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Dear Colleagues,
As summer has arrived in my country, let me keep it relatively light in this week’s intro, in spite of a(n invariably) dire world situation, unfortunately. You’ll find the usual updates on the two-speed pandemic in the newsletter, with increasingly a “post-pandemic” atmosphere in some (vaccine-rich) countries in the North, while elsewhere, amongst others due to the rapidly spreading Delta variant, the situation remains very grim. By now, many citizens in the South are rightly angry about the vaccine and other inequities, and the cynical role played by some Western countries in this. Global health observers are increasingly urging global policy makers to accelerate timetables to vaccinate the world’s LMICs by the end of this year (instead of end of 2022). We’ll need a miracle for that. And oh yes, before we forget it, the climate emergency is also “back” (well, in Northern public opinion) from never really having gone. But so far most of our leaders still don’t treat it as the emergency it is. Neither do most of us, from what I can tell.
Anyway. Yesterday, after months of diligently working from home, I commuted again to Antwerp for the first time. Colleagues seemed to appreciate my ‘Nick Cave’ hairstyle, but for me this was probably the final hint I needed to go see a hairdresser before they start calling me “Slash”. As some of you will know, while I remain a global health afficionado, these days the European Football Championship gets a fair amount of my attention as well, even if I haven’t nearly seen as many games as I would have liked to. Some of the (many?) football fans among you might wonder, though, is there any resemblance between international football and Covid (responses) ?
Well, for a start, although trends also come and go in international football (Total Football, tiki taka, Gegenpressing, …) like in the global health discourse (diagonal approaches, UHC, GHS, …), some of the basics remain true. While an intimidating anthem is just a ‘nice to have’, without a strong defense (“comprehensive PHC”), you’re basically toast. Ask the French. Among others, assertive defending (“surveillance & contact tracing”) is key, especially on the star players before they can work their magic (“rapid response”) (see Thomas “The Verminator” Vermaelen on Ronaldo). More in general, aggressive Gegenpressing by the whole team seems a must in 2021. Strict ‘border control’ in the penalty area remains a plus, but that hasn’t really changed since catenaccio times. Doesn’t mean you have to be as vicious as some of the Portuguese defenders, though, who at times gave the impression they wanted to take out some of the Belgian star players altogether ( taking a leaf from some nutcases on social media who love to “tackle” top virologists (Fauci, Van Ranst, …)). And not because KDB et al don’t pay enough taxes.
There was a whiff of global solidarity (towards the unfortunate Eriksen from Denmark), at the start of the tournament, but most countries are now firmly back in a nationalist mood (with some of the English “starring”). And just like with the “failed” Global Health Security Indices, some of the so called “favorites” in the tournament are already home now ( or, if you want, “à la maison” 😊). The French managed to unite the European Union for an entire evening (quite a feat in the year 2021); more in general, the whole ‘Group of Death’, with France, Germany, Portugal all turned out more vulnerable than one would have reckoned based on their FIFA World Ranking, football reputation or the bookmakers’ odds. So ‘stats’ and ‘indices’ don’t say everything, also in football. Conversely, some ‘outsiders’ have done far better than was expected from them in the tournament.
Still, to win the tournament, just like in the Covid-response, you need to have an ‘all-round game’, as well as quality on every part of the pitch (“layer after layer”). You also need to have strong cohesion and team spirit ( community ‘trust’), and – this goes without saying – preferably a good coach (governance). Maradona was a stunning player, but not exactly a great coach. Same for Van Basten, Pirlo etc. True, most of the fans can’t really tell whether their coach is good or useless (with millions feeling like a national coach/virologist themselves), but trust me, as they also know now in Holland, there is a difference. Coaches have to remain level-headed in all circumstances, especially given the “infodemic” that is coming their way via media and social media, while players need to know exactly what to do in different scenarios (in ball possession, when they try to gain possession again, …). Coaches also shouldn’t shy away from taking difficult decisions, depending on the scenario playing out on the pitch, on aging players for example (although Germany’s ‘traffic director in chief’, Thomas Müller, remains one of my favourite “all time” players, if only because he looks so damned German when he’s ‘directing the traffic’😊). Ideally, coaches have a high EQ (you don’t want your players ànd their girlfriends to nearly start fighting during these six weeks) (France) and yes, coaches shouldn’t stay on too long themselves (Germany again).
Of course the global governance also matters. With UEFA in the role of ‘Team Europe’: great on rhetoric and smokescreens (“Respect”), far less convincing when it comes to real action ( being diplomatic here ). As for Switzerland, they’ve been doing just fine so far, in spite of a few hiccups – I leave it up to you what that might imply on WHO’s performance in the pandemic. As for leaks, occasionally there are media leaksfrom national teams’ bases, but more often than not, it’s much ado about nothing, or coaches playing “mindgames”.
Playing well in the first half (wave) also doesn’t necessarily imply the second half will go your way (among others, with new players (variants) on the pitch, shrewd tactical changes, fatigue of the players…). And as many of you will no doubt have noticed, teams that want to go far in the tournament need to be as ‘resilient’ as Lucy Gilson on a random day. Squads with players who know how to keep it simple and see the game ahead of the others (KDB, Pedri), also have a clear advantage.
Finally, like with the Covid-19 pandemic, there are no certainties in international football tournaments. Euro 2020 continues to surprise, the pitch is a ‘risk society’ for every team. And so, at this stage in the tournament, I’ll refrain from making any predictions. Apart from the near certainty that more surprises are certainly to be expected. Call it the ‘VAR’ (iant) effect, if you want (aided by some goalkeepers). And oh yes, after the tournament, in countries that performed badly, there’ll be plenty of talk of need for “reform”, to make sure they’re ‘ready for the next big tournament’ (“Big One”). Committees and media will come up with multiple (often familiar) recommendations, to be shelved again in a few months – usually when a new coach is in place.
Enjoy your reading.
Kristof Decoster
https://news.un.org/en/story/2021/06/1095012
“As the world grapples unevenly with the effects of COVID-19, “a parallel and equally horrific pandemic” has threatened half the world’s population, the UN chief said on Tuesday, in the lead up to the Generation Equality Forum in France. On Wednesday, leaders from around the world [will] gather in Paris and online, in a massive push for gender equality. The Forum is a landmark event convened by UN Women, and co-hosted by the governments of Mexico and France, in partnership with youth and civil society, to accelerate gender equality. …”
More coverage via UN News: Women must no longer be ‘squeezed into a small corner’, landmark Forum declares
“ In a bid to put gender equality at the heart of COVID recovery, UN Women kicked off a three-day “landmark effort” in Paris on Wednesday, aiming to lay out ambitious investments and policies to bridge the chasm between where women stand in the world today, and where they should be, by 2030….”
And Devex - Harris outlines US plan to strengthen gender equality at UN event
“ UN Women, which convened the forum, said Wednesday that the event has already generated more than $40 billion in new financial commitments, including aid from governments, philanthropic organizations, and the World Bank. That amount represents “the largest-ever collective infusion of resources into global gender equality,” according to a statement…..”
AP - Paris conference aims to fast-track road to gender equality Interview with UN Women’s Executive Director Phumzile Mlambo-Ngcuka.
“Billions of pounds will be pledged to support efforts to tackle gender inequality this week at the largest international conference on women’s rights in more than 25 years. The Generation Equality Forum, hosted in Paris by UN Women and the governments of France and Mexico, will launch plans to radically speed up progress over the next five years….”
“ As part of the Generation Equality Forum convened by UN Women and co-hosted by the governments of Mexico and France, the Bill & Melinda Gates Foundation today announced a commitment of $2.1 billion over the next five years to advance women's economic empowerment, strengthen women and girls' health and family planning, and accelerate women's leadership….”
“The foundation's $2.1 billion commitment over the next five years will advance activity in three areas: economic empowerment, health and family planning, and accelerating women in leadership. “
Re Family Planning and Health: $1.4 billion over five years: “This reaffirms and expands the foundation’s commitment to family planning and women’s health, with a focus on increasing options and access to contraceptives and support for a network of family planning partners, including UNFPA Supplies Partnership, Family Planning 2030, the Global Financing Facility, and the new Shaping Equitable Market Access for Reproductive Health initiative.”
“At Generation Equality Forum, up to US$100 million pledged to Global Financing Facility to help countries reclaim the gains and build a more resilient and equitable recovery.”
“In recognition of the need for urgent action for women and adolescents amid impacts of COVID-19, the Global Financing Facility for Women, Children and Adolescents (GFF) has launched a Sexual and Reproductive Health and Rights Acceleration Plan together with Canada, Netherlands, Norway, UK, Buffet Foundation and Bill & Melinda Gates Foundation. At the same time, and as part of the broader set of commitments made at the Generation Equality Forum, the Gates Foundation is committing up to US$100 million to the GFF to help countries to reclaim the gains lost due to COVID-19 and build a more resilient and equitable recovery, including through support to the urgent SRHR agenda….”
https://www.bmj.com/content/373/bmj.n1621
“The Generation Equality Forum in Paris on 30 June-2 July 2021 marks the 25th anniversary of the Beijing Platform for Action on Women. The 1995 event was a milestone for advancing women’s rights, but it is disheartening that still not one country can claim to have achieved gender equality.
By 2045 most global leaders will be too young to remember the Beijing declaration, but the global community will have failed if gender inequality is still widespread….”
Gender equality is achievable and an imperative, by 2045, this Editorial argues, also laying out what it will require.
Link:
BMJ - Feminist movements are key to public health equity
“ We need greater investment in feminist movements, one of the most effective ways to advance health outcomes for women and girls and to achieve public health equity, say Emma Fulu and colleagues.”
“Gavi Board makes key strategic decisions to support Gavi’s 5.0 strategy of leaving no child behind through immunisation; doubles down on ambitious targets for COVAX; New market-shaping strategy, alliances with civil society among measures aimed at reducing the number of children receiving no doses of vaccine, by 25% globally - by 2025; US$ 775 million in COVAX delivery funding approved for lower-income economies that are eligible for support through the Gavi COVAX Advance Market Commitment (AMC).”
Most focus was on the last point, obviously.
See also Reuters - More funds approved for COVAX vaccines, tighter access planned - statement
“The board of the GAVI vaccine alliance has approved a further $775 million to fund the delivery of COVID-19 vaccines to lower-income economies over the next two years, as it plans to accelerate the rollout, it said on Friday. … It is scaling up and now estimates that its goal of delivering 1.8 billion doses to lower income economies would be reached in the first quarter of 2022, GAVI said…. …. GAVI's board also set new terms for accessing vaccines, which will disincentivise middle-income nations from participating by insisting they pay for COVAX vaccines fully in advance next year. …. "Starting in 2022, the model will enable self-financing participants that rely on the facility to access doses to continue procuring vaccines through COVAX under revised terms and conditions," it said….”
Last week Friday’s GHF’s issue zoomed in on the GAVI Board meeting – especially related to the revision of the Covax facility. In-depth analysis.
“Gavi – The Vaccine Alliance, that legally administers the COVAX Facility, has had to do some serious stock-taking in rethinking its role in the international response to COVID-19. This week the Gavi Board approved proposals, among others, to redefine the way the COVAX Facility engages with Self-Financing Countries and the way it plans to service low- and middle-income countries in the future….”
To subscribe to this (Geneva global health focused) newsletter: https://genevahealthfiles.substack.com/subscribe?utm_medium=web&utm_source=subscribe-widget&utm_content=37931135
“The African Union (AU) Special Envoy on COVID-19 has bluntly blamed the WHO co-sponsored COVAX facility for the dire vaccine shortage on the continent, saying that it had failed to disclose its vaccine supply problems early enough. Strive Masiyiwa, AU Special Envoy and head of the African COVID-19 Vaccine Acquisition Task Team (AVATT) said that had COVAX been honest about its lack of vaccine supplies at the start of the year, the continent might not be facing such a dire shortage of vaccines. When AVATT met COVAX “back in January”, said Masiyiwa, “we were given a schedule in writing that we would receive vaccines from the end of February, going through to December”. “But COVAX failed to disclose that they were still trying to get money, that pledges [of $8.2 billion] which had been made by certain donors had not been met,” said Masiyiwa, in his most forthright condemnation of the global vaccine platform yet. “That’s pretty material information. Had we known that actually this was hope and not reality, we may have acted very differently,” Masiyiwa told the Africa CDC weekly COVID briefing on Thursday, which also disclosed that AVATT had procured 400 million COVID-19 single-dose vaccines from Johnson & Johnson that will start to arrive next month. …”
https://www.gavi.org/news/media-room/gavi-signs-agreement-clover-biopharmaceuticals-supply-covax
“The signed advance purchase agreement (APA) will make up to 414 million doses of the Clover vaccine candidate available to the COVAX Facility, pending WHO Emergency Use Listing (EUL). Supply will be available to self-financing participants of the COVAX Facility as well as lower-income economies eligible to be supported by the Gavi COVAX Advance market Commitment (AMC), expected to commence Q4 2021.”
“… The COVAX Facility portfolio, administered by Gavi, currently consists of agreements related to 9 vaccines and vaccine candidates – AstraZeneca/Oxford, Clover, Johnson & Johnson, Moderna, Novavax, Pfizer-BioNTech, SII-Covishield, SII-Covovax, and Sanofi/GSK – with the aim to expand to 10-12 vaccines in total…”
“The much-trumpeted European Union COVID Digital Green Pass, which launches 1 July and is meant to vastly ease travel to Europe for vaccinated and recovered passengers is being rolled out with one important hitch: Anyone vaccinated with an AstraZeneca vaccine produced by the Serum Institute of India would not be qualified to get the pass – and that includes most citizens of low- and middle-income countries who were immunized with vaccines distributed by the WHO co-sponsored COVAX initiative. That’s because the EU green pass will only recognise the Vaxzevria version of the AstraZeneca vaccine that was produced and manufactured in the United Kingdom or other sites around Europe, and thus approved by the European Medicines agency. In contrast, most of the COVAX facility’s global procurement and distribution was built around the “Covishield” AstraZeneca vaccine, produced by the Serum Institute of India. …”
“… The double standard of EU recognition for identical AstraZeneca vaccines is beginning to send ripples across the African continent and African media – stimulating anger as well as stoking vaccine hesitancy, as reported by the French media channel, RFI.fr this week…..”
Quote: “… At Thursday’s Africa Regional press briefing, WHO’s Regional Director for Africa, Dr Matshidiso Moeti, protested the double standard, telling reporters that the European green pass programme should recognize all eight vaccines that have been approved by the WHO, which include the AstraZeneca vaccines produced in India, as well as two Chinese-made vaccines, rather than only those that are EU approved….”
“The African Union has criticised an EU decision not to include Covishield, a version of AstraZeneca's coronavirus vaccine used by the global COVAX facility, on a list of approved vaccines for a digital certificate meant to ease travel in the bloc.”
For an update on this story, see HPW - Travellers Vaccinated with Covishield ‘Should’ be Allowed into EU – but Member States Will Make the Final Decision
“ Travellers who are fully vaccinated with vaccines authorised in the European Union (EU) “should” be allowed entry for non-essential travel – even if these vaccines were not “produced in facilities covered by the marketing authorisation in the EU”. This is according to Stefan de Keersmaecker, EU spokesperson for health, food safety and transport, in response to Health Policy Watch’s report that Covishield vaccine would not be recognised by the EU digital COVID vaccination certificate, which launches on Thursday. Those vaccinated with Covishield, the AstraZeneca vaccine produced by the Serum Institute of India with exactly the same properties as the European vaccine branded Vaxzevria, “should” be allowed EU entry – but this decision will rest with individual member states, added De Keersmaecker….”
And Devex - Covishield exclusion from EU's green pass inequitable, activists warn
https://www.who.int/news/item/01-07-2021-joint-covax-statement-on-the-equal-recognition-of-vaccines
“#COVAX urges all government authorities to recognize as fully vaccinated all who have received #COVID19 vaccines approved by WHO or one of 11 approved Stringent Regulatory Authorities, when making decisions on who is able to travel or attend events.”
And In Win For India, Covishield Okayed By 7 EU Nations, Switzerland, Iceland
Press release after the Forum.
“The first WHO World Local Production Forum ended today after five days of discussions centered on promoting quality and sustainable local production to improve access to medicines and other health technologies. Delegates from over 100 countries, international partners, civil society groups, industry associations, and major investors joined WHO, WTO, UNIDO, UNICEF and UNCTAD to highlight the challenges facing local production and the steps required to address them, as well as the range of opportunities for the sector. …”
Check out Forum conclusions, recommendations and next steps.
Countries met for another round of informal session (30 June) to discuss the TRIPS Waiver and the EU initiative.
See first of all this Tweet from Geneva Health Files:
“TRIPS Council Informal Meeting @wto today: Meeting took stock of small groups consultations over past weeks. Differences remain on ways to address IP issues in the context of the pandemic Members yet to begin text-based negotiations: sources.”
As usual, Dimitri Eynikel, EU Policy Advisor for MSF's Access Campaign, framed things the correct way, not mincing words.
“There is no point in wasting precious time on an EU initiative that does not provide any new or real solutions …. The EU initiative is nothing more than window dressing on a system that is already in place, which has shown during this pandemic to be insufficient when it comes to improving people’s access to COVID-19 medical tools. “The EU initiative is a disingenuous attempt to derail a process started almost nine months ago and supported by more than 100 governments across the globe to allow countries to swiftly and comprehensively lift intellectual property barriers to facilitate unhindered production and supply of medical tools to protect their people in this deadly pandemic….”
Also from last week’s Friday GHF issue. Focus on the Trips council informal meeting on 24 June (i. e. a meeting from last week).
“The TRIPS Council had an informal meeting on June 24, to consider EU’s proposal on an intellectual property response to the pandemic. This proposal, narrower in scope, competes with the revised TRIPS Waiver initiative, first proposed by South Africa and India. The proposal titled "Draft General Council Declaration on the TRIPS Agreement and Public Health in the Circumstances of a Pandemic" seeks to facilitate the use of current compulsory licensing provisions in the TRIPS Agreement. …. … It appeared that countries were more willing than before to consider both the proposals - the EU and from South Africa-India, in the on-going text-based negotiations at the TRIPS Council, according to a trade official in Geneva….”
“Latin America, which accounts for one-third of the total global COVID-19 deaths, is struggling to secure vaccines. The region's ambivalence toward a patent waiver for vaccines has left many perplexed.”
“…. Latin America, the region worst hit by the pandemic and desperately in need of vaccines, only saw Venezuela and Bolivia proposing the IP waiver, leaving many experts confounded. Argentina and Mexico have voiced their support for a temporary patent relief, while Brazil has only recently endorsed the idea after initially opposing it. Most other Latin American countries, including Chile, Colombia and Peru, are choosing to remain ambivalent or simply stay on the sidelines, fearing a backlash from pharma companies they are relying on to meet the vaccine shortfall and a worsening of diplomatic relations with richer countries like those in the European Union opposing an IP waiver....”
PS: “… Felipe Carvalho, from the Brazilian chapter of nonprofit Doctors Without Borders, told DW that governments' fears stem from the "abusive" clauses that they have been pushed to agree to as part of the supply deals. "It's quite easy under those contractual conditions for pharmaceutical companies to threaten: "If you go through with that political position, I can interrupt supply, and, under the contract, I'm allowed to do that," Carvalho said DW….”
https://www.twn.my/title2/health.info/2021/hi210608.htm
On a new TWN Briefing Paper titled "Trade secrets protection and vaccines: The role of medicine regulatory agencies" by K M Gopakumar, Chetali Rao and Sangeeta Shashikant.
“The TRIPS Waiver proposal for dealing with COVID-19 covers trade secrets, and this Briefing Paper discusses the rationale for including this category of intellectual property in the scope. The authors conclude as follows: "The current pandemic situation demands rapid diversification of manufacturing and scale-up of .supply of vaccines. Under the current regulatory framework, the demand for safety and efficacy data, especially Phase III trial data, delays the entry of follow-on vaccines. In this context, lifting trade secrets protection and allowing the sharing of regulatory dossiers containing safety and efficacy data as well as information about the manufacturing process, especially with other regulatory agencies and potential manufacturers, can accelerate the production and approval of follow-on non-originator vaccines. Further, funding agencies which possess some of this information also can disclose it to potential manufacturers if a waiver is in place….”
“About 108 organizations across four regions responded to a survey conducted by the Coalition for Epidemic Preparedness Innovations to map and identify where vaccine manufacturing capacity and capability can be further developed as part of future epidemic and pandemic preparedness and response. The responding organizations were located across Africa, Southeast Asia, Middle East, as well as Latin America and the Caribbean, and included small academic research and development laboratories to large-scale vaccine manufacturers and pharmaceutical organizations, according to an initial data review presented by Matthew Downham, sustainable manufacturing lead at CEPI, during a session of the first World Local Production Forum….”
“…. Helping ramp up vaccine manufacturing in low- and middle-income countries is part of CEPI’s new strategy. But the coalition won’t be building manufacturing plants. Instead, it will assist in developing capacity in countries, including linking governments and funders, and technology transfers….”
“Talks with Senegal, Tunisia "quite advanced". France will give financial support to project. Hubs could eventually make non-COVID vaccines.”
“Plans for Africa's first independent COVID-19 vaccine production hubs could revolutionise the global vaccine industry but will depend on the willingness of pharmaceutical companies to share their technology, the World Health Organization said on Tuesday….”
Via a tweet Ashley Furlong (Politico):
“ Pandemic treaty scooplet: Some more detail on this — the countries chosen to chair new bureau that will lead on a report about a potential pandemic treaty are France, the U.S., Botswana, Singapore, Iraq and Indonesia, according to multiple diplomats. https://pro.politico.eu/news/137616 “
S Lehtimaki, N Schwalbe et al https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01223-X/fulltext
“A report by the Independent Panel for Pandemic Preparedness and Response, established to assess the response to COVID-19, was recently released. This report proposes the creation of an international treaty on pandemics, to be negotiated under the auspices of WHO, and a Global Health Threats Council to serve as an independent authority at the head of state and government level, endorsed by the UN General Assembly. These instruments alone are inadequate. Effective compliance requires robust and independent mechanisms for reviewing progress and doing investigations that are empowered at the highest political level and armed with both incentives and consequences. On the basis of a review of institutional mechanisms and a mandate to enforce compliance with international agreements, we propose several aspects to complement the proposal….”
https://www.aidspan.org/en/c/article/5655
“On 15 June, the Global Fund Strategy Committee held an extraordinary meeting to discuss the revised Global Fund Strategy Framework.”
“… There now appears to be an acceptable degree of alignment among constituencies on the question of how the Global Fund should engage on PPR (Pandemic Preparedness and Response) and its specific placing of PPR within the Strategy Framework. In brief, there is broad agreement that the Global Fund should be more intentional in building PPR capabilities through its existing mission to end AIDS, TB and malaria and through related efforts to strengthen resilient and sustainable systems for health (RSSH). In turn, this requires integrated, people-centered approaches, support for the engagement and leadership of communities living with and affected by the three diseases, and maximizing health equity, gender equality and human rights…..”
“The World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria signed a cooperation and financing agreement to implement 10 strategic initiatives to accelerate the end of AIDS, tuberculosis and malaria as epidemics and strengthen systems for health. This new agreement, which will cover the 2021-2023 implementation period, aims to address some of the persistent challenges that impede progress against the three diseases and protect hard-won gains from new pandemics like COVID-19…..”
https://www.devex.com/news/african-development-bank-plans-to-build-resilient-health-systems-100241
“The African Development Bank has described the COVID-19 crisis as an opportunity to reassess, rebuild, and better position Africa’s health care defense system against future pandemics that could be even deadlier. In his remarks at the bank’s annual meetings Friday, AfDB President Akinwumi Adesina characterized the state of health care infrastructure on the continent as “appalling.” …. … To better position the continent for future health emergencies, Adesina said priority should be given to local production of vaccines, developing Africa's pharmaceutical manufacturing capacity, and building health care infrastructure…”
“The future could perhaps bring the outbreak of a disease that is as easily spread as COVID-19, as deadly as Ebola virus disease, and as difficult to develop a vaccine for as HIV, suggested John Nkengasong, director at the Africa Centres for Disease Control and Prevention, during the meetings. With this in mind, he said the continent’s defense strategy needs to be reinforced by improving Africa’s health workforce and manufacturing capacity for diagnostics, vaccines, and treatment. … “You don’t build health systems within a pandemic; you build health systems before the pandemic,” Nkengasong said….”
Related link: AfDB demands more support for Africa (with more coverage of the African Development Bank’s 56th annual meeting):
“the AfDB pledged $3bn to produce doses as part of the African Union’s vaccine development plan….” (i.e. to support local vaccine production).
By Simon Scott and Hedwig Riegler; https://www.globalpolicywatch.org/blog/2021/06/24/mismeasuring-foreign-aid/
“For several years now, CSOs have become increasingly concerned that donors are over-reporting their foreign aid efforts….”
“The root of the problem is that donors set the rules themselves in the OECD’s Development Assistance Committee (DAC). The key measure is that of Official Development Assistance (ODA), for which the United Nations has a long-standing target of 0.7% of donors’ national income. ODA is supposed to be concessional – to give something of value away. DAC members as a group have never got near meeting the ODA target, but for political reasons they have also never dared to abandon it. Their unfortunate solution to the conundrum has been a series of dubious rule changes that weaken ODA’s concessional nature and therefore help donors look as if they are spending more without really doing so….”
As for solutions: “…In the long run, therefore, the DAC will need to cede its ODA rule-making authority to a body composed of statisticians. Former senior OECD officials have recommended that these should include developing country representatives. Bringing in UN and other multilateral representatives as well, and allowing a greater voice to civil society, would help ensure that ODA statistics meet user needs and contribute to the international statistical architecture. In the short run, the DAC should stop making politically-driven, piecemeal decisions on ODA rules. These now show clear evidence of a “ratchet effect”, where each new rule change over counts more than the last. Before any further distortions are introduced, the OECD should itself institute a thorough quality review in line with its own standards. At a time when developing countries urgently need real aid to recover from the COVID crisis, the international community must have confidence that official aid data are honest and reliable.”
Tim Schwab; https://www.thenation.com/article/society/warren-buffett-bill-gates/
“The Oracle of Omaha just resigned from the Gates Foundation. But he’s still on the hook for billions in future donations to the troubled charity. …. … tax experts note that Buffett may not have much choice in the matter. He appears to be legally obligated to continue giving billions of dollars to the foundation….”
“… Inside the Gates Foundation, CEO Mark Suzman put a happy face on Buffett’s resignation, publishing a statement that his departure came with a new $3.2 billion donation—his largest ever to the foundation and a signal of his continuing support. But Buffett’s large donation is simply the result of Berkshire’s rising stock price. … while Buffett describes his resignation as merely a consequence of his getting older and retiring from professional responsibilities, it coincides with the continuing controversies emerging around Bill Gates. The same day as Buffett’s announcement, new questions surfaced around the Gates Foundation’s money manager, Michael Larson, who also manages much of Bill Gates’s private wealth….. “
And a link:
Business Insider - Insiders say Bill Gates was an office bully and a womanizer, and that his squeaky-clean image was merely good PR. More bad press on Gates…
“On May 5, 2021, WHO announced the launch of the WHO Hub for Pandemic and Epidemic Intelligence in collaboration with Germany. The initiative aims to track, collect, analyse, and use data from outbreaks, epidemics, and pandemics to better prepare for, predict, and manage them. The Hub will be based in Berlin… …. … Originally proposed by WHO Director General Tedros Adhanom Ghebreyesus to German Chancellor Angela Merkel, the Hub is a key pillar of WHO's emergency programme. “…
“WHO has not provided any details other than those in the press release, and has received mixed reactions in the global health community. Peter Hotez … thinks it is an important step. “[Some people] are often very dismissive and think that such initiatives are paper tigers; that they don’t mean much”, Hotez told The Lancet Microbe. “But I disagree: I think these kinds of initiatives are a reaffirmation of the importance of global governance of health and commitments of countries to protecting the world's population.”…”
“According to Maike Voss (German Institute for International and Security Affairs, Berlin, Germany), instead, at this stage, more questions about the Hub remain than answers: why was it launched during a pandemic? Why is WHO not doing such data integration and analysis already in Geneva (Switzerland) or its regional offices? Will the hub only be a technological intervention, with a sole focus on AI and big data analysis? And, importantly, why was Berlin chosen as the headquarters, instead of a city in a low-income or middle-income country? “WHO is in [so-called] hubization mode and creating more hubs in high-income countries—eg, the WHO Academy in Lyon [France] and the Biobank in Switzerland—and is decentralizing its structure, paid by and in favour of rich countries and not going the formal path through WHO governing bodies”, Voss told The Lancet Microbe.
And a link in the same journal (Lancet Microbe Editorial ) - G7 leaders commit to greater pandemic preparedness (again)
Re the G7 summit from 13 June. “….it is reasonable to be a little sceptical, as these commitments are familiar to those who recall the G7 summit in 2016. Back then, the G7 leaders expressed their commitment “to take leadership in reinforcing response to public health emergencies and antimicrobial resistance”….”
https://www.reuters.com/business/environment/backing-grows-new-imf-covid-climate-fund-2021-06-24/
“Plans for a new IMF "Resilience and Sustainability" fund that would expand its support to dozens more vulnerable countries gained key international backing on Thursday ahead of crucial meetings. IMF chief Kristalina Georgieva this month proposed the new trust to allow rich countries to channel some of their new IMF reserves to poor and middle-income counterparts ravaged by COVID or climate change. …. … Jensen said he hoped the new fund would also give debt-strained countries who have so far resisted restructuring their debt for fear of losing access to borrowing markets, a safety net to take that step…..”
“The Collective is dedicated to advancing research on how power constellations, institutions, interests, and ideological positions affect health within different political systems and cultures, and at different levels of governance….” “The Collective grew out of the Independent Panel on Global Governance for Health, which between 2014 and 2020 followed up the recommendations of the Lancet-University of Oslo Commission on Global Governance for Health.”
Check out the members. Quite a list!
Hani Kim; https://gh.bmj.com/content/6/7/e006598
At this rate, Hani Kim (Gates Foundation) will soon become a ‘household name’ in global health.
“The task of solving global vaccine inequity presents us an opportunity to build better global governance and decision-making mechanism over vaccine production and distribution to assure sustainability and equity between and within countries. Solving vaccine inequity requires sharing the control and ownership over generating and distributing vaccines, beyond reallocating vaccine doses or building new manufacturing facilities in low- and middle-income countries. Losing sight of the unequal power relations undergirding vaccine inequity would leave us at the risk of having the global vaccine production and distribution shaped by a handful of powerful nations, multinational corporations, and private philanthropies. People’s WHO represents our best framework within which governments with limited resources and power can collectively negotiate for the interests of their populations as the global majority.”
Quote:” The world indeed needs a ‘stronger WHO at the centre of the global health architecture’ as emphasized by independent international panels. But that WHO needs to be people’s WHO, not a broker for the global elite….”
With key global trends, WHO messages, …
(June 30 ) “After falling for 8 weeks in a row, the world's weekly number of COVID cases increased slightly last week, as multiple countries battle surges, including those in Africa, the World Health Organization (WHO) said yesterday in its latest situation report….”
“In two earlier surges, Africa's cases and deaths remained relatively low compared with other parts of the world. However, the African region is now into its third wave, and both cases and deaths rose sharply last week—cases by 33% and deaths even higher, at 42%. The WHO also noted case rises in the Eastern Mediterranean and European regions. Globally, of the five countries that reported the most cases last week, three are in the Americas: Brazil, Colombia, and Argentina. The others include India and Russia….”
“… At a WHO Pan American Health Organization (PAHO) briefing today, PAHO Director Carissa Etienne, MBBS, said cases are still rising in many South American countries such as Brazil, Bolivia, and Uruguay, as well as a few in the Caribbean and some in Central America, including Belize, Panama, and Guatemala…..”
For more on the latest trends, see WHO - Weekly epidemiological update on COVID-19 - 29 June 2021
https://healthpolicy-watch.news/countries-scramble-to-contain-delta-variant/
See also NYT - As Delta Variant Surges, Outbreaks Return in Many Parts of the World
“The highly contagious Delta variant is on the rise, and countries that hoped they had seen the worst of Covid-19 are being battered again…..”
And by way of example (of a new wave spiralling out of control in Indonesia): Cidrap News - Red Cross warns of emerging COVID crisis in Indonesia
WHO Afro - Rife COVID-19 variants fuel Africa’s surging wave (1 July)
Quote: ““The speed and scale of Africa’s third wave is like nothing we’ve seen before. The rampant spread of more contagious variants pushes the threat to Africa up to a whole new level. More transmission means more serious illness and more deaths, so everyone must act now and boost prevention measures to stop an emergency becoming a tragedy,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa.”
Via Cidrap: “In other international developments, Africa's COVID-19 cases rose again for the seventh week in a row, and deaths in Brazil—which has endured many months of high virus activity—crossed the 500,000 mark. In Africa, currently experiencing its third surge, COVID-19 cases rose for the seventh week in a row and are now near the peak of the second wave, the World Health Organization (WHO) African regional office said today in its weekly outbreaks and health emergencies report. Compared to the week before, cases were up 20% and deaths rose by nearly 17%. South Africa is the main hot spot, reporting about 62% of last week's new cases. Others reporting high infection numbers include Zambia, Namibia, Rwanda, and Uganda. Health officials again reported high numbers of healthcare worker infections, with 541 new ones reported—nearly all from Namibia, Kenya, and Ethiopia. Several countries have reported the Delta variant, and the Alpha (B117) and Beta (B1351) have been reported in 25 African nations…..”
See also Politico - Africa’s Covid nightmare arrives (1 July)
“With the Delta variant fueling a third wave of the virus on the continent, global health experts fear Africa could face a four-alarm fire. The region is already vulnerable because of its weak health systems and extremely low vaccination rates. The highly contagious Delta variant, first observed in India and now storming the globe, has been found in at least 14 of Africa’s 54 countries so far, according to the World Health Organization. It accounts for most cases in Uganda in the East and the Democratic Republic of Congo in Central Africa. Cases on the continent are up about one-third over the past week….”
And Cidrap News - Africa cases doubling every 3 weeks (1 July)
On last week Friday’s media briefing. “The world's inability to provide enough COVID-19 vaccines for poor countries is a global failure that highlights injustice, the head of the World Health Organization said on Friday. "It's not hesitancy. It's lack of vaccines. And the situation in many low-income countries, especially Africa, it's very worrisome," Tedros Adhanom Ghebreyesus said. "There is no vaccine. You can't even talk about delivery or absorption capacity when there's no vaccine."
(30 June) “The Heads of the World Bank Group, International Monetary Fund, World Health Organization, and World Trade Organization today convened for the first meeting of the Task Force on COVID-19 Vaccines, Therapeutics and Diagnostics for Developing Countries. They issued the following joint statement: “As many countries are struggling with new variants and a third wave of COVID-19 infections, accelerating access to vaccines becomes even more critical to ending the pandemic everywhere and achieving broad-based growth. We are deeply concerned about the limited vaccines, therapeutics, diagnostics, and support for deliveries available to developing countries. …
“…We have formed a Task Force, as a “war room” to help track, coordinate and advance delivery of COVID-19 health tools to developing countries and to mobilize relevant stakeholders and national leaders to remove critical roadblocks—in support of the priorities set out by World Bank Group, IMF, WHO, and WTO including in the joint statements of June 1 and June 3, and in the IMF staff’s $50 billion proposal. At today’s first meeting, we discussed the urgency of increasing supplies of vaccines, therapeutics, and diagnostics for developing countries. We also looked at practical and effective ways to track, coordinate and advance delivery of COVID-19 vaccines to developing countries. …. As an urgent first step, we are calling on G20 countries to (1) embrace the target of at least 40 percent in every country by end-2021, and at least 60 percent by the first half of 2022, (2) share more vaccine doses now, including by ensuring at least 1 billion doses are shared with developing countries in 2021 starting immediately, (3) provide financing, including grants and concessional financing, to close the residual gaps, including for the ACT-Accelerator, and (4) remove all barriers to export of inputs and finished vaccines, and other barriers to supply chain operations….”
https://news.un.org/en/story/2021/06/1094852
Still on last week’s WHO media briefing.
“The head of the UN health agency expressed concern on Friday over the COVID-19’s delta variant, which he called “the most transmissible” mutation to date. Tedros Adhanom Ghebreyesus, Director-General of the World health Organization (WHO) told journalists at a regular briefing that delta has been identified in at least 85 countries and is “spreading rapidly among unvaccinated populations”. “As some countries ease public health and social measures, we are starting to see increases in transmission around the world”, he said. “
Also with the view from M Van Kerkhove: “The delta variant can make the epidemic curve exponentially”, added Dr. Van Kerkhove. But Delta is not the only worrying mutation. According to the WHO expert, “there is a constellation of variants circulating”, including subvariants, four of which are very worrying. “
“…. One of the most important ways WHO coordinates the response to COVID-19 and other emergencies is through its global network of emergency medical teams (EMTs). When crises strike, WHO mobilizes these health professionals to support national responses, treat patients, provide training and supervision, and ensure quality-care standards.
“Globally, WHO has certified teams from 20 countries, who have gone through a rigorous process of quality assurance to ensure they meet internationally agreed standards”, Tedros said, adding that another 87 countries are either in the process of being WHO certified, or are developing quality-assurance systems nationally. “
See also Reuters - Prevent transmission to prevent variants, WHO says
“The best way to prevent new variants of the coronavirus from evolving is to slow its transmission, WHO Director-General Tedros Adhanom Ghebreyesus said on Friday…..”
https://www.devex.com/news/world-bank-deal-to-finance-covid-19-vaccine-production-in-africa-100284
“The World Bank and three governments are investing in a South African vaccine manufacturer in an effort to boost production of COVID-19 vaccines on the African continent….. The €600 million funding package for Aspen Pharmacare, which is Africa’s largest pharmaceutical company and is based in Durban, comes from the International Finance Corp. — the World Bank’s private sector arm — in cooperation with the U.S. International Development Finance Corp.; DEG, the German development finance institution; and Proparco, a subsidiary of France’s Agence Française de Développement. The fund includes money for the entire vaccine supply chain. Aspen aims to produce more than 500 million doses of the Johnson & Johnson single-dose vaccine by the end of 2022. The World Bank also said Wednesday that it will increase its funding aimed at supporting the global vaccine rollout from $12 billion to $20 billion…..”
· See also Reuters - World Bank says will boost COVID-19 vaccine funding to $20 bln
“The World Bank on Wednesday pledged to boost available funding for COVID-19 vaccine purchases and deployment to $20 billion from a previous target of $12 billion, citing a sharp increase in overall financing demand from developing countries. World Bank President David Malpass said the global development bank had already provided more than $4 billion to 51 developing countries for the purchase and deployment of COVID-19 vaccines, and would add billions for 25 more countries soon. "Much more will follow in coming weeks," Malpass told reporters, noting that a total of 41 requests had been received from African countries, where less than half the population has been vaccinated….”
“… The World Bank's vaccine financing package can be used by countries to buy vaccine doses through COVAX, the new African Vaccine Acquisition Task Team (AVATT) or other sources.”
· And Reuters: Aspen to partner with finance institutions to boost vaccine know-how
K Georgieva et al; https://blogs.imf.org/2021/06/28/sub-saharan-africa-we-need-to-act-now/ More from the IMF.
“…IMF staff has put forward a global proposal that targets vaccinating at least 40 percent of the total population of all countries by end-2021, and at least 60 percent by the first half of 2022. Africa is expected to receive 30 percent vaccination coverage through COVAX and another 30 percent coverage through the African Vaccine Acquisition Task Team (AVATT), established by the African Union under the leadership of President Cyril Ramaphosa. We see seven key steps to ensure these vaccination targets are met:…” Check them out.
https://www.devex.com/news/the-beginning-of-the-end-for-africa-s-covid-19-vaccine-struggles-100290
(1 July) Good overview of timelines in the months ahead, for donations (from US for example), shipments, purchased by the African Vaccine Acquisition Task Team, … (overview by Strive Masiyiwa, special envoy of the African Union).
https://healthpolicy-watch.news/kenya-secures-world-bank-loan/
“Kenya has secured $130 million in funding from the World Bank to buy COVID-19 vaccines and help boost the country’s vaccination drive, the Bank announced on Tuesday. The funding comes as the Kenyan government starts to administer the second dose of AstraZeneca vaccines to citizens, amid an upsurge of infections across 13 counties in the western region of the country…..”
https://www.wto.org/english/news_e/news21_e/heal_18jun21_e.htm
“The WTO [held] on 29 June 2021 a technical symposium to contribute to improved public and policymaker understanding of the operation of global COVID-19 vaccine supply chains, the cross-border movement of vaccine inputs, and the need for greater regulatory transparency and convergence. The event map(ped) vaccine production and trade and discuss trade measures that support or constrain the achievement of the rapid scale-up of vaccine production and distribution. Discussions also encompass(ed) diagnostics, therapeutics and other COVID-19-related medical goods….”
T Bollyky et al; https://www.foreignaffairs.com/articles/2021-06-24/real-vaccine-procurement-problem?utm_campaign=tw_daily_soc&utm_medium=social&utm_source=twitter_posts
“Why America Should Make Its Supply Chain More Transparent.”
The authors claim “the DPA (Defense Production Act) did not cause the global shortage of vaccine inputs, and ending or altering its use would not by itself fix the problem. The scarcity stems from the sudden need to produce billions of COVID-19 vaccine doses around the world, an unprecedented feat that would have depleted supplies regardless of what the United States did. Still, because it has invoked the DPA without disclosing how exactly it will use the law and whose supplies it will deprioritize, Washington has unwittingly fueled the perception that it is to blame for global supply shortages. The Biden administration should clarify how and when it has used the DPA to fight the coronavirus pandemic and work with partners—especially the European Union and India—to make vaccine-manufacturing supply chains and production processes more transparent….”
“…Although the murky nature of the DPA makes it difficult to assess the full impact of its invocation, there is little evidence that it has caused the kind of damage its critics allege. A global shortage of inputs was inevitable the moment that ten billion doses of a new vaccine became necessary overnight. …. … The United States should therefore work with the EU, India, and other allies to establish a system of global transparency for COVID-19 vaccines and inputs. ….”
J V A Franco et al ; BMJ ;
“Low and middle-income countries that hosted trials for approved vaccines are not receiving vaccine doses as expected.”
M Smith; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01244-7/fulltext
“What does success look like in a COVID-19 vaccination programme? If vaccination trackers are any indication, whether hosted by Our World in Data, the New York Times, or the Financial Times, success all comes down to one thing: speed. Although speed is measured in many ways including total doses administered, doses administered per 100 people, daily doses administered, total population who has received a first dose, or the share of distributed doses that have been administered, the pace of administration clearly serves as the most prominent (and often only) benchmark by which a country's performance is compared and ranked against other countries. …. … The path of least resistance is the familiar enemy of equity. In addition to speed, countries should be evaluated on metrics that correspond to the actual public health objectives that vaccination programmes should seek to achieve: the extent to which populations at greatest risk (eg, of death, hospitalisation, exposure, or transmission) are being vaccinated; and the extent to which disparities exist among populations eligible to be vaccinated. Measuring success in terms of these additional metrics might compel countries to ensure vaccines are not only deployed rapidly, but also effectively and equitably.”
https://healthpolicy-watch.news/biden-admin-sanctions-cuba-vaccine/
“The Biden administration has been asked to clarify that sanctions against Cuba would not extend to collaborations in the development, manufacturing, distribution and sale of COVID-19 vaccines that the island nation is in the process of developing. A memorandum, sent by Knowledge Ecology International (KEI) on 28 June to the White House, asks the US government to “clear the air” regarding its economic sanctions policies – and thus ensure that private companies and other organizations can work with Cuba on its vaccine programme….”
https://peoplesdispatch.org/2021/07/01/south-south-solidarity-to-challenge-vaccine-inequity/
“The Summit for Vaccine Internationalism organized by Progressive International in June sought to address the pressing issue of global vaccine inequality and come up with concrete solutions.” In-depth analysis of the summit.
https://www.ft.com/content/ced27e46-f3b1-465a-8ecc-5346d608a77f
“…The World Health Organization has called for prices of a Gilead Sciences drug to treat black fungus infections to be cut and supplies boosted amid a sharp rise in cases among Covid-19 patients in India and Nepal. The California-based drugmaker produces AmBisome, a lipid-based amphotericin, which is used to treat the condition, also known as mucormycosis. … …. Mariângela Simão, the WHO’s assistant director-general for access to medicines, told the Financial Times that Gilead should adjust an existing agreement to supply AmBisome at lower prices to poorer nations so that it includes the treatment of black fungus cases linked to coronavirus…..”
“….“An immediate strategy for broadening supply and improving affordability of lipid-based amphotericin is to integrate it into the existing Covid-19 response and for Gilead to extend their existing lower pricing arrangement to Covid patients,” Simão said. Between 150 and 300 vials of the drug are needed to treat a single patient, and a vial can cost up to $69 in India, according to an open letter sent to Gilead in June by Médecins Sans Frontières and experts at Yale and Georgetown universities in the US. Gilead agreed more favourable pricing of $16.25 per vial in 116 lower and middle-income countries in late 2018, but had so far not extended this price to patients suffering from black fungus due to complications from Covid-19, the letter said….”
Links & bits:
· HPW - Pakistani Workers Fear Job Losses as Saudi Arabia and UAE Don’t Recognise Chinese Vaccines
· And the US has started donating vaccines, among others 2 million doses of Pfizer to Peru. Also donations to Pakistan, Bangladesh, … and via Covax to Honduras, …
See also, via HPW: First Shipments of US Donations Days Away for Getting to US
“…. the first shipments of US donations of some 80 million vaccines are now days away from getting to African countries, Masiyiwa said. … “The first US shipments in support of their donations will begin next week to 51 African countries. And they do include Johnson and Johnson and Pfizer vaccines, because these are United States vaccine manufacturers,” he disclosed…..”
· EU, RDB partner to boost vaccine manufacturing capacity in Rwanda
“ The European Union and the Rwanda Development Board have entered a deal worth R3.6 billion Rwandan francs in order to boost vaccine manufacturing capacity in that country.”
· Reuters - CureVac says speaking to EU about ideal region to use vaccine
“…The German biotech firm said late on Wednesday its vaccine was only 48% effective in the final analysis of its pivotal mass trial but it highlighted that efficacy was 77% in the age group younger than 60 years when considering only moderate to severe symptoms and excluding cases of mild disease. Many low and middle-income countries, which have fallen far behind developed nation in the global vaccination campaign, have a younger overall population than Europe. "This is about a broad approach to vaccinate the world population," CEO Haas added…..”
Including a neat world map. “The coronavirus mutation has been detected in 78 countries, and is prevalent in Britain, India and Russia.”
“….According to GISAID, a data-sharing initiative for corona- and influenza-virus sequences, the delta variant has been identified in 78 countries (see chart). The mutation is thought to be perhaps two or three times more transmissible than the original virus first spotted in Wuhan in China in 2019. It is rapidly gaining dominance over others. According to GISAID’s latest four-week average, it represents more than 85% of sequenced viruses in Bangladesh, Britain, India, Indonesia and Russia. It may soon be the most prevalent strain in America, France, Germany, Italy, Mexico, South Africa, Spain and Sweden. ….… The emergence of delta re-emphasises the need to press on, but also to help poor countries inoculate their populations. The moral case is strengthened, but so is one of self-interest: fewer infections means fewer chances for a new mutation to develop. As the world has seen, dangerous variants do not stay in one country for long.”
https://www.theatlantic.com/health/archive/2021/06/novavax-now-best-covid-19-vaccine/619276/
Read why.
“The World Health Organization has received submissions from at least three vaccine makers for emergency approval for additional COVID-19 vaccines and expects to approve at least one or two of them in the next month or two, a top expert said on Friday….”
Z Tufekci ; NYT;
In-depth (troubling) report, among others re some of the practices at the Wuhan lab in recent years.
Conclusion: “Perhaps the biggest one is that we were due for a bat coronavirus outbreak, one way or another, and the research showing bat coronaviruses’ ability to jump to humans was a warning not heeded. …. …. government officials and scientists need to look at the big picture: Seek comity and truth instead of just avoiding embarrassment. Develop a framework that goes beyond blaming China, since the issues raised are truly global. And realize that the next big thing can simply mean taking great care with a lot of small details.”
Wuhan Lab's Last–And Only–Foreign Scientist Speaks Out on Covid Origins Debate - Bloomberg
Very different view than the one sketched above. “Virologist Danielle Anderson paints a very different picture of the Wuhan Institute.” Highly professional, among others.
http://www.healthdata.org/sites/default/files/files/Projects/COVID/2021/1_briefing_Global_9.pdf
Tweet: “IHME’s ’s latest forecast (24 June) provides a sobering look at the state of the pandemic. Transmission is increasing within (some) countries in all regions of the world. “ Check out the trends.
https://www.nytimes.com/2021/06/28/health/coronavirus-vaccine-immunity.html
“New scientific research underscores the effectiveness of vaccines and their versatility in the fight against the coronavirus. Three scientific studies released on Monday offered fresh evidence that widely used vaccines will continue to protect people against the coronavirus for long periods, possibly for years, and can be adapted to fortify the immune system still further if needed. …… Scientists had worried that the immunity conferred by vaccines might quickly wane or that they might somehow be outrun by a rapidly evolving virus. Together, the findings renew optimism that the tools needed to end the pandemic are already at hand, despite the rise of contagious new variants now setting off surges around the globe….”
“The vaccines made by Pfizer-BioNTech and Moderna set off a persistent immune reaction in the body that may protect against the coronavirus for years, scientists reported on Monday. The findings add to growing evidence that most people immunized with the mRNA vaccines may not need boosters, so long as the virus and its variants do not evolve much beyond their current forms — which is not guaranteed…”
https://www.nature.com/articles/d41586-021-01805-2
“A slew of studies suggests that mixing vaccines provokes potent immune responses, but scientists still want answers on real-world efficacy and rare side effects.”
Links:
· Guardian - Third shot of AstraZeneca vaccine could work as booster – study
· Nature News - Is one vaccine dose enough if you’ve had COVID? What the science says
“Research shows that a previous coronavirus infection plus one dose of vaccine provides powerful protection — but concerns linger….”
· NYT - Masks Again? Delta Variant’s Spread Prompts Reconsideration of Precautions.
“… the W.H.O. warned that even immunized people should wear masks indoors. Some scientists agreed, but urged a localized approach.”
I Kickbusch et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00665-6/fulltext
“In a lecture delivered for the Academy of Medical Sciences on Nov 2, 2020, we examined the threat of future pandemics in the light of COVID-19, reviewing how to prepare, how to build resilient health systems, and what we can learn from coronavirus to combat pandemics of the future…. “ Including also 7 political lessons.
A T Gebremeskel, S Abimbola et al ; https://gh.bmj.com/content/6/6/e006108
“Understanding the resilience of health systems to COVID-19 calls for cross-country (within Africa and beyond) comparative analyses of the technical and political response to the pandemic. In this article, we highlight four health system challenges to controlling COVID-19, and offer potential strategies to address them, considering the nuances of the systems across Africa and their widely varying current level of resilience….”
Re: Community and community health worker engagement; medical and diagnostic supplies; data governance and stewardship; health infrastructure development.
Conclusion of the authors: “The COVID-19 pandemic has further exposed the fragility of the health systems in sub-Saharan Africa and the need to boost the resilience of these systems to respond to disease outbreaks. Priority should be given to community-led health initiatives and health workers; ensuring reliable medical and diagnostic supplies; fostering evidence-based practice; and raising additional revenue to boost health system financing within the region, including for health infrastructure development. These recommendations are largely focused on boosting health system resilience at the community level. However, they all require stronger health system governance, including multisectoral collaboration within countries. In addition, greater regional collaborations on these fronts could secure lasting gains for African health systems that extend beyond the current pandemic.”
A Ithibu & A Whiteside; https://www.aidspan.org/en/c/article/5652
“The social and economic consequences of the COVID-19 pandemic have had a devastating impact on the global HIV response. Shrinking economies have undermined the ability of countries (and individuals) to finance their HIV responses as resources are channeled to COVID-19. Widening gender, education, and economic inequalities brought on by the pandemic have increased HIV-related vulnerabilities. Countries and global partners need to rethink and re-strategize the HIV response to offset the loss of gains made due to the pandemic, and jumpstart efforts to get the AIDS response back on track to meet the 2030 goals. “
https://www.economist.com/leaders/2021/07/03/the-long-goodbye-to-covid-19
“The pandemic is still far from over, but glimpses of its legacy are emerging.”
“…So far it looks as if the legacy of covid-19 will follow the pattern set by past pandemics. Nicholas Christakis of Yale University identifies three shifts: the collective threat prompts a growth in state power; the overturning of everyday life leads to a search for meaning; and the closeness of death which brings caution while the disease rages, spurs audacity when it has passed. Each will mark society in its own way…..”
“…The Global HIV Prevention Coalition has published a new report, Preventing HIV infections at the time of a new pandemic: a synthesis report on programme disruptions and adaptations during the COVID-19 pandemic in 2020, which provides a synthesis of the status of HIV prevention programming during the COVID-19 pandemic, identifies critical vulnerabilities, risks and major service disruptions and documents responses in a range of settings. The report places a significant focus on gathering information on programme innovations at the community level….”
D Walker et al ; https://www.cgdev.org/blog/plus-ca-change-covid-19-and-its-collateral-impact-during-vaccine-era
“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 COVID-19’s disruptions to essential health services in those countries, and the health effects of such disruptions. In a working paper released today, we build on a blog we published in March when we released working papers from each country team (the papers are available here: Kenya, the Philippines, South Africa, Uganda). In this new working paper, we summarize the results and lessons across the four countries in more detail. We also tie together many of the blogs we have written on this topic over the past year …”
“….Using a mix of qualitative and quantitative methods, we show that each country experienced disruptions, but they varied in terms of which services, where, who was affected, and most importantly, the degree and duration of the disruptions….”
Good to have a look at this dashboard from time to time.
“As COVID-19 vaccines are being rolled out across the globe, many have wondered whether pregnant and lactating people can or should be vaccinated as part of broader immunization efforts. Countries have taken a variety of positions - ranging from highly restrictive policies that bar access to vaccines based on pregnancy or lactation status to widely permissive positions in which all pregnant or lactating people can receive vaccine, and in some cases, are recommended and encouraged to do so. The COVID-19 Maternal Immunization Tracker (COMIT) provides a global snapshot of public health policies that influence access to COVID-19 vaccines for pregnant and lactating people. Through maps, tables, and country profiles, COMIT provides regularly updated information on country policies and the recommendations of professional medical societies as they respond to the dynamic state of the pandemic and emerging evidence….”
(via Stat): “… countries are divided in their vaccine guidance for pregnant people: There are currently 41 countries that recommend against vaccinating and 91 that at least allow it in some cases….”
https://bridgebeijing.com/our-publications/our-publications-1/china-covid-19-vaccines-tracker/
Good to scan from time to time. As of 28 June: 845M doses sold; 25 m doses donated; 343 m doses delivered. Check in which regions most.
https://www.bmj.com/content/373/bmj.n1271
“Ensuring women’s need for sexual and reproductive healthcare are met should be a priority during disease outbreaks, say Maira L S Takemoto, C Wenham and colleagues. “
“…. To mitigate the effect of the outbreak, policies are needed that are sensitive to maternal health. Using experience from Ebola, Zika, and covid-19, we outline some strategies that can ensure continuity of maternal care during crises, examining supply, demand, and structural challenges….”
R Dhatt et al ; https://www.thinkglobalhealth.org/article/timesup-violence-and-sexual-harassment-against-women-health-professions
Last week marked a milestone in the effort to end workplace harassment.
“…June 25 is a landmark day on the road to eliminating gender-based violence and harassment at work as International Labour Organization Convention 190 (C190) comes into force. To date, Argentina, Fiji, Ecuador, Italy, Namibia, Somalia, and Uruguay have led the way in ratifying this new convention, making commitments to implement policies at the national level that will make the convention’s principles into a reality. We expect other states to follow….”
https://blogs.worldbank.org/health/primary-health-care-needs-be-fit-post-covid-world-how-do-we-do
“…. A new report by the World Bank, “Walking the Talk: Reimagining Primary Health Care After COVID-19”, shows how countries can revitalize their primary health care systems to improve health outcomes and be better prepared for the next global pandemic. ;..”
“In the report, we outline four structural shifts that will be required of countries in the design, financing, and delivery of primary health care: • From low-quality to high-quality services delivered by multi-disciplinary teams to strengthen the range and quality of care. • From fragmented care to person-centered integration, in which cohesive, local primary health teams coordinate care around patients’ needs. • From inequity to fairness and accountability, in which equitable, efficient primary health care delivery fosters and rewards accountability for health outcomes. • From fragility to resilience in which primary health care teams conduct public-health surveillance and outreach, and health sector planning and resource allocation include financial and human-resource surge capacity.”
A Edelman, R Marten et al ; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czab075/6311324?searchresult=1
“…This review synthesizes the current state of knowledge about PHC impacts, implementation enablers and barriers, and knowledge gaps across the three main PHC components as conceptualized in the 2018 Astana Framework….”
And a link:
WB ‘Investing in Health’ blog - A revolution in health service delivery measurement
K Jaelobaiva, S Witter et al ; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00713-4
“This study aimed to map the key global actors investing in action regarding NCDs and review their policies to examine the articulation of priorities regarding NCDs. …”
Results: “In 2019 41% of development assistance for health committed to NCDs came from private philanthropies, while that for other global health priorities from this source was just 20%. Through a range of channels, bilateral donors were the other major source of NCD funding (contributing 41% of NCD funding). The UK and the US were the largest bilateral investors in NCDs, each contributing 8%. However, NCDs are still under-prioritised within bilateral portfolios – receiving just 0.48% of US funding and 1.66% of the UK. NGOs were the key channels of funding for NCDs, spending 48% of the funds from donors in 2019. The reviewed literature generally focused on NCD policies of WHO, with policies of multilateral and bilateral donors given limited attention. The analysis of policies indicated a limited prioritisation of NCDs in policy documents. NCDs are framed in the policies as a barrier to economic growth, poverty reduction, and health system sustainability. Bilateral donors prioritise prevention, while multilateral actors offer policy options for NCD prevention and care. Even where stated as a priority, however, funding allocations are not aligned.”
Bente Mikkelsen et al; http://sdg.iisd.org/commentary/guest-articles/long-overdue-investments-in-ncds-are-vital-to-reach-sdg-3/
Quick explainer of WHO health financing for NCDs. Guest article from Bente Mikkelsen (WHO) et al. explaining why investments to #ActOnNCDs are effective, equitable, and vital to progress #SDG3.
“Disruptions to vital services like cancer treatment, caused by the COVID-19 pandemic, remind us that health predicates the global functioning of societies and economies. Fortunately, the dots are beginning to join between demands on governments, global financial flows, and the health of the commons. …”
C Rinaldi, M Petticrew et al; http://www.ijhpm.com/article_4068.html
“In response to the magnitude of harms caused by alcohol, the WHO Global Strategy to Reduce the Harmful Use of Alcohol (GAS) was endorsed in 2010. We analysed submissions to the 2019 WHO consultation on the implementation of the GAS to identify how different stakeholders frame alcohol use and control; and to assess how stakeholders engage with the consultation process, with possibly harmful consequences for public health policy….”
Results: “….Emerging frames were grouped according to their function: defining the problem, assigning causation, proposing solutions, or justifying and persuading. Submissions varied in terms of the framing they deployed and how this was presented, eg, how the problem was defined. Proposed policy solutions also varied. Targeted solutions emphasising individual responsibility tended to be supported by industry and some Member States. Calls for universal regulation and global mobilisation often came from NGOs and academia. Stakeholders drew on evidence and specific value systems to support the adoption of certain problem and solution ideas and to oppose competing framing….”
“Artificial Intelligence (AI) holds great promise for improving the delivery of healthcare and medicine worldwide, but only if ethics and human rights are put at the heart of its design, deployment, and use, according to new WHO guidance published today. The report, Ethics and governance of artificial intelligence for health, is the result of 2 years of consultations held by a panel of international experts appointed by WHO….”
With six principles to ensure AI works for the public interest in all countries. Promoting human autonomy; promoting human wellbeing and safety and the public interest; ensuring transparency, explainability and intelligibility; fostering responsibility and accountability; ensuring inclusiveness and equity; promoting AI that is responsive and sustainable.
See WHO - Ethics and governance of artificial intelligence for health
Coverage HPW - Artificial Intelligence ‘Very Promising’ for Health, Says WHO
“A UN report that analysed racial justice in the aftermath of the murder of George Floyd has called on member states including the UK to end the “impunity” enjoyed by police officers who violate the human rights of black people. The UN human rights office analysis of 190 deaths across the world led to the report’s damning conclusion that law enforcement officers are rarely held accountable for killing black people due in part to deficient investigations and an unwillingness to acknowledge the impact of structural racism. The 23-page global report, and its accompanying 95-page conference room paper, features seven examples of police deaths, including the case of Kevin Clarke, who died after being restrained by officers in London in 2018….”
“…. The UN human rights 0ffice was tasked in June 2020 to produce a comprehensive report on systemic racism against black people. The report investigated violations of international human rights law by law enforcement, government responses to anti-racism peaceful protests, as well as accountability and redress for victims. The report was led by Michelle Bachelet, the UN high commissioner for human rights and a former president of Chile. Bachelet described the status quo as “untenable”. She said: “Systemic racism needs a systemic response. There needs to be a comprehensive rather than a piecemeal approach to dismantling systems entrenched in centuries of discrimination and violence. We need a transformative approach that tackles the interconnected areas that drive racism, and lead to repeated, wholly avoidable, tragedies like the death of George Floyd…..”
J Olusanya et al ; https://www.nature.com/articles/s41591-021-01422-6
« Black people living in Africa must be involved in setting the priorities for global health research, policies and programs that affect their daily lives, in order to move away from a funding culture that fosters colonialism, racism and white supremacy. »
« …In this article, we share some perspectives on racism as Black Africans resident in Africa who are all engaged in global health. …. a more transparent commitment to equity, equality, diversity and inclusion (EEDI ) [is required] … One consequence of the Black Lives Matter campaign has been the momentum and drive for a paradigm shift toward EEDI in the setting of global health agendas for the Global South. A shift toward EEDI would require that those most affected by research projects, policies and programs have substantive involvement in and joint leadership of these initiatives from conception to implementation. »
…To address these and similar concerns, we offer some suggestions to complement those of our colleagues based in the Global North3, and other initiatives proposed for academic journals in global health ….”
· Link: NPR Opinion - Opinion: I'm Nigerian. I'm Vaccinated. Europe Won't Let Me In
· Tweet Katri Bertram :
« The #DecolonizeGlobalHealth movement has focused on many areas, such as #research #journals & #diversity, but very few people have looked at dependency and power in the space of #advocacy. High time to do so. »
“A new traffic light system on food and drinks packaging is being launched to allow consumers to make more environmentally friendly choices. The scheme has been put together by Foundation Earth, a new non-profit organisation backed by the government, global food giant Nestlé and British brands including Marks & Spencer, Sainsbury’s, the Co-op and Costa Coffee. A pilot run in the autumn will see a range of food and drink carrying front-of-packaging “eco scores” for the first time, ranking the environmental impact of each item and allowing customers to easily assess whether they are buying goods that have a low-carbon footprint from suppliers focused on sustainability….”
O Brown; https://www.chathamhouse.org/2021/06/how-international-system-should-tackle-climate-risk
“For the SDGs to succeed, there must be an urgent move away from reactive ‘defence-oriented’ mindsets when managing climate risk.”
“…. Roughly two dozen international organizations, mostly in the United Nations (UN) family, foster cooperation and set the global agenda on a range of critical issues, including health, water, energy, environment, food, migration, security, and development. Collectively they provide the world with a critical safety net and, in the words of the second UN Secretary-General Dag Hammarskjöld, the purpose is not to lead humanity to heaven but rather to ‘save it from hell’. Climate change certainly provides a potentially hellish problem – happening everywhere, at all scales, and cascading across borders and sectors with unpredictable impacts. It is already damaging critical infrastructure, undermining economic growth, and displacing entire communities, and is an existential challenge for low-lying island states and coastal areas. But our international ‘safety net’ was largely built between the end of the Second World War and the 1970s, before the impacts of anthropogenic climate change were widely understood, leaving the question of whether this system is fit for purpose in a climate-changing world.”
“… Chatham House, together with E3G, has been investigating how climate risks impact the international system as part of a collaboration between British and Chinese research groups. Organizations such as the UN Framework Convention on Climate Change, the World Meteorological Organisation, the World Bank, the World Health Organization (WHO), and the UN Development Programme play a critical role in raising the alarm on how climate change affects global well-being, and also coax governments towards action to address the challenge of mitigating greenhouse gas emissions and adapting to climate impact…..”
https://news.un.org/en/story/2021/07/1095202
“Without an urgent injection of cash, billions globally are at risk of still being without lifesaving access to safe drinking water, sanitation and hygiene services by 2030, according to a new UN (UNICEF/WHO) report published on Thursday. …. “
“…The study also made clear that if current trends persist, by 2030 billions of children and families would be left without life-saving WASH services. It notes that still only 81 per cent of the world’s population would have access to safe drinking water at home, leaving 1.6 billion without; just 67 per cent would have safe sanitation services, leaving 2.8 billion in the lurch; and only 78 per cent would have basic handwashing facilities, leaving 1.9 billion adrift. “Investment in water, sanitation and hygiene must be a global priority if we are to end this pandemic and build more resilient health systems”, Tedros stressed. ….”
TWN - UN: Global social protection fund needed to support low-income countries https://www.twn.my/title2/unsd/2021/unsd210612.htm
“A global fund for social protection needs to be established to increase the level of support to low-income countries, in order to help them both to establish and maintain social protection floors in the form of legal entitlements, and to improve the resilience of social protection systems against shocks, a UN human rights expert has said. In a report to the UN Human Rights Council (A/HRC/47/36), Mr Olivier De Schutter, the Special Rapporteur on extreme poverty and human rights, said that such a fund is affordable, whether funding comes from official development assistance (ODA) or from other sources, including unused or new special drawing rights (SDRs). “Moreover, social protection should be seen as an investment with potentially high returns, since it leads to building human capital, has significant multiplier effects in the local economy, and contributes to inclusive growth and to resilience in times of crisis,” he said….”
“Countries must prepare for future crises by setting up a Global Fund for Social Protection, a new international financing mechanism that will help protect their populations from the next pandemic, says a new report presented …. by Olivier De Schutter, the UN’s special rapporteur on poverty, before the Human Rights Council….”
““Establishing a Global Fund for Social Protection is doable, and it is affordable, but it requires political will,” De Schutter said. “The ILO estimates that less than $78 billion would be needed for low-income countries to establish social protection floors, including healthcare, covering their population of 711 million. While that might sound like a high figure, it is actually less than half of what developed countries are already providing in development aid. The question is therefore not about affordability, but about setting the right political priorities.”…”
In related news, see UN News - Social protection ‘lifeline’ during COVID, depends on where you live
“Although the COVID-19 pandemic had triggered the roll-out of an “unprecedented number” of new and often innovative social protection measures, it was unable to stem a widening gap between rich and poor countries, according to a new UN report released on Thursday.”
“…. Offering fresh data on how social assistance spending has cushioned the unparalleled economic shock triggered by the pandemic, the UN Development Fund’s (UNDP) Mitigating Poverty assessment, revealed that in the 41 countries for which data was available, around 12 million people were prevented from falling below the poverty line, out of 15 million in danger. While the overall mitigation impact was strong, the study also uncovered that it was largely confined to high and upper middle-income States. The authors estimated that between 117 million and 168 million people became poor during the pandemic. Although $2.9 trillion were invested in social protection policies globally, only $379 billion were spent by developing countries. Meanwhile, on average, high-income countries allocated $847 per capita on social protection measures, including assistance and insurance, while low and middle-income counterparts spent an average of just $124 per head. At the same time, total per capita social protection in low-income countries alone, was as little as $4. “
(1 July) “130 countries just agreed a *historic* two-pillar global tax reform with a global minimum tax of at least 15% and reallocation of taxing rights to market countries.
See also the Guardian – Global tax reform: 130 countries commit to minimum corporate rate
Landmark moment for the world economy. “…The announcement comes ahead of further talks on tax reforms expected to be held between finance ministers at G20 meetings in Venice next month, with ambitions for a final global deal to be agreed by October and implemented in 2023.”
D Battacharya; https://www.newsclick.in/UN-Food-Systems-Summit-Implications-India-Civil-Societies-Boycotting
“'The WEF’s multi-stakeholder platforms lack democratic legitimacy and focus instead on harnessing the opportunities of the Fourth Industrial Revolution for the benefit of transnational corporations (TNCs) and global financial capital.”
“The People's Health Movement’s (PHM’s) Food and Nutrition thematic circle has called for a boycott of the UN Food Systems Summit 2021 because of corporate influence and the marginalisation of civil society voices. Civil Society and Indigenous Peoples’ Mechanism (CSM) for relations with the UN Committee has also called for mobilisation to challenge the Summit and reclaim people’s sovereignty over food systems….”
https://www.opendemocracy.net/en/5050/aid-donors-investigate-anti-gay-therapy/
“Major NGOs that run clinics in Kenya and Tanzania also pledge action against ‘abhorrent’ practices to ‘change’ individuals’ sexual orientation.”
https://www.statnews.com/2021/07/01/washingtons-antitrust-limit-amazon-google-health-ambitions/
(gated) “Washington is abuzz with an ambitious new antitrust effort to rein in the power of tech industry power players like Apple, Amazon, Google, and Facebook — and the effort could limit their ascent in the health care industry….”
Good analysis. “Military victories combined with new alliances and shifts in strategy reinforce militants’ position across much of continent.”
“Islamic State’s affiliates in Africa are set for major expansion after a series of significant victories, new alliances and shifts in strategy reinforced their position across much of the continent. …
“Following recent gains in Nigeria, the Sahel, in Mozambique and the Democratic Republic of the Congo, Isis propaganda published by the group’s leadership in its heartland in the Middle East is increasingly stressing sub-Saharan Africa as a new front which may compensate the group for significant setbacks elsewhere. Detailed accounts of recent internal debates in Nigeria, where Islamic State West Africa Province (Iswap) recently routed Boko Haram, suggest a new emphasis by Isis in Africa on providing security and basic services to local communities. Though strategies differ according to local conditions, the new bid by the group to create zones of “jihadi governance” could pose a major challenge to weak, corrupt and inefficient national authorities, analysts fear….”
Analysis by L Rubenstein of the state of affairs, five years after ‘Resolution 2286’.
J Wintrup; https://www.tandfonline.com/doi/full/10.1080/09581596.2021.1945535?src=
“…Drawing on an ethnography of a large-scale global health partnership between the Zambian state and the Clinton Foundation, this paper examines the novel configurations of sovereignty that are created by these large-scale global health partnerships. It shows how officials from the Clinton Foundation came to believe that senior Zambian government actors had granted them the authority to implement the programme outside of the formal channels of the government health system. I conceptualise this as an informal mode of ‘outsourcing sovereignty’ and show how it led Clinton Foundation employees to behave as de facto state actors in rural Zambia. This paper contributes to the broader critical task of describing and analysing new forms of governmental pluralism in contemporary global health and highlights some of the politically troubling consequences when sovereignty is informally outsourced in this way.”
Links:
Lancet Healthy Longevity - A call for standardised age-disaggregated health data
WHO call.
“… [recent] developments led Financial Times columnist Martin Sandbu to recently declare that the IMF and World Bank have undergone a remarkable “conversion” from free markets orthodoxy to now supporting the “activist state.”
“But is it all really so? While the IMF has certainly talked a good game on its new flexibility during the COVID crisis, an independent analysis of expenditure projections in the IMF’s October 2020 World Economic Outlook database shows that austerity cuts are expected in 154 countries in 2021, and as many as 159 countries in 2022, with the trend continuing for an average of 139 countries per year through 2025 – not exactly a striking departure from its traditional predilection for austerity. But beyond the issue of the IMF’s fiscal austerity, the policies of the Washington Consensus are collectively much farther-ranging and have often had a critical impact on the shape of the economic development strategies of developing countries. In order to believe the consensus has really ended, we would need to ask many more questions about the policy challenges still faced by developing countries that are struggling with integrating into the global economy.”
With some examples of what that would entail.
Rowden concludes: “ And at the broadest level, are the Bretton Woods institutions actually now rethinking the need for developing economies to “integrate into the global economy” first, and worry about national economic development later? Are they instead now encouraging such countries to focus first on building up their national economies through long-term national economic development strategies to build up the domestic manufacturing sector, and worry about global integration later? Since the answer to all of these questions is “presumedly not,” it is safe to say that not a whole has changed yet. While it’s easy to be swayed by the institutions’ fashionable new lingo on gender, inequality, green investment and Covid stimulus, we would do better to look at the institutions’ full body of current policy advice on development strategy and the actual loan conditions to see how the nuts and bolts of the Washington Consensus remain quite intact.”
J Pisani-Ferry; https://www.project-syndicate.org/commentary/future-of-globalization-national-priorities-international-threats-by-jean-pisani-ferry-2021-06
“The tension between the unprecedented need for global collective action and a growing aspiration to rebuild political communities behind national borders is a defining challenge for today’s policymakers. And it is currently unclear whether they can reconcile the two agendas.”
“…. The more fundamental question is whether the world can find a way out of the tension between scattered national and regional preferences and the increasingly urgent need for collective action. Climate has become the testing ground for it. The outcome will eventually indicate whether the dual agendas of rebuilding economic belonging and managing the global commons can be reconciled. It will take time to learn the answer. The old globalization is dying, but the new one has yet to be born.”
B Clements et al ; https://www.cgdev.org/blog/avoiding-high-fiscal-costs-terrorism-post-covid-era
“In this blog post, we provide new evidence that in addition to its human cost, terrorism can have important consequences for public budgets. Most of the costs of terrorism—like loss of life and political upheaval—are well-known, but the macroeconomic and fiscal impacts are less well understood. Terrorism can suppress economic activity, reduce government revenue, and cause government finances to be redirected away from social spending to the military, all of which can exacerbate the inequalities that COVID has deepened. In this light, we argue that fiscal policies that build social cohesion—addressing what may be the underlying drivers of extremism—will be helpful in both addressing inequality and reducing the fiscal risks posed by terrorism….”
“The founders of @WHO very consciously decided to move the health organisation out of „political“ New York because of the experiences with the politicisation of health leading up to and during WW2 at the League of Nations. We must go back and read this history.”
“#globalhealth needs to shift its efforts towards strengthening the foundations of health systems -infrastructure (water, electricity, connectivity, oxygen in clinics and hospitals) -human resources for health”.
“@AFD_France is stepping up its response to the #COVID19 crisis through partnerships to strengthen health systems across the world More than US$ 2 billion for health and social protection in 2020 & growing commitments for 2021.”
“Angry is right. I talked with researchers in South America & Africa who were livid about calls for more open-sharing of data on variants so that rich countries could ensure their (exclusive) vaccines are still effective. “
https://sustainabledevelopment.un.org/hlpf/2021
“The HLPF will discuss ways to ensure a sustainable and resilient recovery from COVID-19 that puts us on track to realize the 2030 Agenda. The theme will be "Sustainable and resilient recovery from the COVID-19 pandemic that promotes the economic, social and environmental dimensions of sustainable development: building an inclusive and effective path for the achievement of the 2030 Agenda in the context of the decade of action and delivery for sustainable development".
The HLPF in 2021 will discuss Sustainable Development Goals 1 on no poverty, 2 on zero hunger, 3 on good health and well-being, 8 on decent work and economic growth, 10 on reduced inequalities, 12 on responsible consumption and production, 13 on climate action, 16 on peace, justice and strong institutions, and 17 on partnerships in depth. The Forum will also consider the integrated, indivisible and interlinked nature of the Sustainable Development Goals….”
For some analysis ahead of the HLPF, see UN News - Turning crisis into opportunity: World leaders meet at UN to help drive pandemic recovery
“The humanitarian aid sector has gotten better at meeting vulnerable populations’ needs — but the root causes of humanitarian crises continue to mount, and the present response is “inadequate to the scale of the problem,” according to Mark Lowcock, the United Nations’ recently departed undersecretary-general for humanitarian affairs. In an interview with Devex, Lowcock called for three main changes to help the humanitarian system respond to the world’s mounting crises. The first is increasing the level of anticipatory responses to the growing climate and conflict-related crises to match rising needs, which the COVID-19 pandemic has exacerbated, Lowcock said. The two others are longer-term financing models and regular donor funding streams, which can both help the humanitarian sector get ahead of potential crises before they worsen….”
Lowcock’s successor is Martin Griffiths.
Washington says it sees little scope for deal-making at WTO this year | Reuters
“A U.S. delegate told the World Trade Organization on Friday that he saw "very little scope for negotiated outcomes" ahead of a major ministerial conference set for later this year, citing the difficulties of negotiating in person among the challenges….”
“… The WTO's 164 members are set to negotiate a range of topics at the meeting in November and December, the global trade watchdog's 12th such conference, including trade and the pandemic as well as agriculture and fisheries. "While we would like to see a successful MC12, we must be pragmatic with respect to the circumstances in which we are operating," U.S. Charge d'Affaires David Bisbee told a members-only meeting in a statement seen by Reuters. "There are a large number of challenging issues facing Members, these have been made all the more challenging to address due to the inability to meet in person and the absence of experts from capitals in the room," he added. … …. In the same speech, Bisbee repeated calls for fundamental reforms of the hobbled WTO dispute settlement system, saying the United States "will engage constructively with members at the appropriate time". He also welcomed members' decision to advance negotiations on a possible patents waiver for COVID-19 vaccines. "We are in a global health crisis and need to move urgently in this area," he said. “
“If B3W is to be the better Belt and Road, it will have to embrace the role of government in infrastructure provision and ensure private sector infrastructure projects are designed and run in the public interest. Otherwise, and despite the denials-, low- and middle-income countries would be right to see it as not about them, but just about China.”
D Andrews et al ; https://www.cgdev.org/blog/how-can-countries-use-their-sdrs
“A new allocation of Special Drawing Rights (SDRs) amounting to some $650 billion is now expected the end of August. This allocation of an IMF reserve asset, intended to help countries weather the economic crisis created by COVID-19, will be more than 2½ times the size of the last allocation and substantially boost countries’ gross international reserves. For many low- and middle-income countries (LMICs) these added reserves will provide policymakers much needed room for maneuver as they continue to struggle with huge economic impact of the global pandemic and its aftermath. While much of the current international debate is now focused on how to recycle SDRs from developed economies to support LMICs, we need to ask a more immediate question: How can LMICs use the allocation they will get in late August?...”
And a link:
Globalization & Health - Evaluating implementation of International Health Regulations core capacities: using the Electronic States Parties Self-Assessment Annual Reporting Tool (e-SPAR) to monitor progress with Joint External Evaluation indicators
“China, India, Indonesia, Japan and Vietnam plan to build more than 600 coal power units.”
“… while some social scientists, journalists, and activists have been raising concerns about how social media are affecting our democracy, mental health, and relationships, we haven’t seen biologists and ecologists weighing in as much. That’s changed with a new paper published in the prestigious science journal PNAS earlier this month, titled “Stewardship of global collective behavior.”
Seventeen researchers who specialize in widely different fields, from climate science to philosophy, make the case that academics should treat the study of technology’s large-scale impact on society as a “crisis discipline.” A crisis discipline is a field in which scientists across different fields work quickly to address an urgent societal problem — like how conservation biology tries to protect endangered species or climate science research aims to stop global warming. The paper argues that our lack of understanding about the collective behavioral effects of new technology is a danger to democracy and scientific progress….”
“Majority of land at risk from a 1-metre sea level rise is in the tropics, research finds.”
“Up to 410 million people will be living in areas less than 2 metres above sea level, and at risk from sea level rises, unless global emissions are reduced, according to a new study. The paper, published in Nature Communications, finds that currently 267 million people worldwide live on land less than 2 metres above sea level. Using a remote sensing method called Lidar, which pulsates laser light across coastal areas to measure elevation on the Earth’s surface, the researchers predicted that by 2100, with a 1 metre sea level rise and zero population growth, that number could increase to 410 million people. Their maps showed that 62% of the most at-risk land is concentrated in the tropics, with Indonesia having the largest extent of land at risk worldwide. These projections showed even more risk in the future, with 72% of the at-risk population in the tropics, and 59% in tropical Asia alone….”
https://healthpolicy-watch.news/health-workers-mental-covid-pandemic/
Analysis published ahead of a webinar on 30 June. “Healthcare professionals, and particularly community health workers who have been the backbone of local and national health systems during the COVID crisis, are also unsung ‘first responders’ to the massive mental health fallout from the pandemic, now and going forward. That is the central theme of a webinar panel on ‘COVID-19 and Frontline Workers’, Wednesday, 30th June, 13:00 – 15:00 CET, which featuring COVID response and mental health experts from the World Health Organization, the International Council of Nurses and consumer groups. The panel is sponsored by the Geneva-based Global Self-Care Federation with Health Policy Watch serving as media partners for the event. ….”
M Sommer et al ; https://www.tandfonline.com/doi/full/10.1080/16549716.2021.1920315
“There is increasing global attention to the importance of menstrual health and hygiene (MHH) for the lives of those who menstruate and gender equality. Yet, the global development community, which focuses on issues ranging from gender to climate change to health, is overdue to draw attention to how addressing MHH may enable progress in attaining the Sustainable Development Goals (SDGs). To address this gap, we undertook a collective exercise to hypothesize the linkages between MHH and the 17 SDGs, and to identify how MHH contributes to priority outcome measures within key sectoral areas of relevance to menstruating girls in low- and middle-income countries. These areas included Education, Gender, Health (Sexual and Reproductive Health; Psychosocial Wellbeing), and Water, Sanitation and Hygiene (WASH)…..”
Links:
“The WHO List of Priority Medical Devices for management of cardiovascular diseases and diabetes, released today, will help policy-makers and health-care providers prioritize the selection and procurement of medical devices for these health conditions. It includes more than 500 devices that are required at all levels of the health system, from primary care facilities to highly specialized hospitals, and devices needed for health emergencies such as cardiac arrest, stroke and hypo or hyperglycemic emergencies.”
https://www.ft.com/content/c0a5c2e5-fa34-417d-8ac7-6b4b982b44b7
“French group to open a ‘dedicated mRNA centre of excellence’ after falling behind in Covid-19 jab race.”
“Sanofi plans to invest €400m a year to develop vaccines based on the novel mRNA technology that has disrupted competition among the world’s biggest vaccine makers since the pandemic began. The French pharmaceutical group will open a “dedicated vaccine mRNA centre of excellence”, with 400 employees spanning research and development, and manufacturing at sites in Cambridge in the US and Lyon in France, it said in statement on Tuesday. The group aims to have at least six mRNA vaccine “clinical candidates” by 2025, although it did not specify for what infectious diseases….”
https://healthpolicy-watch.news/frontline-health-workers-covid-19/
“The mental health of frontline healthcare workers must be supported and included in global mental health policy during and after the COVID-19 pandemic, said experts at a Wednesday webinar sponsored by the Geneva-based Global Self-Care Federation (GSCF). …”
Kerry Scott et al; https://academic.oup.com/heapol/article/36/6/982/6274660?searchresult=1
“Cognitive interviewing is a qualitative research method for improving the validity of quantitative surveys, which has been underused by academic researchers and monitoring and evaluation teams in global health. Draft survey questions are administered to participants drawn from the same population as the respondent group for the survey itself. The interviewer facilitates a detailed discussion with the participant to assess how the participant interpreted each question and how they formulated their response. Draft survey questions are revised and undergo additional rounds of cognitive interviewing until they achieve high comprehension and cognitive match between the research team’s intent and the target population’s interpretation. This methodology is particularly important in global health when surveys involve translation or are developed by researchers who differ from the population being surveyed in terms of socio-demographic characteristics, worldview, or other aspects of identity. Without cognitive interviewing, surveys risk measurement error by including questions that respondents find incomprehensible, that respondents are unable to accurately answer, or that respondents interpret in unintended ways. This methodological musing seeks to encourage a wider uptake of cognitive interviewing in global public health research, provide practical guidance on its application, and prompt discussion on its value and practice. To this end, we define cognitive interviewing, discuss how cognitive interviewing compares to other forms of survey tool development and validation, and present practical steps for its application….”
C Rinaldi et al ; https://www.ijhpm.com/article_4070_d279fed024f81a72e3ea0759cdab0ba6.pdf
“…. We distinguish between three main common themes emerging from the commentaries. Gradually zooming out from the original paper, we first discuss the definitions and scope of populism and welfare chauvinism. We secondly reflect on the historic role of mainstream parties in welfare retrenchment, and how this relates to PRR discourses of the ‘(un)deserving.’ Thirdly, we discuss the relevance of the PRR in relation to other policy areas that affect population health and health equity…..”
M Kavanagh et al; https://jamanetwork.com/journals/jama/fullarticle/2781756
“This Viewpoint offers 3 strategies to address inequity in pandemic vaccine response, among others: an agreement to share technology and allow countries to waive intellectual property rights in global public health emergencies.”
“Deep-rooted structural inequalities and patriarchal values are to blame for India’s worrying Covid vaccine gender gap, campaigners and academics have warned….”
“….A handful of states, including Kerala and Andhra Pradesh, have given more doses to women than men.”
https://www.devex.com/news/invisible-wall-bars-refugees-migrants-from-covid-19-vaccine-access-100273
“While more and more countries are including refugees and migrants in their national COVID-19 vaccination plans, barriers remain to ensure equitable access in practice, according to a new report from the International Federation of Red Cross and Red Crescent Societies….”
Stat;
Helen Branswell compiles 12 lessons.
“To stop pandemics in their tracks countries must implement strict border controls, restrict entry and implement quarantine, a study has found. Research published in the journal BMJ Open also showed that case finding, repeat testing to rule out false results, apps and use of GPS data to enable contact tracing are key to curb the spread of infection early on. Self isolation with financial support where needed is also critical. …”
“Elusive “correlates of protection” could lead to approvals without big clinical trials”.