic has unmasked underlying inequities. Measures such as lockdown and physical distancing have confined many people to isolated, unsafe places that may increase risk of gender-based violence (GBV). If lockdowns or restricted movement continue for just a year, it is estimated there will be 61 million more cases of GBV than what would have already been expected. In response to this increase, UN Women launched the Shadow Pandemic public awareness campaign in May, 2020. Meanwhile, the UN Secretary-General has called for countries to include GBV prevention as a component of COVID-19 recovery plans….”
“
GBV is a multifaceted issue, but the failure to implement comprehensive sexuality education (CSE) internationally puts all people at increased risk of violence. CSE includes developmentally and culturally relevant, science-based, medically accurate information on a wide range of topics, including human development, gender identity, sexual behaviours, communication skills, empathy, and mutual respect. CSE teaches the skills needed to develop healthy relationships and to prevent and not perpetrate violence….”
Lancet Commission on Women and Cancer
Lancet (Comment) – A Lancet Commission on women and cancer
O Ginsburg & R Horton;
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31479-3/fulltext
“…
To advance an evidence-based, gendered approach to cancer risk and cancer control, The Lancet Commission on women and cancer will address urgent questions at the intersection of social inequality, cancer risk, and outcomes, and the status of women in society. The Commission will comprise a multidisciplinary and diverse team with expertise in gender studies, human rights, law, economics, sociology, as well as cancer epidemiology, prevention, and treatment. … … We will ask challenging questions about the causes of cancer in women, and “the causes of the causes”, such as the commercial and social determinants of health, that drive the increasing exposures for women to tobacco, alcohol, dietary, and other modifiable risk factors. … The Commission will not, however, be narrowly focused on women's cancers, or solely on the gendered impacts of cancers that affect both women and men. Rather, this Commission will explore the nexus of gender, power, and cancer.”
Black Lives Matter & Decolonize global health
BMJ blog - When Women’s Spaces Don’t Deliver!
https://blogs.bmj.com/bmjgh/2020/06/28/when-womens-spaces-dont-deliver/
Hard-hitting and brave blog by
Shakira Choonara and
Vicci Tallis. Coming back on the ‘Women Deliver’ BLM commotion from recent weeks.
Cfr a
tweet by Shakira: “
When one of the largest movements of women and girls is marked by claims of racism. What is our collective responsibility as a global community, as youth 'activists'? Or do we wait until the loss of life #GeorgeFloyd occurrences then go to protest?”
And a link:
Guardian -
‘Decolonise and rename’ streets of Uganda and Sudan, activists urge
“
Campaigners target statues of slave owners and roads named after imperial armies as protests spread to Africa.”
2020 Triad Statement
https://www.who.int/publications/m/item/2020-triad-statement
No, this has nothing to do with the Chinese triads 😊.
“
Over 600 government chief nursing and midwifery officers, leaders and representatives of national nursing associations and midwifery associations, together with the International Council of Nurses (ICN), the International Confederation of Midwives (ICM), the World Health Organization (WHO) and key partners, including WHO Collaborating Centers for Nursing and Midwifery, regulators, and the Nursing Now campaign, gathered virtually from more than 145 countries for the 8th ICN-ICM-WHO “Triad Meeting” on 16-18 June 2020….”
“…As a result of the proceedings and deliberations of the meeting, the participants within their respective roles commit to supporting WHO Member States in the development and implementation of the following (10) actions, as relevant to the national and local context:…” Check out what these 10 actions are. Our favourite ones are (3) and (10).
Exemplars in Global health platform
Exemplars in Global Health;
Exemplars in Global Health just launched new findings on national success stories.
“
Exemplars in Global Health is a coalition of experts, funders, and collaborators around the globe, supported by Gates Ventures and the Bill & Melinda Gates Foundation, who share the belief that rigorously understanding global health successes can help drive better resource allocation, policy, and implementation decisions. …. … The Exemplars in Global Health platform was created to help decision-makers around the world quickly learn how countries have solved major health and human capital challenges. Our goal is to ensure that our research helps you take action….”
“…
With input from in-country and global experts, we analyze countries that have made extraordinary progress in important health outcomes and disseminate the key takeaways. Our hypothesis is that the lessons contained in this growing list of Exemplar narratives will be a resource to leaders committed to improving health and achieving success in their countries….”
So it’s about
studying positive outliers and learning from them.
WHO Bulletin (July issue)
https://www.who.int/bulletin/volumes/98/7/en/
Do check out first
the Editorial -
Tackling antimicrobial resistance in the COVID-19 pandemic
H Getahun et al argue that
antimicrobial stewardship activities should be integrated into the pandemic response across the broader health system
through five measures.
Some papers & reports of the week
HS Governance collaborative - Private sector landscape in mixed health systems: new drafts documents available
https://hsgovcollab.org/en/news/private-sector-landscape-mixed-health-systems-new-drafts-documents-available
“…
Seven discussion documents have been commissioned by the World Health Organization and recommended by the Advisory Group on the Governance of the Private Sector to support the development of a WHO strategy: Private Sector Utilization: Insights from Standard Survey Data; Measuring the size of the private sector: metrics and recommendations; Engaging the Private Health Sector to Advance Universal Health Coverage: WHO Eastern Mediterranean Region Case Study; Principles for engaging the private sector in universal health coverage; Private sector accountability for service delivery in the context of UHC; International organizations and the engagement of private healthcare providers; Private Health Sector Engagement in the Journey towards Universal Health Coverage: Landscape Analysis.”
Global Health Promotion - Addressing the commercial determinants of health begins with clearer definition and measurement
K Lee et al ;
https://journals.sagepub.com/doi/full/10.1177/1757975920931249
Cfr a few tweets:
Luke Allen: “
Nice distinction between #CDOH definitions from academics vs @who ; the latter lumps commercial actors in with all non-state actors in most of its texts”
Kent Buse: “
In new editorial @profplum8 & Nick Freudenberg argue that a composite index on commercial determinants of health could help better help target prevention efforts at all levels - and particularly for #NCDs.”
BMC Public Health - Defining the commercial determinants of health: a systematic review
C de Lacy-Vawdon et al ;
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09126-1
« …
This research aims to articulate the CDoH as described in the literature, summarize substantive findings, and assess strengths and limitations of current literature.”
Some of the
results & conclusions: “
The dynamics constituting CDoH include broad facilitators such as globalization of trade, corporate structures, and regulatory systems, articulation of social and economic power, neoliberal and capitalist ideologies; additional elements include corporate activities such as marketing, corporate political activities, corporate social responsibility, extensive supply chains, harmful products and production, and issues of accessibility. These contribute significantly to worsened global health outcomes. … … Literature describing effects of macro conditions and corporate activities on health could usefully utilize CDoH terminology. Facilitation via revised, consistent and operational definition of CDoH would assist. Social, political, commercial and economic structures and relations of CDoH are under-theorized. Systematic approaches to identifying, describing, and disrupting these are required to improve global health. »
BMJ GH - Operational research to support equitable non-communicable disease policy in low-income and middle-income countries in the sustainable development era: a scoping review
N Gibbs et al ;
https://gh.bmj.com/content/5/6/e002259
Their conclusion: «
Overall, OR (Operational Research) for NCD health policy in the SDG era is being applied to a diverse set of interventions and conditions across LMICs and researchers appear to be concerned with equity. However, the current focus of published research does not fully reflect population needs and the analysis of differential impact within populations is rare. “
HP&P - What happens when performance‐based financing meets free healthcare? Evidence from an interrupted time‐series analysis
N Kuunibe, M de Allegri et al;
https://academic.oup.com/heapol/article-abstract/doi/10.1093/heapol/czaa062/5864946?redirectedFrom=fulltext
“
In spite of the wide attention performance-based financing (PBF) has received over the past decade, no evidence is available on its impacts on quantity and mix of service provision nor on its interaction with parallel health financing interventions. Our study aimed to examine the PBF impact on quantity and mix of service provision in Burkina Faso, while accounting for the parallel introduction of a free healthcare policy….”
SS&M - Is it Unfair for the Affluent to Be Able to Purchase “Better” Healthcare? “Existential Standards” and “Institutional Norms” in Healthcare Attitudes across 28 Countries
E Immergut et al ;
https://www.sciencedirect.com/science/article/pii/S0277953620303658
“
Existing research has found that individuals often perceive healthcare inequalities as unfair; yet, there is high variation in unfairness perceptions between countries. This raises the question of whether the institutional context of the healthcare system is associated with what people perceive as just. Using data from the ISSP study and OECD health expenditure data from 2011/13, we explore whether individual attitudes about the unfairness of healthcare inequality – the ability to purchase “better” healthcare for the affluent – vary systematically with a country’s institutional environment: namely, with the prevalence of cost barriers to healthcare access, and with the degree and type of public healthcare financing. Three general findings emerge from the analysis: (1) Higher cost barriers correlate with lower levels of perceived unfairness in healthcare inequality, suggesting those exposed to greater levels of inequality tend to be more accepting of inequality. This finding is consistent with empirical justice theory and the expected relevance of an ‘existential’ standard of justice, stemming from individuals’ proclivities to accept the status quo as just. (2) Further, greater public financing of healthcare correlates with higher perceived unfairness. Drawing on neo-institutionalist theory, this may suggest that greater public financing enshrines access to healthcare as a universal right, and hence provides an ideational framing that delegitimizes unequal opportunities for purchasing better healthcare. (3) Further, higher unfairness perceptions of lower income and educational groups are more strongly associated with greater public financing than those of their respective comparison groups. This may indicate that the normative right to healthcare is of particular importance to the disadvantaged, which could potentially explain the political quiescence on healthcare of lower income and educated persons in societies that lack universal health systems. In sum, this study contributes to the larger debate on the interrelatedness of healthcare institutions and public opinion, and specifically on perceptions of injustice.”
Georgetown Law - The Origins and Future of Global Health Law: Regulation, Security, and Pluralism
Sam F Halabi;
https://www.law.georgetown.edu/georgetown-law-journal/in-print/volume-108-issue-6-june-2020/the-origins-and-future-of-global-health-law-regulation-security-and-pluralism/
Cfr a tweet
: “Prof. Sam F. Halabi (of @MizzouLaw ) traces the origins of global health law and argues that COVID-19 is a dramatic illustration of the movements in global health. “ 48 p.
“…The result of these movements is the future of global health law: regulation, security, and pluralism.”
Global Social Policy - Universal Health Coverage: ensuring migrants and migration are included
D Mosca et al ;
https://journals.sagepub.com/doi/abs/10.1177/1468018120922228?journalCode=gspa#articleShareContainer
With a number of recommendations.
SS&M - Fragmentation by design: universal health coverage policies as governmentality in Senegal
P Mladowsky;
https://www.sciencedirect.com/science/article/abs/pii/S0277953620303725
« UHC’s role in making citizen subjects and autonomous subjects is underestimated. Making subjects is a key political driver of UHC fragmentation. Interventions that aim to reduce fragmentation overlook this rationality of UHC. Fragmentation may be an inherent feature of UHC. »
Cambridge working paper - Cut Hours, Not People: no work, furlough, short hours and mental health during the COVID-19 pandemic in the UK
https://www.sociology.cam.ac.uk/sites/www.sociology.cam.ac.uk/files/v6_covid_paper_ghq-12_and_employment_20200629_bb.pdf
Via the monthly
FT Health newsletter.
This advice should be part of the #
Buildingbackbetter” agenda, in our opinion. And not just in the UK.
“…
People who have continued to work at least part time during the coronavirus lockdown have far fewer mental health problems than those who have lost their jobs, according to the most comprehensive study of workers across Britain during the pandemic. Research led by academics at Cambridge university argued that employers should share employment more equitably during the recovery, through shorter working weeks to limit unemployment and the associated rise in mental illness….”
Global Social Policy - Focusing on policy coherence to achieve UHC: The social protection floor approach
https://journals.sagepub.com/doi/10.1177/1468018120935715
By
X Scheil-Adlung. On social protection floors (SPF) as a strategy to address inequities. “Achieving UHC is largely supported and sustained by ensuring policy coherence through SPF strategies.” With
Thailand as an example, the author argues.
Lancet Comment – Investing in surgery: a value proposition for African leaders
D T Jumbam et al ;
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30482-7/fulltext
“…
The need for strengthening surgical care systems is especially urgent in sub-Saharan Africa, where access is strikingly limited, leading to the highest mortality and morbidity from surgically preventable and treatable conditions in the world. Approximately 93% of the population of sub-Saharan Africa lacks access to safe, affordable, and timely surgical care, compared with less than 10% in high-income countries. Despite the immense and growing need for surgical services in sub-Saharan Africa, investments by African public sector leaders to improve surgical systems on the subcontinent have been inadequate….”
“There is a basic ethical responsibility to provide surgical care as a fundamental human right, in keeping with the principles espoused in the Universal Declaration of Human Rights. Additionally, improved access to high-quality surgical care is an essential component of universal health coverage and will contribute to good health and wellbeing, leading to improved human capital—all of which are vital for poverty reduction and economic growth on the continent. … … African leaders have an ethical, social, and economic responsibility to invest in surgical care to increase the individual, societal, and national human capital needed to reap its demographic dividend.”
Some other mainstreams news & blogs of the week
New Internationalist – Broken bonds
https://newint.org/features/2020/06/11/covid-19-broken-bonds
Liam Taylor on the World Bank’s waning reputation in pandemic response. Update on the WB’s pandemic bonds.
“… ‘
There were plenty of people in the Bank who knew it wouldn’t work,’ says Olga Jonas, an economist at the Harvard Global Health Institute who previously worked on pandemic risk at the Bank. ‘This was meant to be impressive and innovative and flashy, to send a signal that the World Bank is solving something.’ These kinds of ‘exotic financial instruments’ were unnecessary, adds Jonas, because the World Bank can cheaply raise its own money from donor countries and capital markets, such as the $160 billion it expects to deploy in response to the Covid-19 crisis. ‘Public health is a public responsibility so it’s a big mistake to delegate it to private capital,’ she says….”
““‘
This instrument is not fit for purpose and seems better designed for the needs of private investors rather than development,’ says Mark Perera of Eurodad, a civil-society network. The World Bank says it will not renew the insurance after the current bonds mature in July. The announcement was made quietly on their website in April, this time without a video.”
Bloomberg – Covid-19 Shows That Scientific Journals Need to Open Up
https://www.bloomberg.com/opinion/articles/2020-06-30/covid-19-shows-scientific-journals-like-elsevier-need-to-open-up
“Publishers have had a good 355 years, but change is coming.”
Katri Bertram - Where does our responsibility in global health end?
https://katribertram.wordpress.com/2020/06/29/where-does-our-responsibility-in-global-health-end/
Reflection, helping to spur debate on
how global health can get to
transformative change, at the scale required, and asap.
CGD (blog) - Out of Tragedy Comes Opportunity: How Can Global Health Multilateralism Seize the Moment?
J Kaufman et al ;
https://www.cgdev.org/blog/out-tragedy-comes-opportunity-how-can-global-health-multilateralism-seize-moment
“
Last month, CGD and the Global Fund to Fight AIDS, Tuberculosis, and Malaria convened a high-level discussion, chaired by CGD President Masood Ahmed, to explore some of the rapidly evolving answers to these questions.”
With
3 key takeaways: 1. The true cost of COVID-19 will likely be measured by its impact on other health services.; 2. COVID-19 is both a devastating emergency and momentous opportunity to build a better future for health financing. 3. More health for the money is an essential element of domestic and global health policy.
Global Governance Project (blog) - Threats to the foundations of global health
I Kickbusch;
https://www.globalgovernanceproject.org/threats-to-the-foundations-of-global-health-2/
"
This is the critical warning: it is essential that major health challenges are taken to the #G7 and #G20, but those institutions must not fall prey to geopolitical posturing and conflicts”.
Some tweets of the week
Kai Kupferschmidt
“5 months. 10,000,000 cases. 500,000 dead. When @WHO declared #covid19 a global emergency on 30.1. there were less than 10 thousand confirmed cases. Five months later, the world has passed 10 million confirmed cases. Half a million people have died. Let that sink in.”
Ilona Kickbusch
“Health has always been political but never before has #globalhealth been so entangled with and dependent on #geopolitics.”
World Health Summit
(on Germany becoming the president of the EU Council from 1 July on)
“Germany has declared strengthening global health as one of the priorities during its Council Presidency. The Role of the #EU in global health is one of the topics at #WHS2020.”