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Dear Colleagues,
Last week I read in the newspaper that instead of just one personality, we might very well have several. Well, at least according to a local celebrity. It sounds like a plausible theory, though. With the pandemic having entered its second year, and the heartwarming social cohesion of last Spring in most countries now largely evaporated, for some reason the opposite has happened to my (remaining) middle-aged hair. In the Covid year, I’ve gone from nearly bald, over the hair “style” of a German footballer from the 80s (bad enough), to – if hairdressers continue to be closed in this country – soon the proud long mane of a heavy metal band guitar player from the 70s, with on top a “Vatican zucchetto-style” bald spot. (Wonder what that says about my personality in Covid times)
Meanwhile, whether we like it or not (and I personally don’t like it too much), our world is rapidly polarizing, with the US (with the EU not far behind) increasingly taking on China. Against that backdrop, WHO released the (much anticipated) Joint WHO/China report on the origins of Sars-CoV2. It’s hard to please anybody in this polarized environment. Tedros himself thus “anticipated”, criticizing access to data via China in the process (for good reason), while WHO’s Ben Embarek argued, “this is only the beginning of a process”, perhaps with the Radiohead song in mind, “Where I end and you begin”… On Tuesday, WHO plus a bunch of world leaders also floated the idea of an international pandemic treaty. First reactions were rather ambiguous as well, to put it diplomatically. My favourite one ( a tweet from Oxfam’s Max Lawson): “The hypocrisy is breathtaking. We need you to stop hoarding vaccines and protecting big Pharma, not present platitudes. #peoplesvaccine now.” (I’m guessing he was thinking of one ‘leader’ in particular)
Speaking of the People’s Vaccine, last week on Friday, dr. Tedros asked rich nations “to donate at least 10 million COVID-19 vaccines so COVAX can vaccinate all countries within the first 100 days of 2021”. Sad that it has come to this. Covax is a (good) start, but obviously not nearly enough to get to global vaccine equity. Let’s hope Joe, who aims to be a “paradigm-changing president in the White House” also goes for a breakthrough in this respect. Which means: ignore the siren song of Big Pharma and US Business groups and go all out for a People’s Vaccine. It’s time to change paradigms in the pandemic too, as this Nature Editorial argued. It won’t come from “Team Europe”, I’m afraid, although I do like Ilona Kickbusch’s proposal, whereby every leader calling for a pandemic treaty would also accept the crisis IP waiver. Sadly, much of our world (and leaders) remain(s) stuck in the “cancer stage of capitalism”( a term coined by John McMurtry). Still, some cancers are curable nowadays. Let’s start with patents during a pandemic.
Enjoy your reading.
Kristof Decoster
FT “‘Illusion’ of stability hides unsustainable borrowing and rising poverty, says Guterres.”
“… The world faces severe problems of debt sustainability in the wake of the coronavirus crisis that have not been properly understood or addressed, and which threaten to tip developing countries into a rising wave of hunger, poverty, social unrest and conflict, António Guterres, secretary-general of the UN, has warned. “The response to Covid and to the financial aspects [of the crisis] has been fragmented, and geopolitical divides are not helping,” Guterres told the Financial Times. “It has been too limited in scope and too late.” … .. Guterres said the fact that only six countries had defaulted on their foreign debts last year — Argentina, Belize, Ecuador, Lebanon, Suriname and Zambia — had created the “illusion” of stability and a “misperception of the seriousness of the situation”.
… Guterres was speaking before the launch on Monday of UN proposals for dealing with the debts of low and middle-income countries, including new finance from the IMF through an issue of its special drawing rights, or SDRs — a form of reserve asset that is used to supplement the official reserves of IMF member countries….”
https://news.un.org/en/story/2021/04/1088852
“Around one in eight nations spends more on debt than on social services, according to a new report from the UN Children’s Fund (UNICEF) launched on Thursday, calling for debt service relief and restructuring to enable countries to bounce back from the pandemic. COVID-19 and the Looming Debt Crisis notes that in 2019, 25 mostly poverty-stricken countries spent a higher proportion of government expenditures on debt services than they did on education, health and social protection combined. …”
“Is Chinese financing good for developing countries? Taking stock of China’s lending activities has long been hindered by the lack of publicly available data on dimensions like loan volumes and interest rates, let alone more esoteric features like loan collateral or default contingencies. A pathbreaking new study by researchers at AidData at William & Mary, the Kiel Institute for the World Economy, the Peterson Institute for International Economics, Georgetown Law School, and the Center for Global Development changes that.”
See also Devex - How does China lend? Insight from a study of 100 loans.
“ The contracts don’t include overt promises of ports or mineral reserves in the case of default. But they do illustrate a country that is aggressive in its terms and seeks to place itself in a position superior to other lenders, authors of the study told Devex….”
“Key discussions will take place on Special Drawing Rights after IMF board support for a $650 billion allocation; Talks on the World Bank's IDA20 replenishment begin; IFIs under scrutiny on vaccine inequality, amidst concerns over Bank's failure to ensure equitable access; Bank's commitment to climate financing called into question.”
IMF/WB Spring meetings take place next week (5-11 April). Theme this year: From crisis to resilience: World Bank Group Spring Meetings to focus on helping countries build a green and resilient recovery.
“Global lender of last resort warns inequality exacerbated by Covid crisis could trigger social unrest.”
“The International Monetary Fund has called on governments to close the income gap between the richest and poorest that has worsened during the Covid pandemic, by spending more and taxing wealthy households. In a warning that the economic shock triggered by the pandemic could undermine public attitudes to the fairness of taxation and welfare systems and lead to social unrest, the Washington-based organisation said surveys showed governments would have the support of the public if they shifted the burden of taxation away from low and middle earners to better-off members of society….”
And via ONE’s newsletter Aftershocks:
“In a curtain raiser for the World Bank-IMF Spring Meetings, Georgieva said what we do now will shape the post-crisis world, with a significant risk of a “great divergence” as rich countries vaccinate their people and recover economically, while poor countries cannot. New IMF research shows low-income countries face a financing gap of $200 billion for the recovery and another $250 billion to get back on track with fighting poverty. Given the positive news about a potential $650 billion allocation of Special Drawing Rights…”
“$450 billion: The financing gap for low-income countries left by COVID-19, according to the IMF. “
https://timjackson.org.uk/ecological-economics/postgrowth-book/
Tim Jackson’s new book. So you know you have to read this, whether neoliberal capitalism allows you the time or not.
“Capitalism is broken. The relentless pursuit of more has delivered climate catastrophe, social inequality and financial instability—and left us ill prepared for life in a global pandemic. Weaving together philosophical reflection, economic insight and social vision, Tim Jackson’s passionate and provocative book dares us to imagine a world beyond capitalism—a place where relationship and meaning take precedence over profits and power. Post Growth is both a manifesto for system change and an invitation to rekindle a deeper conversation about the nature of the human condition.”
“Richer nations also urged to ensure make-or-break climate talks this year are a success.”
“The world’s richest G7 group of countries must double the amount of finance they are offering to poor countries to help them cut greenhouse gas emissions and cope with the impacts of climate breakdown to make vital climate talks this year a success, the UN has said. As part of that commitment, the G7 countries should meet their targets of providing 0.7% of their GDP in overseas aid, said Amina Mohammed, deputy secretary general of the UN. Speaking at a conference of ministers held online on Wednesday by the UK, which is hosting the Cop26 UN climate summit this November in Glasgow, she said finance would be key to success at the talks….”
See also UN News - More climate action needed during ‘make-or-break year’ for people and planet
“The world needs “a major breakthrough” to slow the pace of climate change and build resilience to protect the most vulnerable from increasingly severe and frequent climate impacts, the deputy UN chief told a crucial high-level meeting on Wednesday, looking ahead to November’s COP26. …”
And the Guardian - UK urged to take lead in helping poor countries fund climate action
“Boris Johnson’s government must take the lead in giving poor countries access to the finance they need to tackle the climate crisis, to make vital climate talks a success, the UN’s development chief has said….”
https://www.theguardian.com/us-news/2021/mar/26/joe-biden-climate-change-virtual-summit
“Joe Biden has invited 40 world leaders to a virtual summit on the climate crisis, the White House said in a statement on Friday. Heads of state, including Xi Jinping of China and Russia’s Vladimir Putin, have been asked to attend the two-day meeting meant to mark Washington’s return to the front lines of the fight against human-caused climate change, after Donald Trump disengaged from the process. … … The start of the summit on 22 April coincides with Earth Day, and will come ahead of a major UN meeting on the crisis, scheduled for November in Glasgow, Scotland….”
https://www.sustainabledevelopmentindex.org/
“The Sustainable Development Index (SDI) measures the ecological efficiency of human development, recognizing that development must be achieved within planetary boundaries. It was created to update the Human Development Index (HDI) for the ecological realities of the Anthropocene. …” Results for 2019.
As mentioned by my colleague Willem already, all you need to know: Belgium (125th) beats Holland (146th) this year : )
And Costa Rica tops the list.
https://www.unep.org/news-and-stories/story/new-fund-leverages-nature-adapt-climate-change
“A new funding opportunity is scaling up ecosystem-based adaptation across the world. “
“The UN Decade on Ecosystem Restoration is launching in June this year. The goal is ambitious – to trigger a global movement for restoring the world’s ecosystems. … To support more of this work, known as ecosystem-based adaptation (EbA), the new Global EbA Fund opened its first call for proposals on 25 March. The fund, led by the United Nations Environment Programme (UNEP) and the International Union for the Conservation of Nature (IUCN), will provide grants for innovative approaches to ecosystem-based adaptation….”
“Small group taking most flights should face frequent flyer levy, says environmental charity.”
“…The report, which collates data from the countries with the highest aviation emissions, shows a worldwide pattern of a small group taking a large proportion of flights, while many people do not fly at all….”
“The world needs a global treaty for pandemics to protect states in the wake of Covid-19, akin to the settlement forged after the second world war, Boris Johnson and other world leaders (+ dr Tedros) have urged. … … The G7, made up of the world’s leading industrial nations and of which Johnson is president this year, agreed to explore the idea and is to discuss it further at a summit in Cornwall in June….” So also the G7 seems behind the idea (according to Tedros).
China, the United States and Russia have yet to sign the call. See also HPW - Global Leaders Unite In Calling For New Pandemic Treaty – To Bolster Resilience To Future Pandemics (with some more detail on the launch, WHO staff explaining the rationale, and even a first reaction from IFPMA “saying that pharma partners should play a role in shaping such a treaty”. ).
· Via Geneva Health Files: “In a press briefing this morning, WHO laid out the benefits of a treaty approach, including strengthening the implementation of the International Health Regulations; providing a framework for international cooperation and solidarity; addressing issues such as building resilience to pandemics and other global health emergencies; boosting national and global preparedness systems; ensuring timely and equitable access to pandemic countermeasures, including vaccines; and supporting sustainable funding and capacity for prevention, detection, and responses to outbreaks among others. While top WHO officials noted the IHR as a powerful tool, they also underscored the need for such a treaty for greater political commitments to address health emergencies. It was also suggested that the treaty will address issues such as “transparency in supply chains” and will have provisions on virus-sharing. … … WHO has suggested that such a treaty can be based on its Constitution and can be taken forward by the World Health Assembly.”
· And Reuters - U.S., China positive on pandemic treaty idea: WHO's Tedros
“The United States and China have reacted positively to a proposed international treaty on pandemics, the World Health Organization director-general Tedros Adhanom Ghebreyesus said on Tuesday….”
P Patnaik; https://genevahealthfiles.substack.com/p/examining-the-motivations-for-a-pandemic Analysis from last week. “In this story, we try to explore unfolding discussions towards a pandemic treaty. Apart from some member states, we also spoke with international legal scholars, and experts to understand the treaty making process and the implications of such a treaty for all countries, developing countries in particular. We also mapped a definitive push for an international instrument to deal with future pandemics across different forums. …”
On the political backing… “…Geneva-based observers believe, that DG Tedros and the European Council are “prime movers” who are solidly in favor of a pandemic treaty. …”; What it will look like… A note from a developing country on the pandemic treaty; the power and politics of endorsement “Seasoned watchers also brought to our attention that the idea of a pandemic treaty is also being endorsed by Western scholars in select journals….” …”
And: “Despite the entrenched securitization narrative in global health, COVID-19 undoubtedly marks a new high for the global health security complex.”
As Patnaik mentions, it would be good to hear from the Decolonialize Global Health movement on this potential ‘pandemic treaty’.
Clare Wenham’s view. “…for meaningful pandemic preparedness we need to address the elephant in the room: why did governments not abide by international law and the norms for pandemic management that were already in place?..”
https://news.un.org/en/story/2021/03/1088602
“The Secretary-General welcomed a recommitted and re-engaged United States administration to United Nations Headquarters on Monday, albeit virtually, calling on it to play a leadership role in drawing up a global vaccination plan to beat COVID-19, and make the upcoming COP26 a watershed moment for climate action….”
« The virtual event will bring together world leaders, the private sector, civil society, and key technical partners to galvanize resources and commitment to the Gavi COVAX Advance Market Commitment (AMC). The event, featuring the Secretary of State and the USAID Administrator on behalf of the United States government, and Gavi Board Chair José Manuel Barroso, will take place on April 15…”
“The event on April 15 will aim to use the Biden administration’s $2 billion commitment to Gavi, the Vaccine Alliance to encourage other donors to follow suit with contributions….”
“Dr Tedros Adhanom Ghebreyesus, WHO Director-General, has appointed Mr Carl Bildt as WHO Special Envoy for the Access to COVID-19 Tools Accelerator (ACT-Accelerator). In his role as WHO Special Envoy for the ACT-Accelerator, Carl Bildt will help lead the collective advocacy for the ACT-Accelerator, mobilizing support and resources so it can deliver against its strategy for 2021. He will also support the leaders of the ACT-Accelerator co-convening agencies, particularly in aligning work that cuts across the diagnostics, therapeutics, vaccines pillars and health-system connector; consult widely on the work of the ACT-Accelerator; advise the Director-General, ACT-Accelerator principals and stakeholders on emerging issues; and represent the ACT-Accelerator in key national and international fora….”
M Maclean et al ; https://onlinelibrary.wiley.com/doi/full/10.1111/ijmr.12247?campaign=wolearlyview&s=09
“Elite philanthropy—voluntary giving at scale by wealthy individuals, couples and families—is intimately bound up with the exercise of power by elites. This theoretically oriented review examines how big philanthropy in the United States and United Kingdom serves to extend elite control from the domain of the economic to the domains of the social and political, and with what results. Elite philanthropy, we argue, is not simply a benign force for good, born of altruism, but is heavily implicated in what we call the new age of inequalities, certainly as consequence and potentially as cause. Philanthropy at scale pays dividends to donors as much as it brings sustenance to beneficiaries. The research contribution we make is fourfold. First, we demonstrate that the true nature and effects of elite philanthropy can only be understood in the context of what Bourdieu calls the field of power, which maintains the economic, social and political hegemony of the super‐rich, nationally and globally. Second, we demonstrate how elite philanthropy systemically concentrates power in the hands of mega foundations and the most prestigious endowed charitable organizations. Third, we explicate the similarities and differences between the four main types of elite philanthropy—institutionally supportive, market‐oriented, developmental and transformational—revealing how and why different sections within the elite express themselves through philanthropy. Fourth, we show how elite philanthropy functions to lock in and perpetuate inequalities rather than remedying them. ….”
“Malaria funding hit hard as academics tell of programmes axed part way through grant cycle.”
“The UK’s world-leading malaria research has been hit particularly hard by the cuts. Colin Sutherland, professor of parasitology at the London School of Hygiene and Tropical Medicine (LSHTM), was told last week that a four-year malaria grant awarded last July would be cut by two thirds for the next 12 months from April 1. … … Professor Peter Piot, director of LSHTM, said there would be a heavy toll on researchers in developing countries who partner with institutions such as LSHTM. “This will have a ripple effect in local institutions in developing countries. This is not only affecting their livelihoods but the reputational damage is huge,” he said. …”
Related link: BMJ Opinion - Ten reasons to restore ODA research funding (by Jenny Barclay, Kent Buse, Sarah Hawkes et al).
And op-ed in the Telegraph by Peter Piot et al - The government's aid funding cuts are a wrecking ball to global health security
“Public-Private Partnerships (PPPs) are increasingly promoted as an instrument to provide and finance healthcare in low- and middle-income countries. However, the available evidence does not show that PPPs fulfill the benefits for which they are promoted. In fact, most research points out that PPPs have an opposite, negative effect on achieving equal access to quality key health services for everyone (Universal Health Coverage). As outlined in this paper, PPPs are often far more expensive for governments than public procurement, do not align with the most urgent medical needs and they seem to exacerbate access for poor populations. Wemos therefore strongly recommends global actors such as the World Bank and World Health Organization and country donors to stop promoting PPPs for healthcare provision and financing in low- and middle-income countries. Instead, they should focus on strengthening public healthcare provision and financing - in alignment with the current trend in high-income countries…”
https://news.un.org/en/story/2021/03/1088522
See also last week’s IHP news.
“A new report from the UN agency dedicated to ending HIV and AIDS ( UNAIDS) has shown that investing $29 billion a year to HIV response in low and middle income countries by 2025, will put the world back on track to eradicate the virus as a public health threat by 2030. UNAIDS adopted the new Global AIDS Strategy 2021–2026 during a special session, chaired by the Minister of Health of Namibia, held on 24 and 25 March 2021….”
See also Devex - What you need to know about the new global AIDS strategy.
“…The UNAIDS board has adopted a new global AIDS strategy which advocates say tackles some of the most difficult issues in HIV prevention and response that governments have failed to address for years. The new, five-year strategy calls attention to addressing social and structural factors — such as stigma and discrimination, violence against women, and punitive laws criminalizing gay people — that are keeping high-risk populations from accessing services. At least 92 countries continue to criminalize HIV exposure, nondisclosure, and/or transmission, and 48 countries still block the entry of people or residence of people living with HIV, according to the strategy….”
“Advocates say the next challenge will be executing the strategy, but they hope governments at the U.N. High-Level Meeting on HIV and AIDS in June will back it and make financial commitments to ensure its successful implementation. They also hope governments would support the full replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2022, as well as the Robert Carr Fund, which supports civil society and community networks….”
E Torreele, M Mazzucato et al ; BMJ Opinion;
“… If the covid-19 pandemic taught us one thing, it is that health and the economy are deeply intertwined. We must adopt people-centred and sustainable economic policies that deliver Health for All. A newly created WHO Council, chaired by one of us (MM), will start examining this soon. Vaccines and other health technologies for pandemic preparedness and response often benefit from generous public R&D support. There is therefore a strong case to be made that these technologies should not be under the control of a handful of private companies, but be considered global health commons, available and accessible to all those needing them. We must redesign the underlying industrial policy to make it work for public health, and take a hard look at intellectual property rules and practices. …”
“…Developing an pharmaceutical R&D ecosystem which effectively addresses critical global health needs is an absolute priority. This will require more than global coordination and sustainable financing. We must redress the rules by which the industry is playing, and shape industrial policy with a clear purpose and mission to work together with public health researchers and institutions to deliver needed health innovation in a timely and equitable way to people globally.”
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00079-6/fulltext
Via the press release: “The Lancet Global Health: COVID-19 pandemic worsened pregnancy outcomes for women and babies worldwide, new study finds:
First global assessment of the collateral impact of the COVID-19 pandemic on pregnancy outcomes. Findings reveal overall increase in the chances of stillbirth and maternal death during the pandemic, but chances of pre-term birth decreased in high-income countries. Women requiring surgery for ectopic pregnancies increased almost six-fold during the pandemic across all studies, after accounting for the size of included studies (surgery rate for ectopic pregnancies during pandemic 27/37 vs pre-pandemic 73/272), and symptoms of maternal depression were also increased. Study reveals disproportionate impact on low- and middle-income countries and highlights health disparities worldwide….”
H Clark, Dr Tedros et al ; https://www.bmj.com/content/372/bmj.n719
“Governments and health leaders across the world have published a rallying cry for urgent global action to improve adolescent wellbeing. In an open letter published by The BMJ on 1 April, the leaders warn that 1.2 billion people aged 10-19 worldwide “are at risk of inheriting a world blighted by climate change and scarred by covid-19….”
L Gilby et al ; https://gh.bmj.com/content/6/3/e004659
“The initial International Conference on Population and Development in 1994 contains the first reference to sexual and reproductive health and reproductive rights (SRHR). It has been considered agreed language on SRHR in future United Nations (UN) documents. However, opposition to SRHR in global forums has increased, including in conjunction with an increase in religious, far-right populist politics. This study provides an empirical analysis of UN documents to discover whether opposition to SRHR has resulted in changes in the language on SRHR between and what these changes are….”
“The results demonstrated a disappearance of the language on abortion in the CSW outcome documents from 2017 and a change in the language on comprehensive sexuality education in the CSW as well as the UN General Assembly resolutions from 2018. This change included a removal of ‘sexuality’ to an increased emphasis on the role of families. Furthermore, documents showed an inability of some states to accept any mention of sexual and reproductive health at all, expanding from the usual contestations over abortion. … Our findings suggest that the global shift in politics and anti-SRHR actors at UN negotiations and conferences have removed previously agreed on language on SRHR from future UN resolutions and outcome documents. This is a concern for the global realisation of SRHR.”
https://www.devex.com/news/the-gates-foundation-s-evolving-strategy-on-mnch-discovery-tools-99507
(gated)- “Dr. Rasa Izadnegahdar, director of the MNCH Discovery & Tools team at the Bill & Melinda Gates Foundation, expands on why the program has shifted focus toward addressing the underlying drivers of maternal and newborn mortality.”
“The United States sent a historically senior and diverse delegation to the 65th session of the Commission on the Status of Women, where Vice President Kamala Harris delivered an address to the United Nations last week — making her the highest-ranking U.S. government official ever to do so at the event. Harris used the opportunity to confirm the U.S. commitment to women’s rights on the world stage. … … This show of support wasn’t lost on women’s health and rights advocates, who are watching President Joe Biden’s administration to gauge whether early signals will evolve into global policy and funding choices that elevate women’s voices and agency in the COVID-19 pandemic response and beyond. The largest annual U.N. gathering on women’s rights — which has taken place in a mostly virtual format over the past two weeks and ends Friday — followed a flurry of U.S. legislative action in the first months of 2021….”
“… “This administration is not only deeply committed and convinced of the need to marshal this whole-of-government approach to drive gender equality,” Klein said during a panel at CSW. “We are deeply committed to doing so.” Her statement is reassuring to advocates pushing for broader change, such as a U.S. government commitment to a “feminist foreign policy” — a political framework that borrows from intersectional feminism to center the experiences and agency of women and marginalized groups. It’s an approach that has been adopted in various forms by countries such as Sweden, Canada, and Mexico….”
See also Devex - Devex Newswire: Biden’s feminist foreign aid to-do list
“…There are two big ticket policy items some believe could move forward: 1) a permanent repeal of the Mexico City Policy, or “global gag rule,” and 2) a full commitment to gender mainstreaming in Biden’s 2022 budget request….”
“Gavi, the Vaccine Alliance and Save The Children signed a memorandum of understanding to strengthen vaccination efforts and health services to reach zero dose children in marginalised and hard-to-reach communities in some of the world’s countries with the least resources. The partnership will leverage Save The Children’s existing presence and expertise in Gavi-supported countries in order to implement immunisation and related programmes in these countries. … The partnership will focus on reaching children who are currently receiving no routine vaccines and marginalised communities in line with Gavi’s vision to ‘leave no-one behind with immunisation’. In addition, the partnership will support equitable access to Covid-19 vaccines by engaging with community champions on joint activities….”
Y R Shawar & J Shiffman; https://cdn.who.int/media/docs/default-source/bulletin/online-first/blt.19.247874.pdf?sfvrsn=8ceca81f_3
This article determines the reasons for the lack of priority given to addressing violence against children, and identifies the challenges that proponents must address to improve prioritization of this issue.
“…The analysis of our data sources reveals many obstacles to for global prioritization of addressing violence against children, including the forms of violence considered, inadequate data to describe prevalence and a lack of evidence of the effectiveness of proposed solutions. There exists fundamental disagreement among proponents on the recently introduced frame of violence against children, including differences in the types of violence that should be prioritized and in the proposed solutions (e.g. prevention or remediation). On governance, competition between networks focused on specific forms of violence is hampering efforts to create strong governing institutions. Conclusion: Despite the complex challenges identified, proponents have made some progress in global prioritization of addressing violence against children. To improve this prioritization further, proponents must resolve framing tensions and strengthen governance mechanisms to promote shared goals, while ensuring that networks focused on particular forms of violence are able to maintain their distinct identities….”
https://iapewec.org/reports/iap-2021-final-report/
“Our five-year mandate as the United Nations Secretary-General’s Independent Accountability Panel concluded on 31 March 2021. The UN Deputy Secretary-General, Amina Mohammed, kindly asked us to prepare a final reflections report. The brief was to summarize our learnings since 2016, and from a decade of EWEC accountability for women’s, children’s and adolescents’ health, and to offer our reflections and recommendations on the IAP’s transition to an integrated health and SDG accountability mechanisms. The resulting report is entitled ‘The Health of Women, Children and Adolescents is at the Heart of Transforming our World: Empowering Accountability.’”
“By far the most important lesson is that accountability is about people. Not merely as the ‘end receivers’, but as the first consideration and as essential contributors and partners. Our most lasting achievement will probably be our accountability framework, which we evolved by continually gathering and evaluating evidence, and by stress testing ideas and assumptions about the best way to do accountability. Our overarching recommendation is to Institutionalize an Independent Review Mechanism (IRM) for health across the SDGs as a priority focus of the annual High-Level Political Forum (HLPF) and United Nations Economic and Social Council (ECOSOC) reviews at country, regional and global levels….”
For the report, see https://iapewec.org/wp-content/uploads/2021/03/IAP-Final-Reflections-Report-1.pdf
Key trends, WHO messages, new initiatives, …
“In its weekly snapshot of global COVID-19 activity, the World Health Organization (WHO) said yesterday that new cases rose for the fifth week in a row, an increase that now includes all six of its regions, with deaths accelerating for the second straight week. In its latest situation report, the WHO said of the more than 3.8 million cases added to the global total last week, the five countries reporting the most were Brazil, the United States, India, France, and Poland. Meanwhile, countries reporting some of the steepest rises include Bangladesh (85%), India (55%), Turkey (47%), and the Philippines (43%). Cases rose even in some countries in the African region, where cases had declined over the previous 2 weeks. For example, Kenya's cases increased 25% and Ethiopia's new infections increased 14%.... “
See also Cidrap - COVID cases surge in South American, European hot spots. (1 April)
Coverage of yesterday’s media briefing.
“The World Health Organization is hopeful that all healthcare workers can be vaccinated by mid-April and has again pleaded with rich countries to donate surplus COVID-19 vaccines to the global COVAX facility, which has run out of doses at a crucial time. So far, the WHO has not received any donations since it called on countries last week to donate surplus doses they have accumulated, said Dr. Tedros Adhanom Ghebreyesus at a press conference on Thursday. “Last week, I made an urgent request to countries with surplus vaccines that have WHO emergency use listings to share 10 million doses with COVAX,” said Dr. Tedros. “This challenge has been heard, but we’re yet to receive commitments for those. I’m still hopeful that some forward looking and enlightened leaders will step up.”…”
So WHO repeated (last week’s) urgent call for 10 million COVID-19 vaccine doses for countries that haven't started vaccinating health workers and other vulnerable groups.
https://healthpolicy-watch.news/covax-needs-urgent-donation/
Coverage of last week Friday’s media briefing.
“Covax has run out of COVID-19 vaccines to supply the last 20 countries in the world that have not yet started vaccinations, and it urgently needs a donation of 10 million doses from either manufacturers or countries that have piiled up surplus doses, according to World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyesus. … While 36 countries have not yet started vaccinations, 16 of these are due to receive COVAX deliveries within the next two weeks, Tedros told the WHO bi-weekly pandemic briefing on Friday. “That leaves 20 countries who are ready to go and waiting for vaccines. COVAX is ready to deliver, but we can’t deliver vaccines we don’t have,” said Tedros, who set a global target of vaccination drives in all countries within the first 100 days of 2021. He blamed “bilateral deals, export bans, vaccine nationalism and vaccine diplomacy” for causing delays in “tens of millions of doses” for COVAX.
“The Director-General also warned of the danger of criminals exploiting the “huge global unmet demand for vaccines” and urged people not to buy vaccines outside government-run vaccination programmes as these could be “sub-standard or falsified”… “ On the latter, see also CNBC - WHO warns against sales of counterfeit Covid vaccines on the dark web
But he did emphasize, “Covax works”. See UN News : “COVAX works” the head of the World Health Organization (WHO) said on Friday, informing journalists that the UN-backed vaccine initiative has distributed more than 32 million vaccines to 61 countries in just one month. …”
Also from late last week, this WHO Afro warning.
“Rising cases of coronavirus in Africa threaten to overrun fragile healthcare systems and test the continent’s much-touted resilience to the disease, according to the World Health Organization’s regional office for the continent. The global health body stated that infections were on the rise in at least 12 countries in Africa including Cameroon, Ethiopia, Kenya and Guinea….”
“A joint WHO-China study on the origins of COVID-19 says that transmission of the virus from bats to humans through another animal is the most likely scenario and that a lab leak is “extremely unlikely,” according to a draft copy obtained by The Associated Press. The findings were largely as expected and left many questions unanswered, but the report provided in-depth detail on the reasoning behind the team’s conclusions. The researchers proposed further research in every area except the lab leak hypothesis….”
You find a detailed summary of the report’s key points in HPW.
· See also WSJ - WHO Report Into Covid-19 Origins Leaves Key Questions Unanswered
“Long-awaited report says data examined during China mission was insufficient to explain when, where and how virus began spreading.”
· And Science News - Compromise’ WHO report resolves little on pandemic’s origins, but details probe’s next steps
“… the report concludes that the likeliest start of the pandemic was a bat coronavirus that infected another, unidentified animal and then moved on to humans. That’s long been the favored hypothesis of many virologists, but the team convened by the World Health Organization (WHO) reports little fresh evidence to support it, and members acknowledge several other scenarios, including an accidental release from a lab, remain possible. The report does, however, lay out plenty of next steps. …”
· Nature - WHO report into COVID pandemic origins zeroes in on animal markets, not labs
“ Scientists say the conclusions make sense but note that supporters of the lab-leak theory are unlikely to be satisfied.”
· The WHO report – Origins of the SARS-CoV-2 virus (30 March)
https://healthpolicy-watch.news/84333-2/
Meanwhile, dr Tedros clearly says all options are still on the table. “All four original chains of query remain on the table in terms of the origins of the SARS-CoV2 virus, said WHO Director General Dr Tedros Adhanom Ghebreyesus at a press briefing on Monday. But his comments appear to contradict the leaked conclusions of the investigation which point towards a natural cause for the virus emergence among farmed wildlife. …” “… However, a leading member of the WHO investigative team said on Monday that their report pointed to the Chinese wildlife trade as the most likely source of the virus leap to humans, discounting a lab biosafety accident as a factor. …”
See also Reuters - WHO says COVID-19 origins study not extensive enough, cites data access 'difficulties' ( coverage of Tuesday)
“A World Health Organization team probing the new coronavirus’s origins cited problems accessing raw data, the health agency’s chief said on Tuesday, calling for further studies because the assessment, so far, has not been extensive enough. “In my discussions with the team, they expressed the difficulties they encountered in accessing raw data,” WHO director-general Tedros Adhanom Ghebreyesus said after the report of a team that traveled to Wuhan, China, this year was released. “I expect future collaborative studies to include more timely and comprehensive data sharing.” Although the team concluded a laboratory leak was the least likely hypothesis for the virus that causes COVID-19, the WHO said, the matter requires further investigation, potentially with additional missions. “I do not believe that this assessment was extensive enough,” Tedros said. “Further data and studies will be needed to reach more robust conclusions.””
Cfr : WHO Director-General's remarks at the Member State Briefing on the report of the international team studying the origins of SARS-CoV-2 (30 March)
Cfr tweets M Kavanagh: "However, I do not believe that this assessment was extensive enough. Further data and studies will be needed to reach more robust conclusions." “For those who follow @WHO closely, these are strong and clear words. For those who want to fault the organization, you're going to have to tell me where the added strategic diplomatic pressure is going to come from to get more data & access--is US prioritizing? EU?”
And via the Telegraph: “The UK, United States and 12 other countries are concerned the World Health Organization report into the origins of the pandemic was delayed and lacked access to complete data, according to a joint statement.” They also called for an independent probe.
https://healthpolicy-watch.news/sars-cov2-virus-origins-report/
“The most important takeaway about the just-released WHO report on the origins of the SARS-CoV2 virus that has infected over 100 million people to date may not be its initial findings, which need to be held under the microscope, but the fact that it has been issued at all. Speaking at a press conference on Tuesday, WHO’s Peter Ben Embarek, who coordinated the politically fraught WHO mission to Wuhan, China in January and the report produced after the visit – stressed that it was the beginning of a process – and a quest. It will take much more time for the 17 members of the international expert committee – and the world – to unravel. …”
Finally, a quote (via the Washington Post): ““What stands out starkly is that this is the kind of situation where member states are expecting results from WHO that they have not empowered it to produce,” said Mara Pillinger, a senior associate in global health policy and governance at Georgetown’s O’Neill Institute for National and Global Health Law. “They needed permission to go in, to conduct research and on the report.”..”
https://www.nature.com/articles/d41586-021-00877-4
“A World Health Organization report makes a reasonable start, scientists say, but there are many questions yet to be answered.”
“At this week’s global U.N. meeting on aging, HelpAge International, along with other partner organizations, plans to demand that a convention on the rights of older people be drafted, entrenching their rights and calling attention to the need for protection….”
“With more people forced to flee their homes as a result of conflict, instability, and natural disaster, the World Health Organization is working hard to ensure that migrant and refugee health is incorporated into global health responses.” Overview of efforts taken, by the head of WHO’s Global Health and Migration Programme.
https://www.afro.who.int/news/viral-facts-africa-initiative-combat-dangerous-health-misinformation
“Viral Facts Africa, a first of its kind African initiative to combat health misinformation online, was launched today by the World Health Organization (WHO) and a network of fact-checking organizations and leading public health bodies. Viral Facts Africa will leverage the insights and reach of a unique network of 14 organizations to counter health misinformation as it spreads and to “inoculate” people against falsehoods. The initiative is starting with engaging health fact checks, explainers, myth busters and misinformation literacy messages that are optimized for sharing on Facebook, Twitter and Instagram….”
https://ipolitics.ca/2021/03/29/g7-countries-agree-to-collaborate-on-vaccine-passports-hajdu/
“Federal Health Minister Patty Hajdu said Monday that she and her counterparts from the G7 countries agree they need to coordinate the development of vaccine passports….”
https://www.theguardian.com/world/2021/mar/30/new-covid-vaccines-needed-within-year-say-scientists
“Survey of experts in relevant fields concludes that new variants could arise in countries with low vaccine coverage…”
“Epidemiologists, from some of the world’s leading academic institutions, delivered a stark warning today of the risk the world is taking by failing to ensure all countries have sufficient vaccines to protect people from COVID-19….”
“Researchers propose a mechanism and a treatment for possible deadly side effect seen in at least 30 European vaccine recipients.”
See also The Guardian - Canada suspends use of AstraZeneca Covid vaccine for those under 55.
And The Atlantic - We Need to Talk About the AstraZeneca Vaccine
“ For the moment, reports of a very rare, dangerous blood disorder among recipients cannot be ignored.”
“ The World Health Organization said on Wednesday it continues to monitor safety evidence reviews of AstraZeneca’s COVID-19 vaccine but that the shot’s benefit-risk profile “weighs heavily in favour of its use” amid reports of rare brain blood clots….”
“The human brain evolved to face simple risks, like whether a certain plant is safe to eat. But far more complex and nuanced dangers now fill our world. Neurocognitively, we commonly assess risks using so-called fast thinking, which is essentially gut feelings. As the anthropologist Mary Douglas wrote in her classic book, “Purity and Danger,” people tend to divide the world into the two realms of “risky” and “safe” — what is dangerous and to be avoided vs. what isn’t — or essentially bad vs. good. Our brains see these dichotomies in black and white rather than shades of gray. We don’t deal well with ambiguities or notions of relative safety, and like to think of situations as merely either completely safe or unsafe, rather than as partially or relatively safe. … In the months ahead, many people will face complex decisions with no easy answers….”
“A new study suggests the messenger RNA vaccines produced by Moderna and the Pfizer-BioNTech partnership appeared to be 90% effective in preventing Covid-19 infection in a real-world setting. The study was released Monday in Morbidity and Mortality Weekly Report, an online journal published by the Centers for Disease Control and Prevention….”
“The rapid rise in different parts of the world of deadly, more infectious coronavirus variants that share new mutations is leading scientists to ask a critical question - has the SARS-CoV-2 virus shown its best cards? New variants first detected in such far-flung countries as Brazil, South Africa and Britain cropped up spontaneously within a few months late last year. All three share some of the same mutations in the important spike region of the virus used to enter and infect cells. These include the E484k mutation, nicknamed “Eek” by some scientists for its apparent ability to evade natural immunity from previous COVID-19 infection and to reduce protection offered by current vaccines - all of which target the spike protein. The appearance of similar mutations, independent of one another, springing up in different parts of the globe shows the coronavirus is undergoing “convergent evolution,” according to a dozen scientists interviewed by Reuters. Although it will continue to mutate, immunologists and virologists said they suspect this coronavirus has a fixed number of moves in its arsenal….”
Links:
· Guardian - University scientists deconstruct Covid-19 vaccines and publish 'recipe' on open web
“Stanford University scientists determine sequences of Pfizer and Moderna vaccines from vials set to be discarded.”
· CEPI - CEPI launches funding call to advance development of broadly protective coronavirus vaccines (31 March)
· NYT – Scientists wonder whether a mix-and match approach to vaccines could be the way to go
“The White House is weighing whether to temporarily lift intellectual property protections on Covid-19 vaccines and treatments. The move would allow other countries to replicate existing vaccines….”
See also The Hill - Progressives up pressure on Biden to back COVID vaccine patent waiver
https://www.ft.com/content/9b544e07-d173-4d51-8f4a-0dd970c866e6
Meanwhile, on the other side… “US business groups, including pharma industry lobbyists, are urging the Biden administration to resist pressure from developing nations to suspend intellectual property protections for Covid-19 vaccines….”
“UNAIDS Executive Director Winnie Byanyima has asked the World Bank to support the TRIPS waiver at the World Trade Organization to boost supplies of COVID-19 vaccines. “We really would like to see the bank supporting the waiver. WHO supports it. We support it,” she said during a civil society event at the 2021 World Bank Springs Meetings last week, arguing that the waiver could help get more companies to produce and boost COVID-19 vaccine supply….”
“… Byanyima, who has been a vocal proponent for a people’s vaccine, said governments should require companies to share vaccine technology, given the amount of taxpayer money that has gone to developing these vaccines. They can do this via the World Health Organization-led COVID-19 Technology Access Pool, or C-TAP, where companies can still get paid under certain arrangements. C-TAP has to date struggled to gain traction….”
“The pandemic is not a competition between companies and will not end without more-equal distribution of coronavirus vaccines.”
Excerpt: “…Richer nations were united in their opposition to the IP waiver until last week, when it emerged that the administration of US President Joe Biden is discussing its merits. One factor that could influence a change in policy is that the US government is named on a patent application for a technology used in vaccines being made by several companies, including Moderna in Cambridge, Massachusetts…. … Arguably the strongest argument for a temporary waiver is that patents were never designed for use during global emergencies such as wars or pandemics. A patent rewards inventors by protecting their inventions from unfair competition for a limited time. The key word here is ‘competition’. A pandemic is not a competition between companies, but a race between humanity and a virus. Instead of competing, countries and companies need to do all they can to cooperate to bring the pandemic to an end….”
https://www.wto.org/english/news_e/news21_e/dgno_30mar21_e.htm
Ngozi at an informal General Council meeting on 30 March.
“…DG Okonjo-Iweala also said that she plans to convene an event in mid-April to discuss ramping up COVID-19 vaccine production and how the WTO can contribute to a more rapid and equitable distribution of vaccines. … She stressed that the event would help advance global discussions on access to vaccines. She expressed hope both for increased vaccine manufacturing in the short- to medium-term, and a longer-term framework agreement that would provide for automatic access to vaccines and other medical products for developing countries in future health crises, including a way forward on the TRIPS waiver proposal many of them support….”
“The director-general, World Trade Organisation ( WTO), Dr Ngozi Okonjo-Iweala has said Africa needs to create a "roadmap" for boosting the continent's capacity to eventually produce COVID-19 vaccines. The WTO DG said it has become an emergency as the continent lags in its efforts to vaccinate 60 per cent of its 1.3 billion. Okonjo-Iweala raised this concern in Abuja, during her meeting… “
https://healthpolicy-watch.news/jj-strikes-big-vaccine-deal-with-african-union/
“Johnson & Johnson (J&J) will deliver its COVID-19 vaccine to Africa from October after reaching an agreement with the African Vaccine Acquisition Trust (AVAT) to supply the continent with up to 400 million doses over the next two years. ;..”
See also Reuters : “Johnson & Johnson will supply up to 220 million doses of its single-shot COVID-19 vaccine to African Union's 55 member states from the third quarter of 2021, the drugmaker said on Monday. J&J, through its unit Janssen Pharmaceutica NV, entered into a deal with the African Vaccine Acquisition Trust (AVAT), which could order an additional 180 million doses, for a combined total of up to 400 million doses through 2022. …”
HPW: “…However, Africa may be without vaccines for some months following last week’s decision by the Serum Institute of India (SII) to scale back its delivery of the AstraZeneca vaccine – the backbone of COVAX facility – in order to address domestic demand as COVID-19 cases soar in India….”
On the latter: “Gavi in Talks With Indian Government Over SII supplies: “Meanwhile, late last week the global vaccine alliance, Gavi, announced that COVID-19 vaccines produced by the Serum Institute of India to lower-income economies that as part of COVAX “will face delays during March and April as the government of India battles a new wave of COVID-19 infections”. “COVAX and the Government of India remain in discussions to ensure some supplies are completed during March and April,” added Gavi..”
“India’s recent announcement that it is restricting the export of COVID-19 vaccines means the African continent might not reach the “critical” goal of vaccinating 30% of its population by the end of the year, said John Nkengasong, director at the Africa Centres for Disease Control and Prevention. The move by India is creating uncertainty around when African nations might receive shipments of doses from the COVAX Facility, a global initiative aimed at equitable access to COVID-19 vaccines. “We are very concerned,” Nkengasong said during a press conference Thursday. “There is absolutely no way … we are going to meet our needs if India delays.””
“The EU Commission and Norway are working on a proposal to establish a joint mechanism within COVAX so that hundreds of millions of surplus vaccines can be smoothly shared with poor countries. A team of lawyers led by a Norwegian is trying to solve the legal obstacles. Liability in case of misuse of vaccines or side-effects is a key issue that needs to be addressed.”
https://www.bbc.com/news/uk-56552966
“A group of charities is urging Boris Johnson to "swiftly clarify" how many Covid vaccine doses the UK is prepared to donate to poorer countries. Save the Children and the Wellcome Trust are among those calling on the PM to start donating jabs through Covax. …”
“Culture Secretary Oliver Dowden said the UK does not currently have a surplus of vaccines, but when it does that surplus will be shared. The UK, which has ordered 400 million vaccine doses and will have many left over, has said it will donate most of its surplus vaccine supply to poorer countries. The lower income countries most likely to receive the first vaccines through Covax include Afghanistan, Haiti, DR Congo, Ethiopia and Somalia….”
https://www.nytimes.com/2021/03/26/us/biden-coronavirus-vaccine.html?referringSource=articleShare
“As U.S. manufacturers hit their stride, vaccine scarcity will soon turn to plenty as much of the world goes begging. And vaccine makers need answers now about what to do with the coming surplus. … … For all these reasons, senior officials say, the administration is leaning toward keeping the doses it has ordered then at some point directing the excess to other nations in bilateral deals or giving it to Covax, an international nonprofit organization backed by the World Health Organization that is trying to coordinate equitable distribution of vaccine….”
“Mr. Biden has stressed that his top priority is to protect Americans, but pressure is growing to share the U.S. stock. The United States has ordered a billion doses from the three federally authorized manufacturers and AstraZeneca, whose vaccine is not yet cleared for emergency use in the States but has been authorized by more than 70 countries. It recently announced that it was negotiating a deal with Johnson & Johnson for enough doses to cover another 100 million. Taken together, the supply would be enough to vaccinate 650 million people — nearly twice the U.S. population. …”
D Banik et al ; https://theconversation.com/why-india-is-banking-on-health-diplomacy-to-grow-african-footprint-151934
The authors identify three broad sets of health-related opportunities and benefits that may shape the future of India-Africa relations.
“World Bank rolls out $12 billion programme to support global Covid-19 vaccination. New report [from December already ] finds that wider Bank pandemic programme does not ensure free access to health care. World Bank fails to address key challenges to universal and equitable access to vaccines in Global South.”
Quote: “…While Reuters news agency reported in January that World Bank President David Malpass stated that Bank officials are “working with countries to address…rules that leave vaccine makers open for lawsuits or judgments”, the Bank’s lack of support for enhanced distributed local production, the TRIPS waiver and lack of action on vaccine pricing are deeply problematic. …”
B Kazaz et al ; https://www.cgdev.org/blog/how-can-we-encourage-covid-19-vaccine-developers-expand-manufacturing-capacity
… While public sharing of IP and manufacturing know-how remains an important area of debate, it is prudent to consider how the companies that have developed the vaccines can be incentivized to expand their manufacturing capacity—either by adding more in-house capacity, finding additional third-party contract manufacturing sites, or through voluntary licensing arrangements. In a new note, we try to identify the least-costly financial instrument to achieve this goal….”
“Major drugmakers are teaming up at an unprecedented rate to meet Covid-19 vaccine production demands, but industry watchers say the drive may be short-lived.
… Some companies say the partnerships could help them boost capacity by as many as hundreds of millions of doses this year, a critical need as the world grapples with the pandemic. …. Proponents of the deals laud them as exemplary of what the private sector can achieve—speeding up vaccine creation and increasing output. But some attorneys say the partnerships are an odd byproduct of a unique moment and are unlikely to spur further manufacturing deals beyond the public health emergency. … … Attorneys cite intellectual property and other legal and logistical issues that may get in the way of the trend. And critics of the deals say they came too little, too late—failing to adequately meet the needs of the global community….”
“At the most recent meeting of the Facilitation Council for the Access to COVID-19 Tool Accelerator, or ACT-A, health and aid officials underscored the need to increase access to COVID-19 diagnostics and treatments, including oxygen, in low- and middle-income countries. Apart from supply, they argued cost and other factors, in-country capacity, market competition, and government prioritization are also posing barriers to access….”
Also with the view of Chris Elias (Gates Foundation).
https://www.who.int/publications/m/item/co-chairs-outcome-statement
Meeting report 26 March. 3 pages, well worth scanning.
“Chinese vaccine makers Sinopharm and Sinovac have presented data on their COVID-19 vaccines indicating levels of efficacy that would be compatible with those required by the World Health Organization, the chair of a WHO advisory panel said on Wednesday. The WHO’s Strategic Advisory Group of Experts (SAGE) hopes to issue recommendations on those vaccines by the end of April, its chair Alejandro Cravioto, told a news briefing. The vaccines would first require WHO emergency use listing.”
https://www.ft.com/content/040e867b-a0d1-4e6a-9a58-888da31a220c
“Julphar deal with G42 will allow Gulf state to accelerate global supply plan.” The #UAE will be the hub for #China's production of Sinopharm vaccines in the Middle East.
Overview as of 29 March. “Chinese vaccine deliveries to Africa appear to have picked up pace over the past week. In all, China says it has distributed 260 million doses worldwide…”
“Restrictions on exporting COVID-19 vaccines in India have left countries wondering what to do with doses they’ve already received through the global COVAX initiative. “The uncertainty around vaccine timing changed the plans and slowed down the vaccine rollout … …. “
“Questions around the timing of future shipments leave countries with the dilemma of whether to administer all the doses already in their possession now, in the hope that more batches will arrive in time for people to receive their second shots. The second dose of the vaccine should be administered between four and 12 weeks after the first. Alternatively, each country could vaccinate a smaller group of people than originally planned to ensure enough supplies for the second doses, Ba-Nguz said. … … Africa is heavily dependent on vaccines from COVAX. In the region, 28 countries have already received 16 million doses from the facility, according to the World Health Organization. Of these doses, countries have only administered about 1.8 million, according to a chart that Ba-Nguz presented. “
“More than half of worldwide vaccine doses have been administered in just four countries — India, China, the U.K. and the U.S. That kind of inequity will "extend the pandemic, globally," says Tom Bollyky, director of the Global Health program at the Council on Foreign Relations. …”
https://healthpolicy-watch.news/nigeria-ditches-astrazeneca/
“The Nigerian government has quietly ditched the AstraZeneca COVID-19 vaccine meant to vaccinate tens of millions of citizens, and will gradually shift to the Johnson & Johnson’s one-shot vaccine, saying it is easier to administer. Documents from the Nigerian Primary Healthcare Development Agency (NPHCDA) obtained by Health Policy Watch show that the agency intends to begin rolling out the J&J vaccine to almost 30 million people as soon as it can obtain the vaccine supplies. While denying that safety concerns are an issue, the Nigerian government’s move also comes amidst growing global concerns about AstraZeneca’s efficacy against the SARS-CoV2 virus variant first identified in South Africa, as well as safety concerns that have led to the suspension of AstraZeneca vaccines for people under the age of 60 in Germany, and elsewhere ….”
“Well over three-quarters of the more than half billion vaccine doses that have been administered so far have been used by the world’s richest countries. The reason, experts say, lies in how — and when — deals for doses were struck.” With very formative nice visualizations & timelines.
See tweet Alexandra Phelan: “The world's wealthiest countries have administered 86% of vaccine doses. Only 0.1% of doses have been administered in low-income countries. The cause: Advance Purchase Agreements. A multilateral legally-binding mechanism is urgently needed.”
“The World Bank supports the call for a people’s vaccine that is free to all at the point of use. The bank also supports calls for transparency in the decisions taken in countries with regard to COVID-19 vaccinations to reduce information barriers, and permit scrutiny and monitoring. But its senior health official [i.e. M Pate] also underscored the importance of respecting governments’ decisions on how best to roll out their vaccination campaigns….”
Links:
BMJ Global Health Commentary - Intellectual property rights need to be subverted to ensure global vaccine access (by S Sariola)
Reuters - Russia's RDIF signs deal to produce Sputnik V vaccine in China
Reuters - BioNTech-Pfizer raise 2021 vaccine output goal to 2.5 billion doses
“BioNTech said on Tuesday that it and partner Pfizer expect to increase manufacturing capacity of their COVID-19 vaccine to 2.5 billion doses by the end of 2021, after bringing a new German facility on stream.” (up from 2 billion)
C Krubiner et al; CGD
“… While the evidence of disruptions to essential health services was largely anecdotal to begin with, and its health effects mostly modeled, increasingly detailed evidence is beginning to emerge from countries (see our recent blog looking at claims data from the Philippines). Over the past year we partnered with researchers in Kenya, the Philippines, South Africa and Uganda to document, from a whole-of-health perspective, what we know about the nature, scale, and scope of the disruptions to essential health services in those countries, and the health effects of such disruptions. Today we release working papers from each country team (the papers are available here: Kenya, the Philippines, South Africa, Uganda). …”
“… Each of the four countries experienced disruptions—consistent with the pulse surveys conducted by WHO and UNICEF—but the disruptions varied in terms of which services, where, who was affected, and most importantly, the degree and duration of the disruptions…”
https://www.publiceye.ch/fileadmin/doc/Medikamente/2021_PublicEye_BigPharmaTakesItAll_Report.pdf
“How pharmaceutical corporations profiteer from their privileges – even in a global health crisis like COVID-19.” Check out their 10 strategies for cashing in.
“Covid-related demonstrations have been held in at least 86 countries in the past year.” (The focus of) Demonstrations tended to be different though, in various continents.
https://www.ajtmh.org/view/journals/tpmd/104/3_Suppl/article-p1.xml
Editorial of a Supplement - Pragmatic Recommendations for the Management of Hospitalized COVID-19 Patients in Low- and Middle-Income Countries
“… To address the need for guidance on severe COVID-19 management in resource-limited settings, a COVID–LMIC Task Force was formed, comprising doctors and nurses with experience in critical care in LMICs. These members are either based in LMICs or have worked there extensively out of their home institutions in HICs. The group reviewed the current literature on a wide range of aspects of the management of severe COVID-19, focusing on evidence generated in the target countries. From this review, and supplemented with local expert experience, the group formulated an evidence-informed set of pragmatic recommendations targeting the LMIC bedside practitioner. This led to a set of 10 articles presented as a supplement to the AJTMH. …”
https://www.graduateinstitute.ch/vaccines-RD
New resource on #Covid19 vaccine R&D investments aiming to shed light on the distribution of risks and potential rewards that may influence global access to Covid-19 #vaccines.
“…The preliminary findings show that publicly available announcements of R&D investments are primarily generated by public sources (98.12% of the USD 5.9bn tracked), with substantial information gaps regarding R&D investments from pharmaceutical companies. The United States and Germany are by far the largest investors in vaccine R&D, and the Coalition for Epidemic Preparedness Innovations (CEPI) was the third largest investor in vaccine R&D (with 22% of all investments channeled through CEPI). Private companies and academic groups such as Moderna, Johnson & Johnson, BioNTech/Pfizer, CureVac and the University of Oxford represent the primary recipients of R&D funding. R&D investments for Covid-19 vaccines are concentrated in a relatively small number of high-income countries, with Western European countries, the United States, and Canada accounting for most of the funds received, with India, China, Nigeria, and Indonesia representing important exceptions.”
“Many are concerned about side effects, and want to wait and see if the vaccine is safe.”
“…Around the globe, women are more reluctant to be vaccinated than men, according to a massive global survey of five million people in 100 countries (among responses in the last six weeks). Administered by Carnegie Mellon and the University of Maryland with Facebook's support, it found the difference in many regions of the world, with only a few exceptions. We see these gendered patterns in both places where overall vaccine hesitancy is low and where it is high….”
“… The new ReAct report “Ensuring sustainable access to effective antibiotics for everyone, everywhere – How to address the global crisis in antibiotic Research and Development” includes a comprehensive summary and critical evaluation of recent initiatives to overcome the barriers to achieve sustainable access to antibiotics. As antibiotic resistance will continue to develop as long as we depend on these medicines to treat bacterial infections, a continuous supply of new effective antibiotics is needed.”
“The report identifies five key challenges that must be solved in order to achieve sustainable access for all, and charts out options for governmental action in response to each of them….”
https://healthpolicy-watch.news/dndi-strategy-for-the-decade/
“Global health experts expressed their frustration with the lack of research and attention towards neglected tropical diseases and vulnerable populations and have called for the advancement of sustainable health systems. Speaking at the launch of the strategic plan of Geneva-based Drugs for Neglected Diseases initiative (DNDi) on Tuesday, DNDi Executive Director Bernard Pécoul said greater emphasis should be placed on expanding access and developing treatments for patients in low- and middle-income countries (LMICs) affected by neglected tropical diseases (NTDs) and viral diseases, including pandemic-prone and climate-sensitive diseases. “Treatments were abandoned for years or decades because they fell outside commercial markets,” said Pécoul, at the launch of the plan that charters an eight-year journey to 2028, aiming to deliver 15 – 18 additional treatments, for a total of 25 treatments. … …. DNDi, a WHO-supported organization of private and public sector actors, has committed to five strategic imperatives for the next eight-years: deliver new treatments and expand access for neglected patients for NTDs and viral diseases; join with public health leaders and Research and Development (R&D)stakeholders in low- and middle-income countries to advance sustainable health systems; contribute to building a proactive agenda for maternal, child health, and gender-responsive R&D; champion open science and transparency; and leverage new technologies to accelerate R&D. …… In addition to working NTDs and viral illnesses, DNDi will also address unmet medical needs, utilizing its ‘dynamic portfolio’ approach to explore new interventions in diseases with clear R&D gaps, including snakebite, dengue fever, schistosomiasis, and pandemic-prone diseases. …” “Att the start of their strategic plan period, DNDi is coordinating ANTICOV – the largest African-led clinical trial testing for mild-to-moderate COVID-19. …”
H C Karamagi et al ; https://gh.bmj.com/content/6/3/e004618
“…We present an approach to provide countries with information on the functionality of their health systems in a manner that will facilitate movement towards universal health coverage. We conceptualise functionality of a health system as being a construct of four capacities: access to, quality of, demand for essential services and its resilience to external shocks. We test and confirm the validity of these capacities as appropriate measures of system functionality. We thus provide results for functionality of the 47 countries of the WHO African Region based on this. The functionality of health systems ranges from 34.4 to 75.8 on a 0–100 scale. Access to essential services represents the lowest capacity in most countries of the region, specifically due to poor physical access to services. Funding levels from public and out-of-pocket sources represent the strongest predictors of system functionality, compared with other sources. By focusing on the assessment on the capacities that define system functionality, each country has concrete information on where it needs to focus, in order to improve the functionality of its health system to enable it respond to current needs including achieving universal health coverage, while responding to shocks from challenges such as the 2019 coronavirus disease….”
A Subramaniam et al ; Project Syndicate
Hard-hitting piece. “ Development economics focuses on improving the well-being of billions of countries, but the Global South is severely underrepresented in the field. A small number of rich-country institutions dominate, and their growing use of randomized controlled trials in research is entrenching the imbalance….”
By Tammam Aladat (senior strategic adviser to MSF in Geneva). Well worth a read.
https://decolonise.health/in-global-health-only-the-rich-shall-learn-e29d9e2c7d4b
Another must-read from Tammam Aladat. Among others, pointing out the ridiculous amount of money you have to pay for a tuition fee for a Masters degree in London School of Hygiene and Tropical Medicine, or any other global health institute in the North.
S Atkins et al ; https://gh.bmj.com/content/6/4/e005649
« The COVID-19 pandemic has changed how we live, work and communicate. Global health teaching is no exception. Across universities, professors like us have had to quickly redesign our courses, and deliver them virtually, even as the pandemic continues to bring new challenges every day. Out of that struggle, new learning opportunities have emerged. This editorial, coauthored by 20 professors in seven high-income countries (HICs), aims to synthesise our learnings and insights from over 25 courses we taught (or are currently teaching) … … Our collective experience suggests that despite the pandemic chaos and fatigue, global health teaching can be improved (box 1) by using COVID-19 as a teachable moment to focus on equity and human rights as a central theme, and by integrating anti-racism and anti-oppression as core content and orientation in our curriculum. The online format allows instructors to centre voices from the Global South, Indigenous scholars, and individuals with lived experience of oppression and resilience. Remote teaching also helps us reach wider and diverse audiences, including groups that may not be enrolled in traditional degree programmes. Learning from COVID-19, which is widening disparities within and across countries, global health teaching must educate students to address health disparities wherever they occur, not just in LMICs…”
You might also want to read another BMJ GH Editorial (by A Ghaffar et al) - Public health education post-COVID-19: a proposal for critical revisions.
https://www.tandfonline.com/doi/abs/10.1080/13563467.2021.1899153?journalCode=cnpe20
New paper by Jason Hickel et al. “This paper quantifies drain from the global South through unequal exchange since 1960. According to our primary method, which relies on exchange-rate differentials, we find that in the most recent year of data the global North (‘advanced economies’) appropriated from the South commodities worth $2.2 trillion in Northern prices — enough to end extreme poverty 15 times over. Over the whole period, drain from the South totalled $62 trillion (constant 2011 dollars), or $152 trillion when accounting for lost growth. Appropriation through unequal exchange represents up to 7% of Northern GDP and 9% of Southern GDP….” “..”Regardless of the method, we find that the intensity of exploitation and the scale of unequal exchange increased significantly during the structural adjustment period of the 1980s and 1990s…”
And a link: (JAMA) Editor sidelined after medical journal racism podcast outcry (AP)
https://healthsystemsglobal.org/global-symposia/hsr2022/
And https://healthsystemsglobal.org/news/share-your-ideas-on-a-theme-for-hsr2022/
This week, the final stage of HSR2020 (closing ceremony) took place, among others with Fadi El-Jardali giving an overview of the key messages & lessons learnt. Next stop: Bogota 2022!
Deadline for sharing your ideas for a theme: 23 April.
“The Seventh Global Symposium on Health Systems Research (HSR2022) will be held in Bogotá, Colombia. HSR2022 will welcome around 2,000 delegates between 31 October and 4 November 2022. …” “..Local hosts include the Pontificia Universidad Javeriana, headquartered in Bogotá and Cali, the Universidad de Antioquia in Medellín, the Universidad de Cartagena, the Universidad Colegio Mayor Nuestra Señora del Rosario, and the San Ignacio University Hospital in Bogotá, in coordination with the Ministry of Health and Social Protection of the Republic of Colombia. “
(Gated) “Despite large amounts of taxpayer funding, dozens of the largest U.S. universities failed to commit to policies ensuring that essential medicines and health technologies generated by their labs would be equally accessible around the globe, a new analysis finds. Of the 60 universities examined, only 22 % committed to specific global access licensing strategies and just 12 % adopted licensing that places a priority on generic production of medicines for lower-income countries, according to the Universities Allied Essential Medicines, an organization led by medical students who seek to improve affordable access worldwide. …”
Polio: Guardian - Three female health workers shot dead in east Afghanistan
S Smith, J Shiffman et al; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00691-7
“The global health agenda is ill-defined as an analytical construct, complicating attempts by scholars and proponents to make claims about the agenda status of issues. We draw on Kingdon’s definition of the agenda and Hilgartner and Bosk’s public arenas model to conceptualize the global health agenda as those subjects or problems to which collectivities of actors operating nationally and globally are paying serious attention at any given time. We propose an arenas model for global health agenda setting and illustrate its potential utility by assessing priority indicators in five arenas, including international aid, pharmaceutical industry, scientific research, news media and civil society. We then apply the model to illustrate how the status of established (HIV/AIDS), emergent (diabetes) and rising (Alzheimer’s disease) issues might be measured, compared and change in light of a pandemic shock (COVID-19)….”
Check out the – somewhat surprising – results.
M Marmot et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00710-8/fulltext
“…. the Commission on Social Determinants of Health in the Eastern Mediterranean was charged with assembling the evidence on social determinants of health and on inequities in health within and between countries and to make recommendations. The Commission was convened in 2019 by the WHO Regional Office for the Eastern Mediterranean in collaboration with the Institute of Health Equity at University College London and the Alliance for Health Policy and Systems Research, Geneva. The Commission's report Build Back Fairer: Achieving Health Equity in the Eastern Mediterranean Region was published on March 31, 2021…”
You find the full report here: Build Back Fairer: Achieving Health Equity in the Eastern Mediterranean Region.
https://cdn.odi.org/media/documents/Delivering-Global-Reset-ODI2021.pdf
“In ODI’s sixtieth anniversary year we set out to challenge decision-makers and thought leaders to think differently about global challenges. … “ With 5 key conclusions & recommendations.
N Ismail et al ; https://gh.bmj.com/content/6/3/e004252
« Worldwide, approximately 11 million people are currently being held in prison, a number that has steadily grown since the turn of the 21st century. The prison population is more likely to suffer from physical and mental ailments both during and prior to their imprisonment due to poverty, social exclusion and chaotic lifestyles. Recognition of people in prison is noticeably absent from the Sustainable Development Goals (SDGs), despite the goals’ ethos of ‘leaving no one behind’. We present the first analysis of how improving the health of people in prison can contribute to achieving 15 SDGs. Relevant indicators are proposed to fulfil these goals while meeting the existing international prison health standards. We also assess the political, economic and social challenges, alongside the unparalleled COVID-19 pandemic that can thwart the realisation of the SDGs. To reach the ‘furthest behind first’, prison health must be at the forefront of the SDGs. »
M Ulrichs et al ; https://health.bmz.de/studies/a-systems-perspective-on-universal-social-protection/
For the short version (2-pager), see here.
M Van Schalkwyk, M McKee, M Petticrew et al; https://onlinelibrary.wiley.com/doi/abs/10.1111/1468-0009.12508#.YGL4RHm82z0.twitter
“…In this Perspective, building on the increasingly loud voices of countermovements, we set out an agenda for action that challenges the structures, institutions, and ideas that must be reclaimed, rebuilt, and strengthened to achieve just and flourishing societies living in partnership with a thriving planet. Our agenda has four elements: (1) creating new and better ways of making decisions, (2) reclaiming ideas and institutions for the common good, (3) challenging the discourses defined by the powerful, and (4) rebuilding global solidarity.
PS: also in the Milbank Quarterly - The Commercial Determinants of Three Contemporary National Crises: How Corporate Practices Intersect With the COVID‐19 Pandemic, Economic Downturn, and Racial Inequity
With focus on the US.
Max Roser ; https://qrius.com/how-much-economic-growth-is-necessary-to-reduce-global-poverty-substantially/
PS: Max Roser is the guy behind ‘The World in Data’.
“Billions of people in the world are living in poverty. Adjusted for the purchasing power in each country, 85% of the world population live on less than $30 per day. … … Most people in the world live in countries in which more than 90% live on less than $30 per day…”
“…The minimum necessary growth to reduce global poverty to the level of poverty in Denmark is 410%. An increase by 100% would mean that the size of the economy would double. A 410% increase is therefore a 5.1-fold increase of the global economy. Or put differently, a world economy with substantially less poverty is at a minimum 5-times bigger than today’s global economy….”
PS: “In considering this challenge you might come to the conclusion that it is impossible to decouple economic growth from environmental impact. If this is the conclusion that you arrive at, then you have to decide whether you are willing to accept large environmental impacts or whether you are willing to accept widespread global poverty. Or you consider this challenge and you come to the opposite conclusion – that it is possible to decouple growth from environmental harm….”
R Perry et al ; https://www.globaldashboard.org/2021/03/29/big-elephants-and-small-islands-getting-beyond-the-new-aid-orthodoxy/
“…Marta Foresti writes, there is a need to “bring development inside policy conversations not about poor countries but about global challenges…You don’t begin with development; you begin with climate, conflict and security, mobility, international crime.” Similarly, as Kate Raworth articulated in a recent tweet, “every country – whether rich or poor – is a ‘developing country’, with social shortfall &/or ecological overshoot.” What is required, therefore, is a more complete understanding of the drivers of global poverty and insecurity – one that includes wealthy donor countries in its diagnostic frame. So while the growing momentum for reform of international aid, particularly through localising its delivery, may be a step in the right direction, it is a small one that misses the forest for the trees. This article will suggest how we might initiate a shift in focus by placing the real impediments to equitable development – those that exist outside of ‘recipient’ states’ domestic circumstances – at the heart of the conversation. Changing how we think about where the power to affect change is located is the first step to reforming our practices….”
Crowd-sourced list. “In this crowd-sourced compilation, I have curated a list of 30+ blogs and media platforms that accept and publish blog posts and op-eds. This list does NOT include well known international newspapers or magazines (e.g. NYT, WSJ, Washington Post, Guardian, TIME, Forbes, Atlantic, New Yorker), nor does it include traditional global health or medical journals (e.g. Lancet, BMJ Global Health, PLOS)….”
“Give a country a vaccine and they will vaccinate for a day. Teach a country how to manufacture vaccines and they will be vaccinated for a lifetime.”
“Excellent observations by @PeterASinger. Key Priority For @wto : intellectual property regime currently in place needs to be revisited to take into account reality that public moneys are helping fund R&D and production of new vaccines and drugs, as with COVID-19 vaccines.” “If @wto fails to revamp “poorly designed international intellectual-property regime”, COVID-19 vaccine supply constraints will persist while public moneys will subsidize high financial returns of pharmaceutical companies. “
(on the world leaders pleading for a pandemic treaty)
“After they screwed up and undermined efforts to make covid-19 vaccines fairly and equitably available globally, why would we trust them with designing a global treaty to protect all of us? Capitalism, nationalism and greed do not protect against pandemics.”
(also tweeting on the world leaders’ proposal for a pandemic treaty)
“The hypocrisy is breathtaking. We need you to stop hoarding vaccines and protecting big Pharma, not present platitudes. #peoplesvaccine now.”
“'Global health' pays! Christopher J L Murray @IHME_UW - 8th highest paid public employee in #WashingtonState & highest paid professor. The central question does not concern the merits of his academic work (which one may well discuss!) - but how this is possible. @gatesfoundation”
(re the polarization around the WHO/China report on the origins of Sars CoV2)
“Tricky moment, given US and EU ongoing sanctions and counter-sanctions over human rights in China...let's see what comes to light”.
Reacted to Sara:
“Agreed. This is global high-politics at this point. Hard for @WHO to gain leverage in this kind of highly charged context. Maybe it's time to let WHO focus on the rest of the response and let member states lead on this hugely political study.” (see also an op-ed by him on CNN ).
“We need to talk about how these mRNA vaccines are proving fantastic, with emerging evidence suggesting they’re better than the alternatives, including against common variant in southern African countries, but are not available to most low- mid-income countries.”
IMF/WB Spring meetings (5-11 April) & World Health Day (7 April)
https://www.who.int/news-room/events/detail/2021/04/13/default-calendar/fair-pricing-forum-2021
“…This meeting is the third forum that focuses on improving access to medicines and health products through fair pricing, following the inaugural forum held in the Netherlands in 2017 (10–11 May) and the second forum in South Africa in 2019 (11-13 April)….”
Link:
Devex - Opinion: Will rich nations finally deliver solutions to the debt crisis? By Eurodad authors. Analysis ahead of the Financing for Development Forum (mid-April).
https://www.devex.com/news/in-brief-pandemic-drives-reform-at-imf-georgieva-says-99543
(gated) “The International Monetary Fund must change the way it operates and serves its clients, says Managing Director Kristalina Georgieva ahead of the World Bank Spring Meetings.”
https://odi.org/en/publications/odi-strategy-2021-2025/
ODI’s new global strategy (11 p). “ODI will evolve to make the focus on equity, inclusive growth, social justice and sustainability even more central to what we do. “ Looks great.
https://www.devex.com/news/un-food-systems-summit-moves-ahead-as-some-express-skepticism-99531
“As momentum builds around the United Nations’ 2021 Food Systems Summit, some in civil society say efforts to include farmers and food producers in event preparations are not going far enough. The first-ever summit is designed to unite multiple sectors around food systems transformation in the final decade of the 2030 Sustainable Development Goals. It will take place on the sidelines of the U.N. General Assembly in New York City in September, while a pre-summit gathering in Rome during July aims to galvanize new commitments and mobilize new financing and partnerships….”
S Daws; https://www.chathamhouse.org/2021/03/rebuilding-trust-central-uns-future
“António Guterres is under scrutiny as he prepares to report on the future of the United Nations, with a renewed focus on trust, resilience and prevention.”
The themes in this Comment are explored further in the forthcoming synthesis paper ‘Reflections on building more inclusive global governance: Ten insights into emerging practice’.
“The U.K. government's preexisting aid budget commitments mean that it will have less than £4 billion ($5.5 billion) to spend on bilateral projects, even in its priority areas, according to an analysis by the ONE Campaign, an anti-poverty group. That constitutes a 63% drop since 2019. ONE warned that the U.K. government’s decision to reduce its aid spending to 0.5% of national income risked “severe consequences,” including for humanitarian aid and girls’ education, which were identified as priority areas by the Foreign, Commonwealth & Development Office….”
M Gavas et al ; https://www.cgdev.org/blog/redesigning-global-europe-eus-neighbourhood-development-and-international-cooperation
“EU member states and the European Parliament’s Foreign Affairs and Development Committees finally approved the new Neighbourhood, Development, and International Cooperation Instrument (NDICI)—Global Europe. The instrument, worth €79.5 billion over the period 2021-2027, marks a profound transformation of EU development policy and spending….”
Lancet Commission on Covid-19 Vaccines and Therapeutics Taskforce members; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00140-6/fulltext
“Several global efforts are underway to develop COVID-19 vaccines, and interim analyses from phase 3 clinical testing have been announced by nine organisations: Pfizer, the Gamaleya Research Institute of Epidemiology and Microbiology, Moderna, AstraZeneca, Sinopharm Group, Sinovac Biotech, Johnson & Johnson, Novavax, and CanSino Biologics. The US programme known as Operation Warp Speed provided US$18 billion in funding for development of vaccines that were intended for US populations. Depending on safety and efficacy, vaccines can become available through mechanisms for emergency use, expanded access with informed consent, or full licensure. An important question is: how will these Operation Warp Speed vaccines be used for COVID-19 prevention in global health settings? We address some key questions that arise in the transition from US to global vaccine prevention efforts and from ethical and logistical issues to those that are relevant to global vaccine security, justice, equity, and diplomacy.”
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00771-6/fulltext
“The UK Health Security Agency replaces Public Health England, with a renewed emphasis on protection. Jacqui Thornton reports.”
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00772-8/fulltext
“EU4Health, a €5·1 billion project spurred by the COVID-19 pandemic, aims to strengthen the response to health crises and challenges across Europe. Udani Samarasekera reports. EU4Health, the EU's ambitious health programme for 2021–27, has become a reality, coming into force on March 26. Dedicated funding of €5·1 billion has been agreed for the project, which aims to protect citizens from cross-border health threats, make medicines more accessible and affordable, and build resilient health systems in the EU. The programme is the EU's response to the COVID-19 pandemic…”
“Sidibé was appointed as the African Union Special Envoy for the African Medicines Agency (AMA). … Sidibé will serve as the African Union Special Envoy for the AMA supporting the signing and ratification of the AMA Treaty by African Union Member States….”
See also last week’s IHP newsletter.
Related tweet Rob Yates: “New World Bank health financing paper. NO mention of user fees and hardly anything about insurance. Good!”
“Such losses cannot be offset by planting more trees at home.”
“…For all their tree-planting efforts at home, rich countries continue to contribute, through their consumption, to the levelling of vast tracts of forests in poor ones. A study, published on March 29th in Nature Ecology & Evolution, reveals the extent and location of the world’s “deforestation footprint”. …”
“Calls for forests to be high on Cop26 agenda after loss of 42,000 sq km of tree cover in key tropical regions.”
C Elias, J Nkengasong et al ; https://www.nejm.org/doi/full/10.1056/NEJMp2034517
Helicopter view of what happened after Ebola in West-Africa (among others, the launch of CEPI, and the launch of the Global Preparedness Monitoring Board (GPMB) by the WHO and the World Bank Group, …) and what should be done to prepare for the GHS future.
https://www.mcgill.ca/tb/files/tb/quality_tb_care_ebook.pdf
Edited by M Pai & Z Temesgen.
“A man in Africa who developed Ebola despite receiving a vaccine recovered but suffered a relapse nearly six months later that led to 91 new cases before he died. The case, outlined in the New England Journal of Medicine on Wednesday, adds to evidence that the deadly virus can lurk in the body long after symptoms end, and that survivors need monitoring for their own welfare and to prevent spread….”
Links:
Lancet (Health Policy) - Eliminating postnatal HIV transmission in high incidence areas: need for complementary biomedical interventions
“…Urgent action is needed to evaluate and implement additional preventive biomedical strategies in high HIV prevalence and incidence settings to eliminate MTCT from breastfeeding. Preventive strategies include: pre-exposure prophylaxis in breastfeeding women who have an increased risk of acquiring HIV; postnatal reinforcement strategies, such as maternal retesting for HIV, maternal care reinforcement, and prophylaxis in infants exposed to HIV via breastmilk; and active (vaccine) or passive immunoprophylaxis with long-acting broadly neutralising antibodies.”
The Conversation - Ebola might be a chronic infection – but here’s why we shouldn’t panic (by C Bamford)
https://www.bmj.com/content/372/bmj.n549
“Pablo Monsivais and colleagues reflect on the evidence for interventions to improve access to healthy food and discuss considerations for evidence generation.”
N Rose; https://www.ijhpm.com/article_4024.html
“Critical scholars agree that contemporary globalised and industrialised food systems are in profound and deepening crises; and that these systems are generative of accelerating multiple crises in the earth’s life systems. Why and how did we arrive at this point? This paper argues that, conceiving each individual human as one cell in the greater human body, we are afflicted by what John McMurtry termed ‘the cancer stage of capitalism.’ This provocative framing is adopted here in response to growing calls by climate, earth and physical scientists not to ‘mince words’ in the description and analysis of humanity’s current predicament, but rather ‘tell it like it is.’…”
And via Stat: “A large global study of stroke care early in the pandemic has found a marked decline in strokes and stroke treatments from March through June 2020. Even though strokes have been linked to the inflammatory effects of Covid-19, the falloff was also seen in hospitals with few Covid patients….”
S Igras et al ; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czab028/6199133?searchresult=1
“Over the past 25 years, there has been significant progress in increasing the recognition of, resources for, and action on adolescent health, and adolescent sexual and reproductive health (ASRH) in particular. As with numerous other health areas, however, many of the projects that aim to improve ASRH are implemented without well-thought-out plans for evaluation. As a result, the lessons that projects learn as they encounter and address policy and programmatic challenges are often not extracted and placed in the public arena. In such cases, post-project evaluation (PPE) offers the possibility to generate learnings about what works (and does not work), to complement prospective studies of new or follow-on projects. To fill the gap in the literature and guidance on PPE, the World Health Organization developed The project has ended, but we can still learn from it! Practical guidance for conducting post-project evaluations of adolescent sexual and reproductive health projects. This article provides an overview of the guidance by outlining key methodological and contextual challenges in conducting PPE, as well as illustrative solutions for responding to them.”
(gated) “New research from the International Women’s Development Agency suggests organizations advocating feminist foreign policies may need to rethink their approach….”
https://foreignpolicy.com/2021/03/26/biden-global-women-gender-health-feminist-foreign-policy/
“Biden’s push for gender equality is a huge change from Trump, but experts stop short of calling it a feminist foreign policy….”
Clare Wenham on the likely gender aspects of Covid vaccine passports.
Link:
Globalization & Health - Democratic South Africa at 25 – a conceptual framework and narrative review of the social and structural determinants of adolescent health (by T Jacobs & A George)
Link:
“American taxpayers may have provided $162 million toward researching remdesivir, but the federal government does not have patent rights for the drug because the work contributed by U.S. scientists did not generate any inventive new uses, according to a government report….”
Links:
https://www.weforum.org/reports/global-gender-gap-report-2021
“Another generation of women will have to wait for gender parity, according to the World Economic Forum’s Global Gender Gap Report 2021. As the impact of the COVID-19 pandemic continues to be felt, closing the global gender gap has increased by a generation from 99.5 years to 135.6 years.”
https://www.statnews.com/2021/03/30/google-cloud-health-care-studio/
(gated) “If the pieces come together, Google will be as omnipresent in health care as it is on the internet — a new gateway that will offer faster, easier access to information and insights on patients in a $8.5 trillion global industry….”
https://www.theguardian.com/us-news/2021/mar/26/democrats-missile-funds-vacccine-development
“Congressional Democrats are introducing legislation to transfer $1bn in funding from a controversial new intercontinental ballistic missile to the development of a universal Covid vaccine….”
“Covid-19 has and continues to have devastating impacts on lives around the world with implications for global progress towards the Sustainable Development Goals. As the world looks to recover from the pandemic, the latest IDS Bulletin considers what lessons there are from the crisis and the opportunity to ‘re-build back better’, so people who live in poverty or who are marginalised are not left behind. Through a range of analyses and focused case studies, ‘Building a Better World: The Crisis and Opportunity of Covid-19’ provides evidence from countries including India, Sierra Leone, Kenya and Ethiopia on the impact of the pandemic on universal development challenges. These include health systems, food equity, social protection, gender equality and local governance….”
https://healthpolicy-watch.news/pakistan-plan-for-private-vaccines-is-on-hold-over-price-dispute/
“A controversial plan to sell Russia’s Sputnik V COVID-19 vaccine to wealthy citizens in Pakistan has been put on hold following a dispute between the government and the private pharmaceutical company involved over the vaccines’ sale price, Health Policy Watch has learned….”
https://healthpolicy-watch.news/kenya-goes-into-partial-lockdown/
Third wave in Kenya.
“Undercounting or ignoring cases of the disease on the continent could lead to new variants that might derail efforts to end the pandemic.”
You can imagine this was “news”.
In the US. “Extremist organizations are now bashing the safety and efficacy of coronavirus vaccines in an effort to try to undermine the government.”
R Forman; https://www.sciencedirect.com/science/article/pii/S0168851021000853
“Significant global interest exists around generation of safe and effective COVID-19 vaccines. Addressing eleven challenges (among many others) could greatly benefit COVID-19 vaccine policies. These challenges fall under three dimensions – vaccine development, dissemination, and deployment….”
https://www.devex.com/news/how-embassies-are-tackling-covid-19-vaccinations-99505
“Criticism erupted in Kenya after Reuters reported the country had offered some of its COVAX Facility-supplied COVID-19 vaccines to between 25,000 and 30,000 diplomats, United Nations workers, and their families living in the country….”
“… Countries are taking different approaches as to whether or not to supply their employees abroad with vaccines and whether to prioritize high-risk groups or blanketly vaccinate. Some countries are shipping vaccines to their embassies, while others are working with host countries to integrate their citizens into national vaccination plans. And some are leaving it up to citizens to get vaccinated the next time they visit their home country….”
https://www.nejm.org/doi/full/10.1056/NEJMp2103313?query=featured_secondary
“…As we have learned from the HIV pandemic, biomedical advances alone are insufficient to sustainably control a pandemic. Considerations related to health infrastructure, local epidemiology, and responsiveness to local concerns and beliefs are critical for ending the Covid-19 pandemic — not only in Africa, but also globally….”
https://www.bmj.com/content/373/bmj.n879
“A preliminary study, which compared case fatality rates in Manaus’s first wave of cases in April to May 2020 with the second wave in January 2021, found that deaths among people aged 20-39 were 2.7 times higher in the second wave than in the first. In the general population they were only 1.15 times higher. “If overload was the reason for the increase in the case fatality rate, it would be reasonable to expect that the increase would be similar for different ages and genders,” said André Ricardo, epidemiologist at the Leopoldo Mandic School of Medicine in São Paulo and one of the study’s authors. “P.1 appears to be more lethal among young men and women than the original strain.” “
Links:
NYT - The Pfizer-BioNTech Vaccine Is Said to Be Powerfully Protective in Adolescents.
Julie Buser et al ; https://www.ajtmh.org/view/journals/tpmd/aop/article-10.4269-ajtmh.20-1603/article-10.4269-ajtmh.20-1603.xml
“Limited research about nursing mentorship in low- and middle-income countries (LMICs) is holding science back. This article describes the strengths and challenges associated with global health research mentorship for doctorally prepared nurses whose scholarship focuses on LMICs. Using reflexive narrative accounts from current and former nurse mentors and nurse mentees who participated in a NIH-funded global health doctoral research program, emerging themes revealed the perspectives of mentors and mentees, producing a global health mentoring model for nursing research mentorship relevant to LMICs. Identified themes, which applied across roles and primary affiliations, included 1) collaborative mentor–mentee relationships and 2) enthusiasm for global health nursing. Our global health nursing research mentor–mentee interaction systems conceptual model focuses on nursing science mentoring in LMICs incorporating interpersonal, institutional, and cultural factors….”
T Beia et al ; https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01428-z
“…We examine literature focused on the ‘missing men’ in global health research, in particular empirical studies that document interventions, programmes, and services targeting men’s health issues in Sub-Saharan Africa. Within these studies, we identify dominant conceptualisations of men and men’s health and how these have influenced the design of men’s health interventions and services….”