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Dear Colleagues,
As is often the case, I’ll just offer here some issues that caught my attention this week, without paying too much attention to ‘intro coherence’ : )
The week started with a rather disappointing informal WTO meeting, and then an equally underwhelming G20 leaders’ summit. A tweet related to the former meeting perhaps: “So now wealthy countries are pitching ACT-A against India/South Africa TRIPS waiver request. Isn’t it obvious developing countries would prefer to have power to manufacture on their own over receiving charity from wealthier nations?” To which I would add, linking it to the G20 summit outcome: if “rich” countries are pitching it like this, the least they could do is to properly fund ACT-A. Sadly, that also seems too much asked, at least for now. Let’s hope change comes when the Biden administration takes over. But I have to say, after the rather desperate ACT-A fundraising effort by dr. Tedros et al, for months and months now, and also taking into account all the hoarding of vaccines by rich countries and other “Team Europe” ‘s, I’m increasingly on the side of the ones who argue “Poorer countries can’t wait until 2022. The WTO should suspend COVID vaccine patents now”. It’s probably also time to take the mantra ‘there should be no monopolies in a pandemic’ to the streets.
Early this week, the New York Times came up with a (somewhat sycophantic) analysis piece of Bill Gates’ (huge) role in the Covid-19 ecosystem. It is remarkable how smoothly Bill has made the transition from the MDG to the SDG (and now Covid-19) era, unlike many others in global health. I have my doubts, though, whether this global health “Perkamentus/Voldemort” hybrid (with a good dose more of Perkamentus, in my opinion) will also survive the Decolonize Global Health movement, clearly being one of the ‘elephants in the room’ in that respect.
As you know, from billionaires to global tax justice, is just a small step for this newsletter 😊. End of last week, The State of Tax Justice Network confirmed that “the axis of tax avoidance” (featuring also the Dutch, among others, always in for an extra buck (make that “billion”) or two ) is collectively responsible for over 47.6 per cent of global tax loss incurred from corporate tax abuse. Let that sink in. It’s more than time to do something about these ‘tax haven powers’. But we’ll have to push them, collectively, if not they’ll continue to rob health systems and societies of much needed public resources. With all the political backlash that entails.
Over to our (still miserable) Covid lives then. Huh. Some people have even likened our current Covid lives to ‘pre-retirement’, given how little that actually makes life fun is still allowed, among others a “night life” worth its name. By now, most of us are rooting for the vaccines to get back a bit of our lives from before, the night owls and youngsters first of all. I don’t blame them.
Madhukar Pai wrote a great piece on the need for men in global health (especially privileged ones from elite institutions in the North) to Lean Out. I’m all in favour of that agenda, and his suggestions are very relevant. I’m less fond of the ‘Leaning in, Leaning out’ terminology, though. Feels like the yoga version of ‘breathing in, breathing out’ to me. Being middle-aged, I even feel less enthusiastic about it, not exactly able anymore to ‘bend it like Beckham’ without some serious back consequences. But feel free to ignore me on this one (as I’m also white and work at a Northern institute, though not exactly as a ‘top dog’!) 😊.
Finally, on Wednesday the world also had to say goodbye to Maradona. That was just utterly sad. By the way, I think Diego would also have supported a “People’s Vaccine”. Passionately.
Enjoy your reading.
Kristof Decoster
https://taxjustice.net/reports/the-state-of-tax-justice-2020/
Launched at the end of last week.
“Countries are losing over $427 billion in tax each year to international corporate tax abuse and private tax evasion. That’s nearly 34 million nurses’ yearly salaries lost every year, or one nurse’s yearly salary every second. More tax is lost to tax havens ever year due to corporate tax abuse by multinational corporations then due to private tax evasion by individuals. Multinational corporations short-change countries out of $245 billion in tax every year while people who mover their wealth offshore short-change their governments out $182 billion less in tax every year. Almost all responsibility for global tax losses falls on higher income countries. Higher income countries were responsible for 98 per cent of all the tax loss countries around the world lost, whereas lower income countries were responsible for just 2 per cent. The world’s biggest tax havens are OECD member countries: the UK (with its network of Overseas Territories and Crown Dependencies), the Netherlands and Luxembourg….”
With 3 key recommendations.
“Shutting down tax havens and cancelling debts could pay for the pandemic and more – if countries work together.”
Excerpt: “…Arguing for progressive taxation will be key to winning this debate. … …. . But this approach should not be limited to the UK. If implemented across the globe, an excess profit tax could raise $104bn annually and a new wealth tax $4.4tn annually – theoretically, enough to pay for all the Covid-19 spending in just a couple of years. Global coordination can also help ensure that corporations and the wealthy do not hide their wealth in tax havens. According to the IMF, shutting down tax havens (and taxing corporate profits and hidden individual wealth at current rates in the countries where they live and sell their products) would raise $200-$600bn a year…..”
“Aid agencies say debts should be restructured or cancelled due to the pandemic and warn other countries could follow.”
“… Neighbouring governments are rattled: if Zambia has had to default, they could too.”
“Ghana looks very risky to me,” said Tim Jones, head of policy at the Jubilee Debt Campaign. He said Angola, Chad and Congo-Brazzaville were also at risk. … … A separate study by the Institute of International Finance warned of a “debt tsunami” as global indebtedness topped $277tn in the third quarter of this year. In emerging markets, which are more likely to default, debt has risen by more than a quarter. This potential wave of defaults could have catastrophic effects on already fragile healthcare systems, aid agencies warned.”
“At a time when hospitals and healthcare systems are buckling under the strain of Covid-19, it is perverse that poor countries are having to pay $3bn a month in debt repayments to rich banks, investment funds or the World Bank, while their populations fall further into poverty and destitution,” said Chema Vera, Oxfam International’s interim executive director. “Debt needs to be cancelled, postponing it is futile.” “The UN security council could pass a resolution to compel private creditors to accept a debt restructuring,” said Jones, who argued that private lenders are proving the hardest to negotiate with when it comes to debt restructuring deals.”
New UNAIDS report. “As COVID-19 pushes the AIDS response even further off track and the 2020 targets are missed, UNAIDS is urging countries to learn from the lessons of underinvesting in health and to step up global action to end AIDS and other pandemics.”
“In a new report, Prevailing against pandemics by putting people at the centre, UNAIDS is calling on countries to make far greater investments in global pandemic responses and adopt a new set of bold, ambitious but achievable HIV targets. If those targets are met, the world will be back on track to ending AIDS as a public health threat by 2030. The global AIDS response was off track before the COVID-19 pandemic hit, but the rapid spread of the coronavirus has created additional setbacks. Modelling of the pandemic’s long-term impact on the HIV response shows that there could be an estimated 123 000 to 293 000 additional new HIV infections and 69 000 to 148 000 additional AIDS-related deaths between 2020 and 2022….”
“Although some countries in sub-Saharan Africa, such as Botswana and Eswatini, have done remarkably well and have achieved or even exceeded the targets set for 2020, many more countries are falling way behind. The high-performing countries have created a path for others to follow. UNAIDS has worked with its partners to distil those lessons into a set of proposed targets for 2025 that take a people-centred approach….”
The report also argues that we need to learn from the AIDS battle. Enter a People’s Vaccine.
On the latter, see HPW: UNAIDS Calls For A “People’s” COVID Vaccine – Need To Get Core Public Health Programmes Back On Track
“In a message at the launch of the annual World AIDS Day report, Prevailing against pandemics by putting people at the centre, UNAIDS Executive Director Winnie Byanyima also called on the global pharma industry to unlock the secrets to their COVID-19 vaccine technologies to produce a cheap and accessible “People’s Vaccine”….”
· Coverage of the UNAIDS report via the Guardian - Surge of Aids-related deaths feared as Covid pandemic puts gains at risk
“Just a six-month disruption to medical supplies induced by Covid-19 could result in an extra 500,000 Aids-related deaths in sub-Saharan Africa by the end of 2021, according to data modelling in the annual report from UNAids….”
Byanyima: ““HIV has been slipping down the international agenda for some years. That is why I am calling on leaders to come forward to support a UN general assembly high level meeting on ending Aids in 2021 to address with urgency the outstanding issues that are holding us back from ending the epidemic as a public health threat by 2030.”
· And HPW - UNAIDS Proposes New HIV 2025 Targets – Calls For Countries To ‘Step Up’ Pandemic Preparedness Investment
Maintaining the HIV response in a world shaped by COVID-19
“…. Against the backdrop of an extraordinary health crisis, this year's campaign calls for global solidarity and joint responsibility. To health leaders facing many competing priorities, what might this entail in practice? In 2018, the International AIDS Society-Lancet Commission envisioned a new era of global solidarity, in which the HIV response would integrate with the broader global health field. Built on the AIDS movement's commitment to human rights, gender equality, and health equity, this new era could focus on developing robust, flexible, people-centred health systems, achieving universal health coverage, and addressing the social and structural determinants of health. The Global Fund to Fight AIDS, Tuberculosis and Malaria adopted a systems-strengthening approach in 2016. For other institutions that have been instrumental in the AIDS response, this outlook should mean that fragmented, siloed approaches are replaced with broader health system strengthening and preparedness that integrate HIV with other health priorities. The integration of HIV with COVID-19 is already happening. COVID-19 has compelled numerous countries to accelerate the scale-up of differentiated service delivery for HIV by expediting multi-month dispensing of HIV medicine, which they otherwise may not have done. COVID-19 is imperilling HIV services and forcing health systems to adapt. But adaptations need not always be harmful…..”
In general, the summit failed to deliver, certainly in terms of global health. Strong in terms of rhetoric, but few concrete commitments, at least for now. For example in terms of funding for Covax & the ACT-Accelerator… where huge funding gaps remain.
Also on debt relief, not that much progress was made (apart from what was already in the works).
See below for some reads & analysis :
https://www.g20riyadhsummit.org/pressroom/g20-riyadh-summit-leaders-declaration/
Among others, with this paragraph (3): “We have mobilized resources to address the immediate financing needs in global health to support the research, development, manufacturing, and distribution of safe and effective COVID-19 diagnostics, therapeutics and vaccines. We will spare no effort to ensure their affordable and equitable access for all people, consistent with members’ commitments to incentivize innovation. In this regard, we fully support all collaborative efforts, especially the Access to COVID-19 Tools Accelerator (ACT-A) initiative and its COVAX facility, and the voluntary licensing of intellectual property….” “We recognise the role of extensive immunisation as a global public good.”
“G20 leaders meeting remotely pledged on Sunday to “spare no effort” to ensure the fair distribution of coronavirus vaccines worldwide, but offered no specific new funding to meet that goal….”
“The EU and the UN say there is a £4.5bn funding shortfall this year that the G20 nations should fill. Countries have so far invested $10bn in the Access to Covid-19 Tools (ACT) Accelerator and its vaccine pillar, the Covax Facility. The two schemes are designed to ensure the vaccines do not remain the preserve of the wealthiest economies.”
PS: another 20+ billion is needed (for 2021) for ACT-A.
“… The summit also discussed how to help stave off possible credit defaults among developing nations as their debt soars in the economic upheaval the virus has unleashed. The G20 had already extended a debt service suspension initiative (DSSI) for developing countries until June next year, but Guterres had pushed for a commitment to extend it until the end of 2021. The draft communique did not offer a firm commitment, as countries wait to see the scale of the international debt crisis. G20 finance ministers will instead examine the recommendation when the IMF and World Bank meet next spring and see “if the economic and financial situation requires” another six-month extension. Italy will chair the G20 in 2021….”
https://www.nytimes.com/2020/11/22/us/politics/g20-summit-trump.html?referringSource=articleShare
“….Over all, the communiqué offered little in terms of any breakthrough announcements beyond general appeals for more global cooperation and “affordable and equitable access” to therapeutics and vaccines. The lack of more significant initiatives underscored how difficult it is for the G20 to carry out an agenda when the United States is indifferent — Mr. Trump skipped part of the summit to play golf — or even hostile to many of its positions, even during a pandemic that has killed more than 1.3 million people globally….”
“The G-20 discussions and resulting communiqué from the leaders’ meeting over the weekend include some positive language, but more concrete action on a number of issues — from COVID-19 response to climate — has been delayed until the next U.S. presidential administration is in place, experts told Devex.”
PS: “… LeCompte said there is an expectation that U.S. President-elect Joe Biden will call for an emergency G-20 meeting early in his administration, which could be an opportunity to push forward on a number of issues, including climate and International Monetary Fund Special Drawing Rights. Some of the issues were seemingly being pushed until next year in anticipation of a new U.S. administration with different views, Atienza said….”
https://www.ft.com/content/5f5e5a8c-1b94-438f-8f10-212126883e6c
(PS: this was written before the encouraging news on the Astra-Zeneca vaccine.)
Excerpt: “So far the world’s most powerful economies have bought up almost all of the available doses of the two most promising Covid-19 vaccines from Moderna and the Pfizer-BioNTech partnership. The companies were the first to release data from phase 3 clinical trials and both shots have demonstrated an efficacy rate of more than 94 per cent. Pfizer and BioNTech have the capacity to produce 1.35bn doses of their vaccine by the end of 2021, including 50m doses by the end of the year. The majority of those doses have been reserved by the US, EU, UK and Japan. The G20 leaders skirted the question of how many doses they would reserve for their own populations and how many they would release to the Covax scheme, which aims to ensure the global distribution of 2bn vaccine doses by the end of 2021….”
With the respective stances from EU, China, Russia, …
· For example, the European one:
“…. the European Union urged G20 leaders quickly to put more money into a global project for vaccines, tests and therapeutics - called Access to COVID-19 Tools (ACT) Accelerator - and its COVAX facility to distribute vaccines. “At the G20 Summit I called for $4.5 billion to be invested in ACT Accelerator by the end of 2020, for procurement & delivery of COVID-19 tests, treatments and vaccines everywhere,” European Commission head Ursula von der Leyen said on Twitter. … “We need to show global solidarity,” she said….” …”… To prepare for future outbreaks, the EU is proposing a treaty on pandemics.”
· China: China calls for 'global firewall' to halt spread of COVID-19
“Chinese President Xi Jinping vowed to strengthen his country's cooperation with other countries on COVID-19, stressing the need for a "global firewall" to reopen trade and to make vaccines available to all during a virtual summit of leaders from the world's 20 biggest economies…..”
“China has proposed a global mechanism on the mutual recognition of health certificates based on nucleic acid test results in the form of internationally accepted QR codes…..”
See also Xinhua - Remarks by Chinese President Xi Jinping at 15th G20 Leaders' Summit
NPR;
“Speaking on Sunday during a two-day virtual G20 global summit, Merkel said progress toward developing a system for distribution to less wealthy countries has been slow and that she would raise the issue with the global vaccine alliance, GAVI. "We will now speak with GAVI about when these negotiations will begin because I am somewhat worried that nothing has been done on that yet," she said.
“… Duke University researchers suggested earlier this month that poor countries may have to wait up to four years to get a vaccine, while wealthy nations claim the lion share of the world's future doses, leaving billions of people without immunizations. …. … COVAX recently announced more than $2 billion had been raised from the European Commission, Spain, France, Korea, and others, to aid in this effort, but that there is still a $5 billion shortfall for 2021….”
Interesting read, ahead of the G20 Ryadh Summit. With pieces from many global health leaders (including dr Tedros, Winnie Byanyima, Seth Berkley, …) and analyses, including one by Ilona Kickbusch, among others.
Do check out certainly, Health is Wealth (by Winnie Byanyima).
Tweet Ilona Kickbusch (ahead of the G20 summit): “Minimum expectations for #G20 summit also in my view: Equitable and affordable access to vaccines ( fully funding #COVAX) and expanding the scope of debt relief programme for the poorer countries. #COVID19. “
That didn’t quite materialize. Hopefully early 2021.
https://www.gavi.org/news/media-room/gavi-and-iom-join-forces-improve-immunisation-coverage-migrants
“Today, Gavi the Vaccine Alliance and the International Organization for Migration (IOM) signed a memorandum of understanding to strengthen their collaboration on vaccination efforts and related health services for migrants and forcibly displaced persons across the world, both regarding routine immunisations as well as in response to outbreaks….” The agreement focuses on reaching missed communities in humanitarian and emergency settings with vaccination.
(20 Nov) “The COVAX AMC Engagement Group, composed of Gavi COVAX AMC participants, donors, and other stakeholders, forms a key component of Facility governance. Together with the COVAX Shareholders Council comprised of self-financing participants, all 187 economies participating in the COVAX Facility are represented in the Facility’s governance structure. …” On its first meeting on Monday. “The AMC Engagement Group, which is comprised of all AMC-eligible participants and donor governments and will be self-organising, is a key component of COVAX Facility governance. More than 500 participants, including high-level representatives from 101 economies, participated in the half-day virtual meeting….
https://www.nytimes.com/2020/11/19/us/economist-covid-recovery-mariana-mazzucato.html
“Mariana Mazzucato, a professor who has the ears of world leaders and chief executives, envisions a post-pandemic world that redefines what is valued.” Well worth a read, certainly also with a view on her new role for WHO.
For more on Mazzucato’s views, see also Foreign Affairs - Capitalism After the Pandemic. “Getting the Recovery Right.”
C Wenham et al; https://blogs.bmj.com/bmj/2020/11/20/strengthening-pandemic-preparedness-and-response-begins-with-answering-the-question-where-are-the-women/
“…to tackle the downstream effects of disease outbreaks on women and other excluded genders, we must examine the policies that are created to prevent, detect, and respond to health emergencies, and assess potential revisions to these policies to mitigate against some of these avoidable harms. The Independent Panel for Pandemic Preparedness and Response (IPPPR) and the IHR Review Committee can be starting points for taking action on gender. We identify critical changes to the International Health Regulations (IHR) and the Health Emergencies Programme at the World Health Organization (WHO). As the key normative framework and international legally-binding mechanism for global health security, amendments to the IHR and as a result, WHO’s efforts in health emergencies, would set precedent for meaningful gender mainstreaming in global disease control efforts. This commitment would encourage the cascade of needed gender awareness and inclusion efforts by everyone in the global health landscape, especially member states….”
https://www.ft.com/content/5c593a14-a4f2-4ae7-ac07-b63a40a21e36
“New unit to consider loans for areas such as improving wet markets and sewage monitoring.”
“The Beijing-based Asian Infrastructure Investment Bank is setting up a department focused on healthcare and education infrastructure after the coronavirus pandemic exposed the region’s weaknesses in the area. The AIIB had long been considering a healthcare unit but Covid-19 accelerated its plans, said Erik Berglöf the bank’s chief economist, who is working on the new department’s launch. “Definitely, Covid has shown the importance of the primary healthcare system in offering resilience to pandemics,” Mr Berglöf told the Financial Times. “We saw that in many countries in Asia, the basic healthcare system didn’t hold up very well. That’s clearly something that needs to be addressed.” Adding ‘soft’ infrastructure projects to its portfolio opens the possibility of the AIIB becoming a ‘one-stop shop’ for regional development Ayse Kaya, Swarthmore College The new department is a shift for the development bank, which in the four years since its establishment has focused on financing infrastructure projects in sectors such as energy, transport and water. In April, the AIIB extended a $355m emergency loan to China supporting the public health response to Covid-19 in Beijing and Chongqing, the institution’s first foray into the sector. The bank, which is hiring a director-general to head the new “social infrastructure” unit, is aiming to appoint vital staff before the end of the year. Mr Berglöf said it was too early to disclose the new department’s financing target. But the AIIB would initially co-finance healthcare and education projects and consider standalone projects in the longer term as it built experience. “
“… “Adding ‘soft’ infrastructure projects to its portfolio opens the possibility of the AIIB becoming a ‘one-stop shop’ for regional development,” said Ayşe Kaya, associate professor of political science at Swarthmore College. “This will increase the institution’s competitiveness and help distance it from China’s contentious Belt and Road Initiative.”
And a few links:
“From November 18 to 20, 2020, the United States Agency for International Development (USAID) participat[ed] in the official United States Delegation to the Sixth Global Health Security Agenda (GHSA) Ministerial, hosted this year by the Government of the Kingdom of Thailand in a live virtual format. USAID [came] together with interagency colleagues from across the U.S. Government — including representatives from the Departments of State, Health and Human Services, and Defense, and others — as well as delegations from the governments of dozens of partner countries, non-governmental organizations, and international agencies, to discuss critical issues related to global health security…”.
· Wemos – More engagement and inclusivity in the GFF Strategy – A Lobby success ( blog by M Koutsoumpa)
Concept note: Special Session of the General Assembly in response to the Coronavirus disease (COVID-19) Pandemic.
As a reminder: “…The United Nations system-wide response to COVID-192 is based on three pillars: a largescale, coordinated, comprehensive health response; a wide-ranging effort to safeguard lives and livelihoods; and a transformative recovery process….”
Meanwhile, do join the movement calling on world leaders meeting Dec 3-4 at #UN General Assembly Special Session on #COVID19 to adopt more comprehensive public health approaches. See last week’s IHP’s Featured article (by Kent Buse & Anthony Zwi), and also RCPHcall@gmail.com.
Or this tweet: “*LAUNCHING 1 DEC* Call to #ReclaimPublicHealth. Landing just before @UN General Assembly Special Session on #Covid19 the Call outlines 10 principles based on co-creation, #humanrights & trust that put #communities at centre of #publichealth.”
(Nov 25) “The global surge in COVID-19 cases slowed a bit last week for the first time in months, though deaths from the virus continued a steady rise, the World Health Organization (WHO) said yesterday in its latest weekly situation report. Led mainly by continued levels in the Americas and Europe, the pandemic total topped 60 million cases today. Though acceleration slowed, the world still added about 4 million cases last week, and officials recorded 67,000 more deaths, the WHO said. The decline in cases came many from Europe and Southeast Asia, though Europe still reported the largest portion of cases and deaths over the past week. … As cases and deaths continue to climb in the Americas, especially in the United States, Africa reported the highest jump in cases and deaths over the past week, 15% and 30%, respectively. The Mediterranean and Western Pacific regions also reported increases…”
https://news.un.org/en/story/2020/11/1078372
“Along with other tried and tested public health measures, the head of the World Health Organization (WHO) told journalists on Monday that “there is now real hope” that vaccines will play an essential part in helping end the COVID pandemic. “With the latest positive news from vaccine trials, the light at the end of this long, dark tunnel is growing brighter”, said Director-General Tedros Adhanom Ghebreyesus. “The significance of this scientific achievement cannot be overstated”. … … Noting that no vaccine in history has been developed as rapidly, the WHO chief remarked that the scientific community had set “a new standard for vaccine development” and now the international community must set “a new standard for access”. “The urgency with which vaccines have been developed must be matched by the same urgency to distribute them fairly”, he spelled out, warning of a real risk that the poorest, and most vulnerable will be “trampled in the stampede” to get innoculated. …”
“Ten public health experts, animal health specialists and virus hunters will work alongside Chinese scientists. World Health Organization says it has been reassured by Beijing that they will be on the ground in China ‘as soon as possible’.”
“The 10-person team includes public health experts, animal health specialists and virus hunters from Japan, Qatar, Germany, Vietnam, Russia, Australia, Denmark, the Netherlands, Britain and the United States. They will work alongside Chinese scientists on a set of investigations into how the virus that causes Covid-19 emerged and spilled over into humans, triggering a pandemic that has now claimed over 1.4 million lives. WHO on Monday said the names of the international team members had been shared with member states and released online, despite concerns about harassment given that the virus origins have become a highly contentious subject. …. Members of the international team were selected by the WHO and finalised in consultation with Beijing, Ryan said last month. The Chinese and international teams held their first virtual meeting on October 30 and continue to meet online…. … One hanging question is when the international team will join field studies on the ground in China, considered a critical part of the mission, which was called for by over 130 nations at a May meeting of the WHO’s governing body. Ryan on Monday said they “fully expect” the international team will be on the ground for this work, and they would like the scientists to be “deployed as soon as possible”. …. …. The scientific mission’s phase one work centres around Wuhan, the city where the first cluster of cases was identified. ….”
“Facebook, Twitter and Google are working with a coalition of governments including the UK and Canada to fight misinformation and conspiracy theories around Covid vaccinations. Formed by the British fact-checking charity Full Fact, the new working group will aim to set cross-platform standards for tackling misinformation – as well as how to hold organisations accountable for their failure to do so. … …. As well as the three technology companies, the partnership includes the UK’s Department for Digital, Culture, Media and Sport and Canada’s Privy Council Office, fact-checkers from South Africa, India, Argentina and Spain, the Reuters Institute for the Study of Journalism, and the journalism non-profit First Draft….”
And some links:
AP - Mexico becomes 4th country to hit 100,000 COVID-19 deaths
“Mexico passed the 100,000 mark in COVID-19 deaths Thursday, becoming only the fourth country — behind the United States, Brazil and India — to do so.”
The Telegraph - Fears of Covid-19 second wave in India as daily cases increase again
“A lack of testing gives a false impression that Covid-19 is on the decline in the world's second-most populous country.”
On the (disappointing) WTO (Trips waiver) meeting from end of last week, the potentially ‘gamechanger’ vaccine from Astra Zeneca (still with some caveats, though), and more.
No “white smoke” from WTO so far. In fact, anything but.
“Wealthy nations on Friday reiterated their opposition to a proposal to waive intellectual property rules for COVID-19 drugs, three trade sources said, despite pressure to make an exception to improve access to drugs for poorer countries. Supporters of the waiver say existing intellectual property (IP) rules create barriers on access to affordable medicines and vaccines and they want restrictions to be eased, as they were during the AIDS epidemic. But opposition from the European Union, the United States and some other wealthy nations at a meeting on Friday, means the proposal set to go before the World Trade Organization’s (WTO) General Council next month is likely to fail….”
And a link: India seeks support from China, Russia at WTO to exempt Covid-19 drugs, vaccines from patent protection
Spot on. “Wealthy countries are first in line in the queue for vaccines, and the WTO is refusing to suspend patent enforcement so that poorer countries can manufacture generic versions. Most people will have to wait until 2022. This is unconscionable, say Shaz Memon and Akber Ali. India in particular is in an excellent position to roll out its own versions.”
Geneva Health Files follows the TRIPS waiver discussions closely.
This week’s Feat article: The needle has moved, but the fight is on. “EU bloc and others, push for TRIPS flexibilities, a defining departure from the past.”
“This story tries to capture prevailing dynamics shaping the discussions on this proposal, it also reviews key statements from certain countries and presents the possible course the proposal could run in the coming weeks.”
“The chair Ambassador Xolelwa Mlumbi-Peter, has said a formal TRIPS Council will be convened on 10 December with the aim of adopting a report that can be submitted to the next General Council, scheduled for 16-17 December….”
“The coronavirus vaccine produced by Oxford University and AstraZeneca will be available on a non-profit basis “in perpetuity” to low- and middle-income countries in the developing world.”
“The details of arrangements to supply poorer countries came as AstraZeneca revealed the interim results of a phase 3 trial of the vaccine, which is being heralded as the first to meet the more challenging requirements of the developing world. … …. Unlike the vaccine produced by Pfizer-BioNTech, which requires ultra-cold storage, the AstraZeneca vaccine can be kept in the kind of conventional fridge used to store vaccines around the world, with a shelf life of up to six months. Also unlike the Pfizer-BioNTech vaccine, AstraZeneca’s experimental vaccine is already a part of Covax, the global initiative that is hoping to distribute about 2bn doses to 92 low- and middle-income countries at a maximum cost of $3 a dose. As global justice campaigners demanded more transparency from Oxford and AstraZeneca over details of the deal to supply doses to people in the developing world, the partnership confirmed in a statement that lower-income countries would receive the vaccine on a not-for-profit basis. “A key element of Oxford’s partnership with AstraZeneca is the joint commitment to provide the vaccine on a not-for-profit basis for the duration of the pandemic across the world, and in perpetuity to low- and middle-income countries,” it said. As part of the initiative, AstraZeneca announced during the summer it would make 1.3bn doses of its then untried vaccine available at cost to ensure that any vaccine was not hoarded by the world’s wealthiest countries….”
Later in the week, due to increasing commotion about the results (communication), the CEO (see HPW) announced a new international trial will be done to validate the results (and test a more efficient dose).
For more analysis on this potential ‘gamechanger’ for vaccine access in LMICs, including the growing scrutiny about the vaccine results, as the week progressed, see:
· FT - Doubts raised over AstraZeneca-Oxford vaccine data
“Disquiet is growing over the way that Oxford university and AstraZeneca have handled the early readout from trials of their coronavirus vaccine, which much of the developing world may rely on to emerge from the pandemic. The results were hailed a success for showing an average efficacy of 70 per cent — a figure reached by pooling the results from cohorts on two different dosing regimens. …. But on Tuesday, Moncef Slaoui, the head of Operation Warp Speed, the US government’s funding programme for vaccine development, disclosed that second subgroup was limited to people aged 55 or below, a demographic with lower risk of developing severe Covid-19. Oxford and AstraZeneca did not disclose the age breakdown on Monday, when results were released. “There are a number of variables that we need to understand,” Mr Slaoui said. It is still possible the difference in efficacy was “random”, he added. Markets have taken notice. London-listed shares in AstraZeneca have lost more than 6 per cent after the announcement. …”. …. “Much of the confusion stems from Oxford and AstraZeneca not being fully forthcoming on the reason for the two different dosing regimens — which changed unexpectedly as trials progressed. In a statement late on Wednesday, Oxford acknowledged a difference in manufacturing and measurement processes meant later phases of its clinical studies resulted in half a dose being administered instead of a full one….. Prof Dean contrasted the AstraZeneca disclosures with those from other trials. “We had this precedent set by the other vaccines with Moderna and Pfizer/BioNTech and these were single trials, with a protocol released in advance,” she said. “We had a chance to look through it . . . It was fairly straightforward.”…” See also Science - After dosing mix-up, latest COVID-19 vaccine success comes with big question mark
· NYT - What We Know About AstraZeneca’s Head-Scratching Vaccine Results
“AstraZeneca’s new clinical trial results are positive but confusing, leaving many experts wanting to see more data before passing final judgment on how well the vaccine will work.”
“… it’s increasingly clear that the funds available to support the ambitious worldwide COVAX vaccine procurement and distribution facility planned by WHO and its partners through its ACT Accelerator initiative, is, at present, woefully inadequate. …”
“… Any deadlocked funding also threatens to pit two long standing world views against each other – in much more direct competition than what has been seen in decades. One, led by the G20 economies, is hugely invested in their pharma industries, and a donor-driven regime of massive vaccine purchases at reduced prices, and distribution for poorer countries. They argue that the private sector confidence that they will reap as a reward for their efforts is necessary to incentivize the expensive investments required for any vaccine R&D, let alone the COVID research effort that has taken place at unprecedented scale and speed. Another vision, led by South Africa and India, is challenging that more fundamentally. They are pressing ahead for an IP “waiver” in the World Trade Organization (WTO) – so that countries would have the discretion to waive, for the period of the pandemic, not only COVID-related patents, but also trade secrets, industrial designs and copyrights associated with prized vaccines, tests or treatment technologies. This, South Africa, India and its partners say, would greatly expand countries’ own ability to produce, as well as to export and import desperately needed vaccines, tests, and treatments quickly, and at much reduced prices – while bolstering the greater self-sufficiency that has become so important in the pandemic….”
· A good COVID-19 vaccine is one that works for rich and poor alike (by H Slim)
“There are seven key elements to a pro-poor vaccine, and the Oxford-AstraZeneca vaccine seems to score five out of seven so far ….”
· BBC - Covid-19: Oxford University vaccine shows 70% protection Or 90 % ‘under the right circumstances’.
· Bloomberg - Astra-Oxford Shot Is Key to Escaping Pandemic for Many Nations
https://news.un.org/en/story/2020/11/1078302
“The UN Children’s Fund (UNICEF) is working with more than 350 partners, including major airlines, shipping lines and logistics associations from around the world, to deliver COVID-19 vaccines to over 92 countries, as soon as doses become available, the agency said on Monday. “ “ Meanwhile, nearly 2bn doses of Covid-19 vaccines will be shipped and flown to developing countries next year in a “mammoth operation”, the UN children’s agency Unicef said on Monday, as world leaders vowed to ensure the fair distribution of vaccines.” As part of Covax.
See also Devex - COVID-19 vaccine work for UNICEF is about to become more intense. Here's why.
“UNICEF’s ongoing urgent work to help countries prepare for a COVID-19 vaccine is about to become “even more intense,” according to Benjamin Schreiber, deputy chief for UNICEF's global immunization program. … …. All 92 low- and middle-income countries that are slated to receive vaccines as part of the COVAX Facility will soon release their country-specific COVID-19 deployment vaccination plans. UNICEF, which is partnering with Gavi, the Vaccine Alliance, and the World Health Organization in the monumental task of readying for the deployment of vaccines and vaccine supplies, will want to ensure that countries can carry out their strategies….”
“…. UNICEF is working with 350 global airlines and freight providers to facilitate COVID-19 vaccine transport and delivery. The agency announced in October that it is planning to stockpile 520 million syringes in strategically located warehouses — from Copenhagen to Dubai — so it can quickly deliver the items to countries once approved COVID-19 vaccines become available. “… By way of example: “ … When it comes to cold chain capacity, in particular, countries in South and Southeast Asia, for example, might be “a bit better prepared than a lot of the other countries we work with,” explained UNICEF’s cold chain expert Michelle Seidel….”
https://www.nytimes.com/2020/11/23/world/bill-gates-vaccine-coronavirus.html
Well worth a read. With some interesting, though somewhat sycophantic, quotes. Baffling ones, actually.
“…. The French government is understood to be taking the lead on rallying contributions to the buffer, with president Emmanuel Macron saying in a speech on Friday he hoped France and its European partners would donate a part of their doses to healthcare workers and others “who need it most, in the most fragile countries”. Sources involved in the negotiations said French officials have flagged that giving between 1% and 5% of their doses on a rolling basis to the humanitarian stockpile would be politically realistic, though no figure has been finalised. … … The intention to create the buffer was announced by the WHO, but it is yet to give details of the size of the stockpile and how it would operate…..”
https://qz.com/1937072/the-countries-that-have-already-ordered-enough-covid-19-vaccines/
Based on the Duke data. “…Should all three of these candidates (i.e. Moderna, Pfizer & Astra Zeneca) gain regulatory clearance, four countries—Canada, Japan, the UK, and the US—could vaccinate more than 100% of their entire populations based on the number of these three vaccines they’ve already pre-ordered….”
https://www.ft.com/content/95c49b5a-f2c7-49a3-9ac5-3e7a66e3ad6b
“Campaign groups and some politicians argue more information should be disclosed.”
“…Drug procurement contracts are always confidential and companies rarely disclose commercial information. But given the unprecedented levels of public investment in the development of Covid-19 vaccines, civil society groups and some politicians have argued that an exception should have been made and more information made public. “It’s a culture of non-transparency,” said Jamie Love, the head of US-based advocacy group Knowledge Ecology International (KEI). “It’s particularly frustrating with Covid because of the massive public interest and the amount of money involved.” “Once [secrecy is] peeled away, what you see is a massive privatisation of billions of dollars of government funds,” he added….”
Must-read. “China’s version of Warp Speed aims not just to stem the COVID-19 pandemic, but to build diplomatic and trade ties.” Update on China’s vaccine diplomacy all over the world, and also on the state of affairs with respect to various Chinese vaccines.
A McDonnell et al ; https://www.cgdev.org/blog/covid-19-vaccine-predictions-tool-launch-blog
« Today we launch an interactive tool that analyses the COVID-19 vaccine portfolio, and generates estimates about the timelines for the vaccines in the portfolio. »
“As COVID-19 vaccines begin to emerge, policymakers around the world are feeling buoyant. Although governments will be the initial recipients of vaccines, their decisions on how to distribute these among their populations will be fundamental for the ultimate recipients: individuals.”
“In the first phase, countries will receive vaccine doses proportional to the size of their population to cover up to 20 percent of citizens. With high-income countries also securing bilateral advanced purchasing agreements outside of COVAX, the pressing question of who exactly will make up this 20 percent, is especially pertinent for LMICs. This blog reflects on some of the tough decisions facing policymakers who must ensure that COVID-19 vaccines are first given to those who need them most.;..”
“Mass vaccination against Covid-19 is unlikely to start in Africa until midway through next year and keeping vaccines cold could be a big challenge, the continent’s disease control group said on Thursday. Some European countries expect to start rolling out vaccination campaigns as early as January. But health campaigners are worried that Africa will find itself near the back of the queue for Covid-19 vaccines after wealthier nations signed a raft of bilateral vaccine supply deals with pharmaceutical companies. “We are very concerned as a continent that we will not have access to vaccines in a timely fashion,” said John Nkengasong, director of the Africa Centres for Disease Control and Prevention, an African Union agency….”
See also Devex - Widespread COVID-19 vaccination in Africa will likely start mid-2021
“Widespread campaigns to distribute COVID-19 vaccines in Africa will likely only begin in the second quarter of next year because of challenges around accessing vaccines and preparing countries for their distribution, said John Nkengasong, Africa Centres for Disease Control and Prevention director, during a press conference Thursday….” “….Africa CDC is coordinating with the COVAX Facility, a global initiative working on equitable COVID-19 vaccine access, as well as Gavi, The vaccine alliance, the Coalition for Epidemic Preparedness Innovations, World Bank, and African Export-Import Bank…..”
“COVAX aims to provide African nations with enough vaccines to cover 20% of their populations. Dr. Matshidiso Moeti, regional director for Africa at the World Health Organization, said that it might start providing African nations with vaccines to cover about 3% of populations, primarily those at highest risk such as health workers and elderly people, by the end of the first quarter of next year, to then scale up to 20%. But to achieve levels of herd immunity there is a need to vaccinate about 60% of the population, Nkengasong said, meaning the continent will need to procure the funding to fill this gap. To reach this threshold, it needs about 1.5 billion doses of vaccines, with the understanding that each vaccinated person receives two doses. To pay for this, the continent needs to mobilize about $10 billion to $12 billion, he said.
See also Bloomberg - Africa Looks to China, Russia to Boost Scant Vaccine Supplies
“The Africa Centres for Disease Control and Prevention and the African Union have discussed Covid-19 vaccine trial partnerships with both China and Russia, part of an effort to ensure Africa is not last in the queue for vaccines when they become available. “We are not limiting ourselves to any particular partner,” John Nkengasong, head of Africa CDC, said Tuesday at the Bloomberg Invest Africa online conference. “As a continent of 1.2 billion people, we are willing to work with any partner who adheres to our strategy plan for vaccine development and access in Africa.” There are already moves from the private sector….
And some links:
Well worth checking out, this.
See also Euractiv coverage - EU leaked pharma strategy pushes innovation for a resilient Europe
· Guardian - US, Germany and UK could start Covid vaccinations as early as December
· WP - Pfizer and BioNTech apply for clearance of their coronavirus vaccine amid historic scientific gains and horrific pandemic spread (late last week, the two companies submitted their vaccine to the FDA for emergency use authorization)
· IHP blog - The Coldest Cold Chain: Chilling Effects of Covid-19 Vaccines By Kristin B Sandvik et al. With focus on the ethics impact of a possible roll-out of the Pfizer vaccine.
· An Open Letter to President-Elect Biden. “Over 100 leaders from public health, economics, faith, and racial justice communities have sent an open letter to @JoeBiden calling for the #COVID19 vaccine to be a #PeoplesVaccine.”
“A network of 13 African countries has joined forces with global researchers to launch the largest clinical trial of potential Covid-19 treatments on the continent. The Anticov study, involving Antwerp’s Institute of Tropical Medicine and international research institutions, aims to identify treatments that can be used to treat mild and moderate cases of Covid-19 early and prevent spikes in hospitalisation that could overwhelm fragile and already overburdened health systems in Africa. The clinical trial will be carried out at 19 sites in 13 countries and led by doctors from African countries. The initiative emerged after calls for responses to the coronavirus better tailored to the developing world and the challenges of often underfunded healthcare systems….”
See also DNDi - Largest clinical trial in Africa to treat COVID-19 cases before they become severe is launched in 13 countries
And via Stat : “The “adaptive platform trial” — one that can add or remove treatments as it proceeds — will begin by studying medicines currently used to treat malaria, HIV, hepatitis C, parasitic infections, and certain cancers. That includes the HIV antiretroviral combination lopinavir/ritonavir and the malaria drug hydroxychloroquine, which remains the standard of care for Covid-19 in many African countries although HCQ has been discredited in much of the world….”
https://www.nytimes.com/2020/11/23/health/coronavirus-holiday-gatherings.html
“Yes, the coronavirus can be transmitted over cocktails and dinners. But these get-togethers may not account for the huge rise in cases.”
https://www.nature.com/articles/d41586-020-03219-y
“Immunizations are speeding towards approval before clinical trials end, but scientists say this could complicate efforts to study long-term effects.”
https://www.nytimes.com/2020/11/24/world/covid-mutation.html
“Scientists were initially skeptical that a mutation made the coronavirus more contagious. But new research has changed many of their minds.”
https://www.nature.com/articles/d41586-020-03217-0
“The viruses, both found in bats stored in laboratory freezers, are the first SARS-CoV-2 relatives to be found outside China.”
https://www.ft.com/content/3f26078e-6222-4f16-8395-afec4d87b08a
With vaccines on the horizon, I’m afraid this case will be made more and more.
“Airlines and employers that ask for proof of coronavirus immunity will be acting in the public interest.”
https://www.economist.com/the-world-ahead/2020/11/17/what-to-expect-in-year-two-of-the-pandemic
Peering into 2021. “Vaccines and cheap, rapid tests should make a difference.”
“… In 2021 humanity will continue to adapt to living with the virus—in ways that make the coexistence less taxing. ….. The basics will remain the same. Masks and avid hand-washing will still be necessary. People will give others a wider berth in public spaces without even thinking about it. But as the pandemic enters its second year, be prepared for changes in three areas: testing, quarantine rules and the guidelines for social distancing….”
https://news.un.org/en/story/2020/11/1078022
“While symptoms among children infected with COVID-19 mostly remain mild, infections are rising and the longer-term impact on the education, nutrition and well-being of an entire generation of young people can be life-altering, the UN Children’s Fund (UNICEF) has warned. In a report, released on Thursday ahead of World Children’s Day, UNICEF outlined “dire and growing” consequences for children as the coronavirus pandemic lurches towards a second year…..”
“…The report, based on surveys from 140 countries, paints an alarming picture of a generation facing ‘a trifecta of threats: direct consequences of the disease itself, interruption in essential services and increasing poverty and inequality’…”
https://www.wired.com/story/this-pandemic-must-be-seen/
Making the case that perhaps the horror of Covid-19 (in wards, ICs & nursing homes) should be made more visible.
“… As Covid-19 case numbers escalate, the problem of invisibility has gotten even worse. The media moved on from showing images of suffering, suffocation, and despair, even as an all-out war continues to rage against Covid-19 in hospital wards. …”
A Gelb et al ; https://www.cgdev.org/blog/certificate-covid-vaccination-can-we-do-better-yellow-card
“Can technology help? At the most basic level, a COVID ID would be a digitized version of the Yellow Card, the paper-based International Certificate of Vaccination or Prophylaxis that many international travelers carry with them traveling to and from high-risk areas of the world.”
https://www.bloomberg.com/graphics/covid-resilience-ranking/
Check out how your country does.
“Bloomberg crunched the numbers to determine the best places to be in the coronavirus era: where has the virus been handled most effectively with the least amount of disruption to business and society? The Covid Resilience Ranking scores economies of more than $200 billion on 10 key metrics: from growth in virus cases to the overall mortality rate, testing capabilities and the vaccine supply agreements places have forged. The capacity of the local health-care system, the impact of virus-related restrictions like lockdowns on the economy, and citizens’ freedom of movement are also taken into account.”
PS: 8 of the top 10 are democracies.
https://www.ineteconomics.org/perspectives/blog/to-save-the-economy-save-people-first
New paper.
“…. As new cases have soared, a somber chorus of political leaders, media editorial outlets, and business figures have gravely proclaimed that “lockdowns don’t work” or that “the economic and public health damage from a lockdown are as bad or worse than that inflicted by the virus they are meant to stave off.” A careful analysis of data comparing differing national responses leads to clear delineation of what works, and what does not. This paper demonstrates not only that lockdowns do work but indicates what other measures can slow and even suppress the coronavirus, and why. Our study closes with specific recommendations that promise to work better than blanket lockdowns and what nations, states, and even citizens should do to effectively address the pandemic right now.”
Cfr tweet Adam Tooze: “Choice in dealing with COVID was "suppression, or trading off deaths against the economy.” Suppression did better in every respect. Those that sacrificed lives have tended to end up with high mortality AND economic costs.”
R Horton; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32530-7/fulltext
“Europe is struggling with tragedy. But the crisis Europe faces is not only about health—it is about politics too….”
Among others, he focuses here on the situation in Belgium, and also on the role of ECDC. The latter stumbled, he says. “It was unable to coordinate country action. It could not convene national leaders to synchronise responses. It was too silent, too invisible, and too weak. When it did speak, it was ignored.”
“A new @WorldBank dashboard visualizes cross-country comparable survey data on over 60 indicators in topics such as food security, employment, income loss, and household coping strategies.”
https://healthpolicy-watch.news/tobacco-industry-exploiting-pandemic/
“The tobacco industry has been exploiting the COVID-19 pandemic and resulting health sector resource shortages to gain a stronger foothold in the policy corridors of many national governments – making huge donations of PPE and other desperately needed goods, new research has shown. The Global Tobacco Industry Interference Index 2020, released by STOP (Stopping Tobacco Organizations and Products) on Tuesday, a global tobacco industry watchdog, scores some 57 countries around the world for their policy performance vis a vis the tobacco industry. Key findings reveal that the tobacco industry used endorsement of charitable contributions to capitalize on the vulnerability of governments facing a shortage of resources during the COVID-19 pandemic, including donations of free PPE in Bangladesh, artificial respirators in Costa Rica, sanitizer in Kenya and Indonesia. But those donations often came at a price – for instance in Indonesia the company also asked the local government of Bali to roll back restrictions on outdoor tobacco advertising. All in all, the report found that the worst performing countries were: Japan, Indonesia, and Zambia, with high levels of industry interference in government policies. The South-East Asian country of Brunei Darussalam, as well as France, and Uganda ranked the best….”
https://healthpolicy-watch.news/high-profile-group-named-to-tackle-antimicrobial-resistance/
Announcement from late last week.
“In a bid to step up a battle against other emerging and untreatable pathogens that could wreak havoc on the world in ways similar to COVID-19, WHO on Friday announced the launch of a One Health Global Leaders Group on Antimicrobial Resistance (AMR). The group, led by the prime ministers of Bangladesh and Barbados, aims to raise the political profile of the threat posed by drug-resistant bacteria, viruses and other microbes – and get politicians to act more firmly to ration and control the use of life-saving drugs that are slowly losing their potency due to rampant overuse in both human health and agriculture. But the new initiative co-founded by the WHO, Food and Agriculture Organization of the UN (FAO), and the World Organization for Animal Health (OIE) stops short of setting a clear roadmap for making recommendations to governments about the kinds of tough new regulatory measures that some advocates say would be needed to stem the threat of AMR…”
“… The launch of the group coincided with the announcement of $US 13 million in donations from The Netherlands, Sweden and the United Kingdom to a new trust fund to foster AMR action at country level, said WHO’s Director General Tedros Adhanom Ghebreyesus at the press conference. An initial pilot will take place in Indonesia. …”
See also Cidrap News - New global group will lead fight against antimicrobial resistance
And WHO - One Health Global Leaders Group on Antimicrobial Resistance
And a Lancet World Report - New international group on antimicrobial resistance
“The One Health Global Leaders Group on Antimicrobial Resistance aims to raise awareness and political advocacy on antimicrobial resistance. John Zarocostas reports from Geneva.”
Excerpt: “Health officials and experts welcomed the launch, but also flagged concerns over the group's future. One senior WHO health diplomat who spoke to The Lancet on condition of anonymity warned that AMR is a politically contentious issue, both nationally and internationally, with competing interests and stakeholders, and suggested that the group ought to focus on what people agree on. Viviana Muñoz Tellez, coordinator for health, intellectual property, and biodiversity at the South Centre, said it was unfortunate that accountability for the group rests with the tripartite organisations and not directly with the UN secretary-general. The group could have also benefited, she added, from greater participation of civil society organisations—the key to driving change at the local and country levels. Similarly, Magrini said, “The good mix of high-profile politicians and senior scientists is a well-balanced one. I also hope for a stronger involvement of the many NGOs active in this area.” Ellen ‘t Hoen, director of Medicines Law & Policy, told The Lancet that public money was needed to develop new classes of antibiotics. “We can learn a lesson from COVID-19: the reason why there are now promising COVID-19 vaccines coming out of the pipeline, within a year of the first reports of the outbreak, is because governments spend billions of dollars and euros on the [research and development]. No one waited for the industry to make that investment—this innovation was driven by public financing. The same needs to happen for AMR.”
https://www.bmj.com/content/371/bmj.m4501
“Stop misinformation about antibiotics for covid -19, or resistance will rise.”
“Spread of misinformation during epidemics has been documented before, but covid-19 has brought with it a global deluge of misinformation….. survey of online news articles identified incorrect reports published in 25 languages in 87 countries, roughly a fifth of which were on cure and treatment. In low and middle income countries, many of which already have a high burden of multidrug resistant organisms, misinformation includes overemphasis on the role of antimicrobials. This includes the use of azithromycin, which has been shown repeatedly to have no efficacy against covid-19. Lack of basic knowledge on infections and their treatment has resulted in poor understanding of this viral pandemic and its aetiology by general populations worldwide and, in some settings, medical professionals … …. Strategies must be developed now to counter the detrimental effect of misinformation on the use of antimicrobials and prevent further deterioration in the global crisis in antimicrobial resistance…. …. Some organizations such as the World Health Organization and Nigeria Centre for Disease Control, already use their digital platforms to correct antimicrobial misinformation by discussing the ineffectiveness of antimicrobials as a primary treatment for covid-19. Others, including the Africa Centres for Disease Control and Prevention and the US National Institutes of Health and Centers for Disease Control and Prevention, provide general information on public health measures, disease symptoms, associated myths, and stigma but do not discuss antimicrobial use specifically. They should be encouraged to correct this serious omission.”
They conclude: “Fragile healthcare systems in many parts of the world may not withstand the covid-19 pandemic if also faced with a substantial increase in antimicrobial resistance. We must tackle the twin pandemics of covid-19 and misinformation simultaneously.”
And a link:
https://www.devex.com/news/biden-said-he-ll-rescind-the-global-gag-rule-what-then-98582
“President-elect Joe Biden is expected to repeal the Mexico City Policy as one of his early acts in office. But a memorandum rescinding the policy — which has been expanded during President Donald Trump’s administration — is only the start of what’s needed to reverse its impacts, according to experts. “We have every reason to believe this policy will be lifted almost immediately with the Biden-Harris administration, but I think that what you are going to see is the impacts don’t immediately go away,” said Nina Besser Doorley, associate director of advocacy and policy at the International Women’s Health Coalition. …. …. The Trump administration enacted the policy in January 2017, and later expanded it to cover all global health assistance — not just family planning funding. If the Biden administration rescinds the policy within its first few days of days, it would follow the precedent of previous Democrat presidents. …. But the likely policy reversal won’t result in automatic change, according to Jen Kates, senior vice president and director of global health and HIV policy at the Henry J. Kaiser Family Foundation. She described the process as the “worst game of telephone tag.” Word that the U.S. will again offer global health funding to INGOs that engage in abortion work will take time to reach a “small, foreign NGO working in one corner of a country,” Kates explained. …”
And a link: BMJ GH (blog) (by Roopa Dhatt et al on behalf of Women in Global health) Welcome back to global health, America: An open letter to Joe Biden and Kamala Harris
“The pandemic is deepening existing inequalities, including gender inequality, say Roopa Dhatt, Samira Ouedraogo, Sarah Hillware, and Ann Keeling, but the US can help build a more equal world.” With seven global health (governance) suggestions for the new US administration, going much broader than SRHR.
“Girls are made to marry too young, excluded from healthcare and are sexually exploited, says African Child Policy Forum.”
M O’Donnell; https://www.cgdev.org/blog/preventing-return-normal-addressing-violence-against-women-during-covid-19
“This week marks the International Day for the Elimination of Violence against Women —a day to recognize violence against women (VAW) as a persistent and pervasive human rights and development issue. Since the start of the pandemic, I have been collaborating with Amber Peterman and other researchers to improve understanding of how pandemics and other crises increase the likelihood of violence against women, track a growing evidence base focused on rates of VAW in the COVID context, and propose solutions for how donor institutions and policymakers should respond to this shadow pandemic and prevent a return to a pre-COVID-19 “normal”—a state in which one in three women already experienced some form of violence. Here I summarize our efforts to date and outline plans to build on initial research….”
“The UN is to spend $25m (£19m) from its emergency fund to address what has been called the “shadow pandemic” of gender-based violence against women displaced by wars and disasters. The money will be divided between the UN population fund (UNFPA) and UN Women, and at least 30% of it must be given to women-led local organisations that prevent violence and help survivors access medical and legal help, family planning, mental health services and counselling….”
See also UN Women on this: The Shadow Pandemic: Violence against women during COVID-19
“One in three women worldwide experience physical or sexual violence mostly by an intimate partner. Violence against women and girls is a human rights violation. Before the pandemic 243 million women and girls, aged 15-49 experienced sexual and/or physical violence by an intimate partner in the past year. Since the pandemic, violence against women, especially domestic violence has intensified. Since the outbreak of COVID-19, emerging data and reports from those on the front lines, have shown that all types of violence against women and girls, particularly domestic violence, has intensified….” “This is the Shadow Pandemic growing amidst the COVID-19 crisis and we need a global collective effort to stop it.”
“Scotland has become the first country in the world to provide free and universal access to period products after a four-year campaign that has fundamentally shifted the public discourse around menstruation. The Period Products (Free Provision) (Scotland) Act, which passed unanimously through its final stage on Tuesday evening, will place a legal duty on local authorities to make period products available for all those who need them, building on the work of councils like North Ayrshire, which has been providing free tampons and sanitary towels in its public buildings since 2018….”
F Bustreo et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30507-6/fulltext
“The disruptive effects of pandemics on the delivery of health services is increasingly recognised as a global threat to maternal and child health. The COVID-19 pandemic has further highlighted the need to not only rapidly develop health-care innovations but to also make them equitably available. In this context, innovations that contribute to maintaining coverage of essential interventions, such as by facilitating task shifting, simplifying service delivery, or both, are crucial. We argue that the case for a dedicated financing mechanism for scaling up innovations in women's, children's, and adolescents' health is stronger than ever….. “ “ …. There are options to build such a dedicated system, expanding on existing institutions like Unitaid and the Global Financing Facility. For example, in March, 2019, the Global Financing Facility initiated a call for proposals on scale-up innovations to save the lives of women and neonates. Such efforts should be expanded to realise a dedicated financing mechanism. “
O Bakke et al; https://www.ijhpm.com/article_3965.html
“The global community has already set a goal to reduce alcohol harm, in the Sustainable Development Goals target 3.5. However, there is a growing consensus that the global public health community is failing to address the burden of alcohol… … “ Among others, on the urgent need for realistic funding, and the current lack of Philantropic and earmarked support.
The authors conclude: “As illustrated by the figures above, compared to other public health challenges alcohol is severely under-funded. Funding commensurate with the health burden is needed in order to fulfil the ambition of accelerating action. Despite the difficulties imposed by the COVID-19 pandemic, the need for a much-accelerated response to alcohol harm is urgent. This will not happen unless Member States provide funding proportional to the health burden from alcohol.”
Connie Hoe et al ; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czaa097/5998277?searchresult=1
“Drink-driving is a major cause of global road traffic fatalities, yet few countries have laws that meet international best practices. One possible reason is the alcohol industry’s opposition to meaningful policies that are perceived to directly threaten sales. Our primary objectives are to document alcohol industry involvement in global road safety policies and programmes and to critically evaluate the responses of public health and road safety communities to this involvement. Under the guidance of the Policy Dystopia Model…. . Our study showed that the alcohol industry acknowledges that drink-driving is an issue but argues for solutions that would limit impact on sales, akin to the message ‘drink—but do not drive’. Industry actors have been involved in road safety through: (1) coalition coupling and decoupling, (2) information production and management, (3) direct involvement in policymaking and (4) implementation of interventions. Our study also shed light on the lack of cohesion within and among the public health and road safety communities, particularly with regard to the topics of receiving funding from and partnering with the alcohol industry. These results were subsequently used to adapt the Policy Dystopia Model as a conceptual framework that illustrates the ways in which the alcohol industry has been involved in global road safety. Several implications can be drawn from this study, including the urgent need to increase awareness about the involvement of the alcohol industry in road safety and to build a cohesive transnational alcohol control advocacy alliance to curb injuries and deaths related to drink-driving.”
R Smith et al- BMJ
“We risk having a deeper public health emergency in 2021 in the aftermath of Brexit and new trade deals, warn Richard Smith, David J Hunter, Paul Kingston, and Heather Lodge.”
“… need a concerted effort by the health community, assisted by legal and trade experts, to ensure that health is explicitly included in trade discussions and negotiations, and that parliamentary debate on trade agreements considers their health effects. We must also ensure that there’s support for research on areas where we currently lack evidence. We should know more, for example, about the potential for a framework for alcohol control equivalent to the Framework Convention on Tobacco Control, or which health protective domestic laws and public policies may be at risk in the UK’s new trade agreements. …. …. At PETRA (the Prevention of Non-Communicable Disease Using Trade Agreements) we’re working to support evidence generation and dissemination on the links between trade and NCDs, engage public awareness, and provide expertise in health and law and fit for purpose trade negotiations. As a network, it is critical to have the support and engagement of our peers across the health community. We would invite all readers of The BMJ to visit our website and join our network. https://petranetwork.org ) Focus on the UK, we assume but obviously with broader relevance for other countries as well.
https://www.who.int/news/item/25-11-2020-every-move-counts-towards-better-health-says-who
“Up to 5 million deaths a year could be averted if the global population was more active. At a time when many people are home bound due to COVID-19, new WHO Guidelines on physical activity and sedentary behaviour, launched [today], emphasize that everyone, of all ages and abilities, can be physically active and that every type of movement counts. The new guidelines recommend at least 150 to 300 minutes of moderate to vigorous aerobic activity per week for all adults, including people living with chronic conditions or disability, and an average of 60 minutes per day for children and adolescents…. “ Its first guidance in a decade.
Coverage: Reuters - Adults, children must move more to stay fit in pandemic era - WHO
See also the Lancet - Physical activity guidelines 2020: comprehensive and inclusive recommendations to activate populations.
“The World Health Organization (WHO) and partners launched an online platform today to promote the exchange of evidence and experience across countries in the African region. By working to foster evidence-informed decision-making in an endeavor to re-engineer health service delivery, the initiative is expected to drive countries’ health system resilience efforts. The African Health Observatory Platform on Health Systems and Policy (AHOP) aims to facilitate cross-country learning and accelerate the uptake of high-quality evidence and experiences reflecting the complexity and diversity of the region. This knowledge translation effort will ultimately help strengthen national and regional health system design and performance…..”
“AHOP complements the larger WHO integrated African Health Observatory (iAHO), currently the most comprehensive, freely available online repository for data, analytics and knowledge on health for decision-makers, researchers, stakeholders and citizens in the region. …… This joint initiative is supported by grants from the Bill & Melinda Gates Foundation.”
For AHOP News & Updates Sign-up, see here.
Lauren Do et al ; https://www.thinkglobalhealth.org/article/tackling-worlds-most-vexing-diseases-through-data
“A call to reshape the way policymakers make health decisions by getting the most cost-effective priorities straight. “
“Economic evidence, particularly cost-effectiveness analysis (CEA), is critical for identifying “high-value” health interventions that address the world’s most burdensome diseases. … …. In order to understand how much cost-effectiveness analysis evidence is available for the diseases that account for the greatest global burden, we interrogated two databases of published studies—the Cost-Effectiveness Analysis Registry and Global Health Cost-Effectiveness Analysis Registry—and compared study volume with 2017 Global Burden of Disease estimates (in DALYs) from the Institute for Health Metrics and Evaluation (IHME). We organized our analysis both by country income level and geographic region. We found that high- and upper-middle-income countries and low- and lower-middle-income countries share few similarities from a cost-effectiveness standpoint. …” Check out some of the findings.
The authors conclude: “For policymakers, the take-home message is clear: cost-effectiveness analysis can be an effective tool for identifying high-value health interventions that address conditions with the most consequential burden. However, research gaps for highly prevalent diseases or universal health coverage for critical interventions may be stifling potential efficiency gains. Additionally, most of the cost-effectiveness analysis research output remains focused on high-income settings, even in the face of significant and growing disease burden elsewhere. These trends severely limit the ability of low- and middle-income countries to make context-sensitive, evidence-based investments that are in sync with shifting disease burden. Governments and philanthropic foundations alike should fund new research agendas that will empower academic institutions to increase their local capacity to conduct cost-effectiveness analyses….”
https://www.vox.com/21571842/coronavirus-pandemic-climate-change-covid-19-natural-disaster-vaccine
Coverage of a new IFRC report. “More than 100 disasters — many of which were climate- and weather-related — have affected more than 50 million people around the world since March, when the World Health Organization declared the coronavirus outbreak a pandemic. And though the money needed to protect against these disasters in the countries at risk exists, it’s not getting to those who need it most. Those are the key findings of a new report from the Geneva-based International Federation of Red Cross and Red Crescent Societies (IFRC) released Tuesday. In it, the authors make clear that while global attention has been focused on the coronavirus pandemic — for good reason — the climate crisis and the resulting disasters facing communities around the world are just as catastrophic. … … The IFRC report, titled “World Disasters Report 2020: Come Heat or High Water,” uses what’s known as “extreme event attribution” to show that over the past 10 years, climate- and weather-related disasters such as storms, floods, and heat waves have impacted 1.7 billion people. Over that same period, an additional 410,000 lives were lost, the majority of which were in lower- or middle-income countries. … Making matters worse, the report found that the world’s most vulnerable people aren’t getting the financial assistance they need to withstand such disasters, even though the funds they require exist. The report’s authors argue that the speed at which governments and banks worldwide have developed economic stimulus packages is proof that funds can be assembled rapidly to meet existential threats. And they want to see governments mirror that energy when it comes to addressing the climate emergency. … … Of the 20 countries considered most vulnerable to climate change and associated disasters, the IFRC found that none were in the top 20 countries receiving funding…..”
J Cohen; https://www.hhrjournal.org/2020/11/a-time-for-optimism-decolonizing-the-determinants-of-health/
“… The global movement against anti-Black racism has coincided with a pandemic that has revealed and magnified racial inequality, creating a watershed moment for public health. We are witnessing not only the social, economic, and political determinants of vulnerability to infectious disease, but also the racial and colonial hierarchies that lie underneath these roots. Meeting this moment requires that we look back at the history of public health and ask when our field has acted as a force for racial justice—and more painfully, when it has not….”
“Older people around the world are being “systematically failed” by aid agencies, leaving them unable find enough food or access medicine, research has found. Interviews with almost 9,000 older people affected by natural disasters, conflict or socio-economic crises in 11 countries, including Yemen, South Sudan and Venezuela, found a “one size fits all” aid approach which leaves out older people, according to a joint report published on Thursday by HelpAge International and Age International. Covid-19 has hit an already fragile situation for older people living in precarious circumstances, with women bearing the brunt of the failures, the report found. “The findings of our report show how the humanitarian system is systematically failing older people in what is tantamount to neglect,” said the report’s co-author, Age International’s head of policy, Ken Bluestone….”
“Britain’s overseas aid budget is to be cut from 0.7% of gross national income to 0.5%, slicing more than £4bn from the annual package and breaking a Tory manifesto commitment made only a year ago. The cut was announced in the spending review by Rishi Sunak, the chancellor, which also saw a large three-year increase for the defence budget. Sunak clearly decided to brush aside warnings from across the political spectrum that Britain’s commitment to foreign aid symbolised an outward looking and generous UK. …. …. Hopes that the target would be cut to 0.5% only temporarily in a measure that might not require primary legislation were dashed, as were suggestions that more of the aid budget could be redefined and given to other departments, including assistance with security and climate change, two preconditions for development….”
See also Devex: “…. The government will instead allocate 0.5% of GNI — expected to be around £10 billion ($13 billion) — to the aid budget in 2021, according to Sunak. That is a cut of around £5 billion compared to the 2019 budget and will have a significant impact on the programs it is able to support….” (with some reactions)
Reaction Global Justice Now - Aid cuts are a ‘betrayal’ of UK’s historic responsibility
And that’s not even mentioning the UK’s key role in the global ‘axis of tax avoidance’.
Links:
· the Guardian - UK aid cuts 'unprincipled, unjustified and harmful', say experts and MPs
“Cuts announced by Rishi Sunak will hit girls and women in poorest countries hardest, with charities predicting hundreds of thousands of deaths.”
· Devex - UK aid to refocus on countries where 'interests align'
“The United Kingdom’s future aid strategy will focus only on countries in which its “development, security, and economic interests align,” according to Foreign Secretary Dominic Raab.”
· Devex - UK to introduce legislation to ease aid spending target
“Critics fear the move signals a permanent shift away from the 0.7% aid spending target.”
· Devex - 'Poverty reduction' missing from new UK aid strategy
“Development advocates have expressed concern over the apparent absence of poverty reduction as a focus of the United Kingdom’s new aid strategy. On Wednesday evening, Foreign Secretary Dominic Raab announced that the U.K. would focus its foreign aid on seven “global challenges” where it could “make the most difference,” but reducing poverty was not among them….”
A Soucat & I Kickbusch; https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.12875
“Since the late 19th century, modern welfare states have developed increasingly mature institutions to finance health services using public funds, often in response to perceived shared threats. Yet lessons learned at the national level have been largely ignored in efforts to finance global health. The paper examines the current architecture of global health financing using the framework commonly applied to assess the performance of modern states, based on three key health-financing functions: revenue raising, pooling, and strategic purchasing. Our analysis reveals global health functions to be underfunded, fragmented, and caught in a rigid disease-centered frame of reference. Global health financing needs a full reset. We call for a transformation of global health funding in three major ways to reinforce the global community’s resilience to health shocks: 1. Ensuring a sustained source of revenue for global common goods for health through a mix of national, global, and regional taxation. 2. Pooling resources under coordinated institutional mechanisms accountable to global citizens. 3. Strategic purchasing focused on global common good and function-based rather than disease-centric investments. Global governance could provide a fourth pillar to ensure that global public goods are delivered, and global market failures are addressed. We call for transformation of the governance for global health financing by building a sense of global collective identity and developing new forms of collective action and alliances to address the multiple interests affecting people’s health….”
https://citizensforfinancialjustice.org/resource/gambling-with-our-lives/
Must-read report. “This report seeks to provide its readers with a political economy perspective on the converging climate and health emergencies.”
“The current global health and climate emergencies expose the results of decades of hyper-globalisation and neoliberal policy choices that have eroded peoples’ social and economic rights. These policies have also progressively weakened public preparedness and social safety nets that have proven so essential to cope with crises. Now, market-led policy approaches increasingly used to deal with both climate and health emergencies are failing to protect those most vulnerable, gambling with our lives and deepening pre-existing inequalities. Citizens for Financial Justice’s new report, Gambling with Our Lives: Confronting Global Health and Climate Emergencies in the Age of Financialisation, seeks to provide a political economy perspective on the converging climate and health emergencies (from their root causes to their preparedness systems), introducing some of the key issues and trends that both have in common. The report looks at how rising inequalities, economic instability and vulnerabilities to climate and health shocks have been driven and reproduced by skewed policy choices and unfair rules of the game, often dictated by private financial interests instead of guided towards the wellbeing of the general population. This systemic perspective demonstrates that climate and health emergencies cannot be addressed separately, as they are inherent to a failed global development model that has placed us in the precarious situation that we are in today. With this in mind, the report aims to reinforce the need for worldwide recovery efforts to move away from the pre-pandemic environmentally unsustainable development path, building towards socially and environmentally healthy and just economies….”
S Cleary et al; https://academic.oup.com/heapol/advance-article-abstract/doi/10.1093/heapol/czaa116/5999228?redirectedFrom=fulltext
“…This paper seeks to review the literature regarding the economic evaluation of HSS from low- and middle-income country (LMIC) settings, and to contribute towards the development of methods for the economic evaluation of HSS…”
https://gh.bmj.com/content/5/11/e003471
The authors conducted a scoping review on trans men’s health in low-income and middle-income countries (LMICs).
On a new Afrobarometer suvey (after the last one in 2016, on this topic).
“In 2019/20, Afrobarometer conducted another wave of surveys. Data from 18 countries – gathered face-to-face from a randomly selected sample of people in the language of the respondent’s choice – was collected before the COVID-19 pandemic. The survey questions covered how Africans perceive Chinese loans, debt repayments, and Africa’s reliance on China for its development. Preliminary findings show that the majority of Africans still prefer the US over China as a development model, that China’s influence is still largely considered as positive for Africa, and that Africans who are aware of Chinese loans feel that their countries have borrowed too much….”
But do check out the small print as well. Among others: China’s popularity rises in the Sahel.
“A conference organised by the Geneva Centre for Philanthropy this week [will] delve into the complicated relationship between philanthropy and taxation. “
Excerpts:
“Most governments across the world spend public funds on tax incentives to encourage philanthropy, or this idea of private assets being used for the public good. But for all the benefits it can bring, the relationship between philanthropic giving and taxation raises a number of fundamental questions. For instance, is it justified to offer tax deductions as a “reward” for donations? Does subsidising philanthropy via taxes conflict with principles of democracy - and does it ultimately pay off for society?...” “These are some of the questions being addressed this week at a three-day conference organised by the Geneva Centre for Philanthropy (GCP) and open to experts and academics in the field. “
“…. So assuming that tax incentives for philanthropic initiatives are effective and do benefit society - what is the best way to do it? As part of the joint-research venture, the OECD [will] release a report on Thursday exploring the different types of incentives practised by 40 countries that have taken part in the project. “The outcome will be, for the first time, a set of recommendations on the most efficient and equitable models," said Peter. … Two other major points of discussion will be cross-border philanthropy and the tax hurdles donations face when they leave a jurisdiction - and the booming growth of social entrepreneurship - or “B-corporations” that increasingly blur the lines between charity and business. …”
“Water shortages are now affecting more than 3 billion people around the world, as the amount of fresh water available for each person has plunged by a fifth over two decades, data has shown.
About 1.5 billion people are suffering severe water scarcity or even drought, as a combination of climate breakdown, rising demand and poor management has made agriculture increasingly difficult across swathes of the globe….”
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32527-7/fulltext
“UN Relief and Works Agency for Palestine Refugees in the Near East says that a $300 million shortfall is threatening health services. Sharmila Devi reports.”
“It is crucial to rethink how the global academic ranking competition becomes another potential conflict of interest in academic publishing of health system research…”
And a link:
Africa CDC - Apply for: Kofi Annan Global Health Leadership Programme
For more on this programme, see Africa CDC: “The African Union Commission launched the Africa Centres for Disease Control and Prevention (Africa CDC) – Kofi Annan Global Health Leadership Programme on 25 May 2020 in partnership with the Kofi Annan Foundation, following its approval by the Governing Board of Africa CDC in March 2018. The aim is to support aspirational public health leaders (Fellows) from Africa in acquiring advanced skills and competencies to strategize, manage and lead public health programmes that will transform public health in Africa. Fellows admitted in the programme will be senior public health professionals from African Union Member States who will contribute to and lead the implementation of a new public health order for Africa, and in turn mentor and develop the next generation of public health leaders for the continent.”
"The [WHO] wanted to take more of a leadership role in the vaccine deal making, but the Gates Foundation and global nonprofits said they worried that drugmakers would not cooperate."
(part of a series of tweets on this NYT article on Gates and his role in the Covid vaccine pipeline/ecosystem)
“8/ If the initiative succeeds, it will affirm strategies Gates promotes in his philanthropic work — strategies that include incentives for drug companies. If it falls far short, it could intensify calls for a more radical approach to getting vaccines to the developing world.”
“So now wealthy countries are pitching ACT-A against India/South Africa TRIPS waiver request. Isn't it obvious developing countries would prefer to have power to manufacture on their own over receiving charity from wealthier nations?”
“Let’s define #SustainableHealth as #GlobalHealth 5.0! “
(on WHO & remdesivir)
“The @WHO has learned some lessons from the Tamiflu debacle. We shouldn’t be quick to call things “innovation” until we know the outcomes. All too often by the time we figure out the downsides, $ millions/billions have been made and can’t be retrieved.”
“very interesting to see that amongst the reasons to recommend against #Remdesivir WHO mentions not only its potential harm and the difficulty of administering it intravenously in hospital but also... its high price.”
This week, stage 2 of the 2020 HSR symposium began (with, from now on, every two weeks sessions on Wednesdays).
Do re-watch on HSG’s Youtube channel.
Jonathan Glennie’s book launch.
https://www.weforum.org/events/the-davos-agenda-2021/about
“The Davos Agenda is a pioneering mobilization of global leaders to shape the principles, policies and partnerships needed in this challenging new context. … … The Davos Agenda will also mark the launch of the World Economic Forum’s Great Reset Initiative and begin the preparation of the Special Annual Meeting in the spring. Each day will focus on one of the five domains of the Great Reset Initiative…”
https://healthpolicy-watch.news/manifesto-launches-for-new-global-minded-european-health-union/
“After catching Europe unprepared, the COVID-19 pandemic has created a window of opportunity to create a “European Health Union”. And what was once a long-simmering initiative has picked up steam with a formal endorsement from the European Commission’s President Ursula von der Leyen, as well as proposals to strengthen Europe’s health security. But a group of policy-minded European health experts want to ensure that the new vision of a European Health Union moves well beyond the realm of health security and pandemic response. They are calling for a stronger commitment to climate and environmental health, health equity, preventive health – and the policies to achieve them in the context of the new European Health Union. They also want to etch a vision for the continent’s global health role, post pandemic. The group on Tuesday issued a “Manifesto for a European Health Union” outlining their vision. The manifesto website calls upon other policymakers, health experts and influencers, as well as members of the general public to sign as well, ahead of the moment when political leaders will formalize the frameworks for a new Health Union at upcoming sessions of the European Council and the next Conference on the Future of Europe…..”
https://www.devex.com/news/european-commission-promises-action-on-gender-98636
“The European Commission unveiled its third Gender Action Plan on women’s empowerment and gender equality in external affairs Wednesday, with NGOs welcoming plans to have one gender-focused project per country after years of unsuccessful attempts at “mainstreaming.” The 2021-2025 strategy calls for the European Union to lead by example through gender-balanced leadership in its own ranks, better monitoring, and cooperating more closely with EU member states at a country-level. It also reiterates the aim for 85% of its development projects to contribute to gender issues by 2025. The mainstreaming target first appeared in the commission’s Gender Action Plan for 2016-2020, with an initial aim of hitting 85% by 2020….”
I Lillehagen et al ; https://www.ijhpm.com/article_3961.html
« …. Voluntary national reviews (VNRs) are described as “cornerstones” in the follow-up system [of SDGs], which is premised on international sharing of knowledge and experience. Norway and Sweden are among the world’s most sustainable countries, aiming to be leaders in the implementation of the SDGs. The objective of this article is to investigate and compare how health is framed in the VNRs of these two high-income countries, and to discuss the implications of these framings for potential actions. …. …. Our analysis demonstrates that in the Norwegian VNR (NVNR), the issue of health is simplistically framed, focusing on the favourable situation of the majority, thus providing weak grounds for transformative action. In the Swedish VNR (SVNR), health is framed to highlight health as inextricably tied to societal inequalities. This underscores the need for integrated political action and leadership to counteract structural differences with negative consequences for health. …. …. Analysis of the two VNRs studied found a difference in how health is framed in these documents and these frames point to differences in approach and capacity to address health inequities and realise the holistic and integrative concept of health promoted in the 2030 Agenda. To realize the Agenda’s vision of “leaving no one behind” discourses of implementation that support the Agenda’s inclusive and holistic ambition must be developed. Further development of the follow-up and review system should acknowledge and address how frames can limit or enable integrative actions and are therefore important drivers of change.”
https://www.devex.com/news/why-france-and-germany-s-narrow-approach-to-who-reform-matters-98609
(gated) “The French-German proposal on WHO reform released this year is already influencing discussions at the European level, but critics say it prioritizes the concerns of rich countries.”
And a link:
Guardian - Sicily asks Cuba to send medics as Italy fights second Covid wave
Adam Koon et al; https://academic.oup.com/heapol/advance-article-abstract/doi/10.1093/heapol/czaa133/5998967?redirectedFrom=fulltext
“In 2004, President Mwai Kibaki of Kenya refused to sign a popular Bill on National Social Health Insurance into law. Drawing on innovations in framing theory, this research provides a social explanation for this decision. … …. The frame-critical analysis focused on how actors engaged in (1) sensemaking, (2) naming, which includes selecting and categorizing and (3) storytelling. We demonstrated that actors' abilities to make sense of the Bill were largely influenced by their own understandings of the finer features of the Bill and the array of interest groups privy to the debate. This was reinforced by a process of naming, which selects and categorizes aspects of the Bill, including the public persona of its primary sponsor, its affordability, sustainability, technical dimensions and linkages to notions of economic liberalism. Actors used these understandings and names to tell stories of ideational warfare, which involved narrative accounts of policy resistance and betrayal. This analysis illustrates the difficulty in enacting sweeping reform measures and thus provides a basis for understanding incrementalism in Kenyan health policy.”
Steph Topp & Kabir Sheikh; https://www.ijhpm.com/article_3502.html
From 2018, but worth re-reading.
https://news.un.org/en/story/2020/11/1078502
“Approximately once every minute and 40 seconds, a child or young person under the age of 20 was infected with HIV last year, the UN Children’s Fund (UNICEF) has reported, calling on governments to “protect, sustain and accelerate” efforts to combat childhood HIV. “
“Prevention efforts and treatment for children remain some of the lowest amongst key affected populations, and in 2019, a little less than half of children worldwide did not have access to life-saving treatment, UNICEF said in a new report on Wednesday. Nearly 320,000 children and adolescents were newly infected with Human Immunodeficiency Virus (HIV) and 110,000 children died of Acquired Immune Deficiency Syndrome (AIDS) last year. …”
“The latest progress report of the Global HIV Prevention Coalition shows that despite observed declines in new HIV infections among adults in several countries, overall progress in HIV prevention efforts remains variable and is too slow to reach the 2020 targets committed to at the 2016 United Nations High-Level Meeting on Ending AIDS….”
Via Stat: Genetic differences in mosquitoes could explain why Zika is more common outside Africa
“A more common form of the mosquito known to transmit Zika is genetically different than the wild form that's native to Africa, according to new research. The difference could help explain why there haven't been many widespread outbreaks of the disease on the African continent. The Aedes aegypti aegypti subspecies is the known vector for Zika and is commonly found in tropical, urban environments. After studying 14 mosquito colonies for their susceptibility to the virus, researchers found genetic differences in one chromosome that distinguished mosquitoes in Gabon in Africa and Guadeloupe in the Caribbean. Mouse experiments then found that the African mosquitoes transmitted smaller load of the virus to the animals than their South American counterpart, which could also help explain why the disease has been more common in that part of the world — including during the outbreaks in 2015 and 2016…”
J L Maria et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30449-6/fulltext
Systematic review and meta-analysis of task-sharing intervention strategies for managing type 2 diabetes in LMICs.
“Alzheimer's research has yielded little change in recent decades. Microsoft founder and philanthropist, Bill Gates puts this down to a lack of data-sharing in the field. Data is hard to share due to patient confidentiality and the fact that pharmaceutical companies don't want their competitors to benefit from their research. Gates explains why his Alzheimer’s Disease Data Initiative, or ADDI, is trying to change that.”
M Mukuru, F Ssengooba et al ; https://www.ijhpm.com/article_3966.html
“The persistence of high maternal mortality and consistent failure in low- and middle-income countries to achieve global targets such as Millennium Development Goal five (MDG 5) is usually explained from epidemiological, interventional and health systems perspectives. The role of policy elites and their interests remains inadequately explored in this debate. This study examined elites and how their interests drove maternal health policies and actions in ways that could explain policy failure for MDG 5 in Uganda. …. We conducted a retrospective qualitative study of Uganda’s maternal health policies from 2000 to 2015 (MDG period).” … Maternal health policies were mainly driven by a small elite group comprised of Senior Ministry of Health (MoH) officials, some members of cabinet and health development partners (HDPs) who wielded more power than other actors. The resulting policies often appeared to be skewed towards elites’ personal political and economic interests, rather than maternal mortality reduction. For a few, however, interests aligned with reducing maternal mortality. Since complying with the government policy-making processes would have exposed elites’ personal interests, they mainly drafted policies as service standards and programme documents to bypass the formal policy process. … …. Uganda’s maternal health policies were mainly influenced by the elites’ personal interests rather than by the goal of reducing maternal mortality. This was enabled by the formal guidance for policy-making which gives elites control over the policy process. Accelerating maternal mortality reduction will require re-engineering the policy process to prevent public officials from infusing policies with their interests, and enable percolation of ideas from the public and frontline.“Through the approval of a new $34.3 million grant for the next five years to the Medicines Patent Pool (MPP), Unitaid has reinforced its historic commitment to equitable access to affordable, quality medicines for all. Founded by Unitaid 10 years ago, MPP has established itself as a key player in global health through facilitating rapid access to medicines for people affected by HIV/AIDS, tuberculosis and hepatitis C in low- and middle-income countries (LMICs)….”
https://www.ft.com/content/666c4d3f-2714-4158-aea4-6a4000e9b1b3
“Billions of dollars worth of value erased as investors dump makers of medical equipment.”
“Use of Ayurvedic medicines, already on the rise worldwide, has soared even higher during the pandemic. But few people may be aware that at least one country, India, actually has an entire ministry devoted to promoting use of these traditional remedies, that have been used for centuries: the Indian Ministry for Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH). Appearing at the Geneva Health Forum on Tuesday, India’s Minister for AYUSH, Shripad Yesso Naik, presented the ministry’s guidelines for using traditional treatments, like Ayurveda and Yoga, to build health and immunity against COVID-19….”
PS: “…This follows WHO’s announcement last week that it will set up a Global Centre for Traditional Medicine in India…..”
https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-020-00536-1
by M van Ryneveld et al. “…This paper presents a retrospective analysis of the historical patterns in national health human resources governance in South Africa, based on a desktop policy review spanning 25 years after democracy….”
https://www.sciencemag.org/news/2020/11/9500-nature-journals-will-now-make-your-paper-free-read
“Prominent family of highly selective journals expands open-access option.” You gotta wonder what “open access” means if you charge so ridiculously much.
https://www.globalpolicyjournal.com/blog/23/11/2020/testing-our-way-out-covid-19-pandemic
“Reda Cherif, Fuad Hasanov and Min Zhu introduce a recent IMF paper that argues mass testing infrastructure offers a viable way out of COVID-19 and protection against future pandemics.”
https://www.devex.com/news/inside-the-world-bank-s-new-trust-fund-for-food-systems-98602
(gated) “The Food Systems 2030 Trust Fund intends to raise — and spend — $1 billion by 2030 that will be used to support new agriculture and food models that jointly improve the health of people, economies, and the planet.”
N Gottlieb et al ; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-020-00642-8
“Welfare states around the world restrict access to public healthcare for some migrant groups. Formal restrictions on migrants’ healthcare access are often justified with economic arguments; for example, as a means to prevent excess costs and safeguard scarce resources. However, existing studies on the economics of migrant health policies suggest that restrictive policies increase rather than decrease costs. This evidence has largely been ignored in migration debates. …. …. The public health community has a responsibility to promote evidence-informed health policies that are ethically and economically sound, and to counter anti-migrant and racial discrimination (whether overt or masked with economic reasoning). Toward this end, we propose a research agenda which includes 1) the generation of a comprehensive body of evidence on economic aspects of migrant health policies, 2) the clarification of the role of economic arguments in migration debates, 3) (self-)critical reflection on the ethics and politics of the production of economic evidence, 4) the introduction of evidence into migrant health policymaking processes, and 5) the endorsement of inter- and transdisciplinary approaches. With the Covid-19 pandemic and surrounding events rendering the suggested research agenda more topical than ever, we invite individuals and groups to join forces toward a (self-)critical examination of economic arguments in migration and health, and in public health generally.”
Pepijn Bergsen; Chatham House;
“Hopes that the pandemic would kill off populism in Europe were always optimistic, and the second wave is likely to definitively put an end to this idea.”
https://www.ft.com/content/83e7b65d-89cb-48f8-a42c-0d528236a122
“The makers of Russia’s flagship Covid-19 vaccine said on Tuesday that interim results from phase 3 trials showed efficacy rates of “above 95 per cent”, overperforming some of the most effective of the western vaccines that have released results…..”