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As this is the follow-up to the (special) extra issue on Tuesday on Tuesday, we’ll do our best to keep it short today. Including in the newsletter itself 😊.
As you know, since the start of the Covid pandemic, we’ve already paid a fair amount of attention in this intro to Albert Bourla’s steadfast “moral compass” in the pandemic – aka ‘Equity is our North Star’. This week, more than two years into the pandemic, his kind and generous nature showed once again when he announced, at a press conference in Davos, an “Accord for a Healthier World” (by Pfizer and Partners, partially funded by the Gates Foundation). True, Albert might have been prodded a bit, by the likes of Winnie Byanyima who put it rather bluntly, also in Davos: “Policies that limit access to, and the production of, Covid vaccines, are racist.” Or perhaps Albert even noticed nurse G P Williams (from Liberia), protesting vaccine patents by launching “a big round of applause” for Pharma CEOs at Davos for huge pandemic payouts. Quote: ““If I wanted to earn what Pfizer CEO Albert Bourla made last year, I would have to work every single day until 6100 AD. But what makes me really furious is that Bourla and many of his billionaire buddies here at WEF are doing all they can to block our demands for a patent waiver – just so they can make even more money.” Heck, the more cynical types among us perhaps even see a possible link between the merry Pfizer news of the week and ongoing TRIPS waiver negotiations.
So yes, he might have been a bit ‘nudged’ perhaps, Albert ( and let’s also check the fine print of this “Accord”). Still, Bourla is far from the only generous Pharma CEO these days. Maybe it’s the Davos mountain air, as somebody pointed out on Twitter. On Tuesday, Moderna’s Stéphane Bancel referred to his own Jesuit upbringing when explaining why he’s so keen “to give back to society.” “…When I was a child growing up in France, I was fortunate enough to be raised and influenced by Jesuits. In their teachings, they focus on the idea of “magis”, or ensuring that you strive for excellence. The continued effort for excellence is embedded in what I do, and what we do at Moderna. Another powerful idea is that of servant leadership: having a mindset that you exist to serve a greater good.” And so Stéphane announced he will donate the proceeds of the first stock option he acquired in 2013, totaling around $355 million after tax, “to create positive change in the world.” Heartwarming, no less.
How lucky we are to have people of such strong moral fibre at the helm of Big Pharma in this pandemic! And still the good pharma news wasn’t finished this week. In a new IFPMA report on “lessons learned” during the pandemic , Thomas Cueni et al argue “…The most important lesson of the report is that we must redouble collective efforts to achieve health equity, while ensuring health systems and delivery infrastructure are strengthened.” The biopharmaceutical industry just needs a few billions extra for “…. game changing solutions to equitable access to ensure equitable access to ensure vulnerable populations are prioritized.” Yes, brothers and sisters, like Bourla and Bancel, Cueni ( & constituency) always have first and foremost health equity on their mind (while, no doubt by accident, earning tens of billions in the process). With well-meaning and tenderhearted pharma leaders like that, that ‘Accord for a Healthier World’ should really turn out a piece of cake.
Or as the WEF put it in a blog on the launch of the Pfizer Accord: “The launch was ended with a call for action by Pfizer, who called upon other global health leaders and organizations to join this groundbreaking new initiative, and bring their expertise and resources to help close the health equity gap and create a healthier world.”
Some stuff you just can’t make up.
Enjoy your reading.
In this section, we cover the main news from the 75th World Health Assembly since Tuesday morning, more or less.
“World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyesus has been re-elected unopposed to spend another five years at the helm of the UN health agency, after receiving the World Health Assembly’s overwhelming endorsement as a health diplomat fluent in war and a pandemic. …. He was re-elected in a secret ballot vote in accord with Assembly procedures that required at least two-thirds of its 194 member nations to endorse him. “
“Although it initially appeared that all regions had endorsed his nomination, an indignant Ethiopia berated Botswana after it had delivered a message of support for Tedros on behalf of the Africa region. Neither Ethiopia nor Eritrea support Tedros as he has been outspoken about their blockage of Tigray, his home territory in Ethiopia. After Tedros’s re-election, Botswana then delivered a message of support on behalf of 45 African states – not 47.”
“… In his second term, Tedros will continue to have to deal with the global response to the pandemic and new health threats such as monkeypox and hepatitis. He said he had been humbled by the Executive Board’s decision to nominate him for a second term, and, as he reflected on the past five years, realized they have been “bookended” by two visits to war zones…..”
· See the WHO press release - World Health Assembly re-elects Dr Tedros Adhanom Ghebreyesus to second term as WHO Director-General
· More coverage via Reuters : “… The vote by secret ballot, announced by Ahmed Robleh Abdilleh from Djibouti at a major annual meeting, was seen as a formality since Tedros was the only candidate running. German Health Minister Karl Lauterbach tweeted on Tuesday: "Just re-elected as Director General of #WHO: @DrTedros . 155/160 votes, spectacular result…..”
“In a tweet following the vote, Tedros said that he was “humbled and honoured” by the vote of confidence, adding that he was “deeply grateful for the trust and confidence of Member States.” “I thank all health workers and my WHO colleagues around the world”, he continued saying he was looking forward to “continuing our journey together.” In remarks after the vote, he said his re-election was a vote of confidence in the whole WHO adding: “this is for the whole team.”….”
“… Tedros will stay in the top job at the WHO until August 2027. Under current regulations, directors-general can only be reappointed once.”
· Devex - Tedros' reelection coincides with WHO financing overhaul (with also some analysis of his first five years).
“In a ground-breaking decision that will reduce the World Health Organization’s (WHO) massive reliance on donors, the World Health Assembly (WHA) resolved on Tuesday that half the global body’s budget will be derived from members’ fees by 2030. The Assembly adopted in full the recommendations made by the Sustainable Financing Working Group chaired by Germany’s Björn Kümmel, which also include proposals to increase the body’s efficiency.”
“… Incremental increases to member states’ fees (known as assessed contributions), starting with an increase to 20% in next year’s budget, is the group’s key recommendation. …. A task group of member states will be set up to work with the WHO Secretariat to strengthen the body’s “transparency, efficiency, accountability and compliance”, and the WHO is also mandated to investigate a replenishment model for additional funds. Member states, particularly the US, have been adamant that if they are to pay more fees, they want a more efficient WHO….”
· See also the WHO press release – World Health Assembly agrees historic decision to sustainably finance WHO
“…. The decision adopted, in full, the recommendations of a Sustainable Financing Working Group made up of WHO’s Member States, which was set up in January 2021 and chaired by Björn Kümmel, from Germany.”
“In one of the key recommendations in the Working Group’s report to the Health Assembly, Member States target a gradual increase of their assessed contributions (membership dues) to represent 50% of WHO’s core budget by the 2030-2031 budget cycle, at the latest. In the last budget biennium, 2020-2021, assessed contributions represented only 16% of the approved programme budget. The report includes other recommendations, such as exploring the feasibility of a replenishment mechanism to broaden the financing base. It also asks the WHO Secretariat to work with a Member States task group to strengthen WHO's governance, which will make recommendations on transparency, efficiency, accountability and compliance. The task group’s work will help ensure that increases to Member States’ assessed contributions will be accompanied by further reforms to the way the Organization operates.”
“…. It is intended that the gradual increase to assessed contributions will start with WHO’s 2024-25 budget, with a proposed 20% increase over the assessed contributions in the approved 2022-23 base budget. The aim is to reach 50% of WHO’s budget by 2028-2029 if possible, and by 2030-31 at the latest, up from the current 16% in 2020-21. This would mean that by 2028-2029, WHO would see an increase of roughly US$ 600 million a year in the part of its income that comes from the most sustainable and predictable sources…..”
And via Devex - Countries agreed to sustainable financing for WHO. What's next? On what comes (/might come) next, in the coming years, financing wise.
“…. for the recommendations, the real test will come at next year’s WHA, when the first proposed increase in assessed contributions will be put on the table for the 2024-2025 biennium. “In the program budget approval process, there's a program budget appropriation resolution, and that resolution specifies the amount of assessed contribution that has to be made available for the program. So that's in a way the real test, whether that first increase of 20% of AC [assessed contribution] is really approved,” Imre Hollo, WHO director on planning, resource coordination and performance monitoring, told Devex…..”
“… One proposal to shorten the process for effectively reforming the IHR was put forward by Australia, Bosnia and Herzegovina, Colombia, the EU Japan, Monaco, Korea, the UK and the US – and one with more far-reaching changes was offered by the US. While the first one is more procedural, the US proposal would strengthen the WHO’s ability to gather and share information among nations with disease outbreaks that could put global public health at risk. But African nations led by Botswana voiced unease, dimming hopes for the one concrete action the Assembly might be expected to take on pandemic reform. The US proposal suggests 13 reforms including strict timetables for reporting outbreaks and introducing language on gene sequence sharing, forming a new compliance committee to monitor nations’ implementation, and authorizing expert teams to be sent to outbreak and contamination sites…..”
· See also Reuters - Africa objects to U.S. push to reform health rules at WHO assembly
“African countries raised an objection on Tuesday to a U.S.-led proposal to reform the International Health Regulations (IHR), a move delegates say might prevent passage at the World Health Organization's annual assembly. If Africa continues to withhold support, it could block one of the only concrete reforms expected from the meeting, fraying hopes that members will unite on reforms to strengthen the U.N. health agency's rules as it seeks a central role for itself in global health policy ……. The draft proposal yet to be formally decided is seen as the first step in a broader IHR reform process and would aim to change article 59 that would speed up the implementation for future reforms from 24 to 12 months. …. …. But the African group expressed reservations about even this narrow change, saying all reforms should be tackled together as part of a "holistic package" at a later stage. "The African region shares the view that the process should not be fast tracked...," Moses Keetile, deputy permanent secretary in Botswana's health ministry, told the assembly on Tuesday on behalf of the Africa region…..”
· Nevertheless, HPW reported later in the week : Loyce Pace: US ‘Hopeful’ on Reaching Consensus on Reform of International Health Regulations
“Despite pushback Monday from many WHO member states, including the 47-member ‘Africa Group’, Loyce Pace, US Assistant Secretary for Global Affairs at the Department of Health and Human Services remains “hopeful we may reach consensus” on reforming international health emergency rules at the World Health Assembly this week. …”
“ The proposal backed by Australia, Colombia, the European Union, the United Kingdom, Japan and the United States, is perhaps the only concrete measure that the WHA can take in its current session to address the international rulebook for emergencies that largely failed the world in the COVID-19 pandemic – and was described by the widely-acclaimed Independent Panel review as an “analogue” system in a digital age. While a much broader reform proposal backed only by the US also is technically on the table, it is the much narrower, process-based resolution, A75/A/CONF./7, that has the only real chance of passage this year. Responding to a question from Health Policy Watch at a small media briefing Wednesday at the US Mission to the UN in Geneva, Pace spoke with diplomatic tact about the resistance that has been encountered to making any changes in the rules…..”
PS: “Under the process proposed by A75/A/CONF./7, countries would submit and negotiate proposals for more substantive IHR amendments over the coming two years. An amendment to Article 59 of the IHR, would also create an abridged one-year framework in which any future amendments would actually take force – as compared to the two-year time frame that now exists. ….”
“Faced with a chorus of demands for accountability from member nations, Dr Tedros Adhanom Ghebreyesus again pledged greater efforts by the World Health Organization’s (WHO) leadership to eliminate sexual exploitation and abuse by its staff and contractors at the World Health Assembly on Wednesday. The discussion followed the recent publication of a letter sent to Tedros in March 2022 by three UN Special Rapporteurs regarding the “inadequate response” by the WHO to allegations of sexual exploitation and abuses during the Ebola response in the Democratic Republic of the Congo (DRC) from August 2018 to June 2020…..”
“The World Health Organization’s health emergencies program “certainly don't have enough money” to implement all its plans, according to Maria Van Kerkhove, WHO’s technical lead for COVID-19 response. Amid rising concern at the 75th World Health Assembly over global health financing, particularly for issues other than the COVID-19 responses, Van Kerkhove was asked if the program had enough funding to properly work. Speaking at a Devex event on the sidelines of the WHA, Van Kerkhove replied: “The short answer is, of course not … we certainly don't have enough money to carry out all of the actions.”….”
“…. While Van Kerkhove did not specify the entire shortfall, she gave as an example WHO’s plan to end the emergency phase of COVID-19. The agency was “about a billion dollars short of funding that for 2022,” said Van Kerkhove. Such a shortfall “impacts everything,” she added……”
“…. others also took time to focus on the broader issues WHO is facing in strengthening its own health emergencies response. That is the focus of the report of the IOAC committee, chaired by Felicity Harvey, which describes the challenges faced internally by the global health agency in its emergency response. “The World Health Emergency program continues to be overstretched and understaffed,” said Germany’s Bjorn Kummel, summing up key conclusions of the IOAC review. “The HR management with high level of short term contracts is a concern and must be adequately addressed. ….”
“The World Health Assembly took one step forward in global efforts to create a new instrument for pandemic preparedness and response. The global body of member states approved a report from the Working Group on Preparedness and Response to Health Emergencies on Tuesday that includes priorities and proposed steps forward in creating the instrument and closing other gaps in health emergency prevention, preparedness, and response…..”
“The Intergovernmental Negotiating Body, set up last December, is tasked with drafting and negotiating the instrument. In June, the body will meet to discuss this road map crafted by the working group. If in agreement, the INB will adopt the draft in July, with negotiations to follow. The draft was informed by a survey of member states, nonstate actors, and other stakeholders. … …. The WHA discussions revolved around a focus on equity, cooperation, sustainable financing, and strengthening local capacity….”
“A proposal to condemn the regional health emergency triggered by Russia's aggression in Ukraine will come before a World Health Organization (WHO) assembly on Thursday, prompting a rival resolution from Moscow that makes no mention of its own role in the crisis.”
“The World Health Assembly on Thursday approved a resolution condemning Russia’s invasion of Ukraine by 88 votes to 12 – but the 53 abstentions reflected the discomfort of many member states were uncomfortable with a debate that polarised the global health body. Russia’s counter-resolution garnered 15 votes including those of China and Eritrea, with 66 countries voting against – but this time, a massive 70 countries abstained. Most African nations abstained during both votes, as did many Middle Eastern nations, India and Pakistan. Most of Europe, the United States, Oceania and many Latin American countries supported the Ukrainian-backed resolution, which condemns “in the strongest terms, Russian Federation’s military aggression against Ukraine, including attacks on health care facilities.”…”
“…As much as the vote itself, the very diverse reactions to the dual resolutions underlined the sharply divided perceptions over the war, and the role of WHO in responding to politically-laden conflicts between its member states…..”
Re: Preparing cities and urban centres for emergencies; Improving the quality, efficiency and capacity of clinical trials.
N Ramakrishnan; https://www.twn.my/title2/health.info/2022/hi220509.htm
“The Draft One Health Joint Plan on Action 2022-2026 developed by the quadripartite alliance of the secretariats of four international bodies does not include critical concerns of developing countries in the areas of human, animal, plant and environmental health…..”
Global Health Watch 6 was launched on Tuesday evening. Here you find the introduction (freely available).
“At the 75th World Health Assembly, member states identified primary health care as a means to better deliver services that can help prevent and reduce the burden of noncommunicable diseases on health systems.”
“…. The Global Action Plan for the Prevention and Control of NCDs sets out nine global NCD targets to be attained in 2025, which include a 25% relative reduction in premature mortality from NCDs by 2025. …. …. a draft implementation road map for the global action plan discussed this week, found that the global attention paid to NCDs over the past two decades has been insufficient to reduce the burden of NCDs, and that health system capacity has not kept up with the needs of NCDs. According to the draft road map, while NCD prevention and control is weak in primary health care in many countries, the strengthening and scale-up of NCD interventions at the primary health care level will help to improve access and equitable coverage. “Primary care is the first responder and gatekeeper for NCDs. Early diagnosis and good control of NCDs and their risk factors in primary care will reduce the disease complications that are leading to catastrophic health expenditures and premature deaths,” the road map stated….”
“African countries said more investment in primary care is needed. In a joint statement, countries under the WHO Regional Office for Africa said the ambitious goals in the control of cancers and other NCDs on the continent are being hindered by several “huge challenges” including a lack of resources to implement universal health coverage and an inadequate health workforce that is further depleted by brain drain…..”
“Member states of the World Health Assembly have called on the World Health Organization to heighten its efforts to prevent and respond to sexual exploitation and abuse…..”
And some links:
· Devex - 'Goodwill is not enough' to achieve vaccine equity, experts say (with the views of Githinji Gitahi & Nina Schwalbe on what needs to be done instead)
· CGD (blog) - We Need Better Clinical Trial Systems before the Next Pandemic: The World Health Assembly’s Resolution Is a Good First Step (by A McDonnell)
“Yesterday at the annual World Health Assembly in Geneva, member states passed a resolution tabled by Argentina, Peru, and the UK that aims to strengthen clinical trials to improve public health. As COVID-19 has made abundantly clear, the evidence generated by high-quality clinical trials is essential to responding quickly and effectively to emerging global health threats. But while the goal of strengthening the world’s clinical trial capacity is laudable, and the resolution is a positive step in that direction, it does not, in its current form, go far enough in addressing the public health needs of low- and middle-income countries…..”
· BMJ GH (Commentary) – Envisioning sustainable and equitable World Health Assemblies (by P Khorsand et al)
“…. There is an imperative to reassess the ways in which the WHA functions to ensure both equitable and meaningful participation in global health decision-making, and reduce the environmental impact of this annual forum. Lessons learnt during this reassessment process can be further applied across UN institutions, and political or academic convenings more broadly. In its current state, the organisation of the WHA has a significant carbon footprint. To contribute to GHG emission reduction and commit to combat climate change in line with the Paris Agreement, it is therefore imminent to reduce the WHA emissions and to ‘walk the talk’ in the transition towards more sustainable and healthy societies. At the same time, it needs to be recognised that global health fora have traditionally been, and continue to be inequitable. The recent hiatus on in-person meetings allows us to reconsider what the global health community wants the WHA to look like and to represent. Our aim with this piece is not to provide a comprehensive resource with recommendations, rather we hope it will start a long overdue conversation and call for action to reflect on the way the WHA is currently organised and explore whether the different formats—online and/or hybrid—when adopted, can contribute to reducing carbon emissions while ensuring more equitable participation. Furthermore, it will provide the global health community an opportunity to reflect on how WHA processes must align with the WHO’s ‘triple billion’ goal. We provide a few potential guiding recommendations for the WHO that could lead to more sustainable and equitable WHA….”
Launched on Wednesday morning. “Chief executive Albert Bourla launches plan to offer patented medicines at lower cost to poorer nations.” Targeting 1.2 billion people in LMICs.
“Growing complacency about Covid-19 and politicisation of the pandemic response will cost lives as the world is hit by new waves of the virus in coming months, Pfizer’s chief executive has warned….” “ Global demand for Covid-19 vaccines such as the one that Pfizer developed with Germany’s BioNTech has halved since the start of the year, according to Airfinity. The health data group said people in rich nations were reluctant to take repeated booster shots, while vaccine hesitancy remained common in poorer nations.”
“ Pfizer on Wednesday unveiled an initiative to offer all of its patent-protected medicines and vaccines, including the Covid-19 jab, to 45 lower-income nations on a not-for-profit basis. Ghana, Malawi, Rwanda, Senegal and Uganda are the first countries to sign on to the “Accord for a Healthier World”. They would help identify and resolve hurdles beyond the supply of medicines, Bourla said, such as the need to improve diagnosis, education, infrastructure and storage. Pfizer has invited other pharmaceutical companies to join the initiative, which is part funded by the Bill & Melinda Gates Foundation, and asked governments, global health authorities and philanthropists to provide public and private funding. Bourla said the initiative was not linked to Pfizer’s opposition to a proposal led by India and South Africa at the World Trade Organization to provide nations with the flexibility to waive patents on Covid-19 vaccines. “I don’t connect the two at all. Frankly, I think it is something that is the right thing to do,” he said…..”
“…. Bourla said Pfizer was “doubling down” on production of its antiviral pill Paxlovid, because it believed that antivirals would soon become the main tool to control the pandemic until more durable vaccines were developed which could provide a year’s protection and be combined with flu jabs……”
· See also Reuters – Pfizer to sell all its patented drugs at nonprofit price in low-income countries
“Pfizer Inc (PFE.N) will make all of its patented medicines including COVID-19 treatment Paxlovid and big-selling breast cancer drug Ibrance available at a not-for-profit price to 45 of the world's poorest countries, the drugmaker said on Wednesday. These countries lack good access to innovative treatments. It can take four to seven years longer for new treatments to become available in low-income countries, according to the Bill & Melinda Gates Foundation, if they become available at all. Pfizer said its plan includes 23 wholly-owned, patented medicines and vaccines that treat infectious diseases, certain cancers, and rare and inflammatory diseases. In addition to Paxlovid and Ibrance, the list includes pneumonia vaccine Prevnar 13, rheumatoid arthritis drug Xeljanz and cancer treatments Xalkori and Inlyta. The COVID-19 vaccine Comirnaty developed with BioNTech SE (22UAy.DE) was also on the list. … When Pfizer launches new medicines and vaccines, they will also be included in the drug portfolio at a not-for-profit price, it said….”
“The 27 low-income countries and 18 lower-income countries included in what Pfizer is calling "An Accord for a Healthier World" cover most of Africa and much of Southeast Asia. Five countries - Rwanda, Ghana, Malawi, Senegal and Uganda - have already committed to joining the accord, which was announced at the World Economic Forum in Davos….”
· And for more detail on the launch, see WEF - Pfizer commits to providing patent-protected medicines at cost in Africa (with also Bill Gates & P Kagame)
“ “While we aim to implement the Accord globally," Bourla continued “that is not possible right away. So, we have selected a few countries from which to learn from and improve our processes first.” Rwanda and Malawi will be joined by Uganda, Senegal and Ghana. Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation, commended this approach. "We think that this is a great model – not only will it get medicines out there - but we can also learn from these pioneering countries and apply lessons learned before expanding the Accord.”….”
· PS: Read also this excellent Twitter thread by Melissa Barber on the ‘If’s’ - https://twitter.com/mellabarb/status/1529435666534305792
“….Unfortunately, unless I missed a press release, this epiphany isn't substantially affecting business practices. 7 thoughts…. “
· Reaction People’s Vaccine - Pfizer's non-profit pledge 'too little too late' for millions who died without Covid vaccines and treatments
· And via Devex - Behind Pfizer's new not-for-profit deal on patented vaccines and drugs
Includes an MSF reaction: “Limited information around Pfizer’s announcement is available, so assessing its impact is difficult, according to Mihir Mankad, a senior adviser for global health advocacy and policy at Médecins Sans Frontières. Pfizer has been criticized for not doing enough to expand countries’ access to COVID-19 vaccines and drugs throughout the pandemic. “Certainly it's not anything transformative of the sort that we're otherwise looking for — like, for example, the TRIPS waiver,” Mankad told Devex, referring to a proposal at the World Trade Organization to temporarily waive patent protections on COVID-19 vaccines. “We shouldn't be relying on what's effectively a charitable gesture on the part of the private sector to ensure that people have access to essential, lifesaving medical tools.”….”
PS: via BMJ News :
“ “The initiative shouldn’t cost Pfizer much,” the WSJ reported on 25 May 2022. “Sales to developing countries in Africa and other emerging markets totaled about $8.4bn in 2020, about one fifth of Pfizer’s total sales during the year.” But the initiative could help build a potential new market for the drug industry as well as earning goodwill, the newspaper noted….”
“A global health fund has raised a third of the $18 billion it says is needed to reverse setbacks caused by the coronavirus pandemic and combat AIDS, malaria and tuberculosis. The Global Fund to Fight AIDS, Tuberculosis and Malaria announced its first pledge from the private sector on the sidelines of the World Economic Forum, in Davos, on Tuesday. The $10 million pledge by Comic Relief U.S. unlocks a matching $30 million commitment by the Bill & Melinda Gates Foundation.”
“ …. Disruptions to healthcare caused by COVID-19 around the world saw reversals in testing and treatment of all three deadly diseases, said executive director Peter Sands. The donor environment has also shifted dramatically since 2019 when the fund met a $14 billion target. Sands said the pandemic, the war in Ukraine and growing economic headwinds were impacting investment. Governments are in transition when it comes to budget allocations for COVID-19 and some are also now committing money to help Ukraine. Private sector donations are also being impacted by the recent market losses. "It's a challenging time to be raising large sums of money," Sands said.”
One advice for Peter & colleagues: read the latest Oxfam report. That’s where you need to start looking for money, first and foremost. Or as J Ghosh often says, ‘there’s heaps of money’.
“Some doubt the OECD-brokered agreement, which would levy more tax on the world’s largest firms, will ever be implemented… An international deal that would force the world’s biggest multinational companies to pay a fair share of tax has been delayed until 2024 amid fresh wrangling over the painstakingly negotiated agreement…..”
“Mathias Cormann, the secretary-general of the Organisation for Economic Co-operation and Development (OECD), told the World Economic Forum in Davos, Switzerland, that there were “difficult discussions” taking place that meant the deal could not come into force in 2023, as previously hoped. …. …. Cormann said he remained confident an agreement would eventually be implemented to let countries levy more tax on the world’s largest firms based on the sales generated within their borders…..”
“Firm aims to apply ‘equity lens’ across clinical tests to ensure diverse population groups take part.”
“The pharmaceutical giant AstraZeneca is conducting a major review of diversity across its trials in an attempt to ensure its medicines work for all population groups, although it has admitted that including pregnant women is a particular challenge. The head of oncology at Britain’s biggest drugmaker, David Fredrickson told the Guardian that the firm was among those leading efforts to improve participation of people of colour and other under-represented groups in clinical trials.
Speaking on the sidelines of the World Economic Forum’s annual meeting in Davos, he called it applying an “equity lens” to every phase of the medicine’s lifecycle…..”
With some detail on the Republican nutcases & other conspiracy theories (vs WHO, its leader, and the ‘pandemic treaty’). You can only hope the Republicans lose once again in 2024 (and preferably already now, also, in the midterm elections).
“….Republicans in Congress are renewing their skepticism of the World Health Organization. Several Republicans seized on a handful of Biden administration proposals to amend the international rules governing disease outbreaks and efforts on a larger pandemic treaty. They paint the U.S. as being overtaken by a mighty, China-controlled WHO — but provide little evidence for those claims…..”
Ann Danaiya Usher; https://t.co/xGoZ7Xkqat
“The Oslo-based vaccine agency CEPI depends on aid for 40 per cent of its financing. CEPI’s CEO Richard Hatchett urges donors like Norway and the United Kingdom not to use development budgets to fund pandemic vaccine research.”
Related tweets: “CEO @DrRHatchett of the vaccine agency @CEPIvaccines urges donors to look beyond aid to fund the agency’s work. Aid funds can only be spent on activities that primarily benefit developing countries and compete with other global health needs.”
“Two major CEPI contributors, Germany and Japan, use non-ODA money, taken from the education and health budgets, while Norway and the United Kingdom funds CEPI from their aid budgets.”
“Senior officials from the United Nations — whose budgets would be diminished as a result — are lobbying Oslo to reverse its plans.” The United Nations is lobbying hard to try and reverse the Norwegian government’s plan to spend millions of dollars initially earmarked for U.N. bodies on hosting Ukrainian refugees in Norway instead.”
Eg. “….U.N. Deputy Secretary-General Amina J. Mohammed issued a statement on Friday, saying she was “deeply troubled” by donors’ moves to use foreign aid budgets to cover the costs of hosting Ukrainian refugees at home. With record food prices, an energy crisis, and “overstretched public finances in the aftermath of the pandemic,” Mohammed argued that “this is the exact moment requiring countries and the United Nations system to respond to the surging humanitarian and development needs by bringing additional resources needed to meet Member State ODA pledges …”
E Ritchie, C Kenny et al; https://www.cgdev.org/blog/how-much-foreign-aid-reaches-foreign-governments
“…. the Paris and Accra agreements have seemingly been ignored: even using a generous measure of ownership, we find that only about a third of assistance is actually managed by those it is intended to help. …”
Cfr tweet: “Only about a third of aid is actually implemented by recipient country governments, firms and NGOs. Rest by donor firms/governments and multinational orgs.”
D Wernli et al ; https://gh.bmj.com/content/7/5/e008181
“The 2015 World Health Organization Global Action Plan and other international policy documents have stressed the need for a 'whole of United Nations approach' in addressing antimicrobial resistance (AMR). As several years have passed, the goal of this paper is to take stock of the current role, mandate, and activities of international organisations and other global stakeholders on AMR. …. …. AMR is not a priority for many international organisations, but some of them can leverage current efforts to tackle AMR while contributing to their core agenda. Overall, a ‘whole of UN approach’ to AMR within the framework of Sustainable Development Goals is critical to move the global governance of AMR forward.””
“Experts working with the Access to COVID-19 Tools Accelerator welcome the conclusions of a key report on pandemic preparedness. Ann Danaiya Usher reports.”
“The Independent Panel for Pandemic Preparedness & Response …. recommends an independent evaluation of the Access to COVID-19 Tools Accelerator (ACT-A), which has been welcomed by those involved in the scheme. The panel, established by WHO in September, 2020, delivered its first report 1 year ago. A follow-up report published last week acknowledges that, although some important changes are under way, they will take years to take effect and political resolve is waning.”
“…. As for the ACT-A, the alliance of international organisations—including WHO, Gavi, the Global Fund, UNICEF, and the Bill & Melinda Gates Foundation—set up in the spring of 2020 to ensure global equitable access to COVID-19 tools, it has not achieved any of its targets and remains desperately underfunded. “We largely have right now the very same tools and the same system that existed in December 2019 to respond to a pandemic threat and those tools just weren’t good enough,” Clark said. The report urges donors to fully finance the ACT-A so that COVID-19 vaccines, treatments, and tests can be made available in low-income countries where the virus continues to spread and mutate. Meanwhile, the Independent Panel for Pandemic Preparedness & Response strongly criticises the way in which the ACT-A was conceptualised and calls for an independent evaluation to find out what went wrong with the initiative.”
“…. Ayoade Alakija, the Nigerian doctor who was appointed WHO Special Envoy for the ACT-A earlier this year, concurs with the recommendation of the report on the need for an evaluation. She underlines that it must be truly independent and delve into the reasons why the ACT-A was unable to achieve equitable access to COVID-19 tools. “I posit that part of the reason for ACT-A's challenges in achieving equitable access to COVID tools was that there was a profound lack of understanding of the political economy of the environments in which they were trying to work”, she said. However, acknowledging the huge commitment of time and energy invested by global health leaders in the alliance over the past 2 years, she said: “It is currently the only global mechanism we have…We should not throw out the baby with the bathwater.” Alakija hopes that the ACT-A can shift to become an entity with greater inclusion, clearer governance, and a degree of independence “so that we are in a dynamic state of readiness and can deliver more effectively and equitably”.”
“Norway's Ambassador for Global Health, John-Arne Røttingen, who co-chairs the Facilitation Council of the ACT-A, confirms that planning for the evaluation is already underway…”
“A multi-billion dollar fund set up by G20 countries to help developing countries better prepare for pandemics could be operational within months, according to the World Bank. The bank – which will house the fund – said it was "proceeding quickly" to set up the facility, after releasing a white paper for consultation last week on how it might work. "Pandemic preparedness is a top global priority," a spokesperson for the bank told Reuters by email. "The fund is expected to be open for business later this year." “
“So far, the fund has raised just under $1 billion from the United States, the European Union and Germany, as well as private donors. The World Bank and the World Health Organization, which is advising on the facility, has estimated that the annual funding gap for pandemic preparedness is $10 billion. The fund has been a key topic for discussion on the sidelines of the WHO's annual assembly, taking place in Geneva this week, although it is not officially on the agenda. …”
“In response to the COVID-19 pandemic, a suite of international initiatives has been developed to strengthen and reform the global architecture for pandemic preparedness and response (PPR), including proposals for a pandemic treaty, financial intermediary fund, and mechanisms for equitable access to medical countermeasures, among others. These proposed initiatives seek to draw upon critical lessons gleaned from the ongoing crisis by addressing gaps in health security and traditional public health functions. However, to date, there is insufficient consideration of the vital role of universal health coverage and robust primary health care in sustainably, equitably, and efficiently safeguarding health systems from future public health threats. The international community must not repeat the mistakes of past health security efforts that ultimately fueled the COVID-19 catastrophe – in particular, by overlooking the importance of coherent, multisectoral health systems. This paper outlines major (though often neglected) gaps in PPR, and identifies opportunities to reconceptualize health security by scaling up universal health coverage. We then propose a comprehensive set of recommendations to help inform the development of key PPR mechanisms across three themes – legal governance, financing mechanisms, and supporting initiatives. By synthesizing approaches that simultaneously strengthen global health architecture for both health security and universal health coverage, we aim to provide tangible solutions that equitably meet the needs of all communities while ensuring resilience to future pandemic threats.”
“In a report that builds on its experience of developing and manufacturing vaccines, treatments, and diagnostics to tackle COVID-19, the biopharmaceutical industry shares lessons learned for future pandemic preparedness.” With 10 lessons.
“Mass infections in wild birds pose a significant risk to vulnerable species, are hard to contain and increase the opportunity for the virus to spill over into people.”
Analysis ahead of a meeting on Tuesday. “Even as the coronavirus threat recedes from many parts of the world, a deal on how developing countries can produce and distribute vaccines is not even close to being done. World Trade Organization Director-General Ngozi Okonjo-Iweala staked her political credibility on securing an international agreement on a plan to set aside intellectual property rights to help developing countries vaccinate their populations. No-deal would be a major failure for her personally and another blow to the WTO, which is already seen as flailing and in desperate need of reform. …. On Tuesday, ambassadors from 164 countries will meet in Geneva to discuss the current draft text for an intellectual property waiver for Covid-19 vaccines, negotiated between the EU, U.S., South Africa and India. But according to a host of diplomats and officials who spoke with POLITICO, chances are the talks will be attacked from all sides — and could even fall apart completely…..”
Coverage of a related webinar.
“Some of the member states identified as collaborators on a proposal to temporarily waive patent protections on COVID-19 vaccines, which is currently under intense discussion at the World Trade Organization, have told activists that the text does not reflect their viewpoint….”
“…. Fatima Hassan said that activists in the global south “don’t see it as a Quad text and we certainly don’t see it as the text of what our government basically negotiated or agreed to even informally in Geneva.” … ….. …. She said there was still a possibility of a version of the agreement being adopted if countries in the global south are “bullied” into “agreeing to a watered-down version of the original proposal” made by South Africa and India in October 2020, which would have waived intellectual property claims on COVID-19 vaccines, tests, and treatments…..”
TGH - Building COVID-19 Vaccine Production Capacity in LMICs (by R Adler et al)
“Patents aren't really the problem”.
Tweet E Topol: “From analysis of >6.4 million #SARSCoV2 genomes, the relentless progression of increases fitness of the virus emanating from mutations in the spike, nucleocapsid and nonstructural proteins, w/ ranking.”
“Our original-recipe shots are holding up against new variants. But we may need to improve them, and soon.”
“People with a history of autoimmune disease or depression were also more likely to have the condition.”
“ Women are more than twice as likely as men to suffer from long Covid, according to the largest study of the condition to date, which found a history of autoimmune disease or depression also increased the likelihood of experiencing symptoms. The study by genetic testing company 23andMe surveyed more than 100,000 people who had Covid-19, about a quarter of whom reported having experienced long Covid — where symptoms such as breathing problems, fatigue and brain fog last for more than 12 weeks. Some 7,000 of these had been formally diagnosed…..”
“Results suggest that vaccines offer less protection against lingering symptoms than expected.”
“Vaccination against SARS-CoV-2 lowers the risk of long COVID after infection by only about 15%, according to a study of more than 13 million people. That’s the largest cohort that has yet been used to examine how much vaccines protect against the condition, but it is unlikely to end the uncertainty…..”
PS: “Steven Deeks, an HIV researcher at the University of California, San Francisco, points out that the study includes no data from people infected during the period when the Omicron variant was causing the majority of infections. “We have no data on whether Omicron causes long COVID,” he says. The findings, he adds, “apply to a pandemic that has changed dramatically”. However, Deeks adds, the results do point to the need for more research on long COVID, and for accelerated development of therapies. “We don’t have a definition, we don’t have a biomarker, we don’t have an imaging test, a mechanism or a treatment,” he says. “We just have questions.””
And a link:
“China is trying to navigate its biggest coronavirus outbreak without a tool it could have adopted many months ago, the kind of vaccines that have proven to offer the best protection against the worst outcomes from COVID-19. As early as the spring of 2020 a Chinese pharmaceutical company, Fosun Pharma, reached an agreement to distribute — and eventually manufacture — the mRNA vaccine made by Pfizer and BioNTech. It still has not been cleared in mainland China, despite being authorized for use by separate authorities in Hong Kong and Macao. Now health experts say that delay — a result of putting politics and national pride above public health — could lead to avoidable coronavirus deaths and deeper economic losses because whole cities would be locked down to insulate the country’s unprotected population…..”
“….Regulators have not publicly said why they have not acted — the mRNA vaccines are authorized in much of the world and have proven safe and effective in hundreds of millions of people. But a Chinese health official and another person directly involved in the negotiations told The Associated Press that authorities have held back because they want to master the technology in China and not depend on foreign suppliers. Both spoke on condition of anonymity, given the sensitive nature of the issue. ….”
“….In the meantime, hopes for a Chinese-developed mRNA vaccine center on Abogen Biosciences, a startup founded in 2019 by Bo Ying, an American-trained scientist who once worked for Moderna. …. The company has partnered with more established companies in the country such as Walvax, a private company founded in 2001, and the Academy of Military Medical Sciences, the military’s medical research facility. Abogen has raised more than $1.7 billion since 2020. The company’s vaccine candidate succeeded in eliciting an immune response in a small, preliminary test in humans designed to evaluate safety, according to a study published in the journal Lancet Microbe. The results were “promising,” said Dr. Vineeta Bal….””
“…In the meantime, Chen, the Yale health policy expert, said the Chinese government should better protect its elderly population by both approving the Pfizer vaccine and encouraging booster shots…..”
“Even after two years of the pandemic, the needs of people in poorer countries, and Africans in particular, remain an afterthought for leading global health authorities. The US Food and Drug Administration’s recent tightening of restrictions on the Johnson & Johnson COVID-19 vaccine is yet another example of this.”
And a link:
Excerpt: “….There is another explanation for what at first appears to be an unnecessarily cruel and senseless business decision to block middle-income countries from purchasing nirmatrelvir/ritonavir elsewhere, when Pfizer itself has no supply to sell. In the current paradigm of medicine pricing, pharmaceutical corporations will sometimes offer voluntary access initiatives to the poorest countries, as long as these initiatives remain totally under their control, and as long as they pose no danger whatsoever to future blockbusters.To cede ground on compulsory licensing would be to concede that countries have a legitimate right to use all available legal avenues to protect the health of their people: a slippery slope towards affordable access to medicines.”
“….researchers around the world race to solve a growing mystery: Paxlovid rebound.”
“Almost 90% effective at preventing hospitalizations from Covid-19, Pfizer’s antiviral pill has quickly become one of the most powerful additions to the pandemic arsenal since the advent of mRNA vaccines. But as it’s become more widely available, a growing number of people have found the drug only temporarily effective. …. …These stories raise important questions about how doctors should use the most effective Covid-19 treatment to date: It might mean some patients need longer courses of medicine; guidelines for who should take it could be refined; recommendations for exiting quarantine may have to be updated. …. ….in the absence of data, Kalil and others fear that officials or the public may jump to conclusions. It’s possible, he points out, that the virus has been doing this all along. And more people are only noticing now because they take a pill that they expect will make them better…..”
“….Despite rebounds, physicians and researchers stress that Paxlovid remains a highly effective method of preventing death and hospitalization….”
A Levin et al ; https://gh.bmj.com/content/7/5/e008477
“The infection fatality rate (IFR) of COVID-19 has been carefully measured and analysed in high-income countries, whereas there has been no systematic analysis of age-specific seroprevalence or IFR for developing countries…. ….”
Findings: “ In most locations in developing countries, seroprevalence among older adults was similar to that of younger age cohorts, underscoring the limited capacity that these nations have to protect older age groups. Age-specific IFRs were roughly 2 times higher than in high-income countries. The median value of the population IFR was about 0.5%, similar to that of high-income countries, because disparities in healthcare access were roughly offset by differences in population age structure.
Conclusion “The burden of COVID-19 is far higher in developing countries than in high-income countries, reflecting a combination of elevated transmission to middle-aged and older adults as well as limited access to adequate healthcare. These results underscore the critical need to ensure medical equity to populations in developing countries through provision of vaccine doses and effective medications.”
J Lacy-Nichols, R Marten et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00185-1/fulltext
« Many commercial actors use a range of coordinated and sophisticated strategies to protect business interests—their corporate playbook—but many of these strategies come at the expense of public health. To counter this corporate playbook and advance health and wellbeing, public health actors need to develop, refine, and modernise their own set of strategies, to create a public health playbook. In this Viewpoint, we seek to consolidate thinking around how public health can counter and proactively minimise powerful commercial influences. We propose an initial eight strategies for this public health playbook: expand public health training and coalitions, increase public sector resources, link with and learn from social movements to foster collective solidarity, protect public health advocates from industry threats, develop and implement rigorous conflict of interest safeguards, monitor and expose corporate activities, debunk corporate arguments, and leverage diverse commercial interests. This set of strategies seeks to amplify inherent assets of the public health community and create opportunities to explicitly counter the corporate playbook. These strategies are not exhaustive, and our aim is to provoke further discussion on and exploration of this topic. »
“Are we fools? Do we really believe that the 2015 Paris Agreement will limit global warming to well below 2°C, and preferably to 1·5°C, compared with pre-industrial levels? Commitments made by countries today would limit warming to about 2·4°C (with a range up to 3·7°C). We are way off track to meet the aspirations of Paris. For those who believe we should maintain our optimism—after all, hope encourages action, pessimism feeds nihilism—please consider reading Daniel Yergin's book about energy and climate, The New Map: Energy, Climate, and the Clash of Nations (2021). Five conclusions emerge from his sobering analysis…..”
And Horton concludes: “….For the rest of the world, the war in Ukraine will only accelerate investments in fossil fuels to guarantee long-term energy security. Saudi Aramco, the world's largest oil company, is already committed to increasing its investments by up to $50 billion in 2022. Human societies rose out of poverty—and human health advanced—thanks largely to our ability to harness energy to meet our needs for food, heating, electricity, transport, and communication. Energy remains our most prized human commodity. But almost 1 billion people still lack access to electricity. And only 3·3% of the world's energy currently comes from wind and solar sources. We are fools indeed.”
“At the December 2021 UN Climate Change Conference in Glasgow (COP26), a group of more than 50 countries committed to develop climate-resilient and low-carbon health systems in response to growing evidence of the impact of climate change on people’s health. However, there is not yet a shared understanding of what this commitment means. There is no widely accepted definition of what constitutes a climate-resilient or a low-carbon health system. While national policy-makers recognize the challenge of climate change, they do not always know exactly what to do or how to do it. There is a need to support countries to better understand where to start and what to prioritize to ensure health systems and health policies are mitigating and adapting to the ongoing climate crisis.”
“To help address this challenge, the Alliance has established a new project to identify how health systems policy-makers and managers are responding to climate change and to share lessons on how countries can overcome existing barriers. This project will synthesize evidence to respond to the climate crisis and move towards climate-resilient, low-carbon and sustainable health systems. Using mixed-method approaches and working closely with national health policy-makers, the results are expected to improve health policy as well as broader resilience.”“…. Following an open call for proposals, the Alliance’s Scientific and Technical Advisory Committee selected six country research teams to carry out this work in Bangladesh, Guyana, the Islamic Republic of Iran, Mozambique, Nepal and Peru. Explore the map below to find out more on the areas of focus of the teams….”
“Africa has been hit by 14 extreme droughts in the past two years alone - far more than any other continent - and the UN is warning that some 20 million people are at risk in East Africa this year after the rains failed once more. So it was fitting that Ivory Coast hosted this month's UN-convened summit on the devastating effects of the three Ds - drought, desertification, and degradation of land. However, not much was achieved at the two-week-long meeting in Abidjan to tackle these crises…..”
“Many African countries argued for a legally binding global agreement to tackle droughts - something like the Kyoto protocol launched in 1997 to cut down carbon emissions, sources told the BBC. Uganda and Angola were among the states to amplify the demand of the Africa bloc. But they were keen to ensure that it wasn't seen as being a problem for Africa alone - they wanted drought to be treated as a global problem, to ensure it received global attention….. ….But the proposal did not garner support from other parts of the world. They argued that there were already other global pacts and mechanisms to deal with the crisis - such as the UN Convention to Combat Desertification, Sustainable Development Goals or even the Paris Climate agreement - and that creating yet another instrument would not help…..”
“…. In the end, there was a compromise - an agreement to postpone a decision for two years and form an intergovernmental working group that will look at ways to focus on proactive drought management. It will report back by 2024 - by when the three Ds are expected to become a bigger problem…..”
PS: “ …. A report unveiled at the meeting, Drought in Numbers, showed that . "Africa suffered from drought more frequently than any other continent with 134 droughts between 2000 and 2019, of which 70 occurred in East Africa," it said……”
“Focussing on carbon dioxide alone will not keep world within 1.5C limit of global heating, warn scientists. Cutting methane sharply now is crucial, as focusing on carbon dioxide alone will not be enough to keep rising temperatures within livable limits, scientists have warned.”
“…. …. The IGSD paper, which was , showed the huge potential for “buying time” to change the world’s energy systems by concentrating on cutting methane, and other SLCPs including , , ground-level ozone and nitrous oxide…..”
“Strong climate action could wipe $756bn from individuals’ pension funds and other investments in rich countries.”
· And via Devex - A Just Transition:
“ “Just transitions” could be set to move up the COP 27 agenda, after nearly a dozen African countries agreed to form an alliance to lobby for the issue at the climate conference, Sara Jerving reports. Private meetings at the Sustainable Energy for All Forum held last week led to 11 governments, which include Egypt, Kenya, and Nigeria agreeing “on the importance of articulating a collective position as a bloc of African countries on the just and equitable energy transition,” according to Patricie Uwase, minister of state in Rwanda’s Ministry of Infrastructure….”
“The World Health Organization (WHO) doesn’t fully know what is driving the latest monkeypox outbreaks; it doesn’t know the virus’ animal reservoir nor knows what the future holds for the disease.” Coverage of a related session at the WHA. With the views of M Ryan and others.
“The monkeypox outbreak that has been reported in 16 countries and several regions of the world can still be contained and the overall risk of transmission is low, the UN health agency said on Tuesday. …. Although WHO Member States asked WHO to keep stocks of smallpox vaccine in case of a new outbreak of the disease, Dr Lewis explained that “it’s been 40 years and these stockpiles may need to be refreshed - they certainly need to be revisited - and WHO has been working on that and has been looking at that also now.”….”
“The acting director of Africa's top public health agency said on Thursday that he hoped vaccine hoarding, as seen by wealthier nations during the COVID-19 pandemic, would not be repeated with the current monkeypox outbreak.”
“Monkeypox, a usually mild viral infection, is endemic in the African countries of Cameroon, Central African Republic, Democratic Republic of Congo and Nigeria. But it has caused global alarm after more than 200 suspected and confirmed cases of the virus were detected in at least 19 countries since early May, mostly in Europe. …”
“…. "Vaccines should go to where it is needed the most and equitably, so based on risk, and not on who can be able to buy it," Ahmed Ogwell Ouma of the Africa Centres for Disease Control and Prevention told a news conference. … …. "The prioritisation is first health workers who are in the frontline, and then the affected communities where the outbreaks are first characterised, before contemplating the general public," Ogwell Oumasaid.””
“Monkeypox appears to have exploded out of nowhere in the past two weeks, spreading across Europe, the Americas, and other regions. But warning signs appear to have gone unheeded. An unusual and long-running outbreak in Nigeria should have served as notice that it was only a matter of time before this orthopoxvirus pushed its way to the center of the infectious diseases stage, experts say….”
“After decades without cases, Nigeria experienced a large monkeypox outbreak starting in 2017 that continues to this day. Prior to this year, that outbreak spread beyond Nigeria’s borders eight times, with infected people traveling to the United States, the United Kingdom, Israel, and Singapore. Chikwe Ihekweazu, the former director general of the Nigeria Centre for Disease Control, said his country sought help to try to decipher what was going on with monkeypox. But the requests didn’t get much traction. … “There wasn’t a lot of interest to support that work until now — sadly,” said Ihekweazu, who was recently named to head the World Health Organization’s new Berlin-based hub for pandemic and epidemic intelligence. “It never really received the interest it needed to answer some of these questions.” ….”
“…. “When we saw this emerge suddenly in Nigeria in 2017 out of the blue literally, we were all very surprised,” he told STAT. “In a way, it’s similar to the surprise around the world right now, because it’s a similar scenario. Suddenly from nowhere, we had a lot of cases in the Niger Delta part of Nigeria in the south.” …. Further investigation revealed cases around the country, Ihekweazu said. “So very interesting that a virus that we hadn’t seen for about 40 years at the time in Nigeria suddenly appears and appears in multiple places at the same time.”….” “
“Scientists who have monitored numerous outbreaks of monkeypox in Africa say they are baffled by the disease’s recent spread in Europe and North America.”
What bothers infectious-disease experts across the continent is the double standard that has emerged since monkeypox grabbed the world’s attention: Few seemed to care, or even notice, until people in the West started getting sick…..”
“…. global alarm bells didn’t sound as several African nations battled outbreaks in recent months. The graphic images blazing across social media — some of the same ones used to illustrate monkeypox since the 1970s — rarely feature White patients. “These cases are recorded in Europe,” Tomori said. “Why are you using a picture of an African? Those are your pox.”…. Before monkeypox struck the West this year, the WHO said Nigeria, Cameroon and the Central African Republic all recorded small case numbers. But contact tracing is limited, said Yap Boum, a Cameroonian epidemiologist. Infections tend to arise in remote, forested areas, where people encounter wildlife that carry monkeypox, such as primates and rodents. “Maybe now that it’s happening over there, the problem will get more attention,” Boum said, “and we will gain access to more vaccines, more treatments — all the things we did not have the money for.”….”
“ The Democratic Republic of Congo has been battling the world’s largest outbreak by far: at least 1,238 cases and 57 deaths since January. The strain found there is also much more deadly, with a fatality rate as high as 10 percent. Many deaths are preventable, doctors said, but treatment can be hard to find in areas with underfunded hospitals…..”
“ EU officials are working on a potential centralised procurement deal for smallpox vaccines to be used against rising numbers of monkeypox infections in Europe, according to people familiar with the matter, as nations race to secure orders for the relatively limited number of doses available. Monkeypox typically causes fever and skin lesions but usually clears up on its own, without treatment. The smallpox vaccine is up to 85 per cent effective in preventing a monkeypox infection, according to the World Health Organization, due to similarities in the pathogens…..”
… Bavarian Nordic is the only manufacturer of the vaccine. … The European Commission on Monday, in response to questions from the Financial Times, said HERA was in close contact with member states, the European Medicines Agency and international experts to ensure access to tools to counter disease outbreaks…..”
“Danish biotechnology company Bavarian Nordic (BAVA.CO), the only producer of a vaccine approved against monkeypox, has been approached by many countries keen on procuring vaccines against the disease which has spread to nearly 20 countries…..”
And a link:
· Science - Monkeypox outbreak questions intensify as cases soar (26 May)
“This report examines the causes and effects of an increasing global resistance to antibiotics: from the pressures doctors are under to prescribe them even for viral infections, to what new treatments are currently in the pipeline, as well as what role can the consumer play in reducing antibiotic use in the food chain.”
“Prevention is better than cure — but is too costly for some countries where drug-resistant bacteria are rampant.” Some excerpts:
“The battle against antibiotic resistance is often portrayed as a race between pharmaceutical science and bacterial evolution. Yet health experts warn that prevention is better than cure — and the potential of vaccines in combating drug-resistant infections is often overlooked. … …. Of the six bacteria that are responsible for the most deaths linked to drug-resistance — a combined 929,000 fatalities per year — there is a licensed vaccine for just one: Streptococcus pneumoniae, which can cause pneumonia and other illnesses…..
…. Approved vaccines are available for three of the 12 bacteria on the World Health Organization’s list of antibiotic-resistant “priority pathogens”: Streptococcus pneumoniae; Haemophilus influenzae; and Salmonellae. But high prices and poor medical infrastructure have often held back uptake in low- and middle-income countries, where the available vaccines are most needed to address rampant AMR, which has been driven by the overuse of antibiotics…..
…. Vaccines for some significant antibiotic-resistant infections — including shigella, E.coli and non-typhoidal salmonella — all have “sufficiently advanced R&D” that bringing them to market is a realistic prospect in the short-to-medium term, according to a 2018 report commissioned by medical charity the Wellcome Trust. Antibiotics were a great miracle when they were introduced in the 1940s, and we’ve been digging a hole of resistance for the last 75 years . . . Vaccines are an important part of getting us out of that hole Martin Blaser, professor of medicine and pathology and laboratory medicine at Rutgers University in New Jersey Even so, Cross warns that one serious obstacle remains. “A number of these have the opportunity to be successful, but the big hurdle on all this is how to test them for efficacy because, unlike influenza or other mass infection scenarios, there just aren’t enough cases to do your standard clinical trial,” he explains…..”
“Identifying conditions can prevent inappropriate drug use, but there are barriers to progress in poorer regions.”
Excerpt: ““Investment in developing affordable, accessible and accurate diagnostics is a big missing piece in our aim to fight the continued emergence of antimicrobial resistance,” says Dr Hanan Balkhy, assistant director-general of the World Health Organization’s antimicrobial resistance division. In many cases, the tool for correctly diagnosing a patient’s illness either does not exist or “if it does exist, it’s very costly”. Sexually transmitted infections are a “huge area of need” for diagnostics, according to Daniel Bausch, director of emerging threats and global health security at global diagnostics initiative Find. This is particularly the case, he says, for differentiating gonorrhoea and chlamydia. “[These] are two of the most common sexually transmitted infections,” he notes…..”
“Bacteria in Antarctica have been discovered with genes that give them natural antibiotic and antimicrobial resistance and have the potential to spread out of the polar regions, according to scientists in Chile. Andres Marcoleta, a researcher from the University of Chile who headed the study published in the Science of the Total Environment journal in March, said that these "superpowers" which evolved to resist extreme conditions are contained in mobile DNA fragments that can easily be transferred to other bacteria….”
“As polio cases resurge in many parts of the world, an updated strategy to eradicate the disease begins. Sophie Cousins reports.” In-depth update on the new polio situation and new GPEI strategy to try to deal with it.
“…. Unsurprisingly, the focus has been on vaccines, and a great deal of progress is being made in boosting vaccine production capacity in Africa. However, if we zoom out a bit from the challenge of COVID-19 vaccine production, it is clear there are other areas where the continent should be self-reliant. Routine generic medications—products like fever reducers and analgesics which are available in pill form—are a case in point. As with vaccines, Africa’s generics industry is at early-stage development, similar to where Asia was in the 1980s. Generics production offers a tremendous opportunity for the private sector to focus investments and build capacity. This is a good time for Africa to be expanding in generic medications, given where the market is globally…..”
“GSK majority-owned company in talks with regulators on generic manufacture of highly effective PrEP injection.”
“GlaxoSmithKline’s ViiV Healthcare is “actively negotiating” a voluntary licence on the patents for its injectable HIV prevention drug to make it more widely available in poorer nations, where fewer than a third of those at risk are on prophylactic treatment. Deborah Waterhouse, ViiV chief executive, said in an interview that the GSK majority-owned drugmaker was committed to licensing the patents relating to the drug and that it was in talks over terms with the UN-backed Medicines Patent Pool….”
“The move underscores how protracted battles on intellectual property during the Covid-19 pandemic, especially for vaccines, may have altered how companies think about access to medicines….”
A George et al; https://www.nature.com/articles/d41586-022-01391-x
“The patent system assumes that inventors are human. Inventions devised by machines require their own intellectual property law and an international treaty.”
“… Patent law is based on the assumption that inventors are human; it currently struggles to deal with an inventor that is a machine. Courts around the world are wrestling with this problem now as patent applications naming an AI system as the inventor have been lodged in more than 100 countries. Several groups are conducting public consultations on AI and intellectual property (IP) law, including in the United States, United Kingdom and Europe. If courts and governments decide that AI-made inventions cannot be patented, the implications could be huge. Funders and businesses would be less incentivized to pursue useful research using AI inventors when a return on their investment could be limited. Society could miss out on the development of worthwhile and life-saving inventions. Rather than forcing old patent laws to accommodate new technology, we propose that national governments design bespoke IP law — AI-IP — that protects AI-generated inventions. Nations should also create an international treaty to ensure that these laws follow standardized principles, and that any disputes can be resolved efficiently. Researchers need to inform both steps…..”
“Over-consumption in the world’s richest countries is creating unhealthy, dangerous, and toxic conditions for children globally, according to a new report published on Tuesday by the UN Children’s Fund (UNICEF).”
“The latest Innocenti Report Card 17: Places and Spaces compares how 39 countries in the Organization for Economic Co-operation and Development (OECD) and European Union (EU) impact children’s environments. Indicators include exposure to harmful pollutants, such as toxic air, pesticides, damp and lead; access to light, green spaces and safe roads; and countries’ contributions to the climate crisis, resource consumption, and e-waste dumping. The report states that if the entire world consumed resources at the rate of OECD and EU countries, the equivalent of 3.3 earths would be needed to keep up with consumption levels…..”
And a link:
Lancet Editorial - A hunger for action
“ Aside from one item focused on iodine deficiency disorders, the agenda for the 75th World Health Assembly, on May 22–28, reflects a notable lack of appreciation that a sufficient supply of nutritious food is integral to sustaining health. … …. the negative impact of today's childhood malnutrition will be felt for decades to come. The first three Sustainable Development Goals: no poverty, zero hunger, and good health and wellbeing, are intimately connected and must be tackled together.”
“This might feel like an overwhelmingly complex task, but for severe acute malnutrition, the immediate need is simple—money, now. UNICEF calls for an additional US$300 million in annual funding, so that every child with severe acute malnutrition in the 22 Global Action Plan for Child Wasting countries can be treated. Financing for severe acute malnutrition treatment relies heavily on donors’ official development assistance (ODA), yet the proportion of aid spending on severe acute malnutrition was only 0·2% of total ODA in 2019. Funding for humanitarian food assistance has been falling since 2017, made worse because of global economic decline and competing domestic priorities in donor countries. Except for Germany, none of the top donors to ODA (the USA, Japan, France, and the UK) meet the UN-recommended contribution level of 0·7% gross national income. When the warnings have been so clear, it will be a collective moral failure if severe acute malnutrition is allowed to continue. In the midst of an economic squeeze and a cost-of-living crisis, countries must remember their international obligations.”
J Exley et al ; https://gh.bmj.com/content/7/5/e009200
« The need to shift to effective coverage measures has gained widespread acknowledgement. Effective coverage combines need, use and quality of care into a single metric to estimate the proportion of a population in need of a service that resulted in a positive health outcome from that service. To support efforts towards universal health coverage, effective coverage measures should assess inequalities. At present, direct measures of equity, such as wealth, age, ethnicity, gender, education, place of residence, are only available in household data. However, population-level data alone do not provide information on all components of quality of care and may have poor validity. Many measure of effective coverage require linking household data with information from health facilities on the quality of care provided. Health facility data provide a summary of quality of care at the facility-level and consequently ignores variation that may exist between service users with different characteristics. Inequalities in effective coverage may be larger than we are able to demonstrate using existing data sources most commonly used to construct effective coverage measures. »
“A cohesive and strategic governance approach is needed to improve the health workforce (HW). To achieve this, the WHO Global Strategy on Human Resources for Health (HRH) promotes mechanisms to coordinate HRH stakeholders, HRH structures and capacity within the health sector to support the development and implementation of a comprehensive HW agenda and regular reporting through WHO’s National Health Workforce Accounts (NHWA). Using an adapted HRH governance framework for guidance and analysis, we explored the existence and operation of HRH coordination mechanisms and HRH structures in Malawi, Nepal, Sudan and additionally from a global perspective through 28 key informant interviews and a review of 165 documents…..”
“….African science should have a central place on the world stage and needs to be recognised and supported. African scientists can help the world to prepare for the next pandemic. But the way science is done and recognised needs to change. Scientists in Africa and other LMICs need the opportunity to lead global consortiums, host large grants and events, and guide the global scientific agenda…..”
“While senior United Nations leaders came together in the wake of Floyd’s killing on May 25, 2020, and its secretary-general created a task force to tackle racism at the institution, the resulting action plan has yet to see much movement, Byanyima said. “The United Nations itself, as a structure, was created when the concept of inequality was accepted. So we still have to fight,” she said, adding that many African countries were colonies when the organization was created.”
“While several individual U.N. agencies have taken action, UNAIDS has made anti-racism part of its organizational culture, and each of its units must develop a plan for addressing racism. The agency also created tools to help people analyze and identify unconscious bias, Byanyima said.”
“One clear example of how racism remains a problem is the global response to COVID-19, which she described as racist and sexist. From the unequal distribution of vaccines for many people of color to beliefs that Africans couldn’t produce a vaccine, much of the response has been affected by racist attitudes.”
C A F Guzman et al ; https://www.annalsofglobalhealth.org/articles/10.5334/aogh.3756/
Not much comment needed.
And a link:
“Medical charity’s president calls publication of controversial photographs ‘a mistake’ and says guidelines will be tightened.”
Check out the latest (May) EV newsletter :
With plenty of updates by the EV governance team, Secretariat, and also items and discussions related to EV 2022 in Colombia (and beyond).
Good news on sleeping sickness via WHO Afro. “….Three countries – Benin, Uganda and Rwanda – have now received validation from the World Health Organization (WHO) that at least one form of HAT has been eliminated as a public health problem in their lands…..”
“The European Union is considering using funds initially destined for development projects in Africa to support countries most exposed to the global food crisis caused by the war in Ukraine, EU officials and diplomats said. …. …. The provisional plan, which would allow the disbursement of nearly 600 million euros ($640 million) to boost support to countries most affected by the food emergency, was flagged by the EU Commission in two meetings last week, officials told Reuters.”
“Health facilities and health workers were subjected to devastating and widespread violence and obstruction of care in 49 conflict-affected countries in 2021. A new report published today by the Safeguarding Health in Conflict Coalition, based on data collated by coalition member Insecurity Insight, identifies 1,335 incidents of violence or obstruction against health care perpetrated in 2021…..”
K Diaconu, S Witter et al; https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.ED000157/full
Combined insights from Cochrane and realist review teams on performance-based financing for health care in LMICs.
“Following these evidence synthesis initiatives, this editorial offers a summary of reflections by the review teams on some of the challenges encountered and offers suggestions for future reviews and research on P4P….. “
P Y Grimm & K Wyss ; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-022-00848-y
“…Using the example of non-state actors based in Switzerland, the aim of this study is to explore how and to what extent NGOs with an interest in global health have dealt with unexpected shocks on the health systems of their partner countries and to reflect on the practical implications of resilience for the multiple actors involved. Consequently, this paper analyses the key attributes of resilience that targeted investments may influence, and the different roles key stakeholders may assume to build resilience.”
“The report warns that “years, or even decades, of development progress have been halted or reversed” as a result of COVID-19, the climate crisis, and the conflict in Ukraine.
It calls for “capitaliz[ing] on the opportunity afforded by the recovery to adopt low-carbon, resilient and inclusive development pathways".” “The report recommends addressing the vaccine inequity, ensuring transformation of the international financial and debt architecture, and improving data capabilities.”
“….The UN Secretariat has released an advance version of the Secretary-General’s annual report on SDG progress. The report recommends actions to recover from the COVID-19 pandemic and “rescue the SDGs.” It will inform discussions during the July 2022 session of the UN High-level Political Forum on Sustainable Development (HLPF)…..”
“To address many of the challenges faced in the field of eye care – including inequities in access and lack of integration within the health system – eye care needs to be an integral part of universal health coverage (UHC): all individuals to receive the health services they need, of sufficient quality, without experiencing financial hardship. The concept of UHC is globally adopted as the key guiding principle for health planning. To this end, the Eye care in health systems – guide for action (the Guide) was developed as a manual for health planners. The Guide outlines strategies and approaches proposed by WHO that provide practical, step-by-step support to Member States in the planning and implementation of integrated people-centred eye care (IPEC). Planning periods covered in the Guide include those that are short-term (annual operational planning), as well as mid- to longer term (eye care strategic plans). The Guide further describes and links the following four new tools developed by WHO to support country planning….
A Filol, V Ridde et al ; https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-022-00854-x
“This study aims to investigate whether the source of knowledge influences the perception of that knowledge and the willingness to use it in francophone African health policy-making context….”
“Global health often focuses on prevention and acute care, but in this blog post, Collective member Naoki Ikegami draws attention to the importance of long-term care.”
By Lauren Conway.
(At a session in Davos)
“ 'Let's name it. Some global rules & policies embed racism & have outcomes that are racist. Africans were told by pharmaceutical companies that the vaccine is too complicated for Africans to make - that’s why they were not sharing it – is that not racism?’ …. We have to speak truth: we cannot look at access to COVID-19 vaccines, or health technologies writ large, and not see how it replicates legacies of colonialism. Structural racism drives continuing pandemics. “
“Two options for @WHO reform could be 1. Create a new institution for global statistics and science on the model of #IPCC 2. Split @WHO in two with the creation of a separate autonomous agency & board of scientists & statisticians bringing together country & regional #CDCs.”
“Really striking to follow #globalhealth tweets in parallel from #WHA75 and #WEF22 - and striking to see which #partnerships are being celebrated in the latter. Not just striking, but highly concerning for health outcomes and #equity.”
“Throughout the @WHO sustainable financing process, over many months, Germany's Björn Kummel has modeled a world-improving mix of persistence, wisdom, grace and humility.”
“Despite these new pledges, @Pfizer is once again gate keeping who can & can’t manufacture and access vaccines and medicines. Denying life-saving, pandemic-ending vaccines is racism. #VaccinEquity #WHA75”