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The week started with an underwhelming G7 summit last weekend – commentators used, among others, the terms ‘unforgivable moral failure’, ‘selfie summit’, a ‘historic missed opportunity’ , … and firebrand Jeff Sachs even wants to get rid of the G7 altogether. But hey, at least Boris, Joe, Emmanuel & other Ursula’s “saved Covax” and we all got to see Boris swimming in the sea 😊. If the Beatles still existed, they would probably dedicate an update of “I am the Walrus” to the leader of ‘Global Britain’. I was less impressed by his slow jogging though, even I run faster on a good day.
On a less cynical note, BMJ’s Kamran Abbasi put it like this, commenting on Kent Buse & Katri Bertram’s hard-hitting analysis: “They came. They saw. They said ‘not us’.” Good to keep in mind as more than 10000 people are still dying every day (cfr Tedros), with “a virus still outpacing the vaccine effort” ( among others due to new variants amounting to “Covid on steroids”), and a worryingly aggressive third wave in quite some African countries, among others. True, some commentators reckon that in a few months from now, amongst others due to Chinese pharma companies, global supply might look very different from now, and focus will be much more then on how to deliver the vaccines. At WHO & Covax, they seem to agree. But for now, and probably still for months, global vaccine inequity remains grotesque.
By the way, I’m not too fond of the “China obsession” of some of the G7 leaders (and one in particular). While I’m in favour of them pointing out again and again severe human rights issues in Xinjiang, Hongkong etc. I don’t think the G7 & NATO’s “innovative” interpretation of “systems theory”, i.e. considering China from now on as a ‘systemic threat’, is one we should applaud in global health (and that includes the CAS chaps among you 😊). Slowly but inevitably, we seem to be heading towards a new Cold War, which is probably the last thing we need when it comes to tackling 21st century challenges.
On a more cheerful note, Christiano Ronaldo turned into a public health hero this week, followed by Locatelli (half joking, it seemed). Being Belgian, I also totally get why Pogba, ostensibly for religious reasons, got rid of Heineken “beer”. Anyway, CR7’s press conference action was certainly better than Leo Messi’s usual “jumping for Lays chips” cameo in ads. Now let’s hope CR7 and his fellow football stars go with the same zeal after tax havens. #ahum
In other important news, we want to flag the Mission statement of new journal Plos Global Public Health – PLOS Global Public Health, charting a new path towards equity, diversity and inclusion in global health as well as a remarkable Lancet Global Health July issue, with editorial, ‘Lessons in Humility. Slowly but irresistibly, some things are changing. For the better, in this case.
Enjoy your reading.
Let’s start with the Communiqué & the more specific Carbis Bay Health Declaration – for analysis of these, see below.
25 p. Long communiqué, first section is on health. Other sections on economic recovery, climate and environment, …. As they said, “long communiqué, short on hard commitments…. “
5p. and a must-read.
In a tweet, Kent Buse summarized the G7Summit Health Declaration: “Strengthen WHO; Share 870 million #COVID19 doses; 100 Day mission to speed vaccine R&D & licensing Global Pandemic Radar; Explore Global Health Threats Council & Pandemic Treaty. “
See also UK gov - G7 leaders to agree landmark global health declaration
Press release of UK government. “Leaders [signed-up] to the Carbis Bay Declaration on health, vowing to take steps to ensure the global devastation caused by coronavirus is never repeated; UK will establish a new centre to develop vaccines to prevent zoonotic diseases spreading from animals to humans; Sir Patrick Vallance and Melinda French Gates presented their ‘100 day mission’ to speed up the time it takes to develop vaccines, treatments and diagnostics…. “
“G7 leaders have committed themselves to provide one billion covid-19 vaccine doses for low and low-middle income countries over the next year, but the World Health Organization and campaigners said this falls far short of the 11 billion vaccine doses needed. The Carbis Bay declaration signed at the G7 summit in Cornwall on 13 June also set out steps to prepare better for any future pandemic by improving early warning systems and increasing and coordinating global manufacturing capacity. And the 100 Days Mission to Respond to Future Pandemic Threats report, prepared by the pandemic preparedness partnership formed to advise the G7, set out recommendations to shorten the cycle for the development of vaccines, treatments, and tests from 300 to 100 days. Of the billion vaccine doses pledged, at least 870 million will be shared directly by donating surplus supplies, with the aim to deliver at least half by the end of 2021. Most of the vaccines will be delivered through the UN led Covax scheme. … . The prime minister, Boris Johnson, also announced that a new centre to develop vaccines to prevent zoonotic diseases spreading from animals to humans will be established at the Pirbright Institute in Surrey.”
Worth reading in full. Or see this tweet:
“To truly end the #COVID19 pandemic, our goal must be to vaccinate at least 70% of the world’s population by the time the G7 meets in Berlin next year. To do that, we need 11 billion doses. We welcome the generous announcements made about donations of vaccines, but we need more & now.”
A large ACT-A funding gap remains. “G7 leaders donate 870 million vaccine doses for low and low-middle income countries over the next year, vital for reducing virus transmission. G7 leaders emphasize the importance of all ACT-Accelerator tools to exit the pandemic. ACT-Accelerator’s funding gap remains significant with an urgent need for funding of tests, treatments and health systems to ensure an end to the pandemic everywhere. WHO Director General warns of increasing divide in equity to crucial COVID-19 tools. Total funding committed to the ACT-Accelerator partnership remains US$ 15.1 billion with a gap of over US$16 billion.”
See also UN News - Landmark G7 agreement pledges 870 million COVID-19 vaccine doses, half by end-2021 Not everybody agreed about using the term ‘landmark’ (see intro).
Seemed to be the main sentiment/assessment, also with respect to climate change. “The G-7 summit was widely criticized as a “historic missed opportunity” as it drew to a close Sunday, with many commenting on its failure to deliver meaningfully on the key priorities of COVID-19 vaccine distribution and climate finance….”
See also the Guardian - Johnson defends G7 deal amid criticism of final communique
“Green campaigners and anti-poverty groups say Cornwall summit failed to address challenges facing the world.”
In this section we focus on some of the global health related analyses & reactions, by experts & civil society.
Tedros himself wasn’t very impressed by the G7 outcomes, it seemed. Overview of the WHO media briefing on Monday.
“The has warned that Covid-19 is moving faster than the vaccines, and said the vow by G7 countries to share a billion doses with poorer nations was simply not enough. “This is a big help, but we need more, and we need them faster. Right now, the virus is moving faster than the global distribution of vaccines,” World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus told journalists. “More than 10,000 people are dying every day ... these communities need vaccines, and they need them now, not next year.””
“Global health leaders also warned the pledge was too little, too late, with more than 11bn shots needed. …. The WHO wants at least 70% of the world’s population vaccinated by the next G7 meeting in Germany next year. “To do that, we need 11bn doses. The G7 and G20 can make this happen,” said Tedros. …”
“As well as dose sharing, the G7 pandemic battle plan includes commitments to avert future pandemics – slashing the time taken to develop and license vaccines to under 100 days, reinforcing global surveillance and strengthening the WHO. …. But observers voiced scepticism of their willingness to follow through on the last point especially. “I will believe [that] point when the contributions to WHO are increased,” tweeted Ilona Kickbusch, founding director and chair of the Global Health Centre in Geneva. “
“… WHO and its partners also highlighted the desperate need for funds to overcome the pandemic. More than $16bn is still needed this year to fully fund efforts to speed up production and access to Covid-19 diagnostics, treatments and vaccines….” (see above: ACT-A Funding gap)
Kent Buse & Katri Bertram; BMJ
If you only read one analysis of the G7 summit (from a global health point of view), let it be this one.
“G7 responds to “If not us, who?” with “Not us.” So where are we now with the global health cooperation agenda, ask Kent Buse and Katri Bertram.”
“….G7 leaders delivered five pages on health and a four-page annex full of rhetoric, citing the health ministers’ communiqué. G7 leaders made few concrete, strong, or deep health-related commitments at Carbis Bay. In doing so, the G7 has renounced its role as global health leader….”
Recommended as well. Gordon Brown lays out meticulously why the summit was a grand failure.
The gift of 1 billion doses is nowhere near enough what’s needed, timing of the doses is too late (to deal with the immediate urgency), ACT-A funding remains as worrisome as before, no progress on the trips waiver, …
PS: Check out also a Twitter thread by Alex Harris on the good, bad and ugly:
“This G7 summit was the moment for bold, historic leadership to commit the resources needed to end the Covid crisis. That opportunity has sadly been missed. Here's the good, bad and ugly.”
J Kirton & M Bird (G7 Research group) http://www.g7.utoronto.ca/evaluations/2021cornwall/kirton-byrd-health.html
A slightly more positive take, arguing prospects for compliance (re G7 pandemic preparedness and prevention plans) aren’t too bad.
“The first announcement, issued on June 11, promised that the COVID-19 pandemic would be conquered in the coming year. The second promised there will never be followed by another pandemic from a source similar to the one that caused COVID-19 and such comparable global devastation. At the leaders' third session, ending the formal meetings on their second day, they agreed on a "Carbis Bay Declaration" to prevent viruses from again passing from animals to humans to cause death and destruction to the degree that COVID-19 has….”
“…. G7 leaders would take three key steps: Develop the capacity to develop and license vaccines, treatments and diagnostics to prevent human infections from any new animal-to-human disease; A Global Pandemic Radar to reinforce global surveillance networks and genome sequencing capability to detect and identify such viruses at the earliest possible stage; and Support the reform and strengthening of the World Health Organization (WHO).
“Compliance with these commitments is likely to be strong… “ Kirton et al list some reasons why this might be case.
The same author (J Kirton – from the G7 Research group) put it even more positively in another analysis - The G7 Cornwall Summit's Strong Success
“The G7 Cornwall Summit on June 11–13, 2021, produced a strong success, with high performance on many components of the most critical subjects it had to – and did – confront. Here COVID-19 and climate change stood out above all else…..”
John was overdoing it a bit, I’m afraid.
“American leadership arrives at the G7 summit.” Well, at least according to David Fidler. Perhaps he saw another summit.
“At the recent G7 summit hosted by the United Kingdom, President Biden made and catalyzed bold moves that revealed an ambitious multilateral strategy for global health and restored U.S. global health leadership. … The G7 summit proved to be the moment when President Biden significantly increased U.S. commitments to the pandemic response and global health and integrated these moves into his strategic thinking about the role of the United States in a more dangerous world….”
Neat analysis. The G7 didn’t exactly “save the world” but hey, at least they seem to have saved Covax – for now.
“A G7 plan to donate 1 billion COVID-19 vaccine doses to poorer countries will have limited impact because it includes some previous pledges, but it still offers a small lifeline to a global vaccine buying system, some experts said. Many of the promised doses will flow through COVAX, a global vaccine buying system backed by the World Health Organization and Gavi, the vaccine alliance. The pledge does not represent entirely new resources, and the donation is far short of the 5 billion to 6 billion shots needed by poorer nations. Moreover, the plan does not address distribution gaps that could make it difficult to deliver doses. …. But experts said it is still a much-needed boost to COVAX, which has so far only distributed 83 million shots worldwide. … "It's going to rescue COVAX from its pretty dire predicament right now, so it's a very significant step," said Stephen Morrison, the director of the Global Health Policy Center at the Center for Strategic and International Studies, a think tank.”
Already during the summit, “…. the People’s Vaccine Alliance, a network of over 50 organisations, has called on the G7 to “agree on a global goal to vaccinate 60% of the world by the end of 2021, with everyone reached in the next 12 months”. This would mean that 4.8 billion single-dose vaccines are needed – or 9.6 billion of the two-dose vaccines such as Pfizer, AstraZeneca and Moderna. … But the People’s Vaccine Alliance has warned that any G7 promise to vaccinate the world by 2022 will not happen if governments continue to block proposals to waive patents and transfer technology and know-how….”
With some more reactions. “…. The G7 commitment was too small a part of the estimated 2.5bn excess shots the group’s governments had already acquired beyond their domestic needs, said Professor Suerie Moon, co-director of the global health centre at the Geneva-based Graduate Institute of International and Development Studies. “While a 1bn-dose donation shows that leaders have finally stopped dithering, its less than half of what these countries could and should commit today,” said Moon, who also pointed to the “poor record for follow-up” on G7 summit deals. “A more reliable strategy would be to urgently scale up and diversify production, through technology transfer and clearing intellectual property barriers,” she added….”
“… Africa “could be in a full-blown crisis” of a third pandemic wave by the time the G7 vaccines arrived because of big rises in infections in countries including Democratic Republic of Congo, Botswana and Zambia, said Ayoade Alakija, co-chair of the Africa Vaccine Delivery Alliance. Alakija, whose organisation co-ordinates distribution on the continent, said the US promise of BioNTech/Pfizer jabs was a “generous” donation of “what they consider to be the best vaccine” — but was also still “not enough”….”
“… Officials in rich countries privately acknowledge the need to avoid the perception that they are offloading unwanted “second-class” vaccines on poorer nations. …. … A further concern about the G7 initiative relates to the difficulties in administering vaccines in countries with underfunded health services, inadequate refrigeration storage facilities or poor transport infrastructure. “The G7 will fail if there is no clear road map about how you move the vaccine from the manufacturer to someone’s arm,” said Thoko Elphick-Pooley, director of Uniting to Combat Neglected Tropical Diseases, which works in hard-to-reach places. “A vaccine doesn’t deliver itself, it needs people and a health system.”…”
Scathing, as you can imagine. Focusing on Vaccines, Special Drawing Rights, Climate.
Assessment re climate commitments at the G7. “The G7 summit ended with rich nations reaffirming their goal to limit global heating to 1.5C, and agreeing to protect and restore 30% of the natural world by the end of this decade, but failing to provide the funds experts say will be needed to reach such goals. Boris Johnson badly needed a successful G7 deal on climate finance to pave the way for vital UN climate talks, called Cop26, to be held in Glasgow this November. Climate finance is provided by rich countries to developing nations, to help them cut greenhouse gas emissions and cope with the impacts of climate breakdown, and was supposed to reach $100bn a year by 2020, but has fallen far short…..”
Optimistic take on the future of global supply (and arguing that the G7 is only a sideshow in this).
“"The world will have been vaccinated far sooner than most now expect, chiefly thanks to Chinese donations and sales of vaccines, with some belated but welcome help from the West."”
“…by September or October at least half a billion Chinese doses will likely be available every month for donation and sale to the rest of the world…. “ See also, by the same author, in Project Syndicate.
“The group’s recent summit in Cornwall should be its last. Political leaders need to stop devoting their energy to an exercise that is unrepresentative of today’s global economy and results in a near-complete disconnect between stated aims and the means adopted to achieve them.”
“… The G7 leaders set the goal of vaccinating at least 60% of the global population. They also pledged to share 870 million doses directly over the next year, presumably meaning enough for 435 million fully immunized individuals (with two doses per person). But 60% of the global population comes to 4.7 billion people, or roughly ten times that number. The G7 leaders offered no plan for achieving their stated aim of global coverage, and in fact, have not developed one, even though it would not be hard to do. Estimating the monthly production of every COVID-19 vaccine is straightforward, and allocating those doses fairly and efficiently to all countries is entirely feasible.
“…. One reason such a plan has not yet been developed is that the US government so far refuses to sit down with Russian and Chinese leaders to devise such a global allocation. Another reason is that the G7 governments let the vaccine manufacturers negotiate privately and secretly, rather than as part of a global plan….”
After the G7 disappointment, “All eyes will now be on the United Nations General Assembly in September and the G-20 summit in October, said Hugh Evans, the CEO of the anti-poverty NGO Global Citizen…”
By the G7 Economic Resilience panel. They want to replace the Washington Consensus by this Cornwall Consensus, to tackle challenges and opportunities of the 21st century. Check out what it involves.
“With the covid-19 pandemic only widening inequalities, it’s time for the G7 to lead with humility, vaccinate the world, and invest in the women who deliver health and social care, say Roopa Dhatt and Ann Keeling. “ With five messages. Our favourite one: ‘Lead with humility’. (will be for next time, though)
Amanda Glassman et al ; https://www.cgdev.org/blog/hits-and-misses-world-bank-and-covid-19-vaccine-equity-g7
Starting with an absolutely lovely opening line: “In Cornwall, England this weekend, G7 leaders will need to strike an awkward balance: denouncing global vaccine inequity, while dodging their countries’ role in causing it and the lack of a clear plan to address it.”
Anyway, the blog itself focused on the World Bank: “... while no single country is responsible for vaccinating the world, there is one global institution that could be doing more: the World Bank Group. … the World Bank has missed three major opportunities to lead…. “
As mentioned already in previous newsletter, perhaps on this front most progress was made (ahead of the G7 summit). But a lot more is needed:
Alex Cobham (Tax Justice Network); https://www.ft.com/content/2aa756fd-ec1d-4127-891e-b8873da022af
“G7 measures will disproportionately benefit rich countries”. This op-ed highlights the minimal and lopsided benefits of the Two Pillar proposals in their current form.
“… The OECD process to reform international tax rules has been running since January 2019 and will probably conclude at the October G20 meeting. But the latter’s July meeting will be pivotal in setting the basis for agreement on the scope and ambition of new taxing rights over companies (“pillar one” of the reforms), and on the base and rate for the global minimum tax (“pillar two”).
“…The OECD approach privileges headquarter countries. This means that if a French multinational shifts profits out of Brazil to benefit from Bermuda’s 0 per cent tax rate, it would be France that could “top up” the taxes on that profit to 15 per cent. As most of the largest multinationals are headquartered in OECD countries, the majority of the benefits would go to them. G7 members, with 10 per cent of the world’s population, stand to receive more than 60 per cent of the additional revenues. The alternative proposed by the Tax Justice Network, the Minimum Effective Tax Rate (METR), would allocate undertaxed profits according to the location of the multinationals’ real activities….”
Went viral. “The agency paid the consultants a total of $11.7 million.”
“The world’s leading health organization, the WHO, repeatedly broke its own rules and spent millions of dollars on high-priced management consultants, according to a new independent audit — even as the United Nations agency has struggled to pay for lifesaving equipment and vaccines in its global Covid-19 response….”
Quote: “…. this seems to have been a misuse of funds,” Adam Kamradt-Scott said. “This is disturbing. At least on the surface, it would appear that due diligence checks in how external agencies are engaged don’t appear to have been followed.” “The auditor’s report raises a red flag, and the issue of WHO’s contracts with management consulting firms deserves more scrutiny,” said Suerie Moon, co-director of the Global Health Centre at the Graduate Institute of Geneva. At the end of the day, Kamradt-Scott said, the WHO has a “moral obligation to ensure every cent is spent appropriately.”…”
“In a decision that appalled and angered Syrian opposition groups and international medical organizations, on May 28 Syria was appointed to the World Health Organization's Executive Board, made up of 34 member states. Representatives of these countries hold three-year terms in which they set the agenda for the WHO Health Assembly and help implement WHO policies….”
“Physicians for Human Rights and the Syrian American Medical Society (SAMS), a global medical relief organization that has dozens of medical clinics in opposition-held Syria, have written a joint open letter to the director general of WHO, Tedros Adhanom Ghebreyesus, calling on him to "to do everything in your power to overturn the election of Syria to the WHO Executive Board" and emphasizing that board slots should only be "reserved for Member States with the highest qualifications and international standing." The decision to appoint Syria to the WHO Executive Board was made by the member states of WHO's Eastern Mediterranean group, which comprises 22 countries — among them Afghanistan, Pakistan and many Middle Eastern states, including Jordan and Saudi Arabia. As such, Tedros does not have direct authority in the selection of the board members. But the letter asks him to at least openly criticize the appointment and take action similar to his revocation of the appointment of Zimbabwe's Robert Mugabe as a WHO goodwill ambassador in 2017….”
K K Mc Dade et al; BMJ blog
“The United Kingdom is a major provider of foreign aid, and is the world’s second largest bilateral health aid donor after the United States. The UK is also a major donor to the global health multilateral agencies. However, the UK government recently announced it will only supply bilateral aid to 34 countries, thereby eliminating the aid budget for 102 previously supported countries. The consequences of this sudden departure will affect health systems globally…..”
In related news (BBC) - UK aid cuts risk millions of lives, warns World Health Organization
“Cuts to the UK's aid budget will leave millions of people at risk of dying from "neglected tropical diseases", the World Health Organization has said. Nearly 280 million lifesaving tablets are likely to expire and have to be incinerated due to the withdrawal of UK money, the United Nations agency said….”
“The World Bank Group is convening a COVID-19 pandemic task force, with the IMF and other partners, to further increase supply, especially in 2021, and to track, coordinate and advance delivery of COVID-19 vaccines to developing countries, as called for by the G7 Finance Ministers & Central Bank Governors communiqué. In this context, the World Bank is maintaining a website that provides detailed information on all of our COVID vaccination programs.”…”
“The [US] bill would dramatically expand U.S. anti-COVID aid to end outbreaks and prevent new strains through vaccinating 60% of the population of the most vulnerable countries.”
Cfr tweet A Glassman: “Modeled on @PEPFAR , the NOVID Act would establish the Pandemic Preparedness and Response Program (PanPReP) to immediately coordinate U.S. efforts and investments in response to #COVID19.”
“A World Health Organisation commission is set to recommend the creation of a global health board to oversee the world’s preparation and responsiveness to future pandemics, according to a former UK civil servant who sits on the commission….”
“The Pan-European Commission on Health and Sustainable Development was convened to analyse countries’ response to the COVID-19 pandemic and recommend reforms and investments to improve the resilience of health and social care systems. Speaking at an last week, Sir Suma Chakrabarti said it would make a number of recommendations, with the global health board being its most important.
Chakrabarti… … said the health board would be created by the G20 and would model the financial stability board created after the global financial crisis of 2008. Chakrabarti explained that the commission – which is chaired by Professor Mario Monti, a former Italian prime minister – will also suggest the establishment of an international scientific committee on health threats. This would work along the lines of the UN’s Intergovernmental Panel on Climate Change, according to Chakrabarti. “It would assess existing evidence, create consensus on where action was needed and fill in the gaps of knowledge….”
(gated) “GHSA has multiple means to support countries in advancing their health security plans, according to its members, but these may need to be more visible for GHSA to maintain its relevance as new initiatives and recommendations come in for pandemic preparedness and response…. “
“COVID-19 has exacerbated several pre-pandemic trends in international development cooperation—among the most obvious, the weakening of the multilateral system and its subdued response to crises. One manifestation of this trend is the noticeable wedge in the relationship between process actors and knowledge actors in development cooperation governance.”
Three related trends during the pandemic illustrate the increasing divide. ….
And “How can the gap be closed? Knowledge actors need to be brought closer to process actors at all levels by improving access to safe spaces for engagement and mutual learning. This will require reimagined platforms for the two groups to interact. A fresh initiative for discourse—devoid of competition or political stances between the participants—is the most promising solution. For instance, a “4IForum,” standing for individuals, institutions, ideas, and interchanges, could provide such a venue. …”
“The latest backlash against the Gates Foundation in India is the result of years’ worth of concerns raised by human rights activists and civil society.”
“Last month, Bill Gates’ divorce and allegations of sexual misconduct made headlines in Western media. But in India, the billionaire philanthropist and his foundation have been under criticism for months for completely different reasons. Indians have called for Gates’ arrest over alleged violations of medical ethics and laws by the Bill and Melinda Gates Foundation (BMGF) in the country. #ArrestBillGates trended on Indian Twitter in May, part of a campaign calling Indian authorities to charge the BMGF and Gates for conducting illegal medical trials on vulnerable groups in two Indian states. This is not the first time the BMGF or Bill Gates has been at the receiving end of public anger in India. This latest outburst is part of constantly growing anger against Gates and his foundation in India. …. … Gates has also been criticized by Indian farmer groups, who have been protesting on the border of the national capital New Delhi for six months. The farmers are protesting against controversial laws promoting privatization of agriculture passed by the Hindu nationalist government, and they see Gates as a supporter of such efforts. “
Some more updates and op-eds.
Let’s start with a tweet from Geneva Health Files:
“Today @wto an informal meeting among members will discuss a work programme and a road map for TRIPS Waiver negotiations over the next six weeks up until the General Council meeting at the end of July….”
And a tweet from Balasubraniam:
“At the @WTO TRIPS Council informal today, the United States stated that it wanted member-driven text-based negotiations on a #TRIPSwaiver - The United States indicated that it did not want a chair-led process (perhaps wanting to avoid a repeat of the Motta text?”
Hard-hitting op-ed. Recommended.
“Vietnam’s health ministry said a local company is expected to manufacture Covid-19 vaccines after negotiating a technology transfer deal with an unidentified U.S. producer. The vaccine will be mRNA-based, the health ministry said on its website on Saturday. It initially identified the company as Vingroup JSC before updating the statement to remove the reference….”
“The head of the World Trade Organization said on Monday that trade barriers related to medical supplies used against COVID-19 had risen and urged member states to drop them, as it intensified efforts to reach a deal on vaccine-sharing. "The trend is going in the wrong direction," WTO Director General Ngozi Okonjo-Iweala told a virtual U.N. forum, referring to barriers on goods trade related to the pandemic. … She said the number of trade restrictions was 109 at the start of the pandemic early last year, and had later fallen to 51 but had since risen again to 53.”
“At the same event, she called on WTO members to reach a deal by July on improving access to COVID-19 vaccines after months of talks on waiving drug firms' intellectual property rights….
“But a thriving relationship needs clearer rules around data ownership and intellectual property – and public trust in the process.”
“….respondents noted the limitations that virtual communication and lockdown restrictions have imposed on collaboration. They also urged more clarity on ownership of data and of intellectual property (IP) — areas where discussions with academic colleagues have been difficult….”
Press release. “The Every Breath Counts Coalition and the Access to Medicine Foundation welcomed the announcement by Unitaid and the Clinton Health Access Initiative (CHAI) of the first-ever agreements with the liquid oxygen industry to help low- and middle-income countries (LMICs) avoid the tragedy of further COVID-19 deaths from lack of access to oxygen. Negotiated under the umbrella of the Access to COVID-19 Tools Accelerator (ACT-A) Oxygen Emergency Taskforce, the landmark agreements commit the world’s two largest liquid oxygen suppliers – Air Liquide and Linde – to an unprecedented level of collaboration with taskforce members to help LMICs governments meet their rising needs for oxygen to treat the surge in COVID-19 patients.
The new agreements with manufacturers have the potential to unlock supplies of liquid oxygen for LMICs and fast-track delivery to countries in crisis, or on the verge, preventing another wave of oxygen-related deaths. …. The pandemic has driven LMIC need for medical oxygen to 15 million cubic meters per day, the equivalent of two million large cylinders. The annual cost of meeting this level of need is estimated at $US3 billion. Since the taskforce was established in February 2021, $US4 billion has been mobilized to meet LMIC oxygen and other diagnostic and treatment needs, subject to government demand and available oxygen supply.* … With G7 leaders signaling more support for the ACT-A partners working on oxygen, and by calling on the World Bank and other Multilateral Development Banks to act with greater speed on COVID-19 treatments, we are confident that lack of public sector financing is no longer a rate-limiting factor for effective public- private partnerships. …”
See also The Bureau of Investigative Journalism - Breakthrough Deal to help solve oxygen crisis
“… Two of the world’s largest oxygen companies, whose high prices and anti-competition practices in Africa were revealed by the Bureau last year, have announced landmark agreements with the global health initiative Unitaid to transform access to oxygen in poorer countries….”
“…The Bureau first uncovered the precarious nature of oxygen provision across Africa in August 2020. The investigation highlighted several factors that prevented Covid-19 patients getting the oxygen they needed, including high prices charged by Air Liquide and Linde, which dominate the market in most African countries. Ex-industry employees and analysts said that some gas companies had likely made profit margins of between 45% and 88% on medical oxygen. That investigation helped focus attention on the growing oxygen crisis. Madlen Davies, who led the reporting, presented the findings of the Bureau’s investigation to the Every Breath Counts Coalition, a public-private partnership of 50 organisations, in late 2020. Following this, one of the oxygen companies joined the coalition and also hired “access to oxygen” staff. Every Breath Counts and Access to Medicine Foundation then co-hosted three roundtables. These organisations are members of the oxygen emergency taskforce that brokered the deals this week, after months of engagement with the companies….”
“Leith Greenslade, coordinator of the Every Breath Counts Coalition said: “The work of leading journalists such as the Bureau of Investigative Journalism really paved the way for collaboration between industry and the international Covid-19 response by revealing some of the most egregious barriers to oxygen access.”
Key trends, more WHO messages (not listed yet above), …
“Despite an overall drop in global COVID-19 cases, some countries continue to battle new surges, including in Africa, Russia, the Americas, and parts of Asia. …. Cases in Africa are up for the fifth week a row, the World Health Organization (WHO) African regional office said today in its weekly outbreaks and health emergencies report. Overall, the region's cases increased 36.3% over the previous week. South Africa reported more than half of last week's cases, and other hot spots include Zambia, Uganda, Namibia, and Kenya. Twenty countries reported rises in cases, with increases of 50% or more in 10 of them…..”
Yet, “The number of deaths reported last week was similar to the previous week, and the global decline masks a worrying increase in cases and deaths in many countries”, Tedros explained. Africa ‘especially concerning’ “With the least access to vaccines, diagnostics and oxygen supplies for the critically ill, a steep increase in Africa is “especially concerning”, said the WHO chief. ….”
See also HPW. “Globally, the number of new cases of COVID-19 reported to WHO has now declined for seven weeks in a row, which is the longest sequence of weekly declines during the pandemic so far,” said Tedros.”
And on the delivery of vaccines: “…. The majority of the G7 vaccine donations will be Pfizer vaccines, which need to be transported and stored in ultra-cold conditions – although once they have been taken out of cold storage, they can be kept in normal refrigeration for up to three months, according to Mariangela Simao, WHO’s Assistant Director General for Access to Medicines. But Dr Mike Ryan, WHO’s Director of Health Emergencies, warned that the logistics around cold chain management and vaccination rollouts was complex. “Countries need assistance in preparing for that. And there is underfunding right now of basic preparedness in many, many countries. We would urge donors and others to not only just fund vaccines, but to fund the operations needed to deliver those vaccines, and to fund the agencies like UNICEF, like ourselves and other NGOs who are working very closely with governments to improve their capacity to deliver vaccines.”…”
“Weekly COVID-19 cases dropped to their lowest level since February, though many countries are still struggling with sparse vaccine supply, the spread of variants, and overburdened health systems, the World Health Organization (WHO) said yesterday in its weekly snapshot of the pandemic. … In its weekly epidemiological update, the WHO said global cases were down 12% last week compared with the previous week, with declines seen in all world regions except Africa. The level of deaths is still high, but fatalities declined by 2%. The five countries reporting the most cases include India, Brazil, Argentina, Colombia, and the United States. African countries are among those that reported the biggest rises last week, including Zambia (up 125%), Uganda (49%), and South Africa (49%). …”
“Health officials in Africa have called for an urgent acceleration in the supply of vaccines to the continent to curb a new wave of Covid-19 infections and the evolution of new, potentially dangerous variants. Fewer than one in 100 people on the continent have received a vaccine, meaning the surging infections are likely to kill tens of thousands. “Africa needs millions more doses here and now,” said Matshidiso Moeti, the World Health Organization’s regional director for Africa. “Africa is in the midst of a full blown third wave … We’ve seen in India and elsewhere how quickly Covid-19 can rebound and overwhelm health systems.” Officials have welcomed the G7’s pledge to provide 1bn vaccine doses to the developing world but say they need a much greater supply immediately, after cases rose by more than 30% week on week across Africa. The WHO say the Delta variant is present in 14 countries on the continent and the Beta variant, first detected in South Africa, in 25. At least seven African countries have run out of vaccines and seven more have used 80% of their stocks….” “Among the worst-hit countries are South Africa, Tunisia, Zambia, Uganda and Namibia.”
See also WHO Afro - COVID-19 cases surge in Africa, near first wave peak (17 June)
From last week Friday. “COVID-19 deaths in 2021 worldwide have surpassed the total number of COVID-19 deaths in all of 2020, according to a Wall Street Journal analysis of Johns Hopkins data yesterday. As of Jun 10, 1,884,146 people have died of COVID-19 in 2021, compared with the 1,880,510 in 2020. The numbers highlight how unevenly the pandemic has spread, now hitting poorer nations harder, as they scramble to vaccinate their populations….”
South America hardest-hit continent The United States, Brazil, and India have the most COVID-19 deaths, according to Statista, … South America is currently the hardest-hit continent, with more than 40 new daily cases per 100,000 people in countries like Argentina, Paraguay, Uruguay, and Suriname, according to the New York Times global COVID-19 tracker. Concern for case surge, vaccine supply in Africa. While Africa has mostly avoided huge spikes in COVID-19 so far, public health officials are concerned about rising cases in tandem with a lack of COVID-19 vaccinations. … In addition to receiving external aid, Matshidiso Moeti, MBBS, WHO regional director of Africa, said Africa's national infrastructures will also have to step up. The WHO found that 20 of Africa's 54 countries have used less than 50% of their COVID-19 vaccines, and 12 countries may have at least 10% of their AstraZeneca/Oxford vaccine doses expire at the end of August….”
“Despite the global decline in COVID-19 cases by 12% over the last week, countries in Central and South America continue to be epicenters of pandemic, with high mortality rates and insufficient access to vaccines. Over 1.1 million new COVID-19 cases and 31,000 deaths were reported in the Americas over the last week, officials from the Pan American Health Organization (PAHO) announced at a press briefing on Wednesday. “Cases are peaking, hospitals are full, and we are home to four of the five highest death rates in the world,” said Dr Carissa Etienne, PAHO Director. In terms of cases and deaths per-capita, Uruguay, Argentina, Colombia and Brazil, just to cite a few examples, are still experiencing rates 4-5 times higher than new case rates in the United States and even India – despite relatively high rates of vaccination in those same Latin American countries. …”
And via Cidrap News : re the Lambda variant -
“In other developments, the WHO said it is tracking one more variant of concern, first seen in Peru and called Lambda, which has genetic markers suggesting that it is more transmissible.
“Chinese researchers have this week published two papers that shed new light into the likely bat origins of SARS-CoV2 and related foodborne risks – even as pressures from the United States and the European Union grow for a more complete investigation into the origins of SARS-CoV2. … One study, published in the journal Cell, reviews previously unreported data on the genome sequences of about two dozen novel coronaviruses harborned by bat species in southwestern China’s Yunnan province, including one that may be the most similar yet, genetically speaking, to SARS-CoV2. … A second paper, published in Scientific Reports highlights the poor hygiene and animal market conditions, and a range of pathogen risks associated with Wuhan’s live animal markets, which included many illegally traded species, in a survey of 47,000 live animals sold at 17 Wuhan markets between May 2017 and November 2019. …”
“China's "Bat Woman" has emphatically rejected accusations that the coronavirus leaked from her lab in Wuhan. But her government's longstanding aversion to transparency makes it difficult to validate her claims.”
See also Foreign Policy - The Lab Leak Theory Doesn’t Hold Up (by Justin Ling). Having read now a number of related pieces, we tend to agree.
“Africa will get priority treatment for the Group of Seven's pledged 870 million doses of COVID-19 vaccine, a senior World Health Organization adviser [B Aylward] said on Monday….”
“The World Health Organization (WHO) is planning to study the public health and social measures that countries have used to keep COVID-19 at bay successfully – in case there is no quick vaccine for the next pandemic. A special working group has been set up with the support of Norway to study these measures, WHO Director-General Dr Tedros Adhanom Ghebreyesus told Monday’s WHO COVID-19 media briefing. … The WHO working group will examine the impact, social and economic costs of the different measures used, and develop better tools that can be deployed during the next pandemic…”
“Only 4 out of 10 deaths worldwide are reported — and that can have a critical consequence on the response to the pandemic, said Dr. Soumya Swaminathan, chief scientist at the World Health Organization. Designating COVID-19 deaths as such has been a challenge, and the absence of data on deaths exacerbates the problem. “Our own estimates are that the true death toll [of COVID-19] is at least two to three times higher,” Swaminathan told Devex. WHO is planning a data governance summit for the end of June that will get all the member states and stakeholders to discuss the importance of collecting high-quality data to record deaths and also “to share it, use it, be transparent about it, and WHO would like to play a role in that area,” she said….”
“Efforts to restructure unsustainable debt burdens in some of world's poorest countries has not made enough progress, the head of the International Monetary Fund Kristalina Georgieva said on Tuesday. Speaking on webcast, the IMF's managing director said some progress was being made in Chad, which along with Ethiopia and Zambia has become a test case for a global debt relief plan known as the "Common Framework", more was needed. "I'm pleased to say that we are seeing progress on Chad. I hope we would be successful to bring these cases to fruition so that other countries - because it is not only these three countries that are in a difficult situation - step forward early." A cornerstone of the Common Framework is that private sector banks and investment funds match G20 governments in agreeing to either writeoff or postpone repayments on money they have lent to strained low-income countries in the past. The fact only three countries have utilised the programme so far reflects governments' worries, however, that the process of defaulting would lock them out of international borrowing markets for an indefinite period of time….”
Well worth a read.
Conclusion: “…. In many parts of the world, children and adolescents are contributing to an increasing proportion of the total cases. This change in age distribution is thought to be driven by the emergence of highly transmissible variants, increased testing among school-age children, low adherence to non-pharmaceutical interventions, increased social interactions as restrictions are lifted, and increasing immunity among older age groups following vaccine rollout. Thus, there might be a case for vaccinating children in the not-too-distant future. However, whether at present the children of high-income countries should be prioritised for vaccination over vulnerable adults in LMICs is a matter for serious ethical and practical debate.”
“Long-awaited results from the Phase 3 trial of Novavax’s Covid-19 vaccine show it is 90% effective against lab-confirmed, symptomatic infection. That puts its performance in line with the mRNA vaccines from Pfizer-BioNTech and Moderna. Novavax said it plans to apply for authorization with multiple drug regulators, including the FDA, in the third quarter, and is looking to produce 100 million doses a month by the end of that quarter. The vaccine, stored at fridge temperatures and given in two doses three weeks apart, could play an important role in meeting international vaccine demand; Novavax has committed to deliver 350 million doses to the COVAX global vaccine procurement facility once authorized…”
See also Science News - Powerful new COVID-19 vaccine shows 90% efficacy, could boost world’s supply “ Practicality of protein-based vaccine by Novavax may help fill a global need, observers say.”
“ Biotech manufacturer Novavax announced on Monday it would be able to manufacture 100 million doses of its two-dose COVID-19 vaccine every month by the end of the third quarter of 2021 and 150 million doses per month by the end of the year – once it has secured regulatory approval for its vaccine….” “…CEPI also announced agreements with its partner GAVI to supply vaccines to COVAX. As part of the agreement, Novavax will supply 350 million doses of its COVID-19 vaccine, from as soon as it has secured regulatory approval. “A total of 1.1 billion doses of the Novavax vaccine are expected to be made available to COVAX, with the remaining volumes set to be supplied through the Serum Institute of India,” CEPI stated.”
“Concerns over impact on poorer countries, while richer governments try different containment measures.”
See also Washington Post - The delta variant adds a speed bump to the pandemic escape route
“…. the delta variant, the fast-spreading version of the virus first detected in India last year, is changing the rules of the game as the world tries to exit the pandemic. … … Speaking at an online briefing Wednesday, Maria Van Kerkhove, the World Health Organization’s covid-19 technical lead, said that the delta variant had been detected in more than 80 countries around the world and that public health experts are keeping tabs on potential additional mutations to it. … “If you’re living in a part of the country where there’s a low degree of vaccination or you yourself are not vaccinated, you’re clearly vulnerable because this is basically covid-19 on steroids,” Andy Slavitt, a former senior adviser on the coronavirus response for the Biden administration, told The Washington Post’s Yasmeen Abutaleb….”
“In conclusion, research during the COVID-19 pandemic has been marked by a number of innovations, among them the rise of clinical trial platforms. But we must acknowledge that we have failed to identify the socially optimal dose of nearly every major therapeutic or vaccine, constraining our ability to maximise benefits and mitigate inequities. Incorporating dose-ranging studies into clinical trial platforms will be a key step towards building a global, supply-minded, integrated, and resilient system of pandemic clinical trials research for the future.”
“A new 3.2 billion program will support the development of antiviral pills, which could start arriving by the end of this year. “
See also Cidrap News - White House announces $3.2 billion toward antivirals
“ German pharmaceutical company CureVac has blamed the emergency of new variants for disappointing results of its Covid vaccine...”
The Covax vaccine sharing facility was also hoping to secure doses of the jab.
“A new drug has been found to cut Covid deaths by a fifth among the sickest patients in hospital and may change official practice so that every patient with coronavirus will have an antibody test before they are admitted. The Recovery trial based at Oxford University has found a third drug that can help Covid patients recover in hospital – but this one is the first to tackle the virus itself, rather than the inflammation that develops in the later stages of the disease. The monoclonal antibody combination developed by Regeneron works for those patients who do not develop antibodies in response to coronavirus infection. Without treatment, 30% of them die, compared with 15% of patients who have an antibody response to the virus….
More related links:
· Science News - Monoclonal antibodies cut risk of dying from COVID-19—but only in some patients “Regeneron cocktail reduces mortality by 20% in those who don't produce antibodies themselves, RECOVERY trial shows.”
· And on broader implications (including access), via the Economist - A life-saving new drug for covid-19 is found
“Even if authorisation follows in many other countries, though, access to it is likely to remain extremely restricted.”
Excerpt:“…. Soumya Swaminathan, the chief scientist at the World Health Organisation, said the result was good news, but warned that access to monoclonal-antibody drugs was “limited globally”. A recent study by the Wellcome Trust, a British medical charity, and IAVI, the International AIDS Vaccine Initiative, showed just how unavailable these drugs are in various parts of the world (see chart). More than three-quarters of the market for them is in America, Canada and Europe. So far, two countries, America and Germany, have bought large supplies of Regen-Cov. In January, America agreed to purchase up to 1.25m doses for $2.6bn. In the same month, Germany spent $487m on 200,000 doses. (Donald Trump was treated with Regen-Cov when he fell ill with covid-19.) … The reasons for this geographical concentration are twofold but related: quantity and price. Production facilities for monoclonal-antibody therapies are few. And, in general, only wealthy countries can afford them. Regen-Cov costs many thousands of dollars a dose. ….Dr Swaminathan says more monoclonal-antibody factories need to be established around the world so that such treatments become accessible and affordable. Lack of availability of Regen-Cov will probably become a topic of interest to those who argue that intellectual property in covid-19-related technologies should be waived by the World Trade Organisation…..”
As already flagged above. Interesting read. “With new variants emerging rapidly and new outbreaks in places that had seemed to have the virus under control, COVID-19 remains a global problem. But the recent sharp increase in vaccine supplies indicates that the global solution we need is well within reach. “ Based on some recent data.
“….Let’s look at the numbers. The world’s population is 7.9 billion, an estimated 5.85 billion of whom are adults (74%). If the goal is an immunization rate of 80%, 4.7 billion will need shots, which on a two-dose vaccine regimen means 9.4 billion doses. As of June 11, 2021, Our World in Data reports that more than 2.3 billion doses have already been administered worldwide, leaving just over seven billion doses. Divide that by a mid-range daily figure (34 million) and you get roughly 211 days – January 2022….”
“Until recently, the main constraint and source of frustration was the limited supply of vaccines. But production is rising sharply, with the global monthly output of vaccines approved by at least one major regulatory body increasing from 420 million doses in April to 822 million doses in May. China’s two vaccine makers, Sinovac and Sinopharm, accounted for more than half of this total (nearly tripling output from 164 million doses in April to 454 million in May). Output of Pfizer-BioNTech and Oxford-AstraZeneca vaccine doses in the European Union doubled, from 69 million to 140 million, while the number of Pfizer-BioNTech, Moderna, and Johnson & Johnson doses in the United States rose from 71 million to 105 million. The only disappointing production figures were in India, where output slipped from 76 million doses in April to 62.6 million in May….”
“The International Monetary Fund says it has secured about a third of the $35 billion in grants from public, private, and multilateral donors that it called for last month as part of a sweeping proposal to end the COVID-19 pandemic by ensuring a faster rollout of vaccines. “We obviously have to do more,” IMF Managing Director Kristalina Georgieva said at an event Tuesday on promoting an inclusive economic recovery. However, the quick response made her “optimistic,” she said. IMF proposes that some of the grant money go to the ACT-Accelerator, which is underfunded by about $18 billion. Overall, the IMF plan would fund a range of issues related to vaccine distribution, as well as other health needs, such as testing and therapeutics….”
“The one billion shots the U.S. and other G-7 nations have pledged may not arrive before local supplies run out.”
Quote: “COVID-19 case counts are on the rise in 14 of Africa’s 54 countries, increasing by 26% in the first week of June “The continent is going through a third wave, no doubt about that” (John Nkengasong) …”
“Many southern and east African countries are experiencing a surge in COVID-19 infections, yet their vaccination rollouts have ground to a halt because of lack of supply. African vaccination figures, as recorded by the Africa Centers for Disease Control and Prevention, are dismal. Apart from the tiny island state of Seychelles, only Morocco’s vaccination rate is in the double digits with 16.7% of its population fully vaccinated. The next highest are Equatorial Guinea (6,26%), Tunisia (2,93%) and Zimbabwe (2,6%)….”
“… …. To date, COVAX has supplied 37 of the 55 African states with vaccines. Almost 60% of African countries are reliant solely on AstraZeneca, according to the Africa Centres for Disease Control, and many countries have only administered a single dose to citizens with no idea of when they will receive supplies to administer the second dose. Countries that have been able to reach more than 1% of their populations have done so largely because they have had other vaccine sources besides COVAX – primarily China’s Sinopharm, which is available in Morocco, Egypt, Tunisia, Seychelles, Zimbabwe and Equatorial Guinea among other countries. Some of the north African countries also have access to Russia’s Sputnik V vaccine….”
J Kaufman et al ; https://www.cgdev.org/blog/call-greater-clarity-covid-19-vaccine-deals
“In late May, World Bank President David Malpass for greater transparency in COVID-19 vaccine contracts. While the World Bank, , and other institutions have made steps to of transparency in COVID-19 vaccine deals, actions to translate this agenda into practice are nascent—and these calls remain by the global community. As laid out by our colleague , the , and others, public interest in transparent vaccine purchasing is immense amidst a pandemic. Transparency strengthens global and national decision-making on global vaccine allocation, equity, the scale-up of vaccine production and distribution, and outbreak response efforts. Yet, a by Transparency International (TI) and the WHO Collaborating Centre for Governance, Accountability, and Transparency in the Pharmaceutical Sector highlights how opaque information from COVID-19 vaccine suppliers and buyers has been thus far and calls for rapid and robust policy reforms to embed transparency into contracting processes. “
In this blog you already find five initial takeaways and questions (ahead of a webinar that took place this week on Wednesday).
“New Delhi virus response undermines its coalition with America, Japan and Australia to resist China.”
“India’s catastrophic Covid-19 wave has not only battered its ambitions to become the “pharmacy of the world”, but it has also undermined a US plan for New Delhi to play a leading role in countering Chinese influence in the Indo-Pacific region. President Joe Biden sees a reinvigorated “Quad”, a diplomatic and security initiative consisting of the US, India, Japan and Australia, as an integral part of his strategy to resist Chinese economic and military aggression. But India’s coronavirus crisis and subsequent vaccine export ban have overshadowed the quartet’s first attempt to prove it can provide practical help to the region and is not just an anti-China military alliance. Instead, India’s failure has created an opportunity that China is exploiting….”
“AstraZeneca can charge a higher price for its Covid-19 vaccine in dozens of poor countries once the pharmaceutical company decides the pandemic has ended, according to a copy of its contract with Oxford University seen by the Guardian. The British-Swedish drug firm has promised to provide the vaccine at a not-for-profit price to the developing world in perpetuity, but a review of a redacted version of its contract with Oxford University, obtained by the lobby group Universities Allied for Essential Medicines (UAEM), found that the promise excludes many low-income and lower-middle-income countries. Among those left off the list are 34 countries classified by Unicef and the WHO as being in need of vaccine support, including Sri Lanka, Angola, Timor-Leste, Honduras, Zimbabwe and the Philippines, which could all be charged a higher price once AstraZeneca declares the Covid-19 pandemic has ended….”
Devex - Tanzania finally joins COVAX « …. Tanzania is one of the last countries on the African continent to sign up for free vaccines. Burundi and Eritrea have not joined, and the self-proclaimed Sahrawi Arab Democratic Republic has also not started a COVID-19 vaccination campaign. …”
Lancet Comment - Five priorities for universal COVID-19 vaccination (A Abbecassis)
With five priorities as listed at the Paris Peace Forum (with links to the G20).
J Gamlin et al ; https://gh.bmj.com/content/6/6/e006132
“From its transnational positionality global health homogenises the COVID-19 pandemic as a predominantly biomedical and public health problem, onto which the social sciences are frequently outside looking in. We argue for the inclusion of critical medical anthropology in global health explanatory models of COVID-19, side by side and in equal measure, with important biomedical and public health responses. The theory and methods of critical medical anthropology, particularly those from the Global South, centring on the political economy of health will keep the structural determinants of health and social justice at the centre of global health ontologies of COVID-19….. Critical medical anthropology emphasises how the neoliberal economic system continues to pattern the pandemic though Trade Related Aspects of Intellectural Property Rights (TRIPS) regulation of vaccines and the unequal distribution of mortality within and between nations—among other factors. Southern experiences of the pandemic are less responsive to biomedical solutions. We draw on experiences of COVID-19 in Brazil and Mexico, with weaker health systems and greater burdens of non-communicable diseases, to evidence how southern pandemic experiences, where higher than usual mortality from other causes is a major contributor to excess deaths during the pandemic, require different illness explanatory models and responses. Repetitions of historical experiences of ethnocide with mortality rates up to 50% higher among indigenous underline the importance of decolonisation in global health. Politics is a primary structural determinant of health and we argue for the recognition of this within global health policy and governance to bring political accountability to the discussion table.”
“Many rich countries pre-ordered vast quantities of COVID-19 vaccines when they were still in development, enough to vaccinate their countries many times over. What is the right ‘price’ to pay for surplus vaccines, as opposed to those newly purchased? And how much of their value should be counted as Official Development Assistance (ODA)? The choice matters for two reasons: firstly, it sets a precedent for the valuation of secondhand goods as development aid, which in turn sets incentives for donors. And secondly, some donors operate an ODA ceiling…”
You get a hunch from the title.
New paper by Rosemary Morgan et al. “…we brought together a group of gender experts to answer the question: how are people of different genders impacted by COVID-19 and why? Individuals working in women’s, men’s, and LGBTQ health and wellbeing wrote sections to lay out the different ways that women, men, and gender and sexual minorities are affected by COVID-19. We demonstrate that there is not one group “most affected,” but that many groups are affected, and we need to move beyond a zero-sum game and engage in ways to mutually identify and support marginalized groups….”
“Corruption report says third of EU residents used personal connections to access care during Covid crisis.”
“Almost a third of residents in the EU relied on personal connections to access healthcare during the Covid crisis, and around one in five in Romania, Bulgaria, Hungary and Lithuania paid a bribe for such services, a report on corruption has found. Across the EU’s 27 member states, nearly two-thirds (62%) of the 40,000 respondents in a survey conducted by Transparency International said corruption in their government was a major problem and three-quarters (76%) said it had been stagnating or getting worse. …. …. The authors of the NGO’s report, The Global Corruption Barometer – the , said the findings were particularly worrying given that member states are preparing to allocate billions of euros for post-pandemic recovery….”
G Koblentz et al;
See also last week’s newsletter.
“We studied biosecurity at the world’s most sophisticated laboratories, and found their policies often left much to be desired.”
Excerpt: “… At the international level, we recommend that structures be put in place to systematically oversee maximum containment facilities. The World Health Organization (WHO) could be made directly responsible for this oversight, in much the same way that it conducts biennial biosafety and biosecurity inspections of the two labs in the United States and Russia that store the remaining samples of the variola virus that causes smallpox. Alternatively, the WHO could organise regular biorisk management peer review exercises by international teams of government and non-government experts. Another option would be to expand the membership and mission of the International Experts Group of Biosafety and Biosecurity Regulators, which currently serves as an information-sharing forum for national regulatory authorities from 11 countries, to validate that labs in members states are implementing ISO 35001. In addition to oversight structures of maximum containment laboratories, there is also a need for the WHO to develop internationally recognised guidelines to govern dual-use research and the handling of potential pandemic pathogens….”
“As of June 10, 2021, the World Bank Board approved operations to support vaccine rollout in 32 countries amounting to $3 billion. See the latest project financing, project documents and procurement information in the list below…..”
M Umair et al ; https://onlinelibrary.wiley.com/doi/10.1002/gch2.202100017
“Global health and global economies are predicted to be severely affected by antimicrobial resistance (AMR). The three organizations World Health Organization/World Organisation for Animal Health/Food and Agriculture Organization (WHO/OIE/FAO) are working in their domains to prevent any future AMR crisis. Antimicrobial use (AMU), especially in food animals, is contributing to the development and dissemination of AMR bacteria and genes. AMU monitoring is a strategic objective of the global and national action plans on AMR. However, the AMU reporting metrics at different levels are not harmonized yet, posing difficulties in comparisons among AMU data from different sources. A tripartite WHO/OIE/FAO collaboration is urgently required to develop and implement a globally accepted AMU metric system to ensure reliable comparisons among various data sets.”
“…. The COVID-19 pandemic has highlighted the need for resilient health systems and has resulted in an unprecedented rate of collaboration in scientific, medical, social, and political dimensions. … … In this Viewpoint, we discuss the limitations in the current narrative on antibiotic resistance and how it could be improved, including concerted efforts to close essential data gaps. We discuss the need for capacity building and coordination at the national and global levels to strengthen the understanding of the importance of sustainable access to effective antibiotics for all health systems that could generate tangible links to current processes for global health and development.”
“This World Refugee Day, June 20, coincides with 70 years of the 1951 Refugee Convention, a multilateral treaty that shaped the standards that provide the bedrock of international protection for refugees against discrimination and violation of their human rights. The COVID-19 pandemic has weighed heavily on the 26·3 million refugees worldwide today. International guidelines and national programmes to curb transmission have not always considered the needs of refugees living in densely populated shelters without water and sanitation facilities. The economic harms of the pandemic disproportionately affect the poorest people, applications for asylum and resettlement were disrupted by lockdowns, and refugees have been blamed for spreading SARS-CoV-2. It is timely to consider whether the spirit of the Refugee Convention is being upheld and whether refugees are getting the protection to which they are entitled….”
“New treatment combination for hepatitis C virus (HCV) is an additional affordable option for millions still waiting for access to lifesaving treatments in middle-income countries; Combination is safe and effective, including for hard-to-treat cases and people with HCV and HIV; New drug ravidasvir is the first HCV drug to be developed through South-South collaboration and with support from non-profit organizations…”
(gated) “The Open Society Foundations, one of the world’s largest backers of public health initiatives, is undergoing a “significant” reorganization that will affect grant decision-making, a shift that has created anxiety among advocacy groups that work on access to medicines….”
G C Barron & J Koonin; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01014-X/fulltext
By the newly elected co-chairs of UHC2030.
“… On Sept 23, 2019, world leaders endorsed the most ambitious and comprehensive political declaration on health in history. Their commitment to UHC was loud and clear. But are governments taking action towards meeting these commitments?”
“To try to answer this question and support national accountability and advocacy processes, UHC2030 produced the first review documenting the state of commitment to UHC at the end of 2020. It provides a multistakeholder consolidated view on the state of progress being made towards UHC at country and global levels….”
“… What does the review show? The current state of UHC presents huge challenges. Findings show that in many counties, poor and vulnerable groups are being further left behind, and inequities are widening due to the COVID-19 crisis. The COVID-19 pandemic is also exposing and exacerbating weaknesses in health systems, showing that many governments neglected to invest in health, social safety nets, and emergency preparedness when it really mattered: before a crisis struck.;..”
“… We urge all partners of UHC2030 to use our review's political messages and ask national political leaders in all 193 UN member states to take action on universal health coverage. Specifically, we call on all national political leaders to: prioritise UHC to tackle and recover from the COVID-19 pandemic, stop public anxiety, and rebuild trust in government and political leaders; address the systemic inequities that are widening with COVID-19 by creating stronger social and financial safety nets and prioritising equity; expand and strengthen UHC legislation and regulations, set clear targets, and communicate better; support, protect, and care for health workers, and innovate to improve and maintain quality during emergencies; invest in public health and primary health care as a joint effort of health and finance ministers, and local governments; build partnerships through genuine civil society engagement; empower women, who are proving to be highly effective leaders in health emergencies; and give UHC principles more weight in every crisis response and build emergency preparedness into all health system reforms….”
Some reads in this issue we want to flag:
· Do start with the Editorial - Charting the climate straight and narrow
With an overview of the past month in Planetary health terms, among others:
“… a recent special report produced by the International Energy Agency (IEA) map[s] out a comprehensive scenario for energy development to 2050 that is intended to meets the 1·5°C limit on global heating enshrined in the Paris Agreement. This wording, which sends a strikingly clear message about the need to stop investing in new fossil fuel extraction projects and comes close to aligning with the slogan “keep it in the ground”, is a clear departure from earlier work by the IEA which had been used by fossil fuel companies to justify continued coal, oil, and gas expansion. … …. three of the world's biggest oil and gas companies Shell, ExxonMobil, and Chevron have just been compelled in the courts and through shareholder voting to significantly cut emissions….”
Conclusion of the Editorial: “… The clear message to everyone working for a green, healthy, and liveable future: keep going, momentum is building.”
“We define the constitutional determinants of planetary health as the constitutional structures within which human impacts on the Earth's natural systems affect human health. … In light of these points, we should investigate whether and measure how divergent constitutional structures—presidential or parliamentary, majoritarian or proportional, democratic or autocratic, federal or unitary, judicial independence or the lack thereof—influence and affect planetary health….”
· Comment - The contribution of Islam to planetary health
“The human ecosystem interface, embodied by the planetary health paradigm, is deeply embedded in all the world's religions and indigenous traditions. Yet, the ongoing planetary health discourse remains predominantly Western-orientated. As calls to decolonise health ensues, there is a need to explore and acknowledge other non-Western perspectives, such as those originating from the Islamic faith…..”
“Electronic waste (e-waste) is increasing at three times the pace of the world population, impacting badly on the health of those wading through electronic dump sites, according to the World Health Organization’s (WHO) landmark report – Children and Digital Dumpsites – released on Tuesday. Led by Marie-Noël Bruné Drisse, a children’s health expert of the WHO, the report found that 18 million children, some as young as 5 years of age, are actively involved in the informal e-waste sector – and are being exposed to toxic e-waste that is endangering their lives….”
“Effective and binding action is urgently required to protect the millions of children, adolescents and expectant mothers worldwide whose health is jeopardized by the informal processing of discarded electrical or electronic devices according to a new ground-breaking report from the World Health Organization: Children and Digital Dumpsites....”
“Drought is a hidden global crisis that risks becoming “the next pandemic” if countries do not take urgent action on and tackling the climate emergency, the UN has said. At least 1.5 billion people have been directly affected by drought this century, and the economic cost over roughly that time has been estimated at $124bn (£89bn). The true cost is likely to be many times higher because such estimates do not include much of the impact in developing countries, according to a . Mami Mizutori, the UN secretary general’s special representative for disaster risk reduction, said: “Drought is on the verge of becoming the next pandemic and there is no vaccine to cure it. Most of the world will be living with water stress in the next few years. Demand will outstrip supply during certain periods. is a major factor in land degradation and the decline of yields for major crops.”
“She said many people had an image of drought as affecting desert regions in Africa, but that this was not the case. , and by the end of the century all but a handful of countries will experience it in some form, according to the report. … … The report, entitled , was published on Thursday, and will feed into discussions at vital UN climate talks known as Cop26, which are scheduled to take place in Glasgow in November….”
And a tweet by Jason Hickel:
“Most people in the global North see the ecological crisis as primarily a question of technology, while social movements across the global South recognize that it is primarily a question of justice.”
“Athletes’ efforts to take control force rethink of longstanding marketing strategies.”
“Cristiano Ronaldo’s rejection of strategically placed Coca-Cola bottles at a press conference at the Euro 2020 football championships this week has left sponsors and tournament organisers scrambling to limit the damage on endorsement deals….”
“…Uefa, European football’s governing body, has contacted national federations to tell teams to avoid actions that could affect tournament sponsors, each of which have paid about $30m to endorse the competition. But there are no specific rules to police how players must discuss the corporate partners for the Euros. And there has been no reprimand of Ronaldo who, according to one senior European football executive “is so powerful, no one can tell him what to do”. That admission is a reflection of the changing power balance at the top of the world’s biggest sports. Highly paid athletes appear more willing to challenge the media and marketing deals struck by the leagues and competitions they play in, if those financial imperatives clash with their own carefully tailored corporate image or sincerely-held beliefs. …”
K Lauber et al ; https://gh.bmj.com/content/6/6/e005216.full
“… this study explores how ultra-processed food industry actors have attempted to influence NCD policy at WHO…. Ultra-processed food industry actors have attempted to influence WHO and its policies through three main action-based strategies: coalition management, involvement in policy formulation, and information management. Coalition management includes the creation and use of overt alliances between corporations—business associations—and more covert science-focused and policy-focused intermediaries, the hiring of former WHO staff and attempted co-option of civil society organisations. Industry involvement in policy formulation is operationalised largely through the lobbying of Member States to support industry positions, and business associations gaining access to WHO through formal consultations and hearings. Information management involves funding and disseminating research favourable to commercial interests, and challenging unfavourable evidence….”
Jeff Colin; https://pubmed.ncbi.nlm.nih.gov/34100707/
“The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) is increasingly seen as offering a template for advancing effective global health governance in other spheres, notably including alcohol. In thinking about lessons that can be transferred, there is a simplifying tendency to overstate the FCTC's transformative impacts and, more problematically, to neglect the significance of evolving policies, norms, and practices that collectively enabled its development. This can lead to underestimating the extent to which the FCTC's evolution was protracted and contested, while issues that need to be addressed as prerequisites for an international legal instrument for alcohol are viewed as only feasible after its achievement. This problem is examined here with reference to managing conflict of interest with unhealthy commodity industries. … This article illustrates the legitimating and enabling significance to the FCTC of measures including emergent internal practices within the WHO, the World Bank's decision to withdraw funding from tobacco projects, steps by host governments to restrict support for the overseas expansion of tobacco transnationals, and changes in civil society and researcher engagement with industry actors. Recent developments in seeking to manage conflicts of interest in nutrition policy in the WHO and at national levels highlight the scope for progress in the absence of an international legal instrument. The article concludes by considering implications of these varying innovations for the future development of effective global governance for alcohol.”
“This landmark partnership is part of Norway’s commitment to reduce the global burden of noncommunicable diseases (NCDs).”
“Norad announced today a two-year partnership with the NCD Alliance totalling NOK 12,000,000 (USD $1.5 million approximately) to support prevention and care for noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs) throughout 2021-2023…..”
Editors-in-Chief C Kyobutungi & M Pai lay out their vision for Plos Global Public Health.
A few quotes:
“The mission of PLOS Global Public Health is to address deeply entrenched inequities in global health and make impactful research visible and accessible to health professionals, policy-makers, and local communities. We are committed to amplifying the voices of underrepresented and historically excluded communities and are deliberate about equity, diversity, and inclusion at all levels – editors, editorial boards, peer reviewers and authors– to broaden the range and diversity of perspectives we learn from and advance the health of all humankind. Equity, diversity and inclusion are core to the journal’s mission…”
"With this new journal, we are setting ambitious goals, and we expect to be held accountable. We acknowledge that we need to go beyond pledges."
Really nice new issue of the Lancet Global health.
· Do start with the Editorial - Lessons in humility
“In our first Editorial of the year, we called for submissions—particularly from those who are not regular contributors to our pages—on the theme of “What is wrong with global health?” We wanted to hear first-hand accounts of the injustices and indignities experienced by researchers from regions described variously as “developing”, “low-income and middle-income”, or “the Global South” in the course of their work, including in publishing their findings. We highlighted that both research and publishing remain dominated by institutions and journals situated in high-income countries, and we promised to reflect and engage candidly on any proposed changes. This mid-year Editorial seemed like an apt moment to thank all researchers for their response to our call for contributions so far and to introduce the first batch of accepted submissions….”
The Editorial introduces Four Comments. Check them out.
“… The goal of decolonising global health is to critically reflect on its history, identify hierarchies and culturally Eurocentric conceptions, and overcome the global inequities that such structures perpetuate. We must reflect on the terminology we use when we discuss global health challenges, phrase research questions, write papers, teach students, or interact with patients, research participants, and the public. …. to make real progress in the process of decolonising global health in our minds and practices, awareness, reflection, and change of language are fundamental. …
“Global health comes burdened with the weight of history and uses a range of terms rooted in contexts of historical domination, dependence, and subordination. … …Tropical medicine is a problematic term that slips between its geographical delineation and its imperial heritage, even as its use persists, including in the names of prestigious institutions. This historical burden is reproduced in other artificial and othering dichotomies such as Global North versus Global South, high-income versus low-income and middle-income countries, and resource-rich versus resource-poor settings, which reduce countries with different histories, cultures, and practices into a single identity, and consequently influence policy discussion. Nuanced understandings about alternative terms, and their interpretation and application in multiple contemporary social contexts, are needed to ensure we are equipped to describe complex and highly specific realities...”
Authors propose a framework to: -Bridge the capacity divide between professionals in LMICs and HICs; Foster collaboration with colleagues within regions; Make the investment case for R&D to LMIC governments and private institutions
“The organisation set up to distribute coronavirus vaccines to poorer nations was established with a “very colonial mindset”, a top African Union (AU) official has told the BBC’s Focus on Africa programme. Dr Ayoade Alakija, who is the co-chair of the AU’s Vaccine Delivery Alliance (Auvda), was speaking on the eve of the G7 summit where world leaders are expected to announce vaccine donations to countries that are struggling to cover their populations. “The initial problem with [Covax] is that it was not inclusive, it was a very colonial mindset as it was set up,” she said. “They did not come and ask us Africans, they did not come and ask our leadership, they didn't come and ask our people, 'What would you like?'” Had that been done, Auvda would have said it wanted to vaccinate between 60% and 80% of Africa's population, Dr Alakija said. But Covax seemed to think that covering 20% of the population was enough, she said. The global vaccine sharing scheme was “not the sole solution”. “I think that has been the root cause of our inability so far to purchase our own vaccines, to source our own vaccines, is the fact that we were being told that Covax is enough. 'You stay there and let Covax deal with your needs.'”….”
And a link:
Tweet NS Prashanth: “#Ecologists working in various parts of India write this lovely note in @TheWireScience on #Decolonise; towards Just & inclusive approach to #Conservation that respects local knowledge, history of #wildlife”
“According to new research from the World Health Organization (WHO), caesarean section use continues to rise globally, now accounting for more than 1 in 5 (21%) of all childbirths. This number is set to continue increasing over the coming decade, with nearly a third (29%) of all births likely to take place by caesarean section by 2030, the research finds….”
“A coalition of more than 20 global organisations are calling on UN agencies to “stop access to decision-making” for opponents of women’s and LGBT rights. The Observatory on the Universality of Rights (OURs) – which brings together groups including feminist NGO the Association for Women’s Rights in Development (AWID) and the Coaliton for Sexual and Bodily Rights in Muslim Societies (CSBR) – launched their ‘call to action’ today (17 June) alongside a report called Rights at risk: Time for action….”
Check out among others:
“ The pandemic has laid bare the need to invest in nursing for global health and economic security. Howard Catton and Elizabeth Iro outline how the profession must transform to maximize its effect on patient care and outcomes”
“WHO guidance to help the world reach the target of reducing suicide rate by 1/3 by 2030.”
“…. Suicide remains one of the leading causes of death worldwide, according to WHO’s latest estimates, published today in “Suicide worldwide in 2019”. Every year, more people die as a result of suicide than HIV, malaria or breast cancer ̶ or war and homicide. In 2019, more than 700 000 people died by suicide: one in every 100 deaths, prompting WHO to produce new guidance to help countries improve suicide prevention and care….” With 4 strategies.
“While systems thinking has been generally acknowledged as important to the field of health policy and systems research (HPSR), it remains underutilized. In particular, systems thinking has been perceived as predominantly conceptual, with fewer applications of systems thinking documented. This commentary makes three key points, namely that (1) advances in applied systems thinking in HPSR have been hindered by an imprecision in terminology, conflating ‘[health] systems approaches’ with complex adaptive systems theory; (2) limited examples of applied systems thinking have been highlighted and recognized in research, but have not been fully and equally appreciated in policymaking and practice and (3) explicit use of theory, long-term research-policy collaborations and better documentation of evidence can increase the use and usefulness of applied systems thinking in HPSR. By addressing these matters, the potentials of systems thinking in HPSR can be truly unlocked.”
“The inequity in access to COVID-19 vaccines that we are witnessing today is yet another symptom of a pharmaceutical economy that is not fit for purpose. That it was possible to develop multiple COVID-19 vaccines in less than a year, while at the same time fostering extreme inequities, calls for transformative change in the health innovation and access ecosystem. Brought into the spotlight through the AIDS drugs access crisis, challenges in accessing lifesaving medicines and vaccines—because they are either not available or inaccessible due to excessive pricing—are being faced by people all over the world. To appreciate the underlying framing of current access discussions, it is important to understand past trends in global health policies and the thinking behind the institutions and mechanisms that were designed to solve access problems. Contrary to what might be expected, certain types of solutions intrinsically carry the conditions that enable scarcity, rationing, and inequity, and lead us away from ensuring the right to health. Analyzing the root causes of access problems and the political economy that allows them to persist and even become exacerbated is necessary to fix access inequities today and to design better solutions to ensure equitable access to health technologies in the future.”
“In September 2020, the Thematic Circle has put out a to develop on in the context of Covid-19, under the different sub-themes and guidelines. We received a very rich contribution of about 15 case studies from about 12 countries on variety of subthemes. … Below, please find case study summary table a with case study links….”
“In Canada, the Eurocentric epistemological foundations of knowledge translation (KT) approaches and practices have been significantly influenced by the Canadian Institutes of Health Research (CIHR) KT definition. More recently, integrated knowledge translation (IKT) has emerged in part as epistemic resistance to Eurocentric discourse to critically analyse power relations between researcher and participants. Yet, despite the proliferation of IKT literature, issues of power in research relationships and strategies to equalize relationships remain largely unaddressed. In this paper, we analyse the gaps in current IKT theorizing against the backdrop of the CIHR KT definition by drawing on critical scholars, specifically those writing about standpoint theory and critical reflexivity, to advance IKT practice that worked to surface and change research-based power dynamics within the context of health research systems and policy….”
“While our mission remains the same – to promote the generation and use of health policy and systems research as a means to strengthen the health systems of LMICs – the new strategy slightly realigns our objectives: “Objective 1: Stimulate the generation and synthesis of policy-relevant health systems knowledge, encompassing evidence, tools and methods; Objective 2: Promote the dissemination and use of health policy and systems knowledge to improve the performance of health systems; Objective 3: Facilitate the development of capacity for the generation, dissemination and use of HPSR knowledge among researchers, policy-makers and other stakeholders
See also Alliance - Alliance launches next five-year strategic plan: Broadening horizons
“ Historically, at the Alliance for Health Policy and Systems Research, we have focused our work on supporting research to strengthen the six building blocks of health systems. And while these building blocks remain central to our mandate, it is also time to look beyond them. This is the strategic direction laid out in the Alliance's new five-year strategic plan for 2021-2025: Broadening horizons….”
By Arush Lal. With a number of concrete recommendations.
And a link:
CGD (blog) - Everything Else is Virtual Now, So Why Not HTA? (by D Ollendorf et al)
“Too much public health research is focused on changing the behaviour of the powerless, rather than the powerful.”
“I love how diagrams describing Act-A & COVAX constantly change without acknowledging these changes. This one from April 2021 has just 3 pillars but two connectors & some new "principal groups" category...”
“WTO Members agree to text-based negotiations on revised TRIPS waiver. Issues are now on scope. All IP, or just patents. (US supports all IP). All treatments, or just vaccines. (US supports just vaccines). Or will it do nothing (EU posiiton still).”
“Vaccine euphoria? On average, vaccines administered so far cover the global population with just 1/3rd of a single shot. In discrete terms, ~80% lack the first shot, ~10% lack the second and only ~10% received both. “
“Documentation will be available after the end of our series.” (probably also with recordings of the sessions)
(gated) “Philanthropist MacKenzie Scott [i.e. Jeff Bezos’ former wife] has announced a new multibillion-dollar round of grants to international organizations, saying she wants to amplify neglected voices instead of centering herself.”
See also this blog by MacKenzie Scott - Seeding by Ceding.
“…global health expert and co-director of the Global Health Centre professor Suerie Moon shares her thoughts with Geneva Solutions on some of the fundamental discussions that took place during the WHA and what should be done moving forward to address the current Covid-19 pandemic and future health crises…. “
“Looking back at these experiences and the cycle of panic and neglect, we must begin to see the devastating impact of the pandemic not only as a feature of the lack of compliance with existing instruments but as a deeper system failure that requires a bolder response, reaching out beyond health. Review committees frequently recommend creating new institutions and mechanisms, thus contributing to the already considerable fragmentation of global health. …”
“… What we require are political leaders with a vision and a willingness to address the system failures in an interconnected but deeply divided global risk society. Five such system failures should be addressed: the lack of foresight and undervaluing preparedness at national, regional and global levels; the closing of the mind that leads to weak multilateralism and strong nationalism in times of crisis; the charity model of global health that has fragmented global health, is not fit for crisis, and reinforces the unwillingness to share and pay for global public goods, in particular the WHO; the lack of recognition of the multi-sectoral nature of pandemic origins and response, neglect of One Health and planetary health; and the geopolitical decoupling and provision of support – such as vaccines – not based on need but foreign policy priorities….”
“From philosophy to law to public health, experts respond in a special symposium issue of the journal Global Health Governance to Jennifer Prah Ruger’s book, which foreshadowed pandemic issues. Global Health Governance: The Scholarly Journal for the New Security Paradigm recently published a special symposium issue, the culmination of a May 2019 colloquium hosted at Penn’s Perry World House that brought contributing scholars from across the world for a discussion on Prah Ruger’s book….” Quick overview of some of the themes in the symposium issue.
Comment on the article by Haley Swedlund and Malte Lierl, “The rise and fall of budget support: Ownership, bargaining and donor commitment problems in foreign aid” (2020), which appeared in a special issue on “Ownership in a post-aid effectiveness era: Comparative perspectives” edited by Niels Keijzer and David Black.
Concluding: “…. All in all, I do not think the authors succeeded in explaining the rise or fall of budget support from their bargaining framework. The reason for the demise of budget support is not the fact that donors can no longer make credible commitments. Rather, it appears that donor governments care much less about promoting aid effectiveness than in the first decade of this millennium. Aid policies are increasingly determined by foreign policy and commercial objectives. Despite the positive effects of budget support found in all recent studies and evaluations, most donors no longer provide budget support.”
“Despite almost 30 years of the global anti-corruption agenda, something is clearly not working. Preparing for this week’s special session of the General Assembly against corruption, the UN has recognized that ‘it has become increasingly clear that measures taken to prevent corruption have been insufficient’. In a new paper for the Westminster Foundation for Democracy, Heather Marquette and Franklin De Vrieze discuss why and how to do anti-corruption democratically….”
The debate series 'Decolonization of aid' – continued with a session on development cooperation.
“In the debate about the decolonisation of the aid industry, it is often argued that true decolonisation will be realised if the international aid system abolishes itself. Only last month, in a first webinar in a series on ‘The Decolonization of aid’ however, historian Prof. Bertrand Thaite warned that, while decolonisation is of crucial importance, we have to be careful not to throw away the baby with the bath water. In the second session in this series, again organised by Kuno, Partos and the International Institute for Social Studies (ISS), we explore this conundrum further. Focusing in particular on development cooperation, we ask ourselves how this proverbial ‘baby’ – a baby that might be named ‘global solidarity’ – can be saved and nurtured into the new being we envision? If we dismiss the option of abolishing development aid altogether, what other paths are open to meaningfully transform the development sector? Building on the insights and conversations of the first session in which speakers Dr. Arua Oko Omaka and Prof. Bertrand Thaite enlightened participants with a historical perspective, for this second session speakers Tulika Srivastava and Lydia Zigomo challenged the audience to take a critical look at present-day practices of the development sector. “
“To coincide with the 74th World Health Assembly, Devex hosted a three-day summit, Devex @ WHA 2021, to dig deeper into the global health community’s top challenges, from equitable vaccination rollout to future pandemic preparedness. Here are seven top takeaways…”
“The International Monetary Fund is exploring creation of a new trust that could allow its members to lend their IMF reserves to more countries, including middle-income countries vulnerable to climate change, IMF chief Kristalina Georgieva said on Sunday.”
Conclusion: “Not all agencies involved in malaria policy allocate assistance in alignment with the gross domestic product and malaria burden. While the country size does not negatively impact malaria burden, it does account for greater development assistance per capita from selected international agencies. Novel policy indexes describe complex relationships between malaria policy, international foreign aid and socioeconomic parameters.”
London School - Children with asymptomatic malaria a ‘hidden risk’ to disease control efforts (New study)
“Over the past several decades, the tobacco industry has tried to influence policy by partnering with various United Nations (UN) agencies. Many of these agencies, however, have since cut ties with the industry, thus safeguarding their initiatives and policies from Big Tobacco’s commercial interests. One notable exception remains and must be addressed: the continued membership of the tobacco industry-funded Eliminating Child Labour in Tobacco-Growing Foundation (ECLT) in the UN Global Compact (UNGC). More than 170 civil society organizations have now called on UNGC to end ELCT’s participation….”
“In May 2020, the FDA approved a form of artesunate made by Amivas LLC. Global health and travel medicine specialists were elated that this superior therapy for severe malaria, which had been available for years in other countries, was finally available in the U.S. Yet that approval was accompanied by a 150-fold jump in price: Artesunate costs about $30,000 for an average course of treatment for an adult, compared to less than $200 for quinidine in 2018. In most African countries, artesunate treatment costs $5 or less, highlighting the pitfalls of the American drug market….”
“The “Accountability for Reasonableness” (A4R) framework has been widely adopted in working towards equity in health for sub-Saharan Africa (SAA). Its suitability for equitable health policy in Africa hinges, at least in part, on its considerable successes in the United States and it being among the most comprehensive ethical approaches in addressing inequitable access to healthcare. Yet, the conceptual match is yet to be examined between A4R and communal responsibility as a common fundamental ethic in SAA. A4R and its applications toward health equity in sub-Saharan Africa were conceptually examined by considering the WHO’s “3-by-5” and the REACT projects for their accounting for the communal responsibility ethic in pursuit of health equity…..”
Results: “Some of the challenges that these projects encountered may be ascribed to an incongruity between the underpinning ethical principle of A4R and the communitarian ethical principle dominant in sub-Saharan Africa. These are respectively the fair equality of opportunity principle derived from John Rawls’ theory, and the African communal responsibility principle….”
“Mass vaccination drives in several countries are providing new data on the extent to which adult vaccination protects children — but the conclusions are mixed.”
M Waibel et al; https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2507143
“Technology transfer concerns the efficient and equitable allocation of existing technology in the world. Such a transfer differs from the creation of new technology, even though it may enable further technological developments. The term technology transfer entered international law in the 1960s, though its precise definition remains contentious. Technology transfer has two dimensions. The first is technology as a catalyst for economic development. Technology transfer is widely believed to lead to higher economic growth. In the 1970s and 1980s, dependence theory — the view that integration into the world economy on capitalist terms would gradually worsen the balance of trade for developing countries — had many followers. This model of development emphasized political and economic independence through control of trade, capital, and technology flows. The second dimension concerns the policing of technology licenses by competition authorities, and the co-ordination of national competition policies relating to technology.”
F Arthur-Holmes et al ; https://www.tandfonline.com/doi/full/10.1080/17441692.2021.1938171
« This paper discusses the potential abuse and mistreatment against older adults by informal caregivers during the COVID-19 pandemic in Africa. The COVID-19 pandemic has distorted many informal caregivers’ roles, which require serious adjustment for reducing caregiving stress and burden. Moreover, the COVID-19 pandemic has created challenging situations in caregiving spaces, which have the tendency to cause informal caregivers to abuse older adults. However, research on elder abuse and mistreatment, up to this point, remains underexplored in Africa. We, therefore, call for a deeper research and interrogation on the pathways and dynamics of violence and abuse against older adults in Africa. We also raise awareness of increased risks of domestic elder abuse and neglect during COVID-19 to stimulate the interest of social welfare institutions in understanding this phenomenon and its prevalence in Africa. We argue that the COVID-19 pandemic should serve as an avenue for governments, social welfare institutions, public health authorities, civil society and traditional leaders in African countries to develop a comprehensive programme and create public awareness to protect older adults against abuse, violence and neglect. The practical ways of minimising the effect of COVID-19 on domestic elder abuse in African settings are further discussed. »
“While men over 50 tend to suffer the most acute symptoms of coronavirus, women who get long Covid outnumber men by as much as four to one…”
Zabir Hasan et al ; https://gh.bmj.com/content/6/6/e005667
“Integrated health service delivery (IHSD) is a promising approach to improve health system resilience. However, there is a lack of evidence specific to the low/lower-middle-income country (L-LMIC) health systems on how IHSD is used during disease outbreaks. This scoping review aimed to synthesise the emerging evidence on IHSD approaches adopted in L-LMIC during the COVID-19 pandemic and systematically collate their operational features….”