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Dear Colleagues,
With a new, potentially (ultra-) nasty variant in town, described as having “a Frankenstein mix of mutations” in the NYT (which seems to fit the ongoing horror show that the Covid pandemic is), we are entering the third year of Covid-19. Increasingly, we realize we’re in this for the long haul and will have to learn to live with the virus. Unfortunately, though, as dr. Tedros said at this week’s Special Session of the World Health Assembly (WHASS2), “The lack of a consistent and coherent global approach has resulted in a splintered and disjointed response, breeding misunderstanding, misinformation and mistrust”. Adding, correctly, “Globally, we have a toxic mix of low vaccine coverage, and very low testing – a recipe for breeding and amplifying variants.”
Let’s hope the world will do ( a lot) better in 2022. Even if the evidence is perhaps a bit shaky (see the scientific speculation on the origins of Omicron), I certainly agree that activists should use the Omicron “We told you so” moment big time, and seize the window of opportunity to get to more global vaccine (and other treatment/diagnostics/…. ) equity. If Thomas Cueni can say whatever (or certainly not more than “half- truths”) in fora like FT and Stat, not to mention Albert “Equity is our North star” Bourla, the other side shouldn’t be shy either 😊. Even more so as the general case for vaccine equity remains really strong, both on normative and ‘enlightened interest’ grounds.
In this newsletter issue, we focus among others on WHASS2 (where Omicron also seemed to spark a sense of urgency), the TRIPS waiver discussions and activism (including the very unfortunate MC12 postponement), the 8th Forum on China-Africa Cooperation (FOCAC), and World AIDS day.
PS: We also learnt this week some people are being called “Gatesologists” 😊. Here’s to more ‘Gatesologists” in global health !
Enjoy your reading.
Kristof Decoster
As you know, during the session, the Member States were to consider the following single substantive agenda item: “Consideration of the benefits of developing a WHO convention, agreement or other international instrument on pandemic preparedness and response with a view towards the establishment of an intergovernmental process to draft and negotiate such a convention, agreement or other international instrument on pandemic preparedness and response, taking into account the report of the Working Group on Strengthening WHO Preparedness and Response to Health Emergencies.”
We start first with analysis as WHASS2 was kicking off, on Monday morning, and then continue with Tedros’ speech, and more analysis as WHASS2 progressed. And then of course the adoption of the decision on Wednesday (plus some analysis).
Must-read analysis & coverage, as WHASS2 was starting on Monday morning.
“In a first face-to-face meeting in Geneva since the start of the COVID-19 pandemic, the World Health Organization’s 194 member states appeared set to adopt a landmark decision to negotiate a new treaty or framework convention governing pandemic response, dubbed “Our World Together”, and with over 100 countries now declaring co-sponsorship. But from the start of talks at Monday’s World Health Assembly (WHA) Special Session, it was clear that countries still have very different ideas of how this new legal instrument will take shape – and the role it would play alongside the 2005-era International Health Regulations – that now govern pandemic response, but which critics say has been too weak, ineffective, incomplete, and out-of-date for the current crisis. “
“….Notably, among the dozens of countries that took the floor both in person and remotely at the hybrid session, China sounded the most “treaty hesitant” affirming that “China supports amending the international health legal system with the IHR at its core.” …. … In comparison, the United States, which had been treaty skeptic until very recently, was now sounding almost bullish on the potential advantages a new treaty could offer – light of the failings of the existing IHR legal framework. ….”
More coverage at the start of WHASS2:
· Reuters - WHO reaches draft consensus on future pandemic treaty
“Member states of the World Health Organization have reached a tentative consensus to negotiate a future agreement on preventing pandemics, bridging the gap between sides led by the European Union and United States, diplomats said on Sunday…..”
· HPW - Milestone Moment for Pandemic Treaty in Geneva – Calls for Tough Decisions by Countries (including some in-depth analysis of different legal options being discussed)
Plus: “… Next stop – UN General Assembly Summit: …. there is also building momentum for a summit to be convened by the UN General Assembly soon after the WHA session. There, world leaders would be called upon to adopt a wider political declaration and roadmap for beating down COVID and preventing future pandemics. That roadmap would include, presumably, steps to ensure more sustainable financing for low- and middle-income countries’ pandemic preparedness and vaccine access. “ Wait & see, I guess.
· FT - Global leaders set to discuss pandemic treaty
“Opinions are split over a legally binding agreement on tackling future infectious diseases.”
“… A key question remains, though, about the status of any new legal instrument. At its most powerful, the WHO’s 1946 constitution permits the creation of a convention. The single example to date, the Framework Convention on Tobacco Control, which was established to tackle the debilitating effects of smoking on conditions including cancer and cardiovascular disease, was adopted in 2003. But some officials and policymakers involved in that process are wary of the distraction and delays of a similar effort today. It took a decade from initial discussions in 1995 until its approval in 2003 and its enactment with legal force in 2005. … …. Steven Solomon, principal legal officer at the WHO, is more optimistic about a new instrument. “There is some urgency to seize the moment for WHO and the world,” he says. “It’s conceivable with political will, something could be concluded relatively quickly with the details to be worked out.” He points out that, short of a full treaty requiring ratification, delegates this week could opt instead for a new regulation, similar to the Paris accords on climate, which does not require ratification by each country…..”
· NPR - The WHO is seeking a new treaty on handling future pandemics. It could be a hard sell
(with Suerie Moon’s view among others).
https://apps.who.int/gb/ebwha/pdf_files/WHASSA2/SSA2_CONF1Rev1-en.pdf
The 3-page draft, published on Sunday.
Omicron COVID variant underlines need for global ‘pandemic treaty’
Good coverage of the opening messages by Dr Tedros at WHASS2. “The emergence of the threatening new Omicron variant shows how important it is for the world to end the current “cycle of panic and neglect” over the COVID-19 pandemic, said the head of the World Health Organization (WHO) on Monday.”
Among others: “Tedros said the world has not responded accordingly to COVID-19, and vaccine inequity, among other challenges, has facilitated the appearance of new highly mutated variants such as Omicron…. …. “
““The UN Secretary-General also expressed his deep concern on Monday for the isolation now being felt by southern African countries due to the new restrictions imposed on travel from the region, by dozens of nations across the world. “The people of Africa cannot be blamed for the immorally low level of vaccinations available in Africa – and they should not be penalized for identifying and sharing crucial science and health information with the world”, said António Guterres, in a strongly-worded statement. ….”….”
Speech Tedros in full: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-special-session-of-the-world-health-assembly---29-november-2021
Tuesday’s edition of GHF, zooming in among others on WHASS2. A few quotes:
“ Equity has become buzzword, a term that is central to the success of the negotiations for a new legal instrument. We hope that it will not go down the road of the word “solidarity” - a term full of promise, but one that delivered so little. … “
“…. Statements made by many member states at the Special Assembly illustrate the rich diversity in countries' positions revealing a wide spectrum on where member states stand on the various legal options ahead to frame new rules to govern health emergencies. Countries called for transparency and inclusiveness in the negotiations of new rules. Developing countries have categorically stated that addressing inequities is central to the effectiveness of a new instrument, demonstrating their reason for supporting new rules to govern health emergencies. Even in these early stages it is obvious that the success of these negotiations will hinge on having binding commitments on equity.”
“… Another clear message emerging from the on-going Assembly is the strong political support enjoyed by International Health Regulations.
“… A number of Southern African countries including South Africa, Botswana protested against the imposition of travel restrictions as a result of the detection of the new variant Omicron. Botswana said that countries must incentivise detection and response, not impose travel measures. South Africa hoped that new instrument will address the imposition of punitive travel measures in the context of pandemic preparedness and response….”
Coverage of Tuesday.
“While the vast majority of World Health Organization (WHO) member states expressed support for a negotiated pandemic “instrument” at Tuesday’s World Health Assembly special session (WHASS), many also urged the strengthening of the International Health Regulations (IHR) – currently the only existing legal framework to address pandemics. ….… The agreement to set up an intergovernmental negotiating body to strengthen pandemic prevention, preparedness and response” has been co-sponsored by 114 of the 194 members….”
“However, the new instrument – variously called a treaty, convention and agreement – is likely to take at least 18 months of negotiations to come into existence. The best-case scenario for a “pandemic treaty” agreement is by mid- 2023. … … …. A wide range of civil society observers addressed Tuesday’s session, and most appealed for a well-funded, nimble body that was based on solidarity and equity…..”
“In a consensus decision aimed at protecting the world from future infectious diseases crises, the World Health Assembly today agreed to kickstart a global process to draft and negotiate a convention, agreement or other international instrument under the Constitution of the World Health Organization to strengthen pandemic prevention, preparedness and response… … The Health Assembly met in a Special Session, the second-ever since WHO’s founding in 1948, and adopted a sole decision titled: “The World Together.” The decision by the Assembly establishes an intergovernmental negotiating body (INB) to draft and negotiate a WHO convention, agreement, or other international instrument on pandemic prevention, preparedness and response, with a view to adoption under Article 19 of the WHO Constitution, or other provisions of the Constitution as may be deemed appropriate by the INB…..”
“… Under the decision adopted today, the INB will hold its first meeting by 1 March 2022 (to agree on ways of working and timelines) and its second by 1 August 2022 (to discuss progress on a working draft). It will also hold public hearings to inform its deliberations; deliver a progress report to the 76th World Health Assembly in 2023; and submit its outcome for consideration by the 77th World Health Assembly in 2024…..”
Coverage via HPW - Standing Ovation as WHO Member States Commit to Negotiating New Pandemic Accord Well worth a read.
Includes the civil society reaction - Civil Society Report Raises Concerns About Proposed Pandemic Treaty
Via Politico’s Global Pulse “….the agreement, to be signed in May 2024, would likely cover four major issues: governance and leadership, money for preparedness, global systems and tools that can be activated during health crises and equitable access to goods…..” “But countries disagree whether the agreement should be a legally binding treaty. Some want the legal form decided before the content, while others want the content negotiated before the legal form, said Jaouad Mahjour, WHO assistant director-general on emergency preparedness….”
And via Devex - US ‘not reluctant’ as WHA agrees to negotiate pandemic accord (J L Ravelo)
https://www.nature.com/articles/d41586-021-03596-y
Must-read. “Following a failure to rein in COVID, world leaders begin shaping an accord to prevent future disasters — one that holds them accountable.”
“… Here, Nature explains the negotiations and the prospects for revamping global cooperation….”
Some excerpts:
“… the biggest decision made at the assembly is to collectively develop an accord, agreement or other ‘new instrument’ to govern pandemic response, including ensuring the equitable distribution of diagnostics, drugs and vaccines. A measure outside of the IHRs is helpful, experts say, because those regulations do not oversee vaccines and other means of fighting pathogens. The original proposal for such an ‘instrument’, driven largely by the president of the European Council, Charles Michel, contained toothy terms such as ‘legally binding’ and ‘treaty’, but they were notably absent from today’s announcement. Treaties tend to be legally binding such that a country not in compliance might be taken to international court. “
“…. Many presidents and prime ministers ignored WHO recommendations regarding the COVID-19 pandemic and have not been held accountable for their actions, according to several analyses. For this reason, the European Council and Tedros, along with several countries, including Germany, France, and South Africa, have expressed their strong support for a legally binding pandemic treaty. But putting it — or another measure that holds countries accountable — in place would require adoption by two-thirds of the WHO’s 194 member states. Countries, including the United States and China, that are particularly defensive about their sovereignty, often oppose treaties, preferring terms such as ‘accord’ that can be interpreted differently, depending on the country. “If you’re more strict, you might get less buy-in,” explains Alexandra Phelan, a global health lawyer at Georgetown University in Washington DC. Indeed, backing off of the more rigid terminology of ‘treaty’ seems to have drastically increased the number of countries willing to consider the proposal, with all 194 member states reaching a final consensus to move forward. …”
https://www.bmj.com/global-pandemic-treaty
“This collection was proposed by the Global Health Centre at the Graduate Institute of Geneva, in the frame of a research project on a pandemic treaty co-chaired by Ilona Kickbusch and Haik Nikogosian. The collection was launched on the occasion of the Special Session of the World Health Assembly 29 November - 1 December 2021….”
Most of these papers & comments were already published online before. But make sure you read also:
BMJ - Can geopolitics derail the pandemic treaty?
“During the pandemic, the world has experienced how the geopolitics of global health have immediate, ruthless repercussions for the lives and livelihoods of billions, say Ilona Kickbusch and Anna Holzscheiter. The challenge of a pandemic treaty negotiation process is to be responsive to these interconnected levels of geopolitics”
D Fidler; https://www.thinkglobalhealth.org/article/case-against-pandemic-treaty-0
“Strengthening global health governance after COVID-19 does not require a pandemic treaty”.
“The case against a treaty questions the health, political, and legal components of this strategy and identifies potentially more effective ways to reconstitute global health governance after the COVID-19 disaster…..”
Well worth a read, David Fidler’s stance. However, I don’t quite get his case for a “pandemic concert” strategy.
“…. A “Pandemic Concert” Strategy: The COVID-19 debacle has created demand for collective action under malignant political conditions. This context requires an approach not centered on one treaty regime. What is needed is a dynamic concert of states, international organizations, and non-governmental actors that creates and facilitates global health projects and draws them together in a web of reinforcing and resilient strands…..”
https://www.ft.com/content/a667cf42-dabc-480f-8c0f-ccf5e8d6eb42
“Policymakers believe reform of Nagoya Protocol is essential to fighting the next pandemic.”
PS: As always, Thomas Cueni (IFPMA) seems to have ‘preferential access’ to the FT (and to STAT, by the way).
“… despite the ease of cross-border scientific collaboration over Omicron, some global health experts fear the international law on pathogen sharing is more likely to hamper, rather than hasten, the development of diagnostics, drugs and vaccines to combat future pandemic threats. Their anxiety centres on the rules enshrined in the Nagoya Protocol, a legally binding agreement that guarantees 196 signatory countries access to the products of scientific research done on plants, animals and genetic resources — including pathogens — emerging from their territory. The US is one of the few major nations that never signed up to the protocol. This week, policymakers from around the world will meet at a special session of the World Health Assembly to discuss global preparedness for the next pandemic, and the hotly debated idea of reforming the Nagoya Protocol will be on the table. The protocol, which was added to the Convention on Biological Diversity (CBD) in 2014, calls for signatories to be “mindful” of public health emergencies. However, scientists and pharma industry leaders say it is too open to exploitation by countries looking to barter over pathogens….”
“Some countries consider pathogens a genetic resource under the protocol [and], as a result, are controlling who can access them and when,” says Thomas Cueni, director-general of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA)….”
“… “There’s a fairly clear north-south divide on the issue . . . rich countries want pathogens to study and the global south wants technologies in return,” explains Suerie Moon, co-director of the global health centre at the Geneva-based Graduate Institute of International and Development Studies.” And they are damned right.
Related link: Stat (Op-Ed) - Countries shouldn’t invoke the Nagoya Protocol to avoid sharing pathogens and genetic sequences (by Thomas B. Cueni, with the Pharma view)
D Heymann, I Kickbusch et al; https://globalchallenges.org/wp-content/uploads/2021/11/A-new-understanding-of-global-heath-security.pdf
“…. We propose a new understanding of GHS based on three interlocking functions at the national level. This synergistic approach to universal health coverage, health security, and health promotion was also recently discussed by a Lancet Commission, to be part of an upcoming publication: 1. Resilient healthcare systems with built-in surge capacity (including for primary healthcare); 2. Resilient public health core capacities that meet IHR standards; 3. Proactive investments toward supportive environments, wellbeing and healthy populations. In this article, we explore the structural benefits of the three interlocking functions, propose ways to build them into our existing health architecture, and focus on the two essential requirements of global accountability and sustainable support for low-and-middle-income countries (LMICs)…..”
“….this post will begin with a thorough analysis of the use of soft and hard law in the realm of global health law. It will then argue that rather than focusing on the a priori debate on which of the two approaches is better suited to tackle global health challenges, in the development of new global health instruments more attention should be paid to: a) how soft and hard law can interact with each other; and b) how to foster respect for the norms, irrespective of whether they are legally binding. In the latter regard, capacity-building, compliance mechanisms and engagement with non-State actors should be given due consideration…..”
N Rhodes; https://phmovement.org/do-we-need-a-pandemic-treaty-now-policy-brief-by-peoples-health-movement/
“…This policy brief explores some of the questions raised by the proposal for a new Pandemic Treaty at the World Health Organization (WHO) and assesses the limitations of existing binding instruments, such as the International Health Regulations (IHR) of 2005….”
“…This Policy Brief starts with a background to the Pandemic Treaty and the IHR and the context in which they emerged. This is followed by consideration of key issues: legal considerations of a Pandemic Treaty, fragmentation of health emergency preparedness and response, the need for sustainable and untied funding, and gaps in existing health emergency preparedness and response. The last section concludes with recommendations in view of the World Health Assembly Special Session on the Pandemic Treaty scheduled for 29 November to 1 December 2021.”
First updates from this week, in a next section some analysis.
https://www.ft.com/content/0f5b811e-0681-479e-9f78-f4c8d0796b4a
That was a big bummer. “The World Trade Organization has postponed its biennial ministerial meeting after Switzerland tightened travel restrictions to control the new Omicron variant of coronavirus. The decision was made at an emergency meeting of ambassadors in Geneva on Friday, diplomats told the Financial Times. The meeting was due to begin on Monday but Switzerland banned travel from southern Africa and said that people from Belgium and Israel, where cases have been detected, would have to quarantine for 10 days. That ruled out most of the EU delegation from travelling. The decision was taken “in light of the deterioration of the sanitary conditions and travel restrictions”, according to an internal communication seen by the FT…..”
“… Ngozi Okonjo-Iweala, WTO director-general, said on Thursday that the IP talks were “stuck”. However, ministers had hoped to conclude a deal to protect fish stocks by ending subsidies for deep-sea fishing. India and some EU countries were still resisting but WTO officials believed that a deal could be thrashed out after 20 years of talks. The news is a blow to the 164-member body. It cannot fulfil one of its main functions, to adjudicate trade disputes, because the US is refusing to nominate panellists to its appellate body. Ministers were expected to begin a debate on WTO reform….”
GHF;
After the postponement of MC12, now what?
“…. Moving quickly after the set back over the weekend, when travel restrictions froze plans of negotiators traveling to Geneva, the TRIPS Council met on Monday to discuss next steps. At the meeting, WTO members decided to continue consultations on the proposal by South Africa, India, and the proposal by EU, sources familiar with the developments said. Members want to continue with the momentum and to find an outcome "under the changed circumstances". Members have agreed to keep this agenda open so that the TRIPS Council can be convened at short notice. Small group consultations are expected to continue, with next Council meetings scheduled on the 10th and 16th December and possibly earlier, according to trade officials….”
“…. In the absence of the ministerial, WTO members will need to consider the TRIPS Waiver, potentially in isolation, and not relative to other deliverables (fisheries, agriculture, WTO reforms) that were linked to the conference. … …. While there is an expectation that the waiver should be considered and approved at the General Council in the interest of time, without waiting for the Ministerial to convene, trade sources suggest that the likelihood of that happening is remote. “The EU and others, will want to discuss the waiver relative to other outcomes,” a developing country diplomat told us. ….” “…In addition, the overall WTO’s response to the pandemic, is potentially another negotiating forum, to discuss the waiver proposal. …”
See also WTO - WTO members support maintaining momentum of discussions on common IP COVID-19 response Statement after the formal meeting of the Council for Trade-Related Aspects of Intellectual Property Rights (TRIPS) on 29 November.
And TWN - Pressure mounts on WTO to show its “human face” on TRIPS waiver
“….Pressure is mounting on the World Trade Organization to demonstrate that it has a “human face” by resolving the issue of the temporary TRIPS waiver to fight the growing threat posed by “vaccine inequity” and “vaccine apartheid” that seems to have contributed to the emergence of the new Omicron variant of the SARS-CoV-2 virus that causes COVID-19….”
https://www.politico.eu/article/omicron-outbreak-eu-vaccine-access-southern-africa/
Analysis from Monday. “India and South Africa want a waiver on patents, but Brussels is not budging.” Excerpts:
“An outbreak of the new Omicron coronavirus variant in Southern Africa is boosting critics of the EU, who say that Brussels is preventing a quick roll-out of jabs across poor nations by zealously defending vaccine patents. The European Commission always knew that this was going to be a tough week, in which its trade officials risked being politically isolated as Big Pharma's top allies in a debate over waiving intellectual property on vaccines at a World Trade Organization summit in Geneva. Ultimately, the WTO summit had to be postponed because of Omicron, but that doesn't mean EU diplomats can breathe a sigh of relief that they are suddenly off the hook. Quite the reverse. Advocates of wider vaccine access are immediately leaping on the new variant and the cancellation of the WTO event as evidence that rich countries cannot hope to beat the virus unless developing nations have blanket vaccination too.” “The People's Vaccine, a coalition of over 50 organizations calling for vaccines to be freely available and IP restrictions lifted, made the link between the postponement of this week's WTO meeting and the need to allow wider use of big companies' medical recipes….”
“… The WTO summit planned for this week was widely viewed as a critical test of the institution's credibility. … While the summit has been postponed, negotiations will continue….”“Europe talked a good game in the past few days and even hinted at a softening in its stance but, in reality, nothing has changed in its fundamental position, meaning that the Commission is likely to face increasing flak over Omicron. … Behind closed doors, the Commission has been more adamant that it's not budging. …. Last week, some European countries asked Brussels to show more flexibility in Geneva, according to notes from an EU ambassadors’ meeting on Wednesday, seen by POLITICO. But the Commission insisted that it would stand its ground. A broad waiver on intellectual property rights is a no-go, according to both the EU ambassadors’ meeting notes and several officials involved in the negotiations. …”
“… The EU’s hope is that Washington, despite its public support for the waiver, will keep up its traditional backing for IP in practice. But so far, the U.S. side hasn't given any indication of its game strategy in the weeks ahead. “They hold the cards,” one of the diplomats said. "If they side with South Africa and India with some sort of waiver, this risks going wrong for the EU."Link:
MSF Access - MSF and supporters urge high-income countries blocking the landmark TRIPS Waiver to put proclaimed global solidarity into practice and support the Waiver now (29 Nov)
“As the World Trade Organization (WTO) TRIPS Council meets today, after the indefinite postponement of the 12th Ministerial Conference due to the emergence of the highly transmissible strain of the COVID-19 virus along with changes in border rules for Switzerland, Médecins Sans Frontières/Doctors Without Borders (MSF) again deplored the dogmatic opposition to the landmark TRIPS Waiver proposal to temporarily waive intellectual property (IP) rights on COVID-19 medical products by a group of high-income countries including the European Union (EU), the United Kingdom and Switzerland. …”
“Nursing unions in 28 countries have filed a formal appeal with the United Nations over the refusal of the UK, EU and others to temporarily waive patents for Covid vaccines, saying this has cost huge numbers of lives in developing nations. The letter, sent on Monday on behalf of unions representing more than 2.5 million healthcare workers, said staff have witnessed at first hand the “staggering numbers of deaths and the immense suffering caused by political inaction”. … However, other countries have resisted. The letter to the UN – coordinated by the healthcare umbrella organisation Global Nurses United, and Progressive International, a collection of leftwing parties, movements and unions – cited what it called an “immediate threat to people’s right to health” from the EU, UK, Norway, Switzerland and Singapore. It said that at least 115,000 medical and healthcare staff around the world have died as a result of Covid, and that while 40% on average have been fully vaccinated, in Africa and the western Pacific the figure is lower than one in 10…..”
“After the 12th WTO Ministerial Conference was called off following the discovery of the Omicron variant, trade unions, civil society organizations and parties on the left ramped up actions in favor of a TRIPS waiver for Covid-19 medical products.” Coverage of the morning on 30 November, in Geneva.
https://www.twn.my/title2/intellectual_property/trips_waiver_proposal/CSOLettertoWTODG_1Dec.pdf
That’s exactly right.
Nick Dearden; https://www.theguardian.com/commentisfree/2021/nov/29/developing-nations-wto-vaccine-patents-covid-britain
“The summit, billed as critical for an institution in crisis, is now indefinitely postponed. The irony, not lost on many delegates from Africa, Asia and Latin America, is that global trade rules overseen by the WTO are actually at the heart of the dreadful situation the world is now confronting….”
“… For many, the WTO’s legitimacy expired a long time ago. But the failure to agree a Trips waiver in the past 12 months is the final straw in the eyes of many African, Asian and Latin American governments. If the WTO fails to reform, they will simply have to begin doing things differently….”
J Stiglitz et al ; https://edition.cnn.com/2021/11/30/perspectives/wto-vaccine-restrictions-covid/index.html
Crisp & to the point: "… The WTO must not postpone this decision. It needs to call an online meeting of its General Council and adopt the waiver this week."
U Karunakara; https://healthpolicy-watch.news/europe-treaty-pandemic/
Hard to argue with his conclusion: “The IHR needs to be strengthened. Perhaps we need a treaty. But countries that oppose the TRIPS waiver need to demonstrate that they are willing to put public health before corporate interests. Unanimous support for a TRIPS waiver is the required show of good faith needed for further engagement on a pandemic treaty, for sceptical nations and hesitant civil society groups. WTO Ministers should no longer use COVID-19 transmission as an excuse to delay decisions that could help bring the pandemic to a halt.”
· Politico - Vaccine squabble tests global trade ties as WTO meeting postponed With analysis of Ngozi’s track record so far at the helm of WTO, whether she’s the right person to lead WTO in this time of near existential crisis of the organization etc.
· Geneva Health Files (Deep Dive) - At WTO, Some Developing Countries: "No Waiver - No Walker";
“The Walker Process that has been established to script the WTO response to the pandemic, is now also increasingly under pressure to adequately address questions on intellectual property. … “Mere protestations against the waiver has not helped. The Walker Process should now be addressed decisively,” a developing country diplomat said determinedly. If there is no decision on the waiver, we will not allow any outcome for the ministerial, the source added. “No Waiver – No Walker” seems to be the view shared by some developing countries…..”
https://www.nature.com/articles/d41586-021-03535-x
“Collaborators are locked in a high-stakes dispute over which researchers should be named as inventors on a key vaccine patent application.”
“It was a testament to the power of collaboration: scientists at the biotechnology firm Moderna Therapeutics teamed up with government researchers at the US National Institutes of Health (NIH) to swiftly produce one of the world’s first successful COVID-19 vaccines. But a boiling patent dispute between the collaborators also showcases the complexities of teamwork, as the two groups battle over whether NIH researchers were unfairly left off as co-inventors on a pivotal vaccine patent application….”
“Nature looks at four key questions about the patent spat and its potential ripple effects on collaborations between government and industry….”
Related link: Axios - Moderna loses patent battles tied to COVID vaccine
“ A (US) federal appeals court on Wednesday dismissed two patent challenges from Moderna over key components involved in making its COVID-19 vaccine. Why it matters: The court's decision to side with Arbutus Biopharma means Arbutus could potentially sue Moderna for patent infringement and demand royalties from Moderna's COVID-19 vaccine, which is expected to generate up to $18 billion of revenue this year….”Let’s start by a tweet from Amanda Glassman:
“#COVAX undertaking an end of year sprint to deliver at least 800 million #vaccine doses (now at ~640mill year to date) - the pace of deliveries picking up https://who.int/docs/default-source/coronaviruse/vaccine-allocation-decision-round-10-9-nov2021.pdf?sfvrsn=def83ab8_4&download=true “
PS: This week Covax had a record of 11 million doses delivered in 24 hours.
“Building on lessons learned from our collective experience with dose donations over the past several months, the African Vaccine Acquisition Trust (AVAT), the Africa Centres for Disease Control and Prevention (Africa CDC) and COVAX wish to draw the attention of the international community to the situation of donations of COVID-19 vaccines to Africa, and other COVAX participating economies, particularly those supported by the Gavi COVAX Advance Market Commitment (AMC). … To date, over 90 million donated doses have been delivered to the continent via COVAX and AVAT and millions more via bilateral arrangements. However, the majority of the donations to-date have been ad hoc, provided with little notice and short shelf lives. …”
See also Devex - COVAX, partners call for changes in donated doses in 2022
“ High-income countries not only need to speed up the delivery of their dose donations, COVAX says donations should also be more predictable and have a longer shelf life. COVAX has delivered over 563 million doses as of Nov. 29. About 54% or 307 million of these doses were donations or facilitated by high-income country governments, a spokesperson from Gavi, the Vaccine Alliance told Devex….”
“…They hope that governments and manufacturers will adhere to these [new] standards by Jan. 1, 2022….”
“Of 1.6 billion dose donations pledged to the vaccine facility COVAX, only 171 million have been shipped to developing countries and WHO’s target of 40 per cent global vaccine coverage by the end of the year is slipping away. Norway, Sweden and Belgium have fulfilled their COVID-19 vaccine donation pledges to COVAX, but most donors have not.”
https://www.ft.com/content/974b71d1-d196-46a5-85d5-d32d3aa7f106
“Hoarding heightens likelihood that more variants such as Omicron will emerge, says Covax epidemiologist.” “ One of the main figures behind the Covax vaccine initiative (i.e. Seth Berkley) has questioned why rich countries are ramping up their booster programmes in response to the Omicron variant, insisting the priority should be inoculating the huge number of people worldwide who are still waiting for a first shot.”
“… The scheme has delivered 582m doses to date. But it has suffered from a lack of transparency by drugmakers, manufacturing issues, export bans and what Berkley said was “hoarding” by richer countries…”
“… Airfinity, a health analytics company, said that in a best-case scenario where all manufacturers quickly scaled up production and switched focus completely from other Covid-19 vaccines, it would take until next October for 6bn doses of Omicron-targeted vaccines to be made available….”
“Serum Institute of India has sent doses of COVID-19 vaccine to Indonesia, in its first export of the Novavax (NVAX.O) shot through the COVAX network, the Indian government said on Wednesday. The world's biggest vaccine maker exported 137,500 doses of Covovax, as it calls the shot, to the Southeast Asian country last week. Indonesia has approved the vaccine but India and the World Health Organization, which co-leads the COVAX vaccine-sharing network, have not….”
PS: Reuters: India's Serum Institute resumes vaccine exports under COVAX facility - “Serum Institute of India (SII), the world's biggest vaccine maker, said [last week] on Friday it shipped the first batch of AstraZeneca's COVID-19 vaccine, branded as Covishield, to the COVAX vaccine-sharing programme after an eight-month hiatus.”
And see Reuters - India's SII promises 40 mln more AstraZeneca doses to COVAX this year
“… The company has a deal to supply up to 550 million doses of the shot to COVAX, which mainly provides the vaccines to low-income countries. A GAVI spokesperson told Reuters late on Tuesday that actual vaccine delivery from SII would depend on paperwork including liability agreements with countries. Also, the manufacturer must provide data on shelf life and other things to countries in advance for them to accept or decline supplies….”
With focus on some of the related WHO messages from this week, and other news.
“The Omicron variant is likely to spread internationally, posing a "very high" global risk where COVID-19 surges could have "severe consequences" in some areas, the World Health Organisation (WHO) said on Monday. The U.N. agency, in technical advice to its 194 member states, urged them to accelerate vaccination of high-priority groups and to "ensure mitigation plans are in place" to maintain essential health services.
Related technical brief: Enhancing Readiness for Omicron (B.1.1.529): Technical Brief and Priority Actions for Member States
https://news.un.org/en/story/2021/11/1106672
“The World Health Organization published on Sunday an update on the science regarding the new coronavirus variant Omicron which is causing global concern and sparking increasing flight bans on Southern African countries. … The experts of the UN health agency said researchers in South Africa and around the world are currently conducting studies to better understand the aspects of Omicron, but as of right now, it is not clear whether it is more transmissible compared to other variants, including Delta. …”
“… As a growing number of countries have imposed flight bans on southern African nations due to concerns over the Omicron variant, the UN health agency urged them to follow evidence and International Health Regulations calling for ‘borders to remain open’. While travel restrictions may play a role in slightly reducing the spread of COVID-19, ‘they place a heavy burden on lives and livelihoods’, the agency said in a statement published on Sunday….”
https://news.un.org/en/story/2021/11/1106622
From last Friday, as you no doubt already know by now. “The latest COVID-19 variant identified in South Africa has been given the Greek name 'Omicron', and labeled as a variant of concern by UN health agency experts due to its large number of mutations and possible faster rate of infection.”
WHO - Classification of Omicron (B.1.1.529): SARS-CoV-2 Variant of Concern
“The World Health Organization has said those not fully vaccinated who are vulnerable to Covid-19, including over-60s, should delay travel to areas with community transmission, as more countries imposed curbs to combat the spread of the new Omicron variant. … …. The moves came as the WHO said “blanket bans” would not contain the strain of the virus which it previously warned presents a “very high” risk globally....”
See also UN News – COVID-19: WHO’s Tedros criticizes ‘blunt’ Omicron measures
“ The World Health Organization expects to have more information on the transmissibility of the new Omicron variant of the coronavirus within days, its technical lead on COVID-19, Maria van Kerkhove, said in a briefing on Wednesday.”
“That was faster than the "weeks" the WHO had predicted last week that it would take to assess the data available on the variant after designating it a "variant of concern", its highest rating….”
“G7 health ministers [held] an emergency meeting on Monday about the new Omicron Covid-19 variant spreading across the world and forcing border closures, as experts race to determine the level of threat posed by the new strain. The meeting was called by G7 chair Britain, which is among a steadily growing number of countries that have detected cases of the heavily mutated new variant.”
For the outcome, see Reuters - G7 health ministers praise South Africa for alerts on Omicron
“G7 health ministers praised South Africa on Monday for the work it has done in detecting the new Omicron variant and alerting others, and said they would work together to monitor the strain. "Ministers praised the exemplary work of South Africa in both detecting the variant and alerting others to it," a joint statement issued after a virtual meeting said. "There was strong support to set up an international pathogen surveillance network within the framework of the World Health Organization (WHO)." The G7 health ministers also said they recognised the strategic relevance of ensuring access to vaccines, and would take forward their donation commitments.”
https://www.ft.com/content/a7aa4bd3-4405-41f9-bacc-51fb40181156
“Pharma groups run lab tests after WHO raises alarm about strain with worrying array of mutations.”
“BioNTech, Moderna and Johnson & Johnson are working on vaccines that specifically target Omicron in case their existing shots are not effective against the new coronavirus variant, the companies said on Monday.” (via Reuters)
See also Reuters - Moderna CEO says vaccines likely less effective against Omicron - FT
https://www.science.org/content/article/where-did-weird-omicron-come
On the 3 hypotheses. “Mutations could have accumulated in a chronically infected patient, an overlooked human population, or an animal reservoir.”
“…. Omicron clearly did not develop out of one of the earlier variants of concern, such as Alpha or Delta. Instead it appears to have evolved in parallel – and in the dark. Omicron is so different from the millions of SARS-CoV-2 genomes that have been shared publicly that pinpointing its closest relative is difficult, says Emma Hodcroft, a virologist at the University of Bern. It likely diverged early from other strains, she says. “I would say it goes back to mid-2020.” That raises the question of where Omicron’s predecessors lurked for more than a year. Scientists see essentially three possible explanations: The virus could have circulated and evolved in a population with little surveillance and sequencing. It could have gestated in a chronically infected COVID-19 patient. Or it might have evolved in a non-human species, from which it recently spilled back into people….”
“Lab tests and patterns of spread will show whether the new SARS-CoV-2 variant's many mutations are a serious threat.”
PS: “On Friday, the World Health Organization (WHO) designated the virus a “variant of concern” and christened it Omicron. (Variant names follow the Greek alphabet but WHO skipped the letters Nu and Xi, it said, “because Nu is too easily confounded with 'new' and Xi was not used because it is a common surname.“)… 😊
https://www.nytimes.com/2021/11/27/world/africa/coronavirus-omicron-africa.html
Excerpts from this must-read piece:
“With countries trying to close their doors to the new coronavirus variant, southern African officials note that the West’s hoarding of vaccines helped create their struggle in the first place. Nations in southern Africa protested bitterly on Saturday as more of the world’s wealthiest countries cut them off from travel, renewing a debate over border closures from the earliest days of the coronavirus pandemic and compounding the problems facing poorly vaccinated countries.”
“…. Scientists worried that the restrictions would discourage other nations from reporting variant cases, out of fear of being slapped with travel bans. Border closures have provoked debate during a succession of public health crises, including the Ebola outbreak in 2014, with global health officials warning that such bans can interrupt the flow of medical supplies and do economic damage that makes countries reluctant to report health threats.”
“…. After decades of skepticism toward border closures among global health officials, Covid-19 forced experts to re-examine their views, said Alexandra Phelan, a professor studying global health policy at Georgetown University. “We gained a bit of nuance, and realized that travel restrictions have a potential role to play in slowing the spread of a new respiratory disease, even though it doesn’t stop it,” she said….. “
“Several scientists said they suspected that the variant had been spreading undetected in countries with lackluster sequencing efforts before it surfaced in Botswana and South Africa, giving it more time to scatter globally. Nevertheless, European nations did not find the variant until after South Africa alerted them to it, demonstrating the gaps in their own surveillance efforts. …. Given the uneven global sequencing efforts, Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, said that it was difficult to target individual countries for border closures. She warned that travel bans created a false sense of security, giving cover to elected leaders who wanted to avoid more difficult choices. …”
Link:
“UK and EU accused of ‘recklessly blocking’ plans to allow lower-income countries to produce own vaccines. The emergence of new variants such as B.1.1.5.2.9 could have been avoided if wealthy countries had ensured poorer nations had access to Covid jabs, experts have said. …. ….Experts such as Tim Bierley, a pharma campaigner at Global Justice Now, said the rise of the variant had been “entirely avoidable” and that conditions for its emergence had been created by low- and middle-income countries being “actively prevented” by the UK from having equitable access to vaccines.
“For more than a year, South Africa, Botswana, and most countries have been calling for world leaders to waive intellectual property on coronavirus vaccines, tests and treatments, so they can produce their own jabs. It’s a vital measure that will be discussed at next week’s World Trade Organization conference. But, so far, the UK and EU have recklessly blocked it from making progress….”
See also the Guardian - The Omicron variant reveals the true global danger of ‘vaccine apartheid’.
And Stat - The Omicron variant underscores the global stakes of Covid-19 vaccine inequity
Karen Grepin; https://www.washingtonpost.com/outlook/2021/11/29/omicron-travel-ban-covid/
Recommended. “Border controls work best when they’re part of an overall public health approach.”
The Economist doesn’t agree with the mantra: “ …. nobody is safe until everyone is safe. Large unvaccinated populations in poor countries will contract covid-19. The virus will inevitably go on to mutate and spread back into the rich world. The rich world should therefore supply vaccines to poor countries, lest they become breeding-grounds for dangerous new variants.” For Omicron, the Economist probably has a point.
Though its conclusion is only partial, as it lacks a focus on building regional capacity (for which a TRIPS waiver would be more than welcome): “…The best argument for why the rich world should share its vaccines is simpler and more powerful. Vaccines cost a few dollars. They save lives. They are becoming plentiful and will soon be in surplus. The rich world should supply them to the poor world because it is the right thing to do.”
C Holmes; https://www.thinkglobalhealth.org/article/real-meaning-omicron
“Travel disruptions and shaky financial markets suggest the world is still far from prepared for pandemics.”
“…. Real health security—the kind of health security that adeptly and efficiently deals globally with an even more threatening pathogen—demands we move beyond checking boxes, and toward a new era that better recognizes the actual performance of common health systems functions needed to support rapid, robust responses to emerging and existing pandemics. On a more macro level, it also requires new international agreements and strengthened International Health Regulations that are able to compel greater political and , reduce misinformation, and redouble support for global equity and the needs of vulnerable groups and low- and middle-income countries (LMICs)….”
By J Juno et al. Striking the right balance, as far as I can tell (as sbd with a non-medical background).
https://www.nytimes.com/2021/12/01/health/covid-omicron-booster-shots.html
“Many public health experts were opposed to a boosters-for-all approach. The new variant is changing some minds.”
https://www.ft.com/content/df3738ab-ea2b-438c-96ed-aa7eb75451a2
“First detailed study into new strain will alarm health officials concerned over its ability to evade immune protection.”
“…. The Omicron variant has been linked to a substantial rise in coronavirus reinfections in South Africa compared with previous waves, according to the first detailed study into the heavily mutated strain that has sparked global alarm. “Analysis of routine surveillance data from South Africa suggests that, in contrast to the Beta and Delta [variants], the Omicron variant of Sars-Cov-2 demonstrates substantial population-level evidence for evasion of immunity from prior infection,” South African epidemiologists concluded in the study published late on Thursday….”
https://apps.who.int/gb/wgsf/pdf_files/wgsf5/WGSF_5_3-en.pdf
(24 Nov) Ahead of the 5th meeting of this Working group, scheduled for 13–15 December 2021. With a summary of deliberations & a number of recommendations (for the Executive Board in January).
Vitally important for sustainable and flexible WHO financing, so do have a good look at this draft report. And let’s hope the Working group and then the Executive Board gets to an agreement.
“A new malaria vaccination programme will support Gavi-eligible countries to implement a new tool in the fight against malaria in sub-Saharan Africa in 2022-2025, including vaccine introduction, procurement and delivery… … The Board of Gavi, the Vaccine Alliance today approved an investment to support the malaria vaccine introduction, procurement and delivery for Gavi-eligible countries in sub-Saharan Africa in 2022-2025. An initial investment of US$ 155.7 million for 2022-2025 will initiate the implementation of this additional tool in the fight against malaria. The introduction of the RTS,S malaria vaccine to currently recommended malaria control interventions could help drive down child mortality in Africa – a continent that bears the heaviest malaria burden….”
Coverage via Devex - Gavi decides to fund the rollout of world's first malaria vaccine
“ WHO’s recommendations include providing four doses to children starting at 5 months of age through about 18 months. And while Gavi’s announcement is welcome, funding alone is not enough, Alonso said. There is also a need to “massively” increase production of the vaccine. Current yearly production stands at about 7 million doses, which could easily be increased to about 15 million. But WHO estimates that around 80 million to 120 million doses will be required per year. … GSK already has a technology transfer agreement with Bharat Biotech to produce the vaccine in India. It plans to provide 15 million doses per year, charging 5% above the costs of production. There was also an innovative financing agreement agreed upon by Gavi, GSK, and MedAccess to support the bulk production of the RTS,S antigen to ensure that its production continued even amid uncertainties around the vaccine’s rollout…..”
“Supporting local vaccine production in Africa has become a priority for Germany's Federal Ministry for Economic Cooperation and Development (BMZ). We spoke to representatives of BMZ, KfW and GIZ to understand how and why. ….”
“An initial £3.5 billion is being sought for the ambitious plan to pre-prepare vaccines whilst also growing manufacturing capacity.”
“UK researchers on Monday [were] set to launch a blueprint for a “100-day” vaccine in a bid to stop the next pandemic in its tracks. The plan will see scientists create an estimated 100 prototype vaccines for the 25 viral families known to infect humans. Then, when the next virus with pandemic potential emerges, scientists say they will be able to build on the prototype to develop a vaccine ready for use within 100 days. The vaccine “moonshot” is being spearheaded by the Coalition for Epidemic Preparedness Innovations (Cepi)…. The 100-day vaccine plan has already won the backing of both the UK Government and the G7 group of the world’s most industrialised nations.
“…. One of the key parts of the plan is to produce a library of prototype vaccines against pathogens from “critical viral families”. Cepi will initially target 10 of these families. They are likely to include paramyxovirus: a family that contains measles and mumps, but also Nipah, an emerging virus in south east Asia that is spread via respiratory droplets and has up to a 75 per cent fatality rate. Another key family will be orthomyxovirus, which contains the influenza viruses. Although there is an existing vaccine, it only works against seasonal flu, not pandemic flu….” “… Cepi is calling for an initial £3.5 billion for the plan, although the eventual cost is likely to far exceed that. … … Another key part of the plan is to ensure there is enough manufacturing capacity to make a new vaccine …”
“Bill Gates and Melinda French Gates say they will still work with the Giving Pledge, the campaign they co-founded with Warren Buffett in 2010 to encourage billionaires to donate the majority of their wealth through philanthropy. But following their divorce earlier this year, the two will do it separately and in their own ways.
“In individual letters posted Tuesday by Giving Pledge, Gates and French Gates outlined their differing philosophies to giving. … French Gates, whose net worth is an estimated $6.2 billion according to Forbes, said she plans to focus on “fighting poverty and advancing equality — for women and girls and other marginalized groups — in the United States and around the world” through the Bill & Melinda Gates Foundation and her own Pivotal Ventures. …… For his part, Gates, the Microsoft Corp. co-founder worth more than $138 billion according to Forbes, wrote that he plans to keep the Gates Foundation as his primary outlet for his giving….”
Cfr tweet: “Gatesologist @TimothyWSchwab about recent goings-on in the House of Gates, and what it ultimately means that the world's most famous philanthropist has given so lavishly to media organizations.”
“The role of philanthropy in Bill Gates’s global empire is well known. But the Gates Foundation’s contributions to media organizations are huge, underexamined, and a significant part of how one of the world’s wealthiest men has built and protected his image.”
“….a new infographic detailing the Global Fund’s current work in pandemic preparedness and response and areas where it is well positioned to expand its pandemic preparedness and response work with additional resources….”
See the related 7-page document.
“— As he touted the U.S.’s role in fighting HIV/AIDS at home and abroad and laid out some remaining work, President Joe Biden said Wednesday his administration looks forward to hosting the 2022 replenishment conference for The Global Fund to Fight AIDS, Tuberculosis and Malaria. … … The conference is slated for late September or early October 2022, executive director Peter Sands told Global Pulse hours before heading to a White House World AIDS Day event. Experts are trying to determine by early next year how much money is needed over the next three years, he said. Sands expects the target to be higher than the $14 billion the Fund raised in 2019 when France led the effort. The replenishment would help link funding to fight the old pandemics of HIV, tuberculosis and malaria; battle the current Covid-19 pandemic; and invest in protection against future pandemics….”
https://www.nature.com/articles/d41586-021-03568-2
“A policy paper published 20 years ago led to expanded research collaboration between emerging economic powers. But its main recommendation was ignored.”
“….It’s 20 years since economist Jim O’Neil coined the term BRIC to describe Brazil, Russia, India and China. O’Neill, who was head of economics research at the investment bank Goldman Sachs, wrote in an internal policy paper that the four countries were growing faster than the G7 group of large economies (see go.nature.com/3pgtqsd). World policymaking clubs such as the G7 are usually dominated by the United States and Europe. They should invite BRIC representatives, O’Neill advised. The balance of world economic power was tilting and the big institutions of global governance needed to reflect that, he argued….”
“As the world responds to newly emerged Omicron variant, the battle against Delta (B1617.2)-driven surges continues, with activity showing signs of a plateau last week, the World Health Organization (WHO) said yesterday in its weekly snapshot of the pandemic. The WHO said nearly 3.8 million cases were reported last week, similar to the previous week. It added, however, that cases are rising in three of its regions, including Africa, the Western Pacific, and Europe.
The agency said Africa's cases were up 93% compared to the week before, but added that the bump in cases should be interpreted with caution, due to batch reporting of rapid antigen tests from South Africa. … …. Deaths dropped 10% compared with the previous week. Maria Van Kerkhove, PhD, the WHO's technical lead for COVID-19, said on Twitter that the trend line for deaths should be much lower due to the availability of COVID-19 vaccines. The sluggish drop in deaths shows that the world is not prioritizing vaccination for people at risk in all parts of the world, Van Kerkhove said….
“… The increase in Africa's cases follows a decline that had been underway since late June. Though South Africa's batch reporting made up 43% of cases last week, 21 of the 49 countries in the region reported rises of 10% or more….”
(2 Dec) “….scientists from South Africa in a preprint study detailed early data on reinfection risk, which appears to be three times higher than two earlier variants…..” (see also below)
News from the eighth triennial Forum on China-Africa Cooperation in the Senegalese city of Diamniadio on Monday.
“ President Xi Jinping on Monday said China would offer another 1 billion doses of COVID-19 vaccines to African countries and would encourage Chinese companies to invest no less than $10 billion in Africa over the next three years.” “The pledge of additional vaccine doses - on top of the nearly 200 million that China has already supplied to the continent - comes as concerns intensify over the spread of a new variant of the coronavirus, known as Omicron, which was first identified in southern Africa. …”
For more detail, see also Bloomberg - Xi Pledges a Billion More Vaccines for Africa in Wake of Omicron
“Xi said 600 million doses will be donated while the rest will be jointly produced by Chinese enterprises and African countries, without providing details. He was speaking via video at the … China has already sold 136 million vaccine doses to Africa and pledged 19 million in donations, according to the Beijing-based Bridge Consulting, which tallies deliveries through government press releases and news reports. Beijing has delivered 107 million of those doses, and another 11.6 million through the Covax initiative, the consulting firm said Monday.
And SCMP - China makes billion-dose pledge to Africa to help overcome the coronavirus pandemic
“…. President Xi Jinping said China would supply a billion doses to help Africa vaccinate 60 per cent of its population by next year. …. Chinese President Xi Jinping tells Africa forum that Beijing will also advance billions of dollars for trade and infrastructure… In addition, Chinese medical teams and experts will be sent to help the continent….”
Via ONE’s Aftershocks: “China also pledged 25% of its IMF Special Drawing Rights allocation - trumping the 20% pledged by G7 countries. “
“India stands ready to "expeditiously" send more COVID-19 vaccine to Africa to help fight the Omicron variant, New Delhi said late on Monday after China pledged 1 billion doses to the continent. …. … India said it had supplied more than 25 million doses of domestically made shots to 41 African countries, mostly through the global vaccine-distribution network COVAX. "The Government of India stands ready to support the countries affected in Africa in dealing with the Omicron variant, including by supplies of Made-in-India vaccines," the foreign ministry said in a statement. "Supplies can be undertaken through COVAX or bilaterally." It said the government had cleared all orders placed by COVAX for supplies of the AstraZeneca (AZN.L) vaccine to countries such as Malawi, Ethiopia, Zambia, Mozambique, Guinea and Lesotho, apart from delivering doses of the home-grown Covaxin shot to Botswana. It did not say how many doses have been approved recently…..”
V Fan et al; https://www.cgdev.org/blog/africa-should-bargain-hard-covid-vaccine-equity-lessons-indonesia-during-avian-flu
“If Africa can’t get the vaccines it needs, perhaps Africa should take a play from the Indonesian playbook during the 2007 avian flu. …”
“… When dealing with those who are habituated to a “me first” mentality, you must negotiate and bargain hard. African countries trying to gain support through an idealistic notion of global solidarity will fail unless applying “shrewd business practices.” Not just African countries, but the whole world will fail. So negotiate hard. Know what your opponent wants the most, and don’t give them what they want so easily till you get what you need. Empty promises and excuses won’t stop COVID-19, but hard bargaining might.”
https://www.ft.com/content/0cea5e3f-d4c4-4ee2-961a-3aa150f388ec?sharetype=blocked
“The American company now dominates the market for Covid jabs. But does that give it too much power?” “The Financial Times has spoken to more than 60 people involved in the vaccine process, including current and former Pfizer employees and government officials across the globe, to lift the veil on how the company that has contributed so much to saving the world from Covid has also ensured it is such a lucrative business. They are all grateful for a safe and effective vaccine. But many question if the balance of power has tipped too far in Pfizer’s favour.”
A few quotes of this must-read piece:
“…Aurélia Nguyen, managing director of Covax, says Pfizer has hit its targets for delivering supplies to the programme. But she adds: “From our initial contact with Pfizer, it became clear early on that the best Covax could expect was minimal doses in 2021.” Aylward says Pfizer was not fast enough but should be given credit for stepping up this autumn. Vaccines have now been delivered to 161 countries. It has provided over 740m doses to low and middle-income nations in 2021, about 100m of which come from the Biden administration’s donation. Pfizer has promised another billion in 2022….”
“…Pfizer did not respond to questions about its US pricing strategy. But a former Pfizer executive, present at the time, describes discussing the tricky art of pricing a vaccine during a pandemic. He points out that Pfizer’s pneumonia vaccine Prevnar, costs around $200. If the company used the costs of caring for Covid patients, or the benefits of reopening the economy to justify its pricing, then the bill could have been even higher. “If you did a quick and dirty comparison versus Prevnar, it would be ridiculously high,” he says. “If you took into account economic impact, not just health impact, you could have it ranging up to $1,000 a dose, as there was the potential to avoid trillions of dollars in spending. You come back and think, ‘That’s not going to work’.”…” “Even before the emergence of the Omicron variant on Thursday, these booster programmes looked set to cement Pfizer’s dominance of the Covid vaccine market because of the high efficacy of its shot and the company’s success at production. The rapid expansion in booster plans that some western governments have announced in recent days will only entrench its position further. Pfizer has launched a “Science will Win” ad campaign, while Bourla is writing a book about the “moonshot”. He insists that Pfizer is in a position of “commercial strength” in the Covid vaccine market, with people likely to need boosters year after year…..”
https://www.washingtonpost.com/world/2021/11/28/afrigen-south-africa-vaccine-moderna/
Well worth a read. Insight into how things are going with the replication of Moderna’s shot in South-Africa. Excerpts:
“In an industrial area of this seaside city, a little-known biotech company is entering a pivotal phase of making Africa’s first coronavirus vaccine by attempting to replicate Moderna’s highly effective mRNA-based shot. Afrigen Biologics and Vaccines is racing to make a vaccine…. …. With help from the World Health Organization (WHO) and international consultants, including from the U.S. National Institutes of Health, Afrigen has become part of the African continent’s first training and technology transfer hub for mRNA vaccines, a step toward answering calls from global health officials for Africa to develop its own vaccine-manufacturing capability to avoid supply shortages during a crisis. What’s missing is the vaccine formula. Moderna refuses to share its recipe, citing intellectual property, so Afrigen has used publicly available information and help from outside advisers to begin making the vaccine. ….. If Moderna were to share information, Afrigen Managing Director Petro Terblanche said, the company could produce a replica within a year. Without it, the time estimate balloons to three years…..
https://www.nytimes.com/2021/11/30/health/johnson-johnson-covid-vaccine-africa.html
“The new agreement makes Aspen Pharmacare the first African company to market a Covid vaccine on the continent. But it stops short of allowing Aspen to make the ingredients in the vaccine.”
PS: Aspen strikes deal with J&J to launch own vaccine, called 'Aspenovax'.
“Vaccines are finally available in many African countries, but some people there, as well as in South Asia, are wary of taking them.”
“…. Deep distrust of governments and medical authorities, especially among rural and marginalized communities, may already be stalling out vaccination drives. The legacy of Western exploitation and medical abuses during and after colonialism is weighing heavily, too. …. Misinformation circulating on social media often fills the vacuum, some of it floating in from the United States and Europe, where vaccine refusal has also been an issue. “There’s no doubt that vaccine hesitancy is a factor in the rollout of vaccines,” said Dr. Matshidiso Moeti, the Africa director of the World Health Organization. News or rumors of potential side effects, she said, “gets picked out and talked about, and some people become afraid.”…”
…. It is not just South Africa. Namibia, Zimbabwe, Mozambique and Malawi have also asked vaccine manufacturers and donors to hold off on sending more shots because they can’t use the supplies they have, according to several health officials involved in the effort to distribute vaccines to developing countries…”
https://www.devex.com/news/will-countries-reach-the-70-vaccination-target-by-mid-2022-102156
“Just 3% of low-income countries’ population have been fully vaccinated…. (many of) These countries have already failed to meet the World Health Organization’s target of achieving 10% vaccination coverage in September 2021, and are in danger of missing the 40% target set by the United Nations agency for the end of December, as well as the goal of vaccinating 70% of every country’s population by mid-2022 if current challenges in supply and demand continue.”
“… Modeling and health experts Devex spoke to said it isn’t impossible to reach the 70% milestone, but it’s a tall order and will require significant efforts and investments that include securing the needed supplies, but also increasing vaccine acceptance and addressing gaps in countries’ capacities to deliver the doses. A country’s topography, demographics, and climate conditions could also affect their ability to reach the goal.”
What about Africa? “A number of countries, particularly on the African continent, have a large youth population. In some of these countries, 1 to 14-year-olds account for more than 30% and 40% of their populations. They are not, however, currently part of national vaccination campaigns. “This 70% is a target that has been set at a global level, and individual countries will need to look at their own population structure and then decide how much they want to invest in going down to the young age,” Dr. John Nkengasong, director at the Africa Centre for Disease Control and Prevention, said during a press briefing last week. Dr. Richard Mihigo, coordinator of the vaccines-preventable diseases department at WHO’s regional office for Africa, told Devex that the motive behind the 70% vaccination target was that WHO hopes it will bring the world closer to controlling the pandemic and get back to some form of normality — but the situation is likely going to be different depending on each country’s contexts.”
““The question on [whether] is it aligned with the aspirations of the countries in the [African] region? To some extent, yes, that countries are now taking these different milestones, and trying to customize them based on their needs and their local contexts,” he said. …. That means, for example, vaccinating 54% of the population in Ethiopia, which already covers all people 18 years old and above in the country. Vaccinating more than that will require that doses be given to those aged below 18 years old, but which is not yet the priority for Ethiopia and many other countries in the continent, he said. But even reaching such a low vaccination target won’t be easy. Mihigo said by looking at the current pace of vaccine administration and each country’s performance in terms of weekly vaccine delivery, many countries in the region won’t meet their targets “if nothing different is done.” “We are really now working with countries to help them to develop some sort of acceleration vaccination plans … and that will include a variety of strategies to make sure that the weekly vaccination rates can be increased dramatically. And sometimes, this will require maybe [a] five- to tenfold increase in terms of vaccination rates [from where] we are currently at,” he added. It will also require additional resources, and collective effort by different stakeholders to address not just issues in vaccine supply, but also demand….”
E Emanuel et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02645-3/fulltext
Fierce discussion.
“Merck & Co (MRK.N) said on Friday updated data from its study of its experimental COVID-19 pill showed the drug was significantly less effective in cutting hospitalizations and deaths than previously reported.”
See also Stat – New data, analyses take some of the shine off Merck’s Covid pill
https://www.bmj.com/covid-19-preparedness-and-response
“This collection of articles was proposed by The Independent Panel for Pandemic Preparedness and Response…”
“Covid-19 put every country and the global health system to the test. Responses came in the context of diverse and complex political and social systems. What were the factors that led to success, or failure? This collection comprises unparalleled analyses of 28 high, middle and low-income country responses to covid-19 and draws on the work and analysis of the Independent Panel for Pandemic Preparedness and Response. Based on real-world experience, the collection provides policymakers with a road map to prepare for the next health threat, including whole-of-society approaches, treating pandemic tools as a global commons, and ensuring equity, communities and human rights are central to preparing for and responding to the next threat.”
G Auld et al ; https://link.springer.com/article/10.1007/s11077-021-09442-2
“… We contribute …. by assessing COVID-19 as a “super wicked” problem denoted by four features we originally formulated to describe the climate crisis: time is running out, no central authority, those causing the problem also want to solve it, and policies irrationally discount the future (Levin et al. in Playing it forward: path dependency, progressive incrementalism, and the “super wicked” problem of global climate change, 2007; Levin et al. in Playing it forward: Path dependency, progressive incrementalism, and the "super wicked" problem of global climate change, 2009; Levin et al. in Policy Sci 45(2):123–152, 2012). Doing so leads us to identify three overarching imperatives critical for pandemic management. First, similar to requirements to address the climate crisis, policy makers must establish and maintain durable policy objectives. Second, in contrast to climate, management responses must always allow for swift changes in policy settings and calibrations given rapid and evolving knowledge about a particular disease’s epidemiology. Third, analogous to, but with swifter effects than climate, wide-ranging global efforts, if well designed, will dramatically reduce domestic costs and resource requirements by curbing the spread of the disease and/or fostering relevant knowledge for managing containment and eradication. ….”
Tom Drake et al; https://www.cgdev.org/blog/african-counties-will-continue-face-tough-choices-covid-19-vaccines-weve-developed-toolkit-can
“African countries will continue to face tough choices on COVID-19 vaccines—we’ve developed a Toolkit that can help.”
“…. in many countries (especially in low-income countries), achieving high levels of coverage would be costly. For instance, calculations of the cost of vaccination per capita expressed as a proportion of total government health expenditure per capita have shown the significant budget impact of vaccination campaigns. In over half of African countries where those estimates are available, the cost of vaccination exceeds the total government health expenditure (53 percent or 25/54 …” “ …. The International Decision Support Initiative and the Africa CDC Health Economics Unit have developed a toolkit for collecting evidence to support COVID-19 vaccine policy making….” “
J Sturmberg et al; https://onlinelibrary.wiley.com/doi/abs/10.1111/jep.13640
“…. During this COVID-19 pandemic there have been, at least, three consecutive single stories—the ‘lethal threat’ story, followed by the ‘economic threat’ story, and finally the ‘vaccine miracle’ story. None of these single stories can convincingly and permanently capture the dynamics of the pandemic. This is because countries experienced different morbidity and mortality patterns, different socioeconomic disadvantage, age and vulnerability of population, timing and level of lockdown with economic variability, and, despite heavy promotion, vaccines were beset with a significant and variable degree of hesitancy. Lack of transparency, coherence and consistency of pandemic management—arising from holding on to single storylines—showed the global deficiency of public health policy and planning, an underfunding of (public) health and social services, and a growing distrust in governments' ability to manage crises effectively. …… Holding onto single stories prevents the necessary learnings to understand and manage the complexities of ‘wicked’ problems, whereas listening to the many stories provides insights and pathways to do so effectively as well as efficiently.”
S S Abdool Karim et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003869
Good (short) Perspective on Covid-19 in Africa so far, and what needs to be done for the future.
B M Meier et al ; https://gh.bmj.com/content/6/11/e007710
« The COVID-19 pandemic has revealed the inequitable health harms and human rights violations faced by older persons, raising a need to support healthy ageing policy as a human rights imperative. However, international human rights law has long neglected the health-related human rights of older persons. Drawing from evolving advocacy efforts to advance the rights of older persons through the United Nations (UN), tentative initial steps have been taken at the regional level, with states in the Americas codifying intersectional rights obligations underlying health through the Inter-American Convention on Protecting the Human Rights of Older Persons. These international and regional efforts provide a foundation to advance the right to health for older persons. Amid an ongoing demographic transition and an inequitable pandemic response, the prospective UN Convention on the Rights of Older Persons provides a crucial opportunity to elaborate and uphold the international legal obligations necessary to facilitate healthy ageing. »
https://www.bloomberg.com/graphics/covid-resilience-ranking/
“….After dominating the top rungs of Bloomberg’s Covid Resilience Ranking for months, Europe has largely been dethroned with the United Arab Emirates—one of the most-consistent performers since the Ranking’s inception a year ago—becoming our new No. 1….”
“… Over the past year, only seven countries never fell into the bottom half of the Ranking even as the pandemic shape-shifted. Norway, Denmark, Finland, this month’s No. 1 the UAE, Canada, South Korea and Switzerland…”
“Strong healthcare safety nets and societal cohesion are common denominators among the seven, qualities that advantaged them at every stage of the pandemic. Faith in government and a willingness to follow rules helped with containing the virus, while these countries’ relative wealth meant they had the buying power to snap up the first supplies of vaccines. Investment in public health infrastructure also matters. …”
C Troeger & J Bollyky; https://www.thinkglobalhealth.org/article/ending-covid-19-pandemic-hinges-trust
“Science alone won't pull us out of the pandemic. As previous public health emergencies have shown, the decision to choose COVID-quashing actions depends in large part on trust. …”
“… To learn more, researchers asked people about their behaviors and perspectives on public health interventions. The global survey, conducted on Facebook between mid-2020 and March 2021, reached about 570,000 people in 67 countries (see map below). The researchers surveyed people about the degree to which they trusted specific institutions and people—including politicians, local and government health workers or authorities, journalists, scientists, and people they knew personally—as sources of COVID-19 information….”
“… The survey findings suggest that people who trust scientists and local health workers as sources of COVID-19 information are more likely to perform specific public health behaviors or to hold perceptions that are beneficial to public health. …. … In general, expressing trust in government health authorities and the WHO also makes people more likely to protect themselves and their communities from COVID-19. Trusting politicians is not strongly associated with any factors except for acceptance of the COVID-19 vaccine. This could be due to the politicization of the vaccine and wide-ranging vaccine hesitancy that has manifested in many countries globally….”
Ann Ithubu & Alan Whiteside; https://www.aidspan.org/en/c/article/5821
“The Global Fund has called for an African commission to investigate the COVID-19 pandemic in Africa. We urge the African Union or a similar body to establish the ‘Commission on the Origins and Spread of COVID-19 in Africa’ to examine the continent’s preparedness to detect the outbreak and virus variants. The Commission can also help explain why Africa has, so far, reported a modest number of COVID-19 cases compared to its counterparts, and why some countries in the region were more affected than others. The findings of the Commission of Inquiry can then be used to inform preparedness for future pandemics and other public health emergencies.”
N Gurley et al ; https://cdn.who.int/media/docs/default-source/bulletin/online-first/blt.21.286852.pdf?sfvrsn=cc9e4031_5
“…. National governments and international agencies acknowledged risks to continuity of care early in the COVID-19 pandemic and began developing policies (which we define to include policies, norms, guidelines and strategies) to maintain or adapt the delivery of essential health services. WHO published interim guidance for maintaining these services during the COVID-19 pandemic on 25 March 2020, releasing final guidance on 1 June 2020.5 Other global technical agencies, including but not limited to the Joint United Nations Programme on HIV/AIDS, Centers for Disease Control and Prevention, RBM Partnership to End Malaria, United Nations Population Fund and other WHO departments released guidance on specific technical areas, including for HIV/AIDS, malaria and immunization. To track policy development at a national level, we launched the COVID-19 Essential Health Services Policy Tracker in collaboration with WHO’s Maternal, Adolescent, Child Health and Aging department with funding from the Bill and Melinda Gates Foundation…”
Check out the findings of this review.
S Torres-Rueda et al ; https://gh.bmj.com/content/6/12/e005759
“….in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios….”
“….COVID-19 clinical management costs vary greatly by country, ranging between <0.1%–12% of GDP and 0.4%–223% of total annual health expenditure (excluding out-of-pocket payments). Without mitigation policies, COVID-19 clinical management costs per capita range from US$43.39 to US$75.57; in 22 of 76 LMICs, these costs would surpass total annual health expenditure. In a scenario of stringent social distancing, costs per capita fall to US$1.10–US$1.32.”
“UNAIDS issued a stark warning today that if leaders fail to tackle inequalities the world could face 7.7 million* AIDS-related deaths over the next 10 years. UNAIDS further warns that if the transformative measures needed to end AIDS are not taken, the world will also stay trapped in the COVID-19 crisis and remain dangerously unprepared for the pandemics to come. …. … COVID-19 is undercutting the AIDS response in many places. The pace of HIV testing declined almost uniformly and fewer people living with HIV initiated treatment in 2020 in 40 of 50 countries reporting to UNAIDS. HIV prevention services have been impacted—in 2020, harm reduction services for people who use drugs were disrupted in 65% of 130 countries surveyed….”
For the new report, see UNAIDS - 2021 World AIDS Day report — Unequal, unprepared, under threat: why bold action against inequalities is needed to end AIDS, stop COVID-19 and prepare for future pandemics
More coverage via HPW - Millions of AIDS-related Deaths in Years to Come if Global Inequalities Remain Unaddressed, UNAIDS Warns Ahead of World AIDS Day
“… 2020 saw 1.5 million new HIV infections, with increasing rates of infection in some countries. Infections notably follow lines of inequality, with six in seven new HIV infections among adolescents in sub-Saharan Africa occurring among adolescent girls. Men who have sex with men, sex workers and people who use drugs also face a 25 – 35 times greater risk of acquiring HIV worldwide….”
https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(21)00301-5/fulltext
“This World AIDS Day, UNAIDS calls for an end to the inequalities that affect people with HIV, which threaten the target to end AIDS by 2030. Countries continue to use laws to discriminate against people on the basis of their HIV status, some of which are related to travel. Restrictions can include prohibition of short-term and long-term stays, HIV testing or disclosure for entry, study, work, or residence permits, and deportation of non-nationals.”
“…Aside from travel restrictions, people with HIV can be subject to a plethora of other legal and criminal inequities….”
“… Discriminatory laws that target people with HIV and key populations are counter-productive, bad science, and not compatible with a human rights approach to the HIV response and ending AIDS by 2030. Countries must not only repeal or modernise laws to end inequalities, but legislatures should provide legal structures that support people affected by HIV for the good of individual, public, and global health.”
https://www.nature.com/articles/d41586-021-03546-8
“Failure to get COVID-19 vaccines to nations with high rates of uncontrolled advanced HIV puts people living with that virus at even greater risk, and could drive the emergence of coronavirus variants.”
L Garrett; https://foreignpolicy.com/2021/12/02/hiv-omicron-covid-variants-south-africa-connected/
“It’s a matter of time until an even more dangerous coronavirus variant emerges if we fail to vaccinate the world’s most vulnerable populations.”
“…globally, one of the world’s largest concentrations of immunocompromised people—the untreated HIV-positive people of southern Africa—has been all but ignored….”
“….There is currently no evidence to indicate that omicron arose through southern Africa’s millions of HIV-positive people. But few aspects of the international response to COVID-19 are as idiotic, stupid, and ultimately self-destructive as the failure, born from wealthy-nation selfishness, to make Africa’s HIV-positive population a top vaccination target, just as their cancer and transplant counterparts are in the rich world.”
And a link:
Lancet Comment - Global HIV efforts need to focus on key populations in LMICs
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02742-2/fulltext
“ UHC Day, on Dec 12, has the theme of “Leave No-One's Health Behind: Invest in Health Systems for All”, and is a crucial opportunity for all world leaders to reinstate UHC on the political agenda….”
“… As The Lancet goes to press, a World Health Assembly special session is underway on the need to adopt an international agreement on pandemic preparedness and response and establish a process for advancing negotiations. Encouragingly, the draft report of the working group on Strengthening WHO Preparedness for and Response to Health Emergencies recommended that the treaty consider “universal health coverage and health system strengthening and resilience, for example, primary health care, health workforce and social protection”. This mention appears to be one of the first times UHC has been raised in a space traditionally concerned with health security. However, so far, all signs suggest that this important perspective will be neglected in practice. Ensuring strong, resilient, and inclusive health systems must be meaningfully included in any future international agreement, and more research and guidance to effectively and pragmatically support these efforts must be a priority across countries, major donors, and health organisations. An emphasis on equity in any international treaty has gained largely universal agreement. However, this idea should not be narrowly focused on equity in relation to accessing medical countermeasures like vaccines and information sharing. A much wider concept of equity must be applied that, in addition to essential affordable health services and health system strengthening, should include equity in social care, public health, and health promotion. These services together will not only provide social protection to populations, but also protection against future pandemics and other threats to public health…..”
The Lancet is playing a constructive part in bringing together global health security and UHC communities to create a productive discussion and align and integrate their policies. The Lancet Commission on synergies between UHC, global health security, and health promotion has been created to address the disconnect between these three pillars.
Yi Ling-Chi et al ; https://www.cgdev.org/blog/benefits-and-challenges-developing-and-revising-health-benefits-packages-insights-technical#.YaeBLFoUNMg.twitter
“We worked with the Joint Learning Network (JLN) Efficiency Collaborative to gain insights from Collaborative members who represent technical staff and decision-makers working at the heart of health benefit packages development and revisions in eleven low-and middle-income countries in Africa and Asia. This blog summarizes the initial results from a survey conducted earlier this year to capture their views and experiences on the HPB development and updating process….”
And a link:
UHC 2030 Action on health systems, for UHC and health security
A UHC2030 strategic narrative to guide advocacy and action. Authors synthesized recommendations from major reports into 12 priority health systems actions.
B Wood et al; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00781-6
“…This paper aimed to analyse the extent to which market power and corporate wealth and income distribution in the global soft drink market negatively impact public health and health equity. In doing so, the paper sought to contribute to the development of a broad-based public health approach to market analysis. A range of dimensions (e.g., market concentration; financial performance; corporate wealth and income distribution) and indicators (e.g., Herfindahl Hirschman Index; earnings relative to the industry average; effective tax rates; and shareholder value ratios) were descriptively analysed. Empirical focus was placed on the two dominant global soft drink manufacturers.”
Conclusions: “Market power and corporate wealth and income distribution in the global soft drink market likely compound the market’s maldistribution of harms, and indirectly influence health by contributing to social and economic inequalities. Indeed, a ‘double burden of maldistribution’ pattern can be seen, wherein the wealth of the shareholders of the market’s dominant corporations, a group over-represented by a small and wealthy elite, is maximised largely at the expense of the welfare of LMICs and lower socioeconomic groups in high-income countries. If this pattern continues, the appropriate role of the global soft drink market as part of sustainable economic development will require rethinking.”
“Vast networks of underground fungi – the “circulatory system of the planet” – are to be mapped for the first time, in an attempt to protect them from damage and improve their ability to absorb and store carbon dioxide. … …. The new project, from the Society for the Protection of Underground Networks (SPUN), will involve the collection of 10,000 samples around the world, from hotspots that are being identified through artificial intelligence technology….”
“…. This is believed to be the first major effort to map an underground ecosystem in this way. Climate science has focused on above-ground ecosystems, and although we know that fungi are essential for soil structure and fertility, and the global carbon cycle – as ecosystems with thriving mycorrhizal fungi networks have been shown to store eight times as much carbon as ecosystems without such networks – much of the role of fungi in the soil nutrient cycle remains mysterious. …. Ten hotspots have been identified by the scientists involved, including: Canadian tundra; the Mexican plateau; high altitudes in South America; Morocco; the western Sahara; Israel’s Negev desert; the steppes of Kazakhstan; the grasslands and high plains of Tibet; and the Russian taiga….”
“The Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), the United Nations Environment Programme (UNEP) and the World Health Organization (WHO) welcome the newly formed operational definition of One Health from their advisory panel, the One Health High Level Expert Panel (OHHLEP), whose members represent a broad range of disciplines in science and policy-related sectors relevant to One Health from around the world. “
… The One Health definition developed by the OHHLEP states: One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. The approach mobilizes multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development….”“Aid donors are being urged to revolutionise the way money is spent to move away from colonial ideas and create meaningful change. Ahead of a two-day conference this week, activists from Africa, Asia and Latin America have called on public and private global health donors – including governments, the United Nations, private philanthropists and international organisations – to prioritise funding for programmes driven by the needs of the community involved, rather than dictated by preconceived objectives. In a call to action, Aspen Institute’s New Voices Fellowship want donors to offer flexible, long-term funding for sexual and reproductive health and rights and ensure leaders, those allocating grantsand programme teams reflect the communities and groups they seek to support. …”
Y Hayashi ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02748-3/fulltext
“Nutrition is fundamental for the health and wellbeing of individuals and a basis for sustainable development and economic growth. Investing in good nutrition is an opportunity to positively impact health, increase individual potential and productivity, and support the economic development of nations. The Government of Japan will host the Tokyo Nutrition for Growth Summit 2021 on Dec 7–8. This is the third Nutrition for Growth Summit following London in 2013 and Rio de Janeiro in 2016. The Tokyo Summit aims to review the current status and challenges in nutrition improvement worldwide and to promote global efforts towards better nutrition. At the Tokyo Summit, malnutrition in all its forms will be addressed, including undernutrition, overnutrition, and the double burden of malnutrition, as part of accelerating efforts to achieving global goals and targets, such as the UN Decade of Action on Nutrition (2016–25), the WHO Global Nutrition Targets 2025, and the 2030 Agenda for the Sustainable Development Goals (SDGs)….”
See also a Lancet World Report – Hope for nutrition summit as global hunger spikes
“As COVID-19, climate change, and conflict drive hunger and malnutrition, the health community looks towards the Nutrition For Growth Summit. John Zarocostas reports.”
https://news.un.org/en/story/2021/12/1106972
“Corporate logos and Intellectual Property (IP) receive “greater protection online than we do as human beings”, the UN’s women’s health agency that works to end gender-based violence, UNFPA, said on Thursday, launching a new bodyright campaign to help shield bodies and minds from cyber violence. “It’s time for technology companies and policymakers to take digital violence seriously”, said UNFPA Executive Director Natalia Kanem -“right now”. …”
“…. The bodyright initiative is part of the wider 16 Days of Activism against Violence Against Women campaign, which runs until 10 December. “
https://www.thelancet.com/series/adolescent-nutrition
“Adolescence is a time of rapid changes in both physical growth and development and cognitive and emotional capacities. There rightly has been much emphasis on early childhood nutrition. However, adolescence is an additional important phase of risks and opportunities for healthy nutrition with lifelong and intergenerational consequences. Yet, this age group has been neglected in national and global plans and policies. This Series highlights the effect of nutrition on adolescent growth and development, the role the food environment has on food choices, and which strategies and interventions might lead to healthy adolescent nutrition and growth.”
Including a Comment - A new global policy framework for adolescent nutrition?
“…this Lancet Series highlights insufficient attention to adolescent nutrition in global nutrition policy frameworks…..”
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02747-1/fulltext
Analysis ahead of Biden’s “Democracy Summit”.
Horton concludes: “….the choice we face is not between liberal democracy and autocracy. Rather, it is to understand that there exists a non-liberal version of democracy, which is still able to deliver security, prosperity, liberty, equality, dignity, education, and wellbeing, including health. President Biden's efforts to renew democracy deserve support. But the value of democracy lies not in its liberal form, but in something much more fundamental—and that is what we must defend against populist and totalitarian regimes.”
“Health Systems Global (HSG) and Health Policy and Planning (HPP), with the support of the International Development Research Centre (IDRC), are pleased to announce the publication of a Special Supplement – Reimagining health systems for better health and social justice.
This Supplement distills and spotlights some of the rich debates and discussions that took place during the Sixth Global Symposium on Health Systems Research (HSR2020) – Re-imagining health systems for better health and social justice. The symposium, that took place virtually between November 2020 – March 2021, was hosted by HSG and organized in partnership with the Alliance for Health Policy and Systems Research (AHPSR) and a consortium of organizations from the Eastern Mediterranean Region led by the Mohammed Bin Rashid School of Government, and in collaboration with the American University of Beirut through its Knowledge to Policy (K2P) Center at the Faculty of Health Sciences….”
For a good introduction to the supplement, see the Editorial by S Bennett & F El Jardali - Reimagining health systems: reflections from the 6th Global Symposium on Health Systems research.
https://www.ghspjournal.org/content/9/supplement_2
New supplement. “Global health practitioners and designers recognize that real questions remain around the application of human-centered design in global health. This supplement seeks to clarify its value and document lessons learned, while also distilling and demystifying design. We hope the supplement can act as an inspiration in building a shared vision of how design can advance impact in global health.”
A Kerasidou et al ; https://jme.bmj.com/content/47/12/e27
« Medicine is not merely a job that requires technical expertise, but a profession concerned with making the best decisions and recommendations with reference to, and in consultation with, the patient. This means that the skill set required for healthcare professionals in order to provide good care is a combination of scientific knowledge, technical aptitude, and affective qualities or virtues such as compassion and empathy.”
R Calleja et al ; https://www.cgdev.org/blog/development-agencies-and-new-normal
“In this blog, we map key trends and changes in the development landscape and highlight the implications of these changes for the future of ODA. These findings were presented at the Development Leaders Conference 2021, held earlier this month. All development agencies will need to ask themselves how to better address challenges that extend beyond national boundaries and how to respond to the increasing incidence of poverty and inequality at the national level. Both approaches are linked and can co-exist. But they require a re-think of roles, practices and capacities.”
Quotes:
“…If the purposes of ODA are shifting to increasingly focus on the provision of GPGs and to promote private sector development, then does this change expectations around the role of ODA as a source of development finance?.... “
“… It is clear that for development agencies, adapting to the demands ahead will be no small task. Agencies will be asked to reconcile the tension between the traditional model of country-focused development alongside calls to use ODA to support global public goods. They will need to work effectively in a more diversified development landscape, including within their own governments, and will need to develop new skills, capacities, and ways of working at a time when ODA resources are dwindling and calls to use ODA to support domestic interests remain strong. …”
“To nobody’s surprise the Moderna chief blames everyone else (US govt, COVAX, Africa) for vaccine inequity with no mention of Moderna’s refusal to engage with the @WHO mRNA hub in South Africa @FT.”
“This excellent @TheEconomist graph shows that #COVID19 #vaccination across #Africa parallels routine child immunizations. Countries that do well w/regular vaccines have infrastructures & public trust upon which a COVID campaign can be erected. And vice versa.”
A Constantin - https://news.trust.org/item/20211130170554-pn8gh/?fbclid=IwAR1nMS51ufXtTulU853x_8tTe_nKRAfcvpF6HHSi9RghAZNU4AH8agficY0
“The adoption of a ‘pandemic treaty’ could mitigate harm next time we are hit by disease but only with reforms to the international legal system.”
“… Vaccine diplomacy has been one of the main obstacles to effectively controlling the COVID-19 pandemic. The current international law framework is insufficient to deal with governments that put geopolitical interests first in the midst of a global pandemic….”
https://www.ids.ac.uk/news/new-ids-bulletin-on-chinas-impact-on-international-development/
“China’s rapidly changing role in international development is the subject of intense debate, with profound impact on economies, societies and the environment globally. Against this backdrop, a new issue of the IDS Bulletin brings together analysis of the lead institutions and policies guiding China’s development activities. It aims to provide a better understanding of China’s contributions to international development and the implications for global development cooperation.”
S Kennedy & Y Huang; https://www.csis.org/analysis/advancing-us-china-health-security-cooperation-era-strategic-competition
New report.
“…. This report lays out six concrete, actionable streams where there could be collaborative work. Three areas of cooperation—travel, public health infrastructure, and supply chain resilience—stand out as most likely to deliver substantive results in the short term. They face relatively few barriers to implementation but could generate major positive spillover effects. U.S.-China health cooperation in another three areas—vaccines and therapeutics, biosafety and biosecurity, and countering disinformation—also promises high benefits for improving health security but faces higher substantive and political hurdles….”
G Guerra et al ; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00789-y
« … We present an analysis of the entry processes of health into the foreign policy and diplomatic domains in Mexico from the perspective of key informants of three different sectors….”
By “The Improving Health in Slums Collaborative”.
https://www.bmj.com/content/375/bmj.n2913
“At the beginning of the covid-19 pandemic, many scientific publishers chose to make their articles on covid-19 open access, likely strengthening the world’s response to the pandemic. Caitlin Edgell argues that we should open up research on the climate crisis with the same sense of urgency.”
P JS Stein et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00542-8/fulltext
“…Climate change is directly and disproportionately threatening the right to health of people with disabilities due to higher ambient temperatures, elevated air pollutants, and increasing exposure to extreme weather events that include heatwaves, floods, hurricanes, and wildfires. Strikingly, the global mortality rate of people with disabilities in natural disasters is up to four times higher than people without disabilities due to a scarcity of inclusive planning, accessible information, early warning systems, transportation, and discriminatory attitudes within institutions and among individuals. Disasters also disrupt access to health-care services, medications, oxygen, haemodialysis, personal care assistance, and medical devices…..”
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003866
by M Stoner et al. Conclusion: “The evidence base for large-scale impacts of cash transfers reducing HIV risk is limited; however, government social protection cash transfer programs and programs that incentivize school attendance among adolescent girls and young women show the greatest promise for HIV prevention.”
H Kim et al ; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000013
“The main aim of this study was to generate high-resolution maps of underserved areas where people cannot access the closest health care facilities within appropriate travel time in sub-Saharan Africa (SSA)….”
HP&P - Evaluation of the Implementation of the Framework Convention on Tobacco Control (FCTC) in Colombia
Human Resources for Health - The State of the World’s Midwifery 2021 report: findings to drive global policy and practice
Human Resources for Health - Factors influencing the performance of community health volunteers working within urban informal settlements in low- and middle-income countries: a qualitative meta-synthesis review
https://www.thelancet.com/journals/lanpub/issue/vol6no12/PIIS2468-2667(21)X0012-6
Start with the Editorial - Strengthening public health for a Healthy China
“China's rapid socioeconomic and demographic changes will profoundly affect the health and wellbeing of its population. Preparing the health system and public health responses to old threats and new challenges will be crucial for the country to deliver on its promises—Healthy China 2030. This issue of The Lancet Public Health is dedicated to the health of the 1·4 billion people in China, featuring the best research from China and highlighting the most pressing public health issues….”
https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.13029
New paper by A Cobham et al.
“The coronavirus pandemic had a radical effect on migration, limiting movement despite increasing levels of internal displacement from conflict and climate disasters, the UN’s International Organization for Migration said in a report on Wednesday. Though the number of people who migrated internationally increased to 281 million in 2020 – 9 million more than before Covid-19 – the number was 2 million lower than expected without a pandemic, according to the report. “We are witnessing a paradox not seen before in human history,” said IOM director general, António Vitorino. “While billions of people have been effectively grounded by Covid-19, tens of millions of others have been displaced within their own countries.” Internal displacement caused by violence, conflict and disasters increased to 40.5 million from 31.5 million. Globally, the IOM said governments implemented a total of 108,000 restrictions on international travel, alongside internal restrictions on movement, disrupting migration during the pandemic….”
G A Tessema et al ; https://gh.bmj.com/content/6/12/e007179
Scoping review.
J Ling-Tang et al ; https://www.bmj.com/content/375/bmj.n2806
Editorial from a new BMJ Collection. “Old school public health and technology can allow aggressive containment to succeed.”
“…China was the first country affected and held the world’s interest as it battled to understand and contain the new pathogen. But China has reported only 0.05% of the total number of global cases despite making up 19% of the world’s population. The question then is what can the world learn from China’s response to SARS-CoV-2? A new collection of articles written by people involved with that response attempts to shed light on China’s experiences and draw out lessons for the rest of the world ( for the Collection, see : www.bmj.com/how-china-responded-to-covid-19). Indeed, China’s prevention and control strategies remain more aggressive than most other countries…..”
“This collection of articles was proposed by the Peking University Center for Public Health and Epidemic Preparedness & Response…”
https://www.nytimes.com/2021/12/01/briefing/vaccine-hesitancy-africa-omicron.html?smid=tw-share
“On vaccines, no other continent is close.” On the reasons why.
“Western governments could be forced to bring in fresh emergency financial support for businesses and households if the Omicron coronavirus variant causes a severe global slowdown, a leading economic thinktank has warned. Sounding the alarm as more cases are identified, the Organisation for Economic Co-operation and Development (OECD) said a renewed wave in the pandemic threatened to add to the existing strain on the world economy from persistently high levels of inflation….”
“…the G20 group of wealthy nations had spent about $10tn (£7.5tn) in emergency support since the start of the pandemic, but that it would take just $50bn to ensure vaccination worldwide.”
https://ejhd.org/index.php/ejhd/issue/view/147
“In 2019, the Alliance for Health Policy and Systems Research joined forces with Ethiopia’s Federal Ministry of Health and the University of Gondar – the oldest medical school in the country – in a unique collaboration to tackle a major threat to global health and development: poor immunization coverage. Funded by Gavi, the Vaccine Alliance, and in partnership with United Nations Children’s Fund (UNICEF), the goal of the initiative was to identify key immunization programming issues and support attempts to solve them, while also mitigating wider system barriers if possible. An approach called embedded implementation research was used, which establishes early and sustained collaboration between researchers, implementers and policy-makers to ensure that studies are relevant and recommendations feasible…..”
BMJ GH - Gender-related data missingness, imbalance and bias in global health surveys