Subscribe to our weekly International update on Health Policies
The weekly IHP newsletter offers a digest of key global health (policy, governance, research) reads.
Select a newsletter issue or browse the topics in the current issue.
As Dr. Tedros pointed out on Monday, “One year ago, the first death from COVID-19 was reported and WHO issued its first tranche of technical guidance; A year on, there have been almost 2 million deaths from the COVID-19 virus and while we are hopeful about the safe and effective vaccines that are being rolled out, we want to see this sped up and vaccines allocated equitably in the coming weeks.” Adding, “…Covax is ready. Countries are ready. The time to deliver vaccines equitably is now” ” That summed up the current situation (and challenge) quite well. Including for Covax.
Also on Monday, Mike Ryan (WHO’s health emergencies boss), came up with the (ominous)metaphor of the week, likening the mutating virus to entering the second half of a football game. “While it doesn’t change the rules of the game, it does give the “virus some new energy. It adds to the challenge you face because the opposition is bringing on some new players to the field. It doesn’t change what we need to do to win. It just changes the strength of the opponent and, in that sense, we have to take from that that we have to redouble our efforts.”” That might be true, but many of us will also remember how a ‘second half’ can turn badly wrong (I do remember a disastrous second half for Anderlecht (against Werder Bremen), decades ago; and that has nothing to do with my current neck hair, which – with hairdressers still closed in my country – begins to look suspiciously like that from German football players from the 80s ).
The mutations & variants surely add to the (already high) animosity around WHO’s 148th Executive Board meeting, scheduled for next week.
At a preparatory G2H2 webinar on Tuesday, civil society groups claimed ( correctly but also a bit harshly, I think, given the current geopolitical environment & global health architecture) that WHO Has ‘Outsourced’ Its Role On Vaccine Access, proposing four interventions to ensure that vaccines do get developed (and distributed) as a public good. At the webinar, quite a few speakers also pointed out “WHO should have pushed more for C-TAP (instead of just advertising Covax, …). (PS: On the current “artificial scarcity” of vaccines, even Antony Fauci seems to agree, as he expressed strong support for the US to Join WHO’s C-TAP this week).
In any case, the pressure is on (and will only increase in the months ahead). At the G2H2 webinar, Els Torreele mentioned, rightly, that very uplifting statements were made at the start of pandemic by many global leaders, such as ‘We’re all in the same boat’, “the need for global solidarity”, “vaccination as a Global Public Good”, …but that the reality looks distinctly different, at the start of 2021. Indeed, for now it still looks as if many people in the lowest-income countries might need to wait until at least 2022 to get their vaccines.
Not just WHO, COVAX must also feel the pressure, labelled by our Global Health Now colleagues as “SLOVAX” earlier this week (ahum). Let’s hope that term doesn’t stick, and that soon vaccines also get rolled out in LMICs, through Covax, Chinese/Russian vaccines (if they’re sufficiently effective), & other mechanisms and fora. There was some encouraging vaccine news from the African Union this week.
(PS: it’s clearly not up to me, but I wonder whether it would make sense at this crucial point in time for African health leaders ( such as Winnie Byanyima, Ngozi Okonjo-Iweala, John Nkengasong, Matshidiso Moeti, … and of course dr. Tedros himself), who surely must be coordinating with each other, to come up with a joint op-ed on their preferred strategies to get to a real ‘People’s Vaccine’? C-TAP, Covax & Chinese/Russian vaccines, Trips Waiver proposal, … or a mix of all of them? )
Coming back to the WHO EB meeting, it will also be interesting to see how the current commotion around Big Tech (‘s power) plays out, given how many of these companies have started to engage with WHO recently, and thus entered the ‘global public health space’.
The EB meeting will coincide with the start of Joe Biden as US president. We do look forward to the new Biden administration, even if the challenges are enormous. Although far from perfect, the US can be so much more than what we have seen of it in recent years. At its best, the country is also capable of inspiring the rest of the world. Taylor Swift ft The National’s song “Coney Island” does remind one of this (while sending shivers down your spine). Hope we’ll again see some of that in the years ahead, including in global health.
Enjoy your reading.
Check it out! With Kent Buse and others from Global Health 50/50 behind this great calendar.
“Welcome to the Global Health Events Calendar, where you can find information on a range of international days, conferences and other global health related happenings. If you would like to suggest additional events to include in 2021, please get in touch at email@example.com....”
· For all documents, preliminary agenda, … see WHO: https://apps.who.int/gb/e/e_eb148.html
· Global Health Watch (WHO Tracker): https://who-track.phmovement.org/eb148 (with PHM comments on various agenda items)
P Patnaik; Geneva Health Files;
Absolute must-read analysis ahead of the EB meeting. “…a quick snapshot of some of the key items on the agenda of WHO’s Executive Board which meets next week….”
Among others on the Covid-19 response by WHO: “… WHO has delivered on the technical front, but critics believe that it has dragged its feet on steering the politically tough discussions. The important aspects on why the equitable access to vaccines have failed so far, are conspicuous by their absence in this document, for example. Some civil society stakeholders have called this much-awaited report only a “technical” update without more details…”
On the Budget: “A 100+ page document which gives a glimpse on the potential direction that the financing of WHO may take in the coming months. Emergencies and health security seem to have an overwhelming emphasis here. The 2022–2023 Draft Proposed programme budget sees a 19% jump in the size of the budget to US$ 4.47 billion (including COVID-19 lessons learned accounting for nearly US$ 275 million; a huge bump for digital health strategy at US$147 million; while science and research functions are projected to get only US$ 32.2 million….”
But also zooming in on lots of other items, including engagement with non-state actors, …
You can re-watch them (and also find most of the presentations here). More than worth it!!
Joe Biden starts more or less at the same time as the WHO Executive Board meeting.
Politico looks ahead to what Biden will bring to global health. Joining WHO again (yes), joining Covax?, involvement in WHO reform, …
Quote: “…Biden could also soon make clear whether the U.S. joins COVAX, the global effort to manufacture and equitably distribute coronavirus vaccines. U.S participation would be a big boost for the initiative. Congress last month opened the door to U.S. participation by approving $4 billion for Gavi, one of the organizations running COVAX, to buy and deliver vaccines to countries whose health systems are overwhelmed by the pandemic. Congress didn’t specifically say that the money would go to COVAX, leaving it up to Biden to frame the U.S. participation. …”
“The incoming Biden administration plans to restructure and expand the operations of the White House National Security Council, establishing new senior positions on global health, democracy and human rights, and cyber and emerging technology, signaling a sweeping shift in priorities, according to a senior adviser to the Biden transition….”
“Power, who was U.N. ambassador in the Obama administration, will run an agency that has been slashed and weakened by Trump.”
“…Signaling a dramatic new direction for U.S. foreign assistance, President-elect Joe Biden is expected to announce Wednesday that he will nominate former U.N. Ambassador Samantha Power to head the U.S. Agency for International Development, according to transition officials. … … Biden is also expected to enhance Power's role by elevating the position to membership on the National Security Council….”
See also the Guardian - Biden names ex-US ambassador to the UN Samantha Power to lead international aid agency.
“…President-elect Joe Biden's inauguration is a fundamental reset and refocus of priorities, giving a chance for renewal and revitalisation of science and health agendas, and restoration of the global standing of the USA….”
Excerpt: “In February, The Lancet will publish a Commission on public policy and health in the Trump era, which will look at Trump's impact on health and make suggestions for what Biden should do going forward. Democratic Party control of government could allow for a much more aggressive and proactive agenda on health than would have been possible with a divided government. Democrats can protect and expand the ACA, tighten controls on the use of violence by police, and once again place global health leadership at the forefront of foreign policy. The pick of Rochelle Walensky to head the Centers for Disease Control and Prevention (as described in a World Report in this issue) and promises to rejoin WHO and the Paris Climate Accords signal a serious commitment to addressing the damage….”
See also a Lancet World Report - New leadership at the US CDC (on R Walensky).
“Foreign Minister Toshimitsu Motegi vowed support for Senegal’s health and medical systems in response to the novel coronavirus pandemic during his three-day trip to the West African country through Tuesday, according to Japanese officials. Motegi told Senegalese President Macky Sall and his counterpart Aissata Tall Sall in separate talks that Japan will back Senegal’s efforts to promote universal health coverage to ensure basic medical care for all citizens, the Japanese Foreign Ministry said Monday….” “… Japan is pitching the vision in its diplomacy in Africa amid China’s rising clout in the continent. Motegi’s African visit came as Chinese Foreign Minister Wang Yi traveled to Nigeria, the Democratic Republic of the Congo, Botswana, Tanzania and Seychelles through Saturday….”
Mc Dade KK, G Yamey et al; https://centerforpolicyimpact.org/our-work/covid-19-and-the-future-of-global-health-aid/
““This report summarizes a dialogue held on November 9, 2020 titled ‘how will COVID-19 affect the future of global health aid?’ This dialogue was hosted by the Center for Policy Impact in Global Health at Duke University. Participants included policymakers from health and donor organizations and experts from transitioning middle-income countries. Four key themes emerged from the discussion: 1. COVID-19 has elevated the importance of global health on the global development agenda and presents a window of opportunity for action. This could be the time to focus on health security and health-systems strengthening and take bold steps to prioritize healthcare. 2. The pandemic has severely constrained financial resources available for health at the global and national level. Participants called for urgent action to help weather the storm and ensure resiliency in the health sector. 3. A reorientation towards global public goods for health is needed to ensure resilient health systems in the future. 4. Aid transition plans and approaches must adapt, but details remain limited on how exactly the pandemic will affect these processes.”
W Mao, J Dodoo, G Yamey et al; https://gh.bmj.com/content/6/1/e003896
The authors aimed to identify key challenges and opportunities that Ghana will face in dealing with aid transition, specifically from the point of view of country-level stakeholders.
Results: “Overall, stakeholders identified challenges more frequently than opportunities. All stakeholders interviewed believe that Ghana will face substantial challenges due to donor transitions. Challenges include difficulty filling financial gaps left by donors, the shifting of national priorities away from the health sector, lack of human resources for health, interrupted care for beneficiaries of donor-funded health programmes, neglect of vulnerable populations and loss of the accountability mechanisms that are linked with donor financing. However, stakeholders also identified key opportunities that transitions might present, including efficiency gains, increased self-determination and self-sufficiency, enhanced capacity to leverage domestic resources and improved revenue mobilisation.”
Focus on global trends & key WHO (political & public health related) messages.
(PS: everything related to Covax, we put under the ‘Covid vaccine access’ section below).
Via Cidrap News (14 Jan) – “The global death toll from the virus closed in on 2 million today and is at 1,986,398. The illness number has risen to 92,770,898, according to the Johns Hopkins online dashboard….”
(Jan 13) “… In its weekly snapshot of global COVID-19 trends, the World Health Organization (WHO) said yesterday that after lower reporting over the 2-week holiday period, cases and deaths are on the rise again in all but one of its regions and that 50 countries have now detected the more transmissible B117 variant first detected in the United Kingdom. In a separate announcement today, the WHO said its COVID-19 emergency committee [will] meet tomorrow for the sixth time to discuss the latest developments and tweak their recommendations. …. experiencing increased COVID-19 activity, except for South East Asia. Last week, cases were up more than 30% in the Western Pacific, Africa, and Americas regions. The five countries reporting the most cases were the United States, the United Kingdom, Brazil, Russia, and Germany….”
Eg on the dire situation in the US, see Stat - Covid-19 deaths are the highest they’ve ever been — and the more infectious variants could make things much worse
From earlier this week. (11 Jan) On Monday’s media briefing. “With cases accelerating in many parts of the world due to a post-holiday bump and pushed by more transmissible virus variants in some locations, the world 2 days ago saw its deadliest day of the COVID-19 pandemic so far….”
Link: Reuters - Global coronavirus cases surpass 90 million in battle on new variant (11 Jan)
“Worldwide coronavirus cases surpassed 90 million on Monday, according to Reuters tally, as nations around the globe scramble to procure vaccines and continue to extend or reinstate lockdowns to fight new coronavirus variants. The new COVID-19 variants discovered initially in the United Kingdom and South Africa are rapidly spreading globally. The novel coronavirus has picked up pace in the past few months with about one-third of total cases registered in the last 48 days, according to a Reuters tally….”
PS: Via Cidrap News : “South Africa's hospitals under pressure”. “In South Africa, where a more transmissible 501Y.V2 variant has become the dominant strain, the surge in cases has put hospitals under pressure in most provinces, the World Health Organization (WHO) African regional office said in a weekly update today. Officials said media reports are describing greater oxygen requirements than for earlier spikes, along with greater numbers of infected health workers….”
“ The second year of the COVID-19 pandemic may be tougher than the first given how the new coronavirus is spreading, especially in the northern hemisphere as more infectious variants circulate, the World Health Organization (WHO) said on Wednesday. … The WHO, in its latest epidemiological update issued overnight, said after two weeks of fewer cases being reported, some five million new cases were reported last week, the likely result of a letdown of defences during the holiday season in which people - and the virus - came together. “ …“Certainly in the northern hemisphere, particularly in Europe and North America we have seen that sort of perfect storm of the season - coldness, people going inside, increased social mixing and a combination of factors that have driven increased transmission in many, many countries,” Ryan said.”
Also on Monday’s media briefing.
“There needs to be a “collective commitment” to get vaccinations underway worldwide for health workers and others who are at high risk of catching COVID-19, within the next 100 days, said the UN health agency chief on Monday. Tedros … was briefing journalists in Geneva, a year on from the first ever recorded COVID-19 death. Today, there are more than 1.93 million dead, and nearly 90 million confirmed cases. …”
Tedros also encouraged all countries to do/improve genome sequencing research.
Coverage of a WHO Afro briefing from yesterday.
“African health officials are growing more concerned about the possible regional spread of a variant of the coronavirus known as 501.v2, which was first discovered in South Africa in November and has sparked travel bans and border closures. Authorities say the variant appears to be spreading at a faster rate and could put an increased burden on African health systems, amid fears that it has spread further than currently known. Speaking at a press briefing, Dr. Matshidiso Moeti, the World Health Organization’s regional director for Africa, warned that “a virus that can spread more easily will of course put more strain on hospitals and health workers who are in many cases already overworked and overstretched.” Thus far, Africa has been spared the worst effects of the pandemic with the continent recording a relatively low number of cases, possibly due to social and environmental factors, as well as lower fatality rates than other parts of the world. However the latest situation report from WHO shows that cases in the region have been increasing since mid-September, with steeper increases observed since late November….”
See also WHO Afro (14 Jan) - Africa COVID-19 cases top 3 million, first wave peak surpassed
“…As COVID-19 cumulative cases in Africa top 3 million and daily case numbers exceed the first wave peak, the continent is now confronted with emerging variants of the virus. Revamped public health measures are ever more critical to avert a runaway surge in infections that could stretch health facilities to the breaking point….”
“Countries that conduct a lot of genetic sequencing are more likely to find new strains, say experts.”
“The World Health Organization is planning a naming system for new Covid-19 variants to avoid stigmatising countries that discover new strains of the disease. In the last few weeks new variants have been identified all over the world - including in the UK, South Africa, Brazil and Russia - that are now taking over the previous dominant strains….”
WHO’s Eagle has landed, at last 😊.
“More than a year after a new coronavirus first emerged in China, a team of experts from the World Health Organization finally arrived on Thursday in the central city of Wuhan to begin hunting for its source. The investigation by the team of 10 scientists is a critical step in understanding how the virus jumped to humans from animals so that another pandemic can be avoided. Getting answers will most likely be difficult….” As you know, the whole debate on the origins is very politicized. “
“Despite the troubles, the W.H.O. says it intends to conduct a rigorous and transparent study….”
· Guardian - China agrees to let in WHO team investigating Covid origins From earlier this week. “ Expectations are rather low. “
· See also Xinhua - China ready to work with WHO investigation team on COVID-19: official
“Scientists express caution about what they may find and the political sensitivity around investigation.”
Quote: “…Leendertz is clear about one thing, however. While the international scientists on the team do the investigation, the complex and sensitive diplomacy around access will be handled by the WHO amid concerns in some circles that China might try and obstruct the work. That job will inevitably fall on the head of the WHO, Dr Tedros Adhanom Ghebreyesus, who is expected to keep close tabs on the mission.”
· Science (news) - After aborted attempt, sensitive WHO mission to study pandemic origins is on its way to China “International team hopes to meet Chinese scientists and visit sites in Wuhan after 2 weeks in quarantine.” With an overview what they hope to do there.
On the ‘new picture’ due to the mutations: “…With infections skyrocketing, “it’s a race against time.” The coronavirus has evolved as it made its way across the world, as any virus is expected to do. But experts have been startled by the pace at which significant new variants have emerged, adding new urgency to the race between the world’s best defenses — vaccinations, lockdowns and social distancing — and an aggressive, ever-changing foe. … … The new variant pummeling Britain has already been found in about , from Singapore to Oman to Jamaica, but many countries are effectively flying blind, with little sense of how bad the problem may be. …. …. With the world and the number of cases steeply rising to peaks that exceed those seen last spring, scientists see a pressing need to immunize as many people as possible before the virus evolves enough to render the vaccines impotent. …”
“… Experts say that countries should focus instead on ramping up vaccinations, particularly among essential workers who face a high risk with few resources to protect themselves. The longer the virus spreads among the unvaccinated, the more mutations it might collect that can undercut the vaccines’ effectiveness.”
“The “almost vertical” spike in SARS-CoV-2 infections seen in many countries over the last few weeks is largely due to increased social contact and not virus mutations, WHO has said. Speaking at a media briefing on Monday, Dr Maria Van Kerkhove, WHO’s COVID-19 Technical Lead, stated that sharp increases in transmission had occurred in a number of countries “before these variants were circulating”, adding that this “was due to increased mixing of people”….”
“World Bank President David Malpass urged private sector creditors to finally step up and help poor countries deal with the economic and health crises unleashed by the COVID-19 pandemic and stop collecting funds urgently needed elsewhere. Malpass told the Reuters Next conference on Wednesday that interest rate reductions could play a big role in some of the poor-country debt restructurings being done under a new G20 framework, noting that some developing countries were paying very high interest rates of 6% to 7% on official bilateral debt. Malpass expressed continuing frustration about the lack of private sector support for the G20’s Debt Service Suspension Initiative (DSSI), which allows the poorest countries to defer official bilateral payments through the end of June….”
“Health and technology groups are working together to create a digital vaccination passport in the expectation that governments, airlines and other businesses will require proof people have been vaccinated against Covid-19.The Vaccination Credential Initiative, a coalition of organisations including Microsoft, Oracle and the US healthcare non-profit Mayo Clinic, aims to establish standards to verify whether a person has had their shot and prevent people falsely claiming to be protected against the disease. The coalition builds on work done by one of its members, The Commons Project, to develop an internationally accepted digital certificate to prove travellers have tested negative for Covid-19. The pass developed by the non-profit, established with support from the Rockefeller Foundation, is now being used by all three major airline alliances….”
“The Open Doors African Private Healthcare Initiative will make more than USD$30 million available to private, small- and medium health care providers in Ghana, Tanzania, Nigeria, Kenya, and Uganda….” “…The facility was created by the Health Finance Coalition, a group of leading philanthropies, investors, donors and technical partners focused on mobilizing significant private investment to achieve transformative healthcare impact in Africa….”
“… The Open Doors African Private Healthcare Initiative is one of the first initiatives to address the economic crunch that the private health sector in Africa is facing due to COVID-19. A catalytic $700,000 investment by the U.S. President’s Malaria Initiative (PMI) enables a $17.7 million loan guarantee from the U.S. International Development Finance Corporation (DFC) and $1.5 million in philanthropic funding from The Rockefeller Foundation, the Skoll Foundation, and the MCJ Amelior Foundation. Together, this effort unlocks more than $30 million in loans to SME health providers. Additional support comes from the U.S. Agency for International Development’s Center for Innovation and Impact (CII)….”
Also including some of the more scientifically focused WHO messages.
“Global scientists are intensifying research into COVID-19, as the World Health Organization (WHO) moves to expand its scientific collaboration and monitoring of emerging variants of SARS-CoV-2, the virus that causes COVID-19. A day-long virtual meeting of scientists from around the globe, convened by WHO, brought together more than 1,750 experts from 124 countries to discuss critical knowledge gaps and research priorities for emerging variants of the virus….”
Coverage of the Forum, via UN News - Step up vigilance for emerging coronavirus variants, WHO urges.
“Efforts should be stepped up to quickly identify and study emerging variants of the COVID-19-causing SARS-CoV-2 virus, UN World Health Organization (WHO) scientists said on Tuesday. Alongside monitoring, virus and serum samples should be shared via globally agreed mechanisms so that critical research can be promptly initiated each time, according to the agency. …”
“Manufacturers and regulators need to be ready if shots prove less effective against any new variant. Vaccine makers and medicine regulators are sketching out plans in case the mutating coronavirus turns vaccine development into a game of cat and mouse. Just weeks after leading manufacturers secured the first regulatory approvals, mutations in the virus have forced scientists to re-test their Covid-19 vaccines and prepare to tweak their formula should the shots prove less effective. At the same time, regulators are considering how they could fast-track new approvals and whether they could use the seasonal flu jab as a model to authorise revised versions without requiring long trials…..”
“… Geoffrey Porges, an analyst at the healthcare focused investment bank SVB Leerink, estimated that the entire process until the new shots were in people’s arms would take three to six months for the mRNA vaccines. It would take six to eight months for the adenovirus vector vaccines like Oxford/AstraZeneca and Johnson & Johnson, and up to nine months for protein-based vaccines like those developed by Novavax and Sanofi/GSK, he said.”
“As placebo-controlled testing falls out of favour, vaccine developpers eye blood markers and challenge trials to assess next-generation candidate.”
Lu Lu et al ; https://gh.bmj.com/content/6/1/e004408
“To date, 23 countries from the WHO Africa region have deposited a total of 3995 SARS-CoV-2 sequences to publicly available databases, with the majority of the genomes being from South Africa (56%). Eight-four different lineages have been identified from these countries with 86% genomes belonging to the B.1 sublineage and its descendants. There have been multiple separate introductions of SARS-CoV-2 infections into Africa, with approximately 43% of these coming from Europe. 95% of African SARS-CoV-2 genomes have the D614G mutation in spike protein thought to be associated with higher infectivity but lower disease severity.”
“Immunity from Moderna Inc’s COVID-19 vaccine should last at least a year, the company said on Monday at the J.P. Morgan Healthcare conference….”
“Once immunity is widespread in adults, the virus rampaging across the world will come to resemble the common cold, scientists predict.”
“The coronavirus is here to stay, but once most adults are immune — following natural infection or vaccination — the virus , according to a study published in the journal Science on Tuesday. … … Eventually, the study suggests, the virus will be of concern only in children younger than 5, subjecting even them to mere sniffles — or no symptoms at all. In other words, the coronavirus will become “endemic,” a pathogen that circulates at low levels and only rarely causes serious illness….”
“A variant identified in Japan in arrivals from Brazil shares 'concerning' characteristics with mutations detected in the UK and South Africa…”
Quote: “…Of more concern right now is that the three variants evolved separately in different parts of the world, but have similar concerning mutations, Prof de Oliveira suggested. “This variant is a wake up call that we should try to really decrease transmission of Sars-Cov-2,” he said. “It is clear that if you leave it circulating, the virus has the ability to outsmart us and become better at transmission and evasion of the antibody response.”…”
“Investigations are under way in China and India over fears that new SARS-CoV-2 variants could undermine vaccines.”
“Researchers worry that efforts to free up limited vaccine doses are driven by desperation rather than data.”
· Reuters - New coronavirus variant found in travellers from Brazil: Japan government On the ‘Brazilian variant’.
· Times of Israel - Initial Israeli data: First Pfizer shot curbs infections by 50% after 14 days
“Studies of hundreds of thousands of Israeli vaccinees provide real-life info on efficacy; but health official also warns 17% of current serious cases had already gotten 1st shot…”
See also HPW - Israel As Global Guinea Pig – Data On Initial COVID-19 Vaccines Encouraging – But Infections Still Surging “Initial results coming out have good news and bad – suggesting that vaccine efficacy is high just two weeks after the first dose. But the data also suggests that a very high rate of overall immunization may be required to halt and reverse infection trends….”
Some reads, with focus on Covax first of all. Starting from Tedros’ message late last week. Later in this section, also some more info on the encouraging (vaccine) announcement of the African Union. And updates on Chinese vaccines & much more.
Coverage of Dr. Tedros’ key message at the WHO media briefing last week on Friday. Mostly on state of affairs re Covax.
“Some 42 countries around the world are now rolling out brand new COVID-19 vaccines to their populations. But 36 of those are high-income countries, 6 are middle-income countries, and none at all are low-income countries, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus at a WHO press briefing on Friday. He and other WHO officials at the briefing called upon pharma manufacturers and countries to stop arranging bilateral deals on vaccine supplies – and channel new vaccine procurement through the WHO co-sponsored COVAX facility – In what seemed at times like an almost quixotic vision, in terms of how the real-world rollout is actually proceeding….”
Excerpts: “…As more and more countries race ahead with their own deals, WHO officials clearly are concerned that COVAX could languish in the backwaters as a kind of “poor persons” fund supplying some vaccines to the 92 countries that cannot afford to pay on their own – but in limited quantities and at higher prices to boot.
“… But rather than channel vaccine purchases through the global procurement system, bilateral deals are becoming the norm, he protested, saying: “Both high and middle income countries that are part of COVAX [are] making additional bilateral deals. This potentially bumps up the price for everyone and means high risk people in the poorest and most marginalized countries don’t get the vaccine,” said Tedros. “I want to see manufacturers prioritize supply and rollout through COVAX.”
See also Reuters - WHO tells rich countries: stop cutting the vaccines queue
“…While Tedros did not name countries, the European Union said it reached a deal with Pfizer and BioNTech for 300 million additional doses of their COVID-19 vaccine in a move that would give the EU nearly half of the firms’ global output for 2021.”
“… Earlier this week, the WHO said the COVAX facility had raised $6 billion of the $7 billion that it has sought in 2021 to help finance deliveries to 92 developing nations with limited or no means to buy vaccines on their own….”
Also from late last week. “The world's poorest countries can expect to start receiving their first Covid-19 vaccine doses between the end of January and mid-February, the World Health Organization said Thursday….”
“… Covax, the globally-pooled vaccine procurement and distribution effort, has struck agreements to secure two billion doses -- and the first of those will start rolling out within weeks, said the WHO's head of vaccines, Kate O'Brien. … Asked how quickly lower-income African nations would get vaccines, O'Brien told a WHO live social media event: "The facility has access to over two billion doses of vaccine. "We will start to deliver those vaccines probably by the end of January, and, if not, certainly by early February and mid-February. "That's how countries in Africa and South Asia, and other countries around the world of these 92 that are less able to afford vaccines, are actually going to get vaccines."…”
Important remark: WHO Afro could not confirm this timing.
See a media briefing by WHO Afro’s M Moeti on Thursday (this week) – via Devex:
“The first doses of vaccines from the COVAX Facility are expected to arrive in March, with a larger rollout expected in June, said Matshidiso Moeti, Africa regional director at the World Health Organization, during a press conference….”
“The World Health Organization (WHO) has “outsourced” its role in vaccine access and sidelined member states by leaving the running of the COVAX vaccine procurement facility to GAVI, The Vaccine Alliance and CEPI (Coalition for Epidemic Preparedness Initiative), Third World Network’s Sangeeta Shashikant told a civil society (i.e. G2H2) forum on Tuesday. …”
“… Shashikant proposed that WHO be lobbied to adopt four interventions to ensure that vaccines are developed as a public good, namely: Securing legal commitments from manufacturers that they will reserve a proportion of their supplies for developing countries, Promote vaccine manufacturing in developing countries; Showing strong support for a World Trade Organization “TRIPS waiver” proposal, aimed at suspending aspects of intellectual property rights related to COVID health products during the pandemic; Promoting more transparency, particularly in reporting about the details of COVAX deals with vaccine manufacturers as well as voluntary license agreements between vaccine manufacturers and production companies …”
On (new Covax related ) estimates from the IRC. “There are increased concerns that billions of people will not receive the vaccine, putting the global community at risk of prolonging this pandemic and its devastating knock-on effects. Shortages in supply of COVID-19 vaccines, coupled with vaccine nationalism, means the vast majority of people in conflict and crisis-affected contexts – and in low-income and many middle-income countries – will not be able to access a COVID-19 vaccine in 2021, and possibly for multiple years ahead. COVAX – the global initiative to ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income – currently expects the vaccines to reach at most 20% of populations across low and lower-middle income contexts, with the reality likely much lower. …”
“…But the pandemic and its after effects won’t be truly gone until everyone can be vaccinated, the IRC warns, and asks that wealthy nations shore up their investments into the COVAX facility and share knowledge on Covid-19. …”
The picture so far. This week among others, the UK and the Netherlands announced new contributions. See below.
“The UK has now mobilised $1 billion from global donors to support vulnerable countries to access coronavirus vaccines – stopping the spread of the disease….”
Helicopter view on current state of Affairs re Covax.
Excerpt: “… one reason why COVAX might not be able to reach the target set out in its timetable is its funding mechanism, called the COVAX Facility. This allows countries to make their own purchases — as many have been doing — at the same time as putting money into COVAX. Pressure groups are also concerned about a lack of transparency on pricing. Nations buying their vaccines through COVAX are placing orders without knowing precisely how much they will need to pay. At present, says Andrea Taylor, a researcher at Duke University in North Carolina who is studying COVID vaccine manufacturing capacity around the world, it looks likely that in 2021 COVAX will deliver around 570 million doses, which is between one-quarter and one-third of its total target for the year. COVAX disagrees, and says it has many more deals with suppliers in the pipeline. … However, in an effort to help steady the ship, COVAX launched a scheme in mid-December by which countries can donate surplus vaccine doses. COVAX says some of these donations could be imminent, but, with vaccination programmes just starting, it is not clear at what point countries will be willing to let go of excess supplies. The WHO is urging nations to release any surplus stock immediately….”
“Despite a plea from WHO for immediate help, the Canadian government says it’s still too early to make any plan for redistributing the surplus vaccines it has secured.”
Cfr tweet Amanda Glassman:
“I was hopeful about sharing given #COVID19 #vaccine over-procurement by high-income countries like #Canada but apparently no one can plan to share until there is a huge excess of vaccines lying unused in a high-income country warehouse.”
Coverage of the encouraging AU announcement. “A provisional 270 million doses of Covid-19 vaccines have been secured by the African Union (AU) for distribution across the continent. All of the doses will be used this year, promises current AU head South African President Cyril Ramaphosa. This is on top of 600 million doses already promised (via Covax) but is still not enough to vaccinate the whole region. … … Mr Ramaphosa said officials are worried that the doses from the Covax effort released in the first half of 2021 will only be enough to inoculate health care workers. With a population of 1.3 billion people and each person requiring two vaccine jabs, Africa would need around 2.6 billion doses to eventually vaccinate. everyone.”
You find all detail on the AU announcement here: Africa centres for disease control and prevention secures first tranche of Covid vaccines
“The African Vaccine Acquisition Task Team (AVATT) established by African Union Chair President Cyril Ramaphosa today reported to a special meeting of the AU Bureau of the Assembly that it has secured a provisional 270 million vaccine doses for African countries, with at least 50 million being available for the crucial period of April to June 2021. The vaccines will be supplied by Pfizer, AstraZeneca (through an independent licensee, Serum Institute of India) and Johnson & Johnson. These efforts complement the COVAX facility, a World Health Organisation and Gavi Vaccine Alliance initiative to help low- and middle-income countries secure access to vaccines on a fair and equitable basis. AVATT, a 10-member team drawn from across the continent, was established in August 2020 to ensure that the African continent would be able to secure sufficient vaccine doses to achieve herd immunity. ….”
“… Arrangements have been made with Afreximbank to support member states who want to access these vaccines based on a whole-of-Africa approach. Afreximbank will, upon receipt of firm orders from member states, provide advance procurement commitment guarantees of up to US$2 billion to the manufacturers on behalf of member states. … … There is also close collaboration between the AU team and the World Bank to ensure that member states are able to access about US$5 billion either to buy more vaccines or pay for delivery of vaccines committed on their behalf by Afreximbank…. “
"It’s unfortunate that so far vaccine distribution has been inequitable, but this is a massive undertaking & takes time. The COVAX Facility aims to provide around 600 million doses for Africa in 2021."- "We expect the first doses to arrive by the end of March, with a larger roll-out by June. However, COVAX can only cover 20% of the African population so it’s great to see the @_AfricanUnion efforts to secure a provisional 270 million doses by end of 2021." “
See also HPW - WHO [Afro] Says It’s Not Opposed To Deals Outside COVAX
“Dr Matshidiso Moeti, WHO Regional Director for Africa told Health Policy Watch on Thursday that the Organization is not opposed to individual African countries securing their own doses outside of the COVAX arrangement. Moeti’s remarks directly contradicted those of WHO Director General Dr Tedros Adhanom Ghebreyesus at a WHO press conference last Friday, when the DG admonished countries not to make more deals outside of the COVAX framework. Her more positive reaction to the AU moves, likely reflect both an increasing realism about the limits of what COVAX can supply – as well as the fact that the AU is acting on behalf of a large bloc of states that have often been the last in line for new health innovations. According to Moeti, WHO encourages countries to try every opportunity to mobilize the additional resources outside of COVAX, and to secure additional supplies. “The important thing is to reach a coverage of the population that will then stop the circulation of the virus,” Moeti said….”
“But she also warned Africa’s WHO member states to refrain from ordering vaccines that have not been adequately tested in clinical trials….”
“…. This batch is strictly for purchase by African nations. Purchases will be made through the Africa Medical Supplies Platform, and the African Export-Import Bank will help countries secure financing by providing advance commitment guarantees of up to $2 billion to manufacturers. Once vaccines are delivered, countries can either pay for them using domestic resources or can use a five-year installment payment plan through the bank.
Development Re-imagined – Which African countries will get Covid-19 vaccines in 2021, and from where?
Monthly infographic. This one was the first one of 2021, and well worth checking. (from before the AU news (cfr above) was announced)
“… The good news on vaccines is that a month ago, only 8 countries had put aside finance to ordering vaccines. Today, 21 countries have pre-ordered vaccines, and we know for most of those countries how much they are ordering and from whom. In total, these 21 countries – including low-income and upper-middle-income countries – have ordered a total 260 million doses of vaccines. 35% of those are from the UK’s pharmaceutical manufacturer AstraZeneca to 7 countries, 33% from China’s Sinopharm, to 4 African countries, and on the other end just 1% of total doses from Russia. Some countries such as Tunisia and Sudan have not specified from whom their vaccines have been ordered. … So what’s the bad news? Well, these 260 million doses will be very unevenly distributed between the 21 countries – with some countries such as Seychelles aiming to have enough vaccines to cover a whopping 178% of its population, versus others such as Cote D’Ivoire, Algeria, Rwanda and even South Africa covering 1% or less of their populations. Overall, only 4 of the 21 have ordered enough to cover more than 20% of their population so far. Not to mention the other 34 African countries that have not made any orders as yet….”
(9 Jan ) “ Indian Prime Minister Narendra Modi said on Saturday the nation would continue to export medicines, including vaccines, as companies have ramped up production….”
“ India, one of the world’s largest manufacturers of inoculations, plans to offer 20 million doses of coronavirus vaccine to its neighbors as it draws up a policy to supply vials to countries across the globe, people with knowledge of the matter said. An Indian state-run company will buy vaccines from the Serum Institute of India Ltd. and Bharat Biotech International Ltd. for supplying to Nepal, Bangladesh, Sri Lanka, Afghanistan, Seychelles and Mauritius, the people said, asking not to be identified as the plan is still under discussion. Some of supplies may be free and treated as aid, they added. The first batch of the vials will be shipped over the next two weeks, the people said. The government will then offer the vaccines to countries in Latin America, Africa and the former Soviet republics….”
PS: as a reminder: China is relying on vaccines manufactured by two of its domestic companies, China National Biotec Group and Sinovac.
Confusing reports on the CoronaVac vaccine, developed by China’s Sinovac Biotech: “…Brazilian health officials say a Chinese coronavirus vaccine has demonstrated an overall efficacy rate of 50 per cent, far lower than originally indicated in a blow to one of the Latin American nation’s hopes for defeating the pandemic. … A level of 50 per cent is widely considered the minimum threshold for a vaccine to be considered viable. While just above that, the data still casts doubt over a flagship Chinese initiative to tackle the Covid-19 pandemic….”
See also Science - Third time’s the charm? Brazil scales back efficacy claims for COVID-19 vaccine from China “Lower efficacy for Sinovac's vaccine still meets recognized threshold for emergency use, but barely.”
“…The implications could be significant for a vaccine that is crucial to China’s global health diplomacy. At least 10 countries have ordered more than 380 million doses of CoronaVac, though regulatory agencies have yet to fully approve it….”
PS: Via Cidrap News : “WHO team assessing Chinese vaccines: “Tedros said in the briefing that a separate WHO team is in China to work with producers of the Sinovac and Sinopharm vaccines to gauge compliance with international quality manufacturing practices ahead of potential emergency use listing by the WHO, a step that would allow the vaccine to be deployed to developing countries. Also, Tedros said the WHO looks forward to the Serum Institute of India's submission of data for review of its AstraZeneca vaccine for international use….”
“Several Southeast Asian countries — including Vietnam, Malaysia, and the Philippines — are hoping to finalize deals with Sinovac, the Chinese vaccine manufacturer behind the CoronaVac vaccine, despite limited data on the vaccine’s efficacy and safety to date. …” … While pursuing other Western vaccine candidates, Vietnam, Malaysia, and the Philippines are also eyeing deals with the Chinese vaccine manufacturer….”
“… …. Data from Sinovac’s phase III trials will be crucial, not only in getting countries’ regulatory approval but also for low- and middle-income countries hoping to access financing from the Asian Development Bank’s Asia Pacific Vaccine Access Facility, launched in December….” “The facility is meant to help the bank’s low- and middle-income member countries procure and deliver COVID-19 vaccines. But it comes with strict criteria: the vaccine must be procured via the global vaccine initiative — more commonly known as COVAX, which aims for an equitable distribution of COVID-19 vaccines. If not, the vaccine should at least receive prequalification from the World Health Organization, or receive regulatory approval from a “stringent regulatory authority.””
“Indonesia has “lost control” of its coronavirus response, experts have warned, complicating a planned mass rollout of China’s Sinovac vaccine to vanquish the pandemic in the world’s fourth most populous country. The south-east Asian nation has been battling one of the region’s most stubborn Covid-19 outbreaks, attributable to ineffectual lockdowns and contact tracing. …”
“… Indonesia will rely heavily on the Chinese Sinovac-manufactured CoronaVac to inoculate its population, with 3m of 125m doses already delivered and being distributed at health facilities across the country. Mr Widodo, who is popularly known as Jokowi, has volunteered to be the first to receive the jab on national television on Wednesday in a bid to boost public compliance. It is clear that the 15-month timeframe was developed under Jokowi’s pressure. Most experts believe that it is not realistic….”
See also Reuters – (11 Jan) Indonesia approves China's Sinovac vaccine as infections surge
“Indonesia gave Sinovac Biotech’s COVID-19 vaccine its first emergency use approval outside China on Monday as the world’s fourth most populous country launches nationwide inoculations to stem surging infections and deaths….”
“China and Russia are spreading their vaccines—and forging new ties—to some of Washington’s closest allies.”
See also the Economist - Bahrain and the UAE are relying on a Chinese-made vaccine “They are hoping for both political and public-health benefits.”
https://www.ft.com/content/197f81da-2165-3583-884d-bf30b01dda3d “Russia has begun trials of a one-shot coronavirus vaccine that its developers believe could be used to meet export demand. State-run Gamaleya Institute, which developed the country’s flagship two-dose Sputnik V vaccine, has begun trials on 150 people to test the efficacy of administering just one shot, dubbed “Sputnik Lite”. The single jab would be marketed for export, the head of the country’s sovereign wealth fund, which has financed Sputnik V’s development, said on Monday….”
See also Reuters - Russia to try out 'Sputnik-Light' COVID vaccine to make it go further
““‘Sputnik-Light’ can serve as an effective temporary solution for many countries, which are experiencing a peak of coronavirus infection,” Dmitriev, head of the Russian Direct Investment Fund (RDIF), which is covering the costs of the Sputnik-Light trial, said….”
“Pfizer’s partner BioNTech boosted the 2021 delivery target for their COVID-19 vaccine to 2 billion doses, up from 1.3 billion previously, as they bring new production lines on stream and as more doses can be extracted per vial. Special syringes known as low dead space syringes were instrumental in the increase, which would result in 1 billion people getting the designated two-dose regimen, BioNTech said in a presentation posted on Monday….”
“BioNTech and Pfizer plan to supply an additional 700m doses of their Covid-19 vaccine this year thanks to a new factory in Germany and adjusted European guidelines that allow for an extra shot to be extracted from each vial. The companies had originally pledged to make 1.3bn doses in 2021 but now intend to provide as many as 2bn, BioNTech said in a statement…”
Good overview of where things stand re the Trips waiver proposal.
Excerpt: “Negotiations at the TRIPS Council in January and February may well produce a draft text or declaration on the waiver. When, and if, the waiver or declaration text makes it to the WTO General Council in March, both developing and developed countries should vote in support of it. WTO member state decisions are usually made by consensus. But in the absence of one, they can be passed with a three-fourths majority (123 of 164 members). Between now and then government leaders of developing countries and others who support the waiver should contact non-supportive member states directly, making their arguments in favour of it. …”
“… If the waiver fails, developing countries should explore a collaborative effort to make use of TRIPS Article 73 (Security Exceptions). A legal interpretation of this article suggests that the pandemic satisfies the conditions set out in the article and its conditions could achieve much the same outcome as the proposed waiver….”
J Krellenstein et al; https://www.nytimes.com/2021/01/12/opinion/world-covid-vaccines.html?smid=tw-share
“Two decades ago, the U.S. launched a program to help supply the world with H.I.V. medication. It should take a similar approach to Covid.” Floating the idea of “PEPVAR” 😊.
“… Mr. Biden can help address today’s urgent global health challenge by establishing the President’s Emergency Plan for Vaccine Access and Relief, or Pepvar, and rapidly building facilities to manufacture vaccines and their constituent components at scale….”
“The U.S. needs J.&J.’s one-shot vaccine more than ever. But the company is behind on manufacturing promises made in its Operation Warp Speed contract”
PS: “A vaccine that is one dose would have a tremendous, tremendous public health impact, of course for low-income countries, but also in high-income countries,” said Ruth Faden, a professor of biomedical ethics at Johns Hopkins University.”
FT - Australian scientists cast doubt on Oxford/AstraZeneca vaccine (comparing with Pfizer & Moderna vaccines, and with a view on reaching herd immunity)
“Covaxin, India’s indigenous COVID-19 vaccine, cleared for emergency use…”
“An effective government response to COVID-19 doesn't necessarily correlate with economic gain … … In general, the connection between economic growth and pandemic performance is weaker when once one accounts for the contribution of (economic) stimulus….””
The authors draw two lessons from this insight.
“The technology exists to rapidly tweak vaccines in the face of new coronavirus mutations. But it would take time, and a global strategy is needed to ensure that scientists stay one step ahead. … … global agreement may be needed. “The scientific side of it is straightforward; it would be the regulatory side that might be more of a challenge,” said Dr John McCauley, director of the Worldwide Influenza Centre at London’s Francis Crick Institute, one of six centres around the world that analyse influenza samples to help guide vaccine development. “If a vaccine is going to be produced globally, then you need a global recommendation on its composition. For flu, that’s worked out through the WHO making a recommendation and regulators in different countries fine-tuning them. It requires cooperation and a recognition by the regulators that they are not necessarily in the best position to make a decision.”…”
E Demarais (from Economist Intelligence Unit); https://www.globalhealthnow.org/2021-01/what-it-means-when-billions-people-must-wait-years-covid-vaccine
Focusing on some of the (possible) political consequences in LMICs (and also geopolitics at play).
Excerpt: “ … reactions to the map show that resentment is running high across the world. In many cases, people direct their rage at their governments, asking their elected leaders to explain why they could not secure early access to the shots. Some may see this as a positive development: People are holding their governments accountable for a perceived failure. However, these comments are worrying because they point to the possibility of popular backlash and social unrest in many LMICs. The political landscape of several Asian, African or Latin American countries may well change as a result of the pandemic. Third, people are angry at the West. Some believe that rich travelers contaminated poorer countries by refusing to stop leisure travel. In many of these tweets, condemnations of capitalism, perceived Western “imperialism,” and globalization abound. …”
“…In fact, there appears to be much hope across the world that Chinese and Russian vaccines will come to the rescue of lower-resource countries, for free. This is an interesting twist, as there is still a dearth of reliable scientific data regarding these vaccines. It is also unlikely that Beijing and Moscow would provide their vaccines to lower-resource countries with no strings attached….”
“This paper examines the different socio-economic determinants of the fatalities associated with the COVID-19 pandemic globally in social determinants of health frameworks. … … The COVID-19-related data is from Our World in Data, and the socio-economic variables are from the World Bank’s World Development Indicators. The results establish that an improved adequate health infrastructure for both testing and treatment is necessary, but not sufficient. Health systems ultimately become overwhelmed and ineffective in managing cases and reducing mortality in the face of the rising pandemic. Complementary social, economic, physical and environmental factors are necessary for curbing deaths. These factors relate to improving the health stock of the population through reductions in both communicable and non-communicable comorbidities; enhancing sanitation and hygiene; and improving the nutrition of the population. Socio-economic and environmental measures are the reduction of household and ambient air pollution; reduction of exposure to alcohol and cigarettes; reduction of poverty and ensuring economic inclusion; and learning from the past to fine-tune governments’ control measures in order to minimize harm to the population while effectively curbing mortality.”
“Although socioeconomic status partly explains ethnic disparities seen with covid-19, cultural and structural racism also adversely affect health, argue Mohammad Razai and colleagues.”
“Governments have spent at least €93 billion on COVID-19 vaccines and therapeutics globally since the beginning of the pandemic,a new study has found.”
“Published on Monday research, the kENUP Foundation, a European non-profit supporting research-based innovation in health industries, found that in 11 months, the public sector invested heavily in the development of vaccines, with a commitment of 95% – €86.5 billion – of the total spending, while only 5% of the funds were spent on therapeutics. Somewhat surprisingly, the majority of the investments made by governments for vaccines was made in Small and Medium Enterprises (SMEs) and corporations with a market value between $2 billion and $10 billion. Only 18% of public COVID-19 funds went to large pharmaceutical manufacturers. “
“… …. 93% of funding – €86.5 billion – was committed through AMCs and was carried out through various national, multilateral, and global efforts to accelerate the development, manufacturing, and distribution of COVID-19 vaccines, such as through Operation Warp Speed in the US, the European Commission, and the COVAX Facility. The majority of the public funds directed towards vaccine developers originated from high-income countries, with 32% invested by the US, 24% by the EU, and 13% from Japan and South Korea. …”
“Governments are variable in their reliance on highly cited research, while international intergovernmental organizations such as the World Health Organization reliably link policy and science, according to an analysis of thousands of policy documents from the first half of 2020.”
See Science for the study - Coevolution of policy and science during the pandemic.
Recommended blog. With focus on the UK, but probably also true in a number of other settings.
Quote: “…The problem, then, is that in psychologising and individualising the issue of adherence, one disregards the structural factors which underlie the spread of infection and the differential rates in different groups. One also avoids acknowledging the failures of government to provide the support necessary to follow the rules (most obviously in the case of self-isolation) … The way in which issues of adherence have been portrayed and understood during this pandemic have been spectacularly wrong. If anything, the headline stories should not be of “fatigue” and “covidiots”’ and house parties. They should highlight the remarkable and enduring resilience of the great majority of the population – including those who have been most subject to blame such as students and young people in general – even in the absence of adequate support and guidance from government. Indeed, in many ways the narratives of blame serve to project the real frailties of government policy onto the imagined frailties of public psychology.”
“The pandemic could amount to $10trn in forgone GDP over 2020-21.” “…Converted into today’s money, $10.3trn is enough to buy the ten biggest listed companies in the world, including Amazon, Apple and Saudi Aramco….”
“Policymakers should heed lessons learned in 2020 to craft a more inclusive and effective pandemic response.”
“Australia, New Zealand, Taiwan and Japan are among those that won’t start vaccinating for months, in part to see how other populations react to the jab.”
Do scan the findings. “… In the throes of the pandemic, half of countries fail to report up-todate sex-disaggregated data; worryingly some countries that had been reporting have stopped. The number of cases for which we have not been able to locate data by sex has grown to almost 30 million and the sex of almost half a million deaths is also unknown. Two of the top 10 countries with the highest COVID-19 caseloads, Russia and India, reported no sex-disaggregated data in the past month. Data from these two countries would help identify the sex of a large proportion of cases and deaths. Globally, confirmed cases are evenly distributed between men (50%) and women (50%). However, we continue to see that men comprise a higher proportion of hospitalisations (54%), ICU admissions (68%) and deaths (58%) than women. A small handful of countries have begun reporting sex-disaggregated data on COVID-19 vaccinations. We plan to begin tracking the availability of this data systematically.”
“One year ago, China announced the first Covid-19 death. Now, the disease is among the 10 deadliest pandemics in history.”
Israel, Bahrein & UAE. Some of the factors explaining, structural ones and in terms of population attitude.
C Lakner et al; World Bank;
“As the new year brings some hope for the fight against COVID-19, we are looking back and taking stock of the effect of the pandemic on poverty in 2020. In October 2020, using the June vintage of growth forecasts from the Global Economic Prospects, we estimated that between 88 and 115 million people around the globe would be pushed into extreme poverty in 2020. Using the January 2021 forecasts from GEP, we now expect the COVID-19-induced new poor in 2020 to rise to between 119 and 124 million. …”
“Collateral Global is an international scientific effort to study the full effects of public health measures implemented in response to SARS-CoV-2.” Mental, physical & social health.
“In a major milestone in the fight against deadly diseases, United Nations agencies and humanitarian partners announced on Tuesday, the establishment of a global Ebola vaccine stockpile, to help control future epidemics by ensuring timely access to vaccines for populations at risk, during outbreaks. “
“The International Coordinating Group on Vaccine Provision (ICG), which includes WHO, UN Children’s Fund (UNICEF), the International Federation of Red Cross and Red Crescent Societies (IFRC), and Médecins Sans Frontières (MSF), led efforts to establish the stockpile, with financial support from Gavi, the Vaccine Alliance. The stockpile is stored in Switzerland, and vaccines are ready to be shipped to countries for emergency response. …”
“The four leading international health and humanitarian organizations announced today the establishment of a global Ebola vaccine stockpile to ensure outbreak response. ….”
“ A Gavi-funded global emergency stockpile of Ebola vaccines will be accessible to all countries following a procurement process concluded by UNICEF…”
S Stawacki et al; https://www.intechopen.com/books/contemporary-developments-and-perspectives-in-international-health-security-volume-1/introductory-chapter-international-health-security-expanded-and-re-defined
“International health security (IHS) is a complex and highly heterogenous area under the broader umbrella of health sciences. Within that general context, IHS encompasses all domains that potentially influence (and more specifically - potentially endanger) the well-being of human health and wellness, from natural disasters to outbreaks and pandemics, including rapid urbanization, population growth, various environmental matters, critical supply chain vulnerabilities, misuse of antibiotics leading to unpredictable microbial resistance patterns, and even social media (SM) misinformation. The need for this expanded definition of health security came about with the realization that topics such as emerging infectious diseases (EID), food, water, and pharmaceutical supply chain safety, medical and health information cybersecurity, and bioterrorism – although clearly dominant factors within the overall realm of health security – constitute only a small proportion of forces able to actively modulate the wellness and health of human populations.”
“A coalition of 50 countries has committed to protect almost a third of the planet by 2030 to halt the destruction of the natural world and slow extinctions of wildlife. The High Ambition Coalition (HAC) for Nature and People, which includes the UK and countries from six continents, made the pledge to protect at least 30% of the planet’s land and oceans before the One Planet summit in Paris on Monday, hosted by the French president, Emmanuel Macron….”
See also Devex - Country coalition aims to protect 30% of land and oceans on Earth
And via UN News: “…Also on Monday, the Great Green Wall for the Sahel and Sahara, an initiative to combat desertification in the vast region, received a pledge of more than $14.2 billion in new funding over the next 10 years, to restore degrading land, protect biodiversity and strengthen resilience. …”
Big read on the rise of climate change litigation.
“If successful, the legal action in the Netherlands, could force companies to accelerate the shift to cleaner fuels.”
“Litigation against fossil fuel companies is not new. But until now the focus has largely been on liability suits, asking corporations to pay damages for past behaviour. Attention is now shifting to so-called human rights-based cases which have the potential to redraw the future business models and plans of corporate polluters. These cases are designed to advance climate policies, say their backers, raise public awareness and drive behavioural shifts by entire industries. … … Lawyers, environmentalists and energy analysts say if Shell loses, it and some of its rivals, might preemptively adopt policies — from divestments to ramping up investment in clean energy — to avoid further legal action. They would be forced to prepare for climate litigation failure as a financial risk. It is also likely, they say, that future legal cases will target not just fossil fuel companies, but also investors and related entities, such as banks extending finance to them.”
“COVID-19 and climate change are two sides of the same coin. To overcome both we must confront their root cause: an economic system that is killing the planet.”
Messing up 2021 would mean: “… If ‘build back better’ turns out to be an empty slogan; President Biden’s climate plan fails to pass the gridlock of the US political system; China’s five-year plan includes a vast expansion of coal power plants; and COP26 is a diplomatic failure – then we will find ourselves locked into a very dangerous trajectory indeed….”
“The planet is facing a “ghastly future of mass extinction, declining health and climate-disruption upheavals” that threaten human survival because of ignorance and inaction, according to an international group of scientists, who warn people still haven’t grasped the urgency of the biodiversity and climate crises. The 17 experts, including Prof Paul Ehrlich from Stanford University, author of The Population Bomb, and scientists from Mexico, Australia and the US, say the planet is in a much worse state than most people – even scientists – understood. “The scale of the threats to the biosphere and all its lifeforms – including humanity – is in fact so great that it is difficult to grasp for even well-informed experts,” they write in a report in which references more than 150 studies detailing the world’s major environmental challenges….”
Climate adaptation is, by far, not high enough on the political agenda, with the situation getting worse due to the Covid-19 crisis.
“Millions of people around the world are facing disaster from flood, droughts, heatwaves and other extreme weather, as governments fail to take the measures needed to adapt to the impacts of climate breakdown, the UN has warned. Nearly three-quarters of countries around the world have recognised the need to plan for the effects of global heating, but few of those plans are adequate to the rising threat, and little funding has been made available to put them into force, according to the , published on Thursday. … … ….Spending on measures to adapt to extreme weather has failed to keep pace with the rising need, according to UNEP. Only about $30bn (£22bn) is provided each year in development aid, to help poor countries cope with the effects of the climate crisis, which is less than half of the $70bn currently estimated to be needed. Those costs are set to increase further, to between $140bn and $300bn by the end of the decade. About half of global climate finance should be devoted to adaptation, the UN secretary-general, António Guterres, has said, with the rest going to efforts to reduce greenhouse gas emissions. …”
PS: and a link on Bill Gates’ “guilty pleasure (his words) : Bill Gates joins Blackstone in bid to buy British private jet services firm
“Public settings, such as schools, childcare centres, nursing homes, hospitals and correctional facilities and all other canteens of public institutions, can play a key role in ensuring people are provided with healthy food and helping prevent the 8 million annual deaths currently caused by unhealthy diets. A new WHO Action framework for developing and implementing public food procurement and service policies for a healthy diet aims to increase the availability of healthy food through setting nutrition criteria for food served and sold in public settings. The action framework also aims to reduce preventable diseases and deaths from high consumption of sodium and salt, sugars and fats, particularly trans fats, and inadequate consumption of whole grains, legumes, vegetables and fruit….”
“In the past year, decolonising global health has gained prominence. … As a reaction schools of global health have made statements about racial equality and have avowed to address racism, increase staff and student diversity, and to train their staff in the art of decolonisation. I have been involved in these processes of decolonisation at my own institution. Yet I also view such efforts critically….”
After referring to Fanon’s views (on Algeria & decolonizing (and the need for violence, in his view)), she says: “ … I am not advocating violence, but I am questioning whether we will achieve structural change while seeking progressive reform and working through channels that were set up within structures that uphold white supremacy….” “Although I am not advocating violence, I am advocating anger and revolution. The global health community should be angry because the polite institutional processes with which we are trying to decolonise belie the structural violence and hurt caused by racism in global health institutions….”
Hirsch questions whether decolonising global health institutions is possible.
And says: “…If we want to work towards health justice, the institutions that have been built on and benefited from the racist exploitation of Black, Brown, and Indigenous populations the world over cannot decolonise and keep their epistemic, political, and financial power….”
« …conducted a scoping review of qualitative studies, opinion and editorial pieces about what equity is and how it can be promoted in international collaborations. … identified 10 key domains which are important for promoting equity in international collaborations: funding; capacity building; authorship; sample ownership and export; trust; research agreement; acknowledging inequality; recognition and communication. … Our findings suggest that for international collaborations to be considered more equitable, it must at least consider the 10 domains we highlighted. The 10 domains map onto five key aspects of social justice theory, namely avoiding unequal power relations like subordination, group recognition and affirmation, promoting the well-being of all, inclusion in decision-making and ensuring self-development….”
D Baranshamje et al ; Guardian
“…Worldwide, more than 99% of humanitarian and philanthropic funding goes to predominantly white-led international NGOs. Despite Africa’s growing and dynamic social sector, only 5.2% of US foundation giving to Africa goes to African-led organisations. Global giving to Africa needs its own Black Lives Matter reckoning….”
By way of example of what the authors have in mind: “… The African Visionary Fund is a new pooled fund, seeded by a group of US foundations, designed to drive millions of dollars in unrestricted funding to African-led organisations. We do the due diligence, advocate for our partners and make grants directly to African leaders to accelerate their impact….”
“In 2020, the Global Fund signed 157 grants for a total of US$8.54 billion for lifesaving HIV, TB and malaria programs and to strengthen systems for health. This is the highest amount of grants ever signed in a single year by the Global Fund. The grants will begin implementation this month….”
“People worldwide have overwhelmingly highlighted their faith in multilateralism to address global challenges, the results of a year-long survey by the United Nations have shown.”
“Nearly all of the 1.5 million people surveyed over the past year as part of a United Nations initiative said they believe international cooperation is important for addressing global challenges, and engagement across borders has gained more relevance during the COVID-19 pandemic. But for most respondents, the international body remains an abstract concept, removed from their everyday realities. These are some of the new findings released by Fabrizio Hochschild, U.N. special adviser on the preparations for UN75, and his office last week. The initiative has worked over the past 12 months to provide a “reality check” on what changes the 75-year-old global institution should implement to become more relevant. … … Globally, 49% of respondents said they believed that people will be better off in 2045, as opposed to the 32% who said that people will be worse off, according to the report, “Shaping Our Future Together,” released Friday. People living in lower-income countries and those living in conflict situations expressed greater optimism about the future than people in high-income countries….”
And see also IPS with more detail on respective priorities: “The peoples of the world are unanimous – access to basic services such as universal healthcare must become a priority going forward. So too should global solidarity, helping those hardest hit by the COVID-19 pandemic and addressing the climate change emergency. “When you ask people about their fears and hopes for the future, when you ask people about their expectations of international cooperation about their priorities in the immediate, post-COVID, there is remarkable unity across generations, regions, income groups, education groups, and from people from different political direction,” Fabrizio Hochschild, Special Adviser to the Secretary-General on the commemoration of UN’s 75th anniversary, said during a virtual press conference on the findings on Friday, Jan. 8. Indeed respondents of the UN conversation from all but two regions – sub-Saharan Africa and Eastern and South-eastern Asia – had listed access to universal healthcare as an immediate short-term priority, according to the report. In the regions of sub-Saharan Africa and Eastern and South-eastern Asia the call for increased support to places hardest hit by the pandemic and greater global solidarity ranked top. Next was the need for universal healthcare….”
PS: earlier this week, UN SG Guterres announced he’s candidate for a second term at the helm of the UN.
“A US$40 million research consortium has been created to repurpose existing medicines for hepatitis, tuberculosis and malaria into long-acting treatments that can benefit low- and middle-income countries (LMICs) where people often have trouble accessing medicine over and over again, Unitaid experts told Health Policy Watch. The consortium on Tuesday launched the new Centre of Excellence for Long-acting Therapeutics (CELT) at the University of Liverpool, as a first of its kind research center in the world. Unitaid, a global WHO-hosted partnership of private and public sector actors, is engaged in finding innovative solutions to prevent, diagnose, and treat infectious diseases more quickly, cheaply, and efficiently in LMICs, was the major funder of the cutting-edge Centre and research consortium….”
“Twitter last week permanently suspended the account of Sci-Hub, the website that has posted millions of freely accessible copies of scientific articles pirated from subscription journals. Twitter said Sci-Hub had violated its policy against promoting “counterfeit goods,” according to Sci-Hub’s founder, Alexandra Elbakyan….”
New White Paper. China's State Council Information Office on Sunday issued a white paper titled "China's International Development Cooperation in the New Era."
Excellent coverage via Devex - New white paper outlines China's development past and future
“The Chinese government has published a white paper outlining its work on international development cooperation, laying out a mission for its young aid agency, and putting forward its vision for the future. Beijing is targeting both an international and a domestic audience with the white paper…”
“While many countries are cutting aid budgets, the white paper indicates that China is expanding its foreign aid funding and making it more concessional. It appropriated about $41.8 billion between 2013 and 2018, with about 47% coming in the form of grants, 48% as concessional loans, and 4% as interest-free loans, according to the white paper. … The “strong narrative around China’s responsibility to the rest of the world,” and about showing solidarity with the rest of the world by supporting global public goods, is targeted at a domestic audience, Ryder said. Language around how China prioritizes the needs of its south-south partners meanwhile, is “internationally focused and crafted in such a way that it brings out contrasts between China and other developed countries’ approach,” she added. … “
“The 45-page document goes into detail about how China is supporting the 2030 Agenda for Sustainable Development including through poverty reduction efforts, supporting agricultural productivity to address food security, improving health care systems, and supporting education. … The paper also outlines where the funding is going by region — 45% of funding between 2013-2018 went to Africa, with 37% going to Asia and 7% going to Latin America and the Caribbean — and the types of projects China has funded … … What this paper doesn’t include, that Ryder thought it might, was a more detailed breakdown by country of where Chinese aid is going. … … “This is not a response to the international community for transparency in Chinese aid but is giving a number of clear messages about what the direction of China’s foreign aid is,” she said. … … … While the white paper includes few surprises and little new information it is the first time that the Chinese government has articulated the connection between its Belt and Road Initiative and its development cooperation agenda. BRI is mentioned repeatedly as an “overarching, driving force for foreign aid,” she said — the clearest articulation yet from Beijing…. This is the first white paper released since China launched its own development agency and it outlines the mandate of the agency … “
· PS: do also check out the China Global Development Knowledge network “The China Global Development Knowledge Network (CGDKN) fosters UK-Chinese collaboration by providing a platform for Chinese and British researchers to share their work….”
· PS: you might also want to read a paper from last year (by E Yoo), in Development Policy Review, Chinese Development Finance and its determinants: Does global governance matter?
“…The article tests the three sets of hypotheses on Chinese development finance, positing that countries will receive more Chinese aid if: (1) they have a UN General Assembly voting alliance with China and do not recognize Taiwan; (2) the more oil and gas reserves they have; and (3) the more memberships of intergovernmental organizations (IGOs), such as the UN agencies, and international non‐governmental organizations (INGOs), which include non‐profit organizations and charities, such as Oxfam, as well as foundations and professional associations….”
N Jensen et al ; https://www.tandfonline.com/doi/full/10.1080/17441692.2020.1867881
“… This paper reviews evolving ways that equity goals have featured in key World Health Organization (WHO)-related policy documents, before discussing the heuristic value and empirical traction that the concept of equity can bring to the health system strengthening (HSS) agenda. We argue that while health equity is often presented as the overarching goal of HSS, in practice this is typically circumscribed to the provision of healthcare services. Although healthcare equity is important, we suggest that this narrow focus risks losing sight of the structural political, social and economic drivers of health and health inequities, as well as the broader contexts of care and complex socio-political mechanisms through which health systems are strengthened. Drawing on new lines of empirical inquiry, we propose that broadening the equity lens for HSS offers exciting opportunities to put health systems at the heart of a more ambitious equity agenda in global health.”
“There are too many projects in developing countries; ill health continues because most projects fail to be institutionalized. Although a district-led integrated community case management project in Uganda had donor support, sufficient implementation led by a nongovernmental organization, and adequate human resources, it had no national or district budget for commodities and lacked supervision and monitoring. All these are characteristics of a failed design for institutionalization. Institutionalization requires optimal design with stewardship, autonomy, capacity, affordability, minimal complexity, and a system for accountability.”
On the need for utility-scale service models (for WASH & clean cooking). “The public health community has tried for decades to show, through evidence-based research, that safe water, sanitation, and hygiene (WASH) and clean cooking fuels that reduce household air pollution are essential to safeguard health and save lives in low-income and middle-income countries. In the past 40 decades, there have been many innovations in the development of low-cost and efficacious technologies for WASH and household air pollution, but many of these technologies have been associated with disappointing health outcomes, often because low-income households have either not adopted, or inconsistently adopted, these technologies. In this Viewpoint, we argue that public health researchers (ourselves included) have had an oversimplified understanding of poverty; our work has not focused on insights into the lived experience of poverty, with its uncertainties, stresses from constant scarcity, and attendant fears. Such insights are central to understanding why technologies for safe water or clean cooking are unused by so many households that could benefit from them. We argue that, rather than improved versions of household-scale delivery models, transformative investments in safe water and clean cooking for all require utility-scale service models. Until then, research should focus on interim safe water and clean cooking options that are directed towards the utility-scale service model.”
“This bibliography sets out the following. i. History and development of intersectoral thinking ii. A brief outside-health scoping of the issue (partnership, interorganisational, JUG and WOG) iii. The WHO as an underappreciated and ill-peer reviewed font of wisdom iv. Health sector conceptualisations v. Guidance documents and reviews vi. Intersectoral pronouncements in a number of issue domains…”
« This special issue “Realizing the Right to Health in Latin America and the Caribbean” provides an overview of one of the most challenging objectives of health systems: equity and the realization of the right to health. In particular, it concentrates on the issues associated with such a challenge in countries suffering of deep inequity. The experience in Latin America and the Caribbean demonstrates that the efforts of health systems to achieve Universal Health Coverage are necessary but not sufficient to achieve an equitable realization of the right to health for all. The inequitable realization of all other human rights also determines the realization of the right to health….”
“BRAC is considered the world’s largest NGO. But like many international organizations, COVID-19 has led BRAC to rethink its work.”
Including a discussion on Africa’s response to Covid. Conclusion: “…The thing that was lacking is okay, you have this incredible planning at the continental level; you have this incredible solidarity at the neighbourhood and community level, but where are the linkages? And, if we could get that right, that would I think be a significant step forward….”
“Ranil Dissanayake calls for developing country governments, donors, and researchers to commit to: invest in, and use, national data collection systems.”
With reflections from current TWG leads.
“Sanofi, Merck and GSK are three of the largest vaccine producers in the world. The fact they are not being directed to ramp up vaccine production in a pandemic is a *massive* policy failure.”
“Good news! Test results in #Brazil show #China's @Sinovac #COVID19 vaccine is 78% effective & requires ordinary refrigeration. China has promised to produce for developing countries. China shd submit its #CoronaVac to @WHO for approval & start rolling out! #PeoplesVaccine.”
“China's Sinopharm #COVID19 vaccine also reported as 79% effective is being rolled out in #UAE & #Bahrain & trialed in Peru, Morocco, Argentina & Egypt. We need more vaccine producers to supply whole world. No country wait in line. Pharma shd share tech & IP #PeoplesVaccine.” https://public.tableau.com/profile/brooks.miner#!/vizhome/Coronavirus_Effective_R/WorldMaps
“The #B117 #coronavirus variant could dramatically change trajectory of #covid19 epidemic in countries that currently have it under control @mridulkthomas and I worked intensely to launch this datavisualizations as fast as possible, given the urgency of the message.”
“Africa needs 1.5 billion doses of vaccines to achieve population immunity, Cyril Ramaphosa says. The AU is planning a pooled purchasing system, for African countries to share access to vaccines.”
With a Tweet linked to WHO update on status of COVID-19 Vaccines within EUL/PQ regulatory evaluation process.
“Pfizer Jan, Moderna and AZ (non-Covax) February (Serum later), AZ Covax April, Chinese March (earliest), JnJ June...not many options for LMICs relying on WHO PQ as things stand will add pressure to govs for bilateral deals.”
“Vaccine companies are pressuring LMICs to waive all liability in return for #CovidVaccines. Should countries grant companies immunity for future harms caused? We need international norms to guide if and when to waive liability. And finding fair no fault compensation for patients”
Re this Euractiv article - Commission takes evasive action over Germany’s vaccine side deal
“Wow. The bilateral negotiation with Pfizer-BioNTech occurred when Germany was holding the EU rotating presidency and preaching the benefits of joint purchasing of vaccines alongside the Commission.”
“Africa's first 270 million vaccine doses will be distributed on the basis of population size, extent of pandemic etc, according to John Nkengasong, director of Africa CDC. (Note: the Tanzania government says it doesn't want any vaccines. It still claims there's no COVID there.)”
« 2020 was a challenging year for Jutta Urpilainen, the European Commissioner for International Partnerships. In this blog, we look back at the EU’s international development performance and assess the extent to which it has lived up to the EU’s pledge to be a reliable international partner. » “We also look forward and set out our thoughts on where the EU development portfolio needs to go in 2021. While there have been some successes and worthwhile initiatives launched by the European Commission, not least in its attempt to effectively coordinate European actors to mitigate the impact of COVID-19, there is still a long, winding road ahead towards the EU’s stated ambition of being an impactful geopolitical heavyweight …”
Excerpt « …From the design of a new strategy for Africa to the negotiations of the Post-Cotonou agreement with African, Caribbean, and Pacific countries, all against the backdrop of a global pandemic, her first year in office has represented both a test for European Union (EU) international solidarity and an obstacle to progress on development priorities. …” « …In 2020 we saw the emergence of “Team Europe,” a variable-geometry collective of EU institutions, European member states, and European development finance institutions….”
Quarterly column on “Global Health Law” in the Journal of Law, Medicine & Ethics.
This new Global Health Law column addresses "The World Health Organization in Global Health Law" — examining legal authorities under the WHO Constitution & WHO governance in the legal response to #COVID19.
See also Benjamin Mason Meier’s website (for all columns so far) - Global Health Law Column | Journal of Law, Medicine & Ethics
“….We delineate how regional organizations can support how countries address health threats namely by serving as a bridge between the global and national policy levels; strengthening disease surveillance; mobilizing supply chains and facilitating trade; supporting the production and procurement of medicines and supplies; and coordinating policies and work with other actors. We finalize by arguing that mechanisms for regional cooperation must be strengthened themselves in order to effectively contribute to positive health outcomes within member states.”
“Raj Shah, the head of the Rockefeller Foundation, spent a career working on disaster response in the developing world. The coronavirus pandemic has put his focus on the U.S. “ Interview with Raj.
“… Mr. Shah the Rockefeller Foundation in 2017. Since then, he has focused the foundation’s $5 billion endowment on efforts to combat poverty in the developing world. When the pandemic hit, he pivoted, announcing a $1 billion commitment for relief efforts in communities hit hard by the virus.”
And a quote on USAID: “U.S.A.I.D. is the one agency that gets to make huge investments in lifting up the world’s most vulnerable people. …. We’ve helped 40 million people move out of poverty and hunger. It’s a vision of American leadership. But during Covid, the act of turning the other way — of asking other nations to support America with protective equipment, with diagnostic supplies, with key necessary tools, and then of pulling out of the World Health Organization — has so dramatically undermined America’s role as the global health leader in the world, that the clear answer to your question is, “No.” One thing I learned during my time in government was, like it or not, American leadership defines the degree to which the world can cooperate to tackle our toughest problems. When we exit that role, no one can take our place. We should embrace that role….”
Looks like US development organisations are also preparing for a role in the Covax vaccine roll-out.
“The U.S. Agency for International Development released its gender policy this week, raising renewed concerns from gender experts and advocates who say it has been heavily influenced by politics and fails to follow evidence-based best practices….”
“When the draft policy was released in late August, advocates and lawmakers said it would be a step back for the U.S. government’s gender equality work. Advocates had hoped that the policy would be left for the incoming administration to adapt and implement, they told Devex, but instead the final draft was pushed through and released in the final weeks of the Trump administration. …. “This policy is a pretty cynical 11th hour effort to enshrine some of the anti-gender agenda of this administration in policy before they head out the door,” [she] told Devex.” “…. “Key concerns with the gender policy are that it has a binary view of gender, leaves out LGBTQ individuals, is not based on best practices, and doesn’t use internationally accepted language about human rights, instead qualifying those rights or using the term “unalienable rights,” experts told Devex.”
“… U.S. President-elect Joe Biden’s administration, once in office, should freeze the policy and “begin a process of developing a technically sound update of the 2012 [gender] policy,” Fugle said. That prior policy does need revisions, but the version released this week should be ignored until it can be replaced, he said.”
“In a paper and blog, Charles Kenny discusses the idea of the declining marginal utility of income and its potential use in allocation decisions.”
Key message: “We Should Be Spending More of Available Aid in Poorer Countries, Not Less.”
Suerie Moon, Anna Bezruki, Gian Luca Burci, Temmy Sunyoto, Marcela Vieira; https://repository.graduateinstitute.ch/record/298856
“Access to countermeasures – personal protective equipment (PPE), therapeutics, diagnostics, and vaccines – is critical for preventing, detecting, and responding to disease outbreaks. No country is self-sufficient in the research, development, and production of all countermeasures. Ensuring such products reach people in a timely manner, in adequate volumes, at acceptable levels of quality and affordable prices requires concerted international action. This Working Paper analyzes the global “system” for access to countermeasures. It was a commissioned background paper for the Global Preparedness Monitoring Board’s1 2020 annual report A World in Disorder, and originally published in September 2020….”
Identifying eight global governance challenges that can impede countermeasure access if unaddressed.
“The case of the WHO reveals the largest discrepancy between key formal rules governing budgeting procedures and the reality of budgeting dynamics and administration. The highly regionalized and fragmented structure of the WHO results in a budget process that is much more complex in practice than formal rules suggest. To accommodate strong regional interests and regionally organized principals, while at the same time managing budget constraints, the WHO budget process combines bottom-up, top-down, and horizontal administrative and political coordination. Due to the increasing importance of earmarked voluntary contributions for the financing of the WHO to approximately 80 percent of its budget, including very substantive financial support from the Bill & Melinda Gates Foundation of around a quarter of its budget, new administrative structures and procedures have been introduced. For example, the Financing Dialogue has become a new element of budgeting in international organizations that attempts to regain control over an ever-more segmented budgetary landscape….”
“Drawing from a workshop in February 2020, the authors offer an evidence review and proposed approach to inform policymakers as they evaluate contraception for inclusion in health benefits packages.” See related new paper - Evaluating Contraception for Inclusion in Health Benefits Packages: Conceptual Issues and a Proposed Analytical Framework
“Early next month, policymakers, researchers, and family planning (FP) advocates will convene virtually for the . The very title of the event is a call to action: to help ensure that all women can access FP services without financial hardship. One concrete step to promote is including contraception in the —a defined list of health services to be funded with public monies. To , policymakers must weigh competing priorities within the health sector and ensure alignment between the cost of the package and the reality of finite resources. Yet thus far, the family planning community has remained largely disengaged and siloed from HBP and broader health financing discussions. …”
“The Astana Declaration on Primary Health Care reiterated that PHC is a cornerstone of a sustainable health system for UHC and health-related SDGs. It called for governments to give high priority to PHC in partnership with their public and private sector organisations and other stakeholders. Each country has a unique path towards UHC, and different models for public-private partnerships (PPPs) are possible. The goal of this paper is to examine evidence on the use of PPPs in the provision of PHC services, reported challenges and recommendations….”
Conclusion: “Despite various challenges, PPPs in PHC can facilitate access to health care services, especially in remote areas. Governments should consider long-term plans and sustainable policies to start PPPs in PHC and should not ignore local needs and context.”
“Kenya needs $62bn (£46bn) to mitigate and adapt to the climate crisis in the next 10 years, according to a government document sent to the UN framework convention on climate change. It equates to almost 67% of Kenya’s GDP. … The illustrates the scale of the challenge as the country aims to cut greenhouse gases by 32% within the next decade. It will rely on international sources to fund close to 90% of the expenditure. Securing such a colossal amount of often contentious climate financing from rich countries yet to honour their commitments to the $100bn target pledged during the 2015 Paris agreement will be a tall order. Kenya accounts for less than 0.1% of global greenhouse gas emissions and has a per capita emission of less than half the global average….”
“Positive “tipping points” in the uptake of electric vehicles and the decarbonisation of electricity generation could spark a global transition to a climate neutral economy, scientists say, providing fresh hope in the fight against global warming. … The world is already “dangerously close” to several tipping points that could worsen climate change, warned co-author Professor Tim Lenton, director of the Global Systems Institute at the University of Exeter. But positive changes could help tip the scale, with a small coalition of countries triggering “upward-scaling tipping cascades” to rapidly decrease carbon emissions, according to Lenton and Simon Sharpe, who co-authored a study on the matter, published on 10 January….”
“An agreed system for measuring funding of green projects in poorer nations will be vital to achieving action on climate change in 2021.”
And a few links:
“…Andy Haines outlined a few of those co-benefits this week at a conference hosted by Project Drawdown and the National Council for Science and the Environment…”
“A Bangladeshi man with asthma has avoided deportation from France after his lawyer argued that he risked a severe deterioration in his condition, and possibly premature death, due to the dangerous levels of pollution in his homeland. In a ruling believed to be the first of its kind in France, the appeals court in Bordeaux overturned an expulsion order against the 40-year-old man because he would face “a worsening of his respiratory pathology due to air pollution” in his country of origin…..”
By UNDP’s head of energy.
“The technology could revolutionize efforts to immunize against HIV, malaria, influenza and more.”
“The era of RNA vaccines has arrived — and dozens of companies are getting in the game. “All of the major pharmas are, in one way or the other, now testing out the technology…”
“With the world still focused on the COVID-19 pandemic and hopes for vaccine rollout, the 2020 WHO global reports on tuberculosis and malaria are timely reminders that these diseases remain two of the three deadliest infectious diseases. A key question in early 2020 was how the added strains of the pandemic on health-care systems would impact their management, with some dire early conjectures. So where are we now?...”
The authors “…examined the coverage of HIV testing among pregnant women in sub-Saharan Africa countries. The study focused on women of reproductive age. Our results confirm a huge gap between countries. Only 6.1% of pregnant women tested in Chad compared to 98.1% in Rwanda. Local and national governments in west and central African countries must prioritise investment in providing access to HIV testing for all pregnant women…..”
“An analysis was performed focused on available studies that have quantitatively measured the negative impact that stigma and discrimination and the criminalization of sex work, drug use and same-sex sexual relationships would have on HIV prevention, testing and treatment efforts. The analysis suggests that failure to make any progress on HIV-related stigma and discrimination would undermine efforts to reach the HIV testing, treatment and viral suppression targets, resulting in an additional 440 000 AIDS-related deaths between 2020 and 2030, and that failure to make any progress across all societal enablers would undermine efforts to reach HIV prevention targets, resulting in 2.6 million additional new HIV infections over the same period….”
“Green wave, blue breakwater”. “The country’s decision will encourage campaigners for more liberal laws but may invigorate their opponents, too.”
“…Pro-abortion groups hail it as part of a marea verde (green wave), named for the verdant scarves worn by women’s-rights campaigners, not all of whom advocate greater access to abortion. …” Their opponents wear ‘blue’ as their colour.
“Just after New Year’s Day, regulators in India granted authorization for restricted use to Bharat Biotech’s Covaxin, adding another Covid-19 vaccine to the list of those that have been approved for use in various countries around the world. … … The Covaxin rollout, however, illustrates another worrisome trend. Regulators in India gave the vaccine the go-ahead before data from large-scale clinical trials are available, just as Russian and Chinese regulators did for their own homegrown vaccine candidates.”
“…Premature approvals in India, Russia, and China reveal a different side of vaccine nationalism, one that prioritizes political advantage over scientific evidence and risks undermining widely accepted standards for vaccine testing and development…”
And a link:
“…This scoping review sought to identify the most common domains of individual capacity strengthening, as well as their most common forms of measurement, to generate a better understanding of what is meant by the term ‘capacity strengthening’ for primary health care workers….”
PS: “This paper is a product of PERFORM2Scale (2017–2021), a H2020 programme to strengthen management at district level in Ghana, Malawi and Uganda, in support of the achievement of Universal Health Coverage.”
« …This systematic review summarizes the evidence on interventions used to motivate health workers in LMICs….”
“This collection presents a selection of the peer-reviewed manuscripts issued from these contributions. World-renowned scholars, as well as emerging scientists, practitioners and professionals in health promotion share their findings, reflections, and insights on a variety of health and social-related issues that are raised or amplified by this global crisis. Cross-country comparative case studies, regional and country studies and in-depth analyses highlight the implications and impacts of this pandemic at individual, regional or global levels, on social equity and inequalities, public policies, mental health and resiliency, the vulnerable populations (immigrants, impoverished communities, etc.). A variety of topics are addressed, including the role of religion, arts, mobile and digital health solutions as well as local and regional intersectoral initiatives in tackling the challenges of the pandemic. The collection features perspectives from several regions – Europe, Asia, Africa, Latin America, as well as North America – and various approaches and viewpoints to highlight the lived experiences since the beginning of this unique crisis that humanity faces….”
Cfr tweet Max Roser: “This study estimates the cost to produce the missing vaccines to protect *the entire world* from COVID. Facilities to produce 16 billion doses of a Moderna type vaccines would only cost around $4 billion, ~$2 a jab. Easily the best deal of the decade.”
“The UN’s labour agency (ILO) called on Wednesday for greater recognition and protection for the hundreds of millions of people who work from home, accounting for almost eight per cent of the global workforce even before the COVID-19 pandemic….”
“…The report, “Working from home. From invisibility to decent work”, also showed that homeworkers do not have the same level of social protection as other workers, and are less likely to be part of a trades union or to be covered by a collective bargaining agreement…
“Researchers race to determine why variants identified in Britain and South Africa spread so quickly and whether they’ll compromise vaccines.”
“The millions of people who cannot afford to self-isolate face a choice between Covid compliance and financial devastation.”
(9 Jan) “China will provide COVID-19 vaccines free of charge once they become available to the general public, government authorities said on Saturday.”
“Social isolation among older adults raises major issues for equity in healthcare in the context of the COVID-19 pandemic. This commentary describes current challenges in preventing social isolation among older adults and proposes pathways to develop inclusive approaches to intervention in this vulnerable population. Building interventions that take account of structural inequities among older persons, as well as their subjective experiences, expectations and perspectives, appears fundamental to improve their health and quality of life in pandemic and post-pandemic contexts…..”
Op-ed by K Esvelt & M Lipsitch. With focus on US (and how to vaccinate in order to nip the B-117 variant in the bud). Interesting view and analysis (but good luck with that).
Archives of Public Health - Disentangling depression in Belgian higher education students amidst the first COVID19 lockdown (April-May 2020)
J De Man et al; https://link.springer.com/article/10.1186/s13690-020-00522-y
Also in many other (education) settings & countries, worth a read.
“They are the world’s first non-human primates with confirmed cases of the virus.”
“When hospitals fill up, the risk of death for coronavirus patients spikes, new studies find.”
“Initiative aimed at shielding young people from economic impact of Covid-19 will provide 750,000 paid placements.”
“Blood sample tests from 20 people show vaccine is effective against UK and South Africa variants.”
Based on new JAMA study.
A T Aborode et al ; http://www.ajtmh.org/content/journals/10.4269/ajtmh.20-1181
“…Here, we present our views on the potential collateral impact of COVID-19 on malaria and the likely implications of the COVID-19 pandemic on malaria, especially in Africa….”
“Genetics expert also warns of a 'cat and mouse' game with the virus as researchers ensure vaccines remain effective.”
“Much has happened in the two decades since the BRICs (Brazil, Russia, India, and China) became a group to watch in the twenty-first century. While some of them have surpassed expectations, others have fallen short, as have the relevant global-governance institutions.”
PS: “…There appears to be some momentum behind the idea of creating a larger Democratic Ten (D10) alliance comprising the G7 members and Australia, India, and South Korea….”
(8 Jan) “Russia and China have opposed a candidate from Fiji seen as a staunch human rights defender to lead the top U.N. rights body, diplomats and observers say, creating a deadlock just as Washington may seek to rejoin the forum it quit in 2018. The Human Rights Council presidency rotates annually between regions and is usually agreed by consensus, with any contests typically resolved quickly and cordially, diplomats say. The impasse means the council, the only intergovernmental global body to promote and protect human rights worldwide, is set to resume work in Geneva next week with no leader for the first time in its 15-year history. …”
(gated) “ It’s tempting to see Haven as another casualty of entrenched interests in American medicine. But the endeavor, however ambitious, also collided with the equally unmovable aims of Amazon, whose sweeping campaign to disrupt health care began long before it formed Haven with Berkshire Hathaway and JPMorgan Chase in 2018. Amazon beat Haven to the punch on one of its core initiatives, an effort to develop a digital product to streamline access to primary care and prescriptions for employees. …”
“….We use four case studies from the Philippines, Zambia, India and Uganda to assess the challenges and opportunities of remote data collection during COVID-19. We present lessons learned that may inform practice in similar settings, as well as reflections for the field of qualitative inquiry in the post-COVID-19 era…..”
E McGill, M Petticrew et al; https://www.sciencedirect.com/science/article/abs/pii/S0277953621000290
“Public health evaluators are interested in applying a complex systems perspective. There is uncertainty about which methods to use and the findings they produce. We reviewed the methods of complex systems evaluations in public health. We developed a framework for complex systems methods and evaluation stages. Further methodological development in this field is required….”