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Dear Colleagues,
While over here in Belgium it sort of felt like half a holiday (with quite some colleagues enjoying their autumn holidays), in the world it feels like anything but, given the two major wicked challenges and tragedies (amongst a bunch of others) raging on the planet: the pandemic and the climate crisis/emergency. Last weekend’s G20 summit didn’t really “deliver” on either of them ( in the words of Amanda Glassman in a webinar: “it wasn’t exactly a slam dunk”). Two pictures will no doubt become iconic ones, though. The (already notorious) ‘G20 leaders tossing coins’ picture at the Trevi fountain, and the opening “family” picture, whereby G20 leaders and health workers shared the stage. The latter was great “We’re all in this together” & “let’s cherish our global health heroes” PR, but unfortunately, our leaders then mostly came up again with “recycled promises” on the pandemic. Conversely, on the climate emergency, mid-century ( or even 2060/2070) pledges seem in vogue these days. By then, chances are all these leaders will be dead and buried deep under the ground like me (bar Mr Modi perhaps). Still, there were some exceptions at the COP (see below). In any case, though, like in the Covid pandemic, implementation of all these lofty pledges, short or longer term, will be crucial. And accountability. Not sure that rhymes well with BoJo & co.
Time for a Tedros quote. Recently, the WHO chief stated with respect to health emergencies, “We need to fix the roof before the rain comes”, which is no doubt sound advice, but when it comes to the climate crisis, one starts to wonder whether mankind still hàs a roof in the first place. A “quick win” for Tedros’ great communication team, perhaps: how about starting WHO press briefings with that lovely Travis song, “Why does it always rain on me?” . Multifunctional song too, if you ask me. As for global health security reform (i.e. pandemic preparedness & response), these are crucial weeks and months, amongst others with a special WHA session coming up end of the month.
Over to COP 26 then, in Glasgow. While the world had to listen to sorry James Bond comparisons during the Leaders’ opening of COP 26, saw at least a few of our aged leaders nodding ( being sort of “early aged”, I can relate to that 😊), ‘greenwashing’ remains a big risk at these events, and too many world leaders, billionaires and other VIPs again flew in with their private jets “to set bold goals for mankind” (as is their annoying habit), climate adaption seems to be rising steadily on the agenda (no doubt because we’ve proven collectively so damned good at mitigation). Also, with a cosmopolitan moment clearly not around the corner (even if I put on my multifocal glasses), it seems we’re instead going through a “methane moment” of sorts. More to come no doubt in the coming days.
By now, you probably know my take on the climate emergency. We’ll have to throw everything at this incredibly hard challenge in the years and decades to come: the “take no hostages” activism of a brave young generation, mitigation, adaptation, climate justice (including some real ‘finance’), carbon capture & storage, even some of the fancy (and frankly, frigthening) stuff that is coming close to geoengineering, I’m afraid. We clearly also need Mazzucato’s mission-oriented approach, as well as systems change towards a care economy. And perhaps, most of all, as Monbiot pointed out in a recent article in the Guardian : “The difficult truth is that, to prevent climate and ecological catastrophe, we need to level down. We need to pursue what the Belgian philosopher Ingrid Robeyns calls limitarianism. “ I personally doubt Sapiens has that sort of ‘sufficiency & care economy’ in his/her veins. But as the saying goes, there really is no alternative. Even if in the end, we all end up under the ground (except Modi perhaps 😊).
Enjoy your reading.
Kristof Decoster
We start with a few must-reads, then follow up with some optional links and more analysis.
Grim but accurate overall analysis (of the Leaders’ summit). “There will be no airlifting of COVID-19 vaccines to poor countries struggling to get their immunisation figures into double digits. There are also no concrete plans for wealthy countries to make good on their earlier dose promises to COVAX by giving actual delivery dates. And, there is no date for wealthy countries to phase out coal-based power. Instead, the weekend G20 meeting of the world’s richest nations offered a bland declaration that failed to offer solutions to COVID-19 vaccine equity or the climate change crisis. … In fact, the most decisive action at the Rome meeting came on its margins – when US President Joe Biden issued an executive order enabling the release of “strategic and critical materials from the National Defense Stockpile” to ease global supply-chain shortages related to vaccines…..”
“The Rome Declaration, adopted on Sunday after months of negotiation, is bland and non-specific, particularly as far as concrete commitments of money or vaccine doses are concerned. …”
PS: Final Declaration of the Rome (Leaders’) Summit 20 p. (For the lovers of bland and vague declarations). PS: you might want to read (4) and (5) more in detail re health.
Coverage of the Finance & Health Ministers’ meeting on Friday. “Finance and health ministers from the world's 20 biggest economies (G20) said on Friday they would take steps to ensure 70% of the world's population is vaccinated against COVID-19 by mid-2022 and created a task force to fight future pandemics. They could not reach agreement on a separate financing facility proposed by the United States and Indonesia, but said the task force would explore options for mobilising funds to boost pandemic preparedness, prevention and response….”
"To help advance toward the global goals of vaccinating at least 40 percent of the population in all countries by the end of 2021 and 70 percent by mid-2022 ... we will take steps to help boost the supply of vaccines and essential medical products and inputs in developing countries and remove relevant supply and financing constraints," the G20 ministers said in a communique seen by Reuters. The previous goal had eyed vaccinating 70% of the world's population by the autumn of 2022. …. "We establish a G20 Joint Finance-Health Task Force aimed at enhancing dialogue and global cooperation on issues relating to pandemic prevention, preparedness and response, promoting the exchange of experiences and best practices, developing coordination arrangements between Finance and Health Ministries, promoting collective action, assessing and addressing health emergencies with cross-border impact and encouraging effective stewardship of resources," the statement said. …. … They also called for boosting the resilience of supply chains through voluntary technology transfer hubs in various regions, such as the newly established mRNA Hubs in South Africa, Brazil and Argentina, and through joint production and processing arrangements. The call for a voluntary mRNA technology transfer means that talks on the idea of a temporary waiver of intellectual property rights on COVID-19 vaccines and therapies ….” remain stuck at the World Trade Organisation.”
See Final communiqué: Italian G20 presidency - Joint G20 Finance and Health Ministers meeting .
And some links:
· Reuters - G20 set to commit to cutting period to develop vaccines in pandemic- draft To 100 days.
· Beijing Review - Xi proposes global vaccine cooperation action initiative
“Chinese President Xi Jinping on October 30 proposed a six-point Global Vaccine Cooperation Action Initiative while addressing the 16th Group of 20 (G20) Leaders' Summit via video link…” (including Trips waiver, by the way.
· Guardian - Xi Jinping calls for mutual Covid vaccine approvals So did Vlad.
· Reuters - G20 leaders endorse tax deal, pledge more vaccines for the poor
“Leaders of the world's 20 biggest economies endorsed on Saturday a global minimum tax aimed at stopping big business from hiding profits in tax havens, and also agreed to get more COVID vaccines to poorer nations. Attending their first in-person summit in two years, G20 leaders broadly backed calls to extend debt relief for impoverished countries and pledged to vaccinate 70% of the world's population against COVID-19 by mid-2022…..”
· Politico - G20 countries launch task force to put financial firepower into tackling health crises
“….. But the proposal stops short of the ‘Global Health Board’ proposed by commission led by former Italian PM Mario Monti. …. The G20 Joint Finance-Health Task Force, announced in a communiqué, is charged with enhancing coordination against health threats and promoting joint actions, including deciding how to invest funds. It will be staffed with officials from both the ministries of health and finance of participating countries. It will be initially led by Italy and Indonesia, the G20 hosts for 2021 and 2022, respectively. According to the communiqué, it will cooperate with the World Health Organization [hosting its Secretariat] as well as receiving the support of the World Bank … The G20 proposal does fall short of the full-blown board envisaged by the WHO panel. But even in its less ambitious form, it met political resistance from a number of G20 countries. ….”
· Tweet Kent Buse:
“#G20healthfinance communiqué - Great to see coordination/progress, yet * heavy on principles; light on commitments * no numbers/plan on vaccine sharing * scant reference to Independent Panel recs * #G20 Joint Finance-Health Task Force - is it inclusive?”
· Chatham House (Expert comments) – G20's lack of progress highlights challenge for COP26
“A positive outcome from the G20 summit was committing to end international financing for coal projects but, on other issues, the communique was ultimately weak.”
The Expert comments include Rob Yates’ take: “Platitudes and vague Plans on Pandemic Preparedness” (let’s call this, “PPPP”)
“As G20 leaders head to Glasgow to tackle the evolving climate crisis, they leave Rome having failed, yet again, to take serious action to end the ongoing COVID-19 crisis. Despite the obvious urgency to achieve universal vaccine coverage, their communique contains little more than platitudes and vague plans to prepare better for future pandemics. It is not as if they had not been briefed. …”
· G20 Summit COVID-19 outcome deeply disappointing: Statement by Former Co-Chairs of the Independent Panel for Pandemic Preparedness and Response, Her Excellency President Ellen Johnson Sirleaf and Right Honourable Helen Clark
Read why the former co-chairs of the IPPPR were disappointed.
· TGH - The G20 Disappoints on Global Health, but That’s OK with the United States
David Fidler’s take, focusing on the US. “U.S. foreign policy on global health did not require the G20 Summit to be transformative.” Recommended read.
Excerpts:
“… Global health experts were not enthusiastic about the task force. However, the Biden administration supports a pandemic PPR funding mechanism as an important global health governance reform. For the United States, the task force has tactical significance in advancing a funding mechanism. Under this perspective, criticisms that the task force comes with no funding confuse what is tactical and what is strategic….”
On the “global health "boilerplate" language”: “…The Rome declaration acknowledged the health, economic, and social damage that the pandemic has inflicted beyond COVID-19 illnesses and deaths. It contains commitments, recommitments, and statements of support concerning responses to global health challenges created, highlighted, or made worse by the pandemic. These parts of the declaration replicate global health "boilerplate" language ubiquitous before COVID-19 struck but that, considering the behavior of G20 members during the pandemic, raise hard questions. ….
Yet, “…. Although frustrating, such a boilerplate creates no problems for U.S. policy. The G20 Summit was never going to overcome U.S. skepticism about a pandemic treaty. The Biden administration had already signaled its support for strengthening the IHR. U.S. foreign policy on other global health problems remains a work in progress given the emphasis on COVID-19 and strengthening future pandemic PPR, so the declaration's global health laundry lists do not tie U.S. hands moving forward. ….
And he concludes: “ … The way that global health played out during the G20 Summit provides another indication that the foreign policy significance of COVID-19 and its aftermath for the United States is shifting as other pressing problems emerge and re-emerge to challenge U.S. power, interests, and ideals. Whether this transition anchors global health more firmly amongst other competing priorities in U.S. foreign policy or becomes another fade into marginalization remains to be seen.”
Given the wealth of news & reports coming out of Glasgow, we also refer to the extra section on ‘planetary health’, below.
https://www.devex.com/news/cop-26-world-leaders-summit-5-takeaways-for-the-development-sector-101972
“World leaders gathered in Scotland on Monday to launch the 26th United Nations Climate Change Conference, amid dire warnings of the effects of a heating planet for humankind, especially people in lower-income countries. The high-stakes event began just as a summit of the G-20 group of nations closed, failing to achieve major breakthroughs on climate, as many had hoped. There was little in the way of big announcements at the World Leaders Summit subevent as COP 26 opened, with the major exception of a commitment from Indian President Narendra Modi that his country would reach net-zero emissions by 2070. But there were some key takeaways for the development sector from leaders’ speeches Monday — which saw climate adaptation rapidly advancing up the agenda….”
See also Devex - A subdued start for COP 26
But see also UN News - ‘Dramatic’ boost needed in climate adaptation: UN environment agency
“ Although policies and planning for climate change adaptation are increasing, financing and implementation lag behind, the UN Environment Programme (UNEP) said in a new report published on Thursday. The Adaptation Gap Report 2021: The Gathering Storm calls for ramping up funding and action to address the growing impacts of climate change….”
https://www.devex.com/news/devex-newswire-where-cop-26-goes-from-here-102004
As a reminder: “…. These international climate summits serve multiple purposes. Their primary — and yet, arguably most convoluted — function is to advance international climate change policy and agreements through two weeks of intensive negotiations. … With delegates facing thorny questions this year around fulfilling climate finance commitments, raising ambition in emissions reduction pledges, and increasing support for adaptation — the smart money is on that happening again. But the COPs are also a big moment for complementary announcements of new initiatives, partnerships, and strategies as governments, businesses, and civil society use the occasion to make a splash. These can have the added benefit of lending credibility to promises made inside the negotiating halls by turning jargon-riddled climate treaties into — hopefully — more tangible projects in the real world….”
Guess that’s the benign view on a COP : )
https://www.chathamhouse.org/2021/11/cop26-preliminary-progress-world-leaders-exit
“COP26 has been described as the ‘last, best chance’ to keep 1.5 degrees in reach but, with the high-level segment concluded, what progress has been made?”
Good and concise analysis. (as of 3 November)
https://www.devex.com/news/at-cop-26-civil-society-groups-fear-exclusion-from-negotiations-102008
“Civil society activists have criticized what they call a “quasi ban” on observing negotiations at COP 26 in Glasgow, amid fears that observers will be excluded again from talks….”
“Johan Rockström, the director of the Potsdam Institute for Climate Impact Research and one of the world’s foremost climate scientists, warned that the 1.5C target was not like other political negotiations, which can be haggled over or compromised on. “A rise of 1.5C is not an arbitrary number, it is not a political number. It is a planetary boundary,” he told the Guardian in an interview. “Every fraction of a degree more is dangerous.”….”
“World leaders have agreed a deal that aims to halt and reverse global deforestation over the next decade as part of a multibillion-dollar package to tackle human-caused greenhouse gas emissions.”
“Land-clearing by humans accounts for almost a quarter of greenhouse gas emissions, largely deriving from the destruction of the world’s forests for agricultural products such as palm oil, soy and beef. By signing the Glasgow Leaders’ Declaration on Forest and Land Use, presidents and prime ministers from major producers and consumers of deforestation-linked products will commit to protect forest ecosystems. …”
PS: “ India pledged to reach net zero emissions by 2070. Although it is the first time the world’s third biggest polluter has set this target, and experts said it was a realistic commitment, it is 20 years behind the 2050 date set agreed by other developed countries….”
“The US and EU got more than a hundred countries on board with a commitment to cut methane emissions 30% by 2030, putting oil and gas sector leakage in the spotlight.”
‘It is the methane moment.’ How a once ignored greenhouse gas moved to center stage | Science | AAAS
“With the 26th annual international climate summit (COP26) underway in Glasgow, U.K., methane is basking in the spotlight. The potent heat-trapping molecule was once a footnote in discussions about climate change, largely because it breaks down much faster and is less abundant in the atmosphere than the more notorious greenhouse gas carbon dioxide (CO2). Now, however, researchers and policymakers are paying more attention to reducing methane. ….”
See also Vox - It’s time to freak out about methane emissions
“This lesser-known greenhouse gas will make or break a “decisive decade” for climate change.”
“If this is the “decisive decade” to take action, as the Biden administration has said, then a methane strategy has to be at the center of any policy for tackling global warming. Methane could mean the difference between a rapidly warming planet changing too quickly and drastically for humanity to handle, and buying the planet some much-needed time to get a handle on the longer-term problem of fossil fuels and carbon pollution….”
David Wallace-Wells; Climate Reparations: The Case for Carbon Removal (nymag.com)
Long read on the need for climate reparations.
And a tweet by the author: “ “Research by Marshall Burke and Noah Diffenbaugh shows that climate change has already exacerbated global inequality by as much as 25 percent. In India, they found, per capita GDP is 30 percent lower today thanks to warming.”
“The pledges on greenhouse gas emissions on the table at the Cop26 climate summit in Glasgow would limit global temperature rises to below 2C, the first time the world has been on such a trajectory, according to research. Plans by India, the world’s third biggest emitter, have made a sizeable difference to the global temperature estimate, research by the University of Melbourne has found. If its commitments and those of other nations at the talks are fulfilled, temperatures would probably rise by about 1.9C above pre-industrial levels. That would be lower than the 2C upper limit but higher than the 1.5C lower limit set out in the 2015 Paris climate agreement….”. On Thursday that was already 1.8 C.
For now they’re just pledges though.
See a related Science (Policy Forum) - Can updated climate pledges limit warming well below 2°C?
“ … We find that compared with the 2015 pledges, the updated pledges suggest a strengthening of ambition through 2030. By calculating probabilistic temperature outcomes over the 21st century for five emissions scenarios (see the figure and table S1), we find that the updated pledges provide a stronger near-term foundation to deliver on the long-term goals of the Paris Agreement of reducing the probability of the worst levels of temperature change this century and increasing the likelihood of limiting temperature change to well below 2°C.” But for now, these are just promises.
https://news.un.org/en/story/2021/11/1104812
“It’s ‘Finance Day’ at COP26, and the spotlight is on a big announcement: nearly 500 global financial services firms agreed on Wednesday to align $130 trillion – some 40 per cent of the world’s financial assets – with the climate goals set out in the Paris Agreement, including limiting global warming to 1.5 degrees Celsius. Mark Carney, the UN Special Envoy for Climate Action and Finance, assembled the Glasgow Financial Alliance for Net Zero, a group of bankers, insurers and investors who now have committed to put climate change at the centre of their work….”
Encouraging. The fine print looks less optimistic, though, for the time being. See the Economist - The uses and abuses of green finance (Leader) “…Pledges like GFANZ are good as far as they go, but the world needs a widespread price on carbon if finance is to be transformational….”
“Not a single day will be devoted to food and agriculture, the source of a quarter of global emissions.”
https://healthcareclimateaction.org/covid-19
“A new report from the World Bank, Health, Nutrition and Population Global Practice, coauthored by Health Care Without Harm, and supported by the Climate Investment Funds (CIF) focuses on how low-carbon and climate-resilient health solutions present opportunities to tackle the converged crises of the current pandemic, those in the future, and climate change. The report examines how vulnerable communities– the elderly, people with preexisting or chronic conditions (especially related to respiratory illnesses), ethnic minorities, indigenous people, and those experiencing poverty are disproportionately impacted by COVID-19 and climate change impacts. It also looks at how the two crises laid bare the chronic capacity deficiencies in managing these public health threats. Despite these immense challenges, the report offers synergistic interventions for low- and middle-income countries to enhance health system resilience during the COVID-19 crisis, future pandemics, and climate change impacts. Many of these interventions can also help limit health sector emissions by decoupling progress toward Universal Health Care (UHC) from global environmental impacts. Case studies from seven countries demonstrate how climate-smart solutions benefited health system responses to COVID-19 and climate disasters. Health Care Without Harm produced case studies from Colombia, India, Nepal, and the Philippines.”
N Beyeler & R Guinto; https://www.thinkglobalhealth.org/article/closing-gap-health-related-climate-financing
“Vulnerable communities need support for health systems as they adapt to climate change.”
“…While there has been much focus on closing the global climate financing gap—just $79.6 billion of climate finance was mobilized in 2019—there is another critical gap that must be urgently addressed. It is the largely nonexistent funding for health sector adaptation to climate change….”
“…Finance for health adaptation falls through the cracks of siloed funding schemes. Almost no climate finance targets the health sector, and nearly no global health finance targets climate adaptation. Less than 5 percent of total global adaptation spending, and less than 1 percent of multilateral climate adaptation finance targets health. Of more than 200 adaptation projects supported by the Green Climate Fund and other funding pools under the auspices of the UN Framework Convention on Climate Change since 2015, none specifically focused on health. At the same time, very little development assistance for health targets climate change. In 2018, only 3 percent of international donor funding for health was allocated for climate change projects. …”
And some links:
· Devex - Philanthropies, governments pledge $1.7B to Indigenous climate efforts
“A coalition of several governments and 17 private funders has announced plans to make a five-year, $1.7 billion commitment to directly fund Indigenous and local communities working to protect tropical forests as part of a broad effort to conserve the world’s lands and oceans. …”
· Devex on climate donors:
“Since the publication of the COP 26 presidency’s Climate Finance Delivery Plan last month — detailing how and when high-income countries could reach the $100 billion climate finance goal — the Devex data team has combed through climate finance data, … to provide a rundown of donor funding information. What they found was that almost 80% of the $34.4 billion bilateral overseas development finance for climate objectives came from the top five climate donors. “ See Devex Pro: The top 5 climate donors (gated)
· Guardian - More than 40 countries agree to phase out coal-fired power
“Major coal-using countries, including Canada, Poland, Ukraine and Vietnam, will phase out their use of coal for electricity generation, with the bigger economies doing so in the 2030s, and smaller economies doing so in the 2040s. However, some of the world’s biggest coal-dependent economies, including Australia, China, India and the US were missing from the deal, and experts and campaigners told the Guardian the phase-out deadlines countries signed up to were much too late….”
“The 2021 Global Conference on Health & Climate Change, with a special focus on Climate Justice and the Healthy and Green Recovery from COVID-19, will convene on the margins of the COP26 UN climate change conference. The aim of the conference is to call on governments, businesses, institutions and financial actors to drive a green, healthy and resilient recovery from COVID-19. The Conference will support and highlight countries’ ambitious and just Nationally Determined Contributions (NDCs) to the Paris Agreement that promote and protect health. It will also mobilize the rapidly growing movement of health professionals around the world who are now driving ambitious climate action. …”
“Tedros Adhanom Ghebreyesus, who has steered the global response to the COVID-19 pandemic, is on course to serve a second five-year term as head of the World Health Organization (WHO) after being the only candidate nominated by 28 countries.”
See also HPW - Tedros is Sole Nominee For Next WHO Director-General
“Tedros …. is the sole nominee for his position, which will be decided upon at the 75th World Health Assembly in May 2022. With the backing of 28 member states, Tedros is likely to be re-appointed unopposed as the deadline to submit nominations was 23 September. … Even though Germany called for support for Tedros’s nomination last month, the US, China, and the UK have not endorsed him, as per documents on the WHO website. …”
PS: 3 African countries supported him ( Botswana, Kenya and Rwanda). Ethiopia didn’t, for the reasons you know. See also WHO - World Health Organization Secretariat announcement regarding the election of the next WHO Director-General
And a Lancet World report - WHO's Tedros set to be re-elected unopposed
“Nominated by 28 member states, he is the sole candidate for the post of director-general of WHO. John Zarocostas reports from Geneva.”
“…Some observers were surprised that no challenger came forward, although some diplomats said Tedros, an astute campaigner, had the numbers to ward off any challenge…. “ Among others with the views of Suerie Moon & David Fidler.
https://www.bmj.com/content/375/bmj.n2644
Clearly a must-read. “The World Health Organization is needed now more than ever, but it is handcuffed by lack of funds and a structure that leaves it vulnerable to politics. These problems can be fixed, and must be urgently, writes Anthony Costello.”
“WHO faces enormous and growing challenges: covid-19, vaccine apartheid, emerging infections, increased food emergencies, disruption to health systems, a pandemic of non-infectious conditions such as obesity, cardiovascular disease, diabetes, and mental ill health, and the objective of universal health coverage, to say nothing of the routine plagues of HIV, tuberculosis, malaria, and childhood pneumonia. Above all, WHO must respond to a deteriorating climate crisis, the greatest global health threat in our century, which imperils the future of our children and young people.
But WHO in its present form is not fit to meet these challenges. It needs systemic reform to build the confidence of citizens and states around the world, to attract funds, and to build global scientific networks….”. Read what Costello recommends.
https://www.devex.com/news/last-chance-for-who-funding-reform-lead-diplomat-warns-102005
“ Support is growing among countries for raising the World Health Organization’s membership fees to address its long-standing funding woes, though discussions are far from over, according to a German official leading the consultations. WHO’s Working Group on Sustainable Financing was set up earlier this year…” (for this purpose).
“… “There's a strong, positive dynamic with regards to really making change happen now,” said Kümmel, who is also vice chair of WHO’s executive board and deputy head of the global health division at Germany’s Federal Ministry of Health. He said if the COVID-19 pandemic is not enough to fix the “historic challenge” of how to better fund the U.N. health agency, then “we will not get a second chance in the WHO.” Even so, Kümmel said the discussions still have a “long way to go,” and “not everybody is convinced yet.”…”
“… Björn Kümmel is drafting the working group’s report in Geneva this week, and he said the “vast majority” of proposals from member states so far included calls for raising assessed contributions and a replenishment model. The full working group will then meet next month, with its final report to be submitted to WHO’s executive board in January.”
“The foundation of a new post-pandemic global health structure is being built on shaky ground between concerns over how to pay for the effort and establishing rules on how to respond to future public health disasters. The U.S. and Norway are trying to set up a worldwide fund for pandemic preparedness, but many European and Asian countries are pushing for a new international pandemic treaty. Still unclear, though, is how long it would take to birth either and how much of the world would buy into the effort….”
“… The U.S. and Norway plan to set the technical details by year’s end so the fund can start mobilizing resources, with the goal of reaching $10 billion a year by the end of 2023, according to a working paper read by Global Pulse. The effort will take the shape of a financial intermediary fund managed by the World Bank that draws in public and private money to help the world prepare for pandemics. Norway’s Global Health Ambassador John-Arne Røttingen told Global Pulse it will be set up to accomplish three things: — Build countries’ and regions’ capacity to prevent and prepare for pandemics; — Invest in a worldwide network of disease surveillance systems coordinated by the World Health Organization; — Support readiness to develop, produce, procure and distribute vaccines, tests, medicines, protective equipment and oxygen.”
“…The U.S. and Norway have consulted with several nations and international bodies, including the African Union and European Union institutions, as well as Argentina, Germany, Italy, Japan and the United Kingdom. The G-20 didn’t jump on board at last weekend’s summit. Instead, it set up a finance-health task force to consider a potential financial facility….”
Dr. Tedros & S Swaminathan; BMJ;
“The world is unprepared for global health crises and is not ready for using artificial intelligence for the covid-19 response.”
“…. Artificial Intelligence (AI) holds much promise in revolutionizing pandemic preparedness and response and healthcare more broadly. The pandemic has accelerated the application of AI in health, but applying the technology for real world impact has generated many hard questions. The World Health Organization (WHO) is committed to supporting countries to use these transformative technologies to advance pandemic preparedness and response capacity and strengthen their health systems. WHO’s Department of Digital Health and Innovation spearheads digital technologies for covid-19, and plays a pivotal role in supporting countries at various stages of digital development. … … Some of the challenges faced by countries implementing AI into their covid-19 response are explored in a recent collection of articles in The BMJ. These challenges include the legal, economic, ethical, equitable application of AI and the importance of culture and collaboration. For countries aiming to increase their AI capacity for health, there are two strategic steps for which WHO is actively providing guidance: fundamental readiness and operational readiness. …”
Re Biden’s Build Back Better. “Section 31022 of Build Back Better, on pandemic preparedness, includes $1.3 billion for “Public Health and Preparedness Research, Development and Countermeasure Capacity,” including specifically “to support expanded global and domestic vaccine production capacity and capabilities, including by developing or acquiring new technology and expanding manufacturing capacity through construction, expansion or modernization of facilities.” Public Citizen long has called for a $25 billion investment to make enough mRNA vaccine for the world in less than one year. Peter Maybarduk, Public Citizen’s access to medicines director, issued the following statement: “This modest investment will make an outsized difference in the global fight against COVID-19, virus variants and future threats. It is a critically important contribution, if still far too little, to building the world back better….”
For related (US) analysis, see also CGD - What We Know (and Don't) about US Funding to End the Global Pandemic (E Collinson et al)
“…This blog unpacks what we know about the status of emergency funding and examines what might be on the horizon for US global health spending in the months ahead….”
P Patnaik; Geneva Health Files;
Priti Patnaik on some of the pressure she experiences with Geneva Health Files reporting & analysis. “Global health makes for strange bedfellows. …. Our reading and analyses on many political issues in global health suggest that groups with divergent interests align towards common goals. And yet our understanding on what agreed outcomes should be – is very different. … our critical approach means that we have questioned evthng - from the ACT Accelerator to the processes around the discussions towards pandemic treaty. What I had not anticipated was pressure from certain quarters of the civil society"…”
“Nineteen European health organisations have asked that HERA be more transparent, prioritise the public interest, and involve Parliament more in the decision-making process, in a joint letter published on Wednesday, 3 November.”
https://www.devex.com/news/opinion-usaid-at-60-101934
Op-ed and analysis by John Norris on 6 decades of USAID.
Related: Devex - Samantha Power lays out her vision for USAID
“U.S. Agency for International Development Administrator Samantha Power has laid out her vision for the agency — one focused on increasing local partnership and participation and making development more inclusive of marginalized groups. The goal is to make USAID not only an agency of “international development” but of “inclusive development,” she said in a speech Thursday at Georgetown University…”
“… … The three key pillars of the new strategy, Power said, are to make aid more accessible by diversifying the types of partners USAID works with, more equitable by focusing on the needs of those who are most marginalized and incorporating their voices, and more responsive by better listening to partners in the countries where the agency works…”
“A global research effort worth tens of billions of dollars is needed to ensure the world is better prepared for the next pandemic, which could be far worse than Covid, Bill Gates has said. … …. In an interview with the former UK health secretary Jeremy Hunt for the Policy Exchange thinktank, Gates said research and development budgets should focus on weaknesses exposed by the rapid spread of Covid around the world. “You know, we didn’t have vaccines that block transmission. We got vaccines that help you with your health, but they only slightly reduced transmission,” he said. “We need a new way of doing the vaccines.” … … “It’ll take tens of billions in research and development,” he said, “and probably about a billion a year for a pandemic taskforce at the WHO [World Health Organization] level”.”
“The WHO taskforce would perform pandemic surveillance and run what Gates called “germ games” where countries practise responses to events that could spark the next crisis, such as a bioterrorist unleashing smallpox at 10 airports. … …. A lot of the work needed to prepare for the next pandemic involved making vaccines cheap, having big factories to manufacture them, and “eradicating” influenza and the common cold, Gates added. Vaccines could be “just a little patch you put on your arm” and would be “incredibly beneficial” even outside a pandemic, he said….”
“List of 26 experts chosen for new permanent body has been subject to a two-week consultation period that ends on Wednesday. There has been criticism of some nominees for the group, which will guide research into the origins of this and future outbreaks…”
And this was also worth noting re SAGO – WHO – Re-opening – additional call for experts to join the Scientific Advisory Group for the Origins of Novel Pathogens (SAGO)
“Re-opening call for applications from 1 to 3 November 2021: WHO is re-opening the call for applications for three additional days to encourage additional applications from the fields of social science/anthropology/ethics/political science and biosafety/biosecurity….”
· See also The Telegraph - WHO seeks more laboratory safety experts for pandemic origins inquiry
“Application process reopened as WHO looks for 'greater diversity' in its investigations team.”
“… A spokesperson for the WHO would not comment on the reasons for the relaunch, merely saying the organisation was seeking “greater diversity across the technical areas represented in Sago”. …. But the decision follows criticism that the new panel did not include the specialists required to fully assess a lab leak. One group of scientists from across the globe warned the presence of only two biosecurity experts “strongly hamper Sago’s ability to accomplish its task... at worst this will fundamentally harm Sago’s credibility”….”. On the lack of social scientists till now, the article also has Clare Wenham’s view.
· See also HPW coverage - WHO Wants More Diversity for SARS-CoV2 Origins Group, While US NGO Calls for ‘Conflicted’ Scientists to be Removed
https://www.theguardian.com/world/2021/oct/29/us-intelligence-report-covid-origins
“ODNI reject bioweapons claims but says origins of virus may never be known, barring dramatic breakthrough in Chinese cooperation.”
“Allegations that the Covid-19 virus was designed as a bioweapon – a theory aired by some senior Republicans – are based on “scientifically invalid claims” whose proponents “are suspected of spreading disinformation”, the US intelligence agencies have reported. Most of the 17 US agencies also agree that the virus had not been genetically engineered, while observing it is becoming increasingly difficult to detect signs of such tampering. However, the intelligence community is still divided on the question of whether the virus was spread by animal-to-human transmission or as the result of a lab accident, concluding that that may never be known barring a dramatic breakthrough in Chinese cooperation. A summary of the findings were first published by the Office of the Director of National Intelligence (ODNI) in August, but on Friday the ODNI published a fuller version of the study, giving explanations for their agencies’ conclusions….”
No surprises there, even less in the current international environment.
Among others, the Chinese didn’t agree with this: “…The [intelligence community] paper said that, without new information, intelligence agencies would not be able to offer a better judgment on whether the virus emerged via animal-to-human transmission or a lab leak. It added that China’s cooperation would probably be needed to reach a conclusive assessment on origins, although it emphasised that Beijing continued to “hinder the global investigation”…”
While waiting for the probably critical WTO MC-12 meeting, starting at the end of this month, some news, analysis & other reads.
P Patnaik; Geneva Health Files;
“…The Voluntary Licensing approach, that allows pharmaceutical companies to set the terms of manufacturing and sales, has finally found its moment with MSD’s investigational oral COVID-19 antiviral medicine Molnupiravir….”
“In an announcement last week, Merck said, “This agreement will help create broad access for molnupiravir use in 105 low- and middle-income countries (LMICs) following appropriate regulatory approvals” . The licensing arrangement with the Medicines Patent Pool, has been hailed, in some quarters, as “the best agreement” commended for its reach in geographical area and the extent of transparency in the contract. “
But see this quote (re Merck & C-TAP): “… We asked WHO last week if Merck had consultations with the COVID-19 Technology Access Pool for a non-exclusive licensing approach. WHO’s top official Mariângela Simão said: “Actually Merck approached the C-TAP partner, which is the Medicines Patent Pool, a few months ago and the licensing was finalised yesterday so they had not approached. We had discussions with Merck but Merck was already going through bilateral agreements with seven or eight generic manufacturers and now finalised the Medicines Patent Pool approach. Let me say that the licensing through the medicines patent pool is very much welcomed by WHO because it's an open, transparent public health-oriented licence and the Medicines Patent Pool is a partner on C-TAP.”… A source familiar with the discussions, who wished to remain anonymous told us that Merck was not interested in engaging with C-TAP. The arrangement currently works through only a limited number of manufacturers and therefore was not suitable in a C-TAP framework in any case, the source added….”
Along the same (critical) lines, TWN: Medicines Patent Pool License Strengthens Merck’s Market Control and Undermines the Pool’s Core Principles.
“The Africa Centres for Disease Control and Prevention (Africa CDC), a Specialised Technical Institution of the African Union (AU), has designated two institutions to serve as part of a network of Centres of Excellence (CoE) for COVID-19 vaccination. These include the Institut Pasteur, Casablanca, Morocco and the Rwanda Biomedical Centre, Kigali. Africa has vaccinated only about 5% of its population with COVID-19 vaccine and a 70% coverage target has been set by the World Health Organisation to bring the pandemic under control….”
“ ‘Crunch’ time is coming at the World Trade Organization (WTO) for a proposed waiver of patents and other intellectual property rights on vaccines, treatments, diagnostic tests and devices needed to fight COVID-19….”
PS: The Collective Blog was launched last week – with fortnightly entries on topics related to the political determinants of health, written by @Collective_hlth members.
“… To know where and how we need to ramp up manufacturing capacity and capabilities, CEPI ran a first-of-its-kind landscaping exercise earlier this year to map all current and potential vaccine production efforts. The study focussed on gathering data on vaccine manufacturing in Africa, Southeast Asia and the Western Pacific, the Middle East, and Latin America and the Caribbean. These key geographies are predominantly thought to be where vaccine production capabilities and capacities need to be established and/or expanded. Available data, submitted by over 95 vaccine manufacturers, global health organisations, research and veterinary institutes, and government agencies from 37 countries across all four regions, from March to June 2021, confirmed this perspective…..”
Check out some of the key findings from CEPI’s vaccine manufacturing capacity survey.
And a Link:
Paper: Non-Patent Intellectual Property Barriers to COVID-19 Vaccines, Treatment and Containment (by S Flynn et al)
“The World Health Organization granted emergency authorization to a Covid-19 vaccine co-developed by India’s medical-research agency and local manufacturer Bharat Biotech International Ltd., ending a months-long wait that added to controversy around the homegrown shot. The WHO approved the vaccine’s use in people aged 18 and older on a two-dose schedule with four weeks between shots, according to a statement on Wednesday. Covaxin joins a range of WHO emergency-cleared shots from AstraZeneca Plc, China’s Sinopharm Group Co. and Sinovac Biotech Ltd., Pfizer Inc. and BioNTech SE , Johnson & Johnson and Moderna Inc. ….”
See also HPW - WHO Gives India’s Covaxin Approval, Opening the Door to COVAX distribution
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02400-4/fulltext
“The WHO-led pandemic response coalition plans to focus on the countries worst hit by inequities in COVID-19 resources. Ann Danaiya Usher reports.”
“… On the eve of the G20 summit in Rome, WHO appealed to the governments of high-income countries to provide at least US$23 billion for the Access to COVID-19 Tools Accelerator (ACT-A) to help low-income countries control the pandemic. “We would be happy to see G20 countries begin to announce the first new pledges this weekend”, an ACT-A spokesperson said on Oct 29. But the G20 made no financial commitments….”
“… The first ACT-A budget was for $33 billion, but donors contributed only about half the amount, leaving huge funding gaps especially for tests, medical oxygen, and personal protective equipment.
A new strategy, launched on Oct 30, covers the period up to September, 2022, and will cost $23·4 billion. Its investment case calls for a shift in focus to the countries worst hit by inequities in access to COVID-19 tools. …”
“ACT-A makes clear that fully financing the $23·4 billion is far from sufficient. An additional $19·7 billion for procurement of tools, delivery of vaccines, voluntary licensing, and technology transfers to create regional manufacturing capacity will be “essential to end the acute phase of the pandemic in all countries”. These will have to be covered by other mechanisms. The total bill of $43 billion is equivalent to a quarter of global official development assistance. Many have pointed out that ending the pandemic is a global public good that should not be financed from aid budgets….
https://www.who.int/publications/m/item/access-to-covid-19-tools-tracker
Resource. “The ACT-Accelerator Commitment Tracker provides transparent reporting on funding commitments made against ACT-Accelerator Pillar budgets. … The tracker is updated every 2 weeks on a Friday and based on data received from ACT-Accelerator Pillar co-conveners. … This commitment tracker was prepared by the ACT-A Hub with cooperation from the ACT-A partners….”
As mentioned in the intro, important weeks. A special session of the WHA is being convened on 31 November – 1 December to consider an international agreement to address future pandemics.
Some reads, updates & related analysis.
Nithin Ramakrishnan and K M Gopakumar https://www.twn.my/title2/health.info/2021/hi211021.htm
“… Despite the lack of consensus on the proposed pandemic treaty, the Bureau of the Working Group on Strengthening WHO Preparedness and Response to health emergencies (WGPR) still pushes a two-track approach in its zero draft report (Draft Report).”
“… Instead of providing recommendations on developing a WHO convention, agreement or other international instrument on pandemic preparedness and response, the draft report proposes a two-track approach i.e. targeted amendment of IHR, and the identification of the elements of a potential WHO instrument and modalities of its negotiations….”
https://www.twn.my/title2/health.info/2021/hi211020.htm
“– The “non-paper” of the Group of Friends of a Pandemic Treaty (Friends of the Treaty) on the principal benefits of a new legally binding international instrument on pandemic preparedness and response is conspicuously silent on Article 19 of the World Health Organization’s Constitution. The non-paper submitted to the Member State Working Group on Strengthening WHO Preparedness and Response to Health Emergencies (WGPR) also does not use the phrase “Pandemic Treaty” or “Pandemic Framework Convention”. Instead, it refers to a “new agreement” indicating an inconsistency between the discussions happening inside and outside the WGPR, and the documents recording those discussions….”
“On May 25, 2021, the World Health Assembly (WHA) of the World Health Organization (WHO) called for a Special Session to be convened in late November to consider developing a convention, agreement, or other international instrument on pandemic preparedness and response. On September 8-9, the O’Neill Institute and FNIH convened 30 of the world’s leading authorities on global health law, financing, biomedical science, implementation, and emergency response along with leaders from prominent international organizations involved in defeating the pandemic. The high-level experts had in-depth discussions on the weaknesses and persisting gaps in global pandemic preparedness and what a new international agreement might include to address them. This meeting was followed by regional consultations convened in Africa, Latin America-Caribbean, and Southeast Asia. This report summarizes the major themes that arose across the listening sessions, along with specific project or program proposals, potential avenues of international collaboration, and operational considerations for use by policymakers and the international community as they consider how to move forward. This summary report is not meant as a consensus document, but a compilation of the ideas and diverse perspectives offered.”
K F Ginsbach et al; https://www.healthaffairs.org/do/10.1377/hblog20211027.605372/full/
Read how they re-imagine the role of IHR in the global health law landscape. They conclude: “The COVID-19 pandemic may be a watershed moment in global health, for the WHO, its member states, and other stakeholders to mobilize and secure a robust international disease surveillance and outbreak response system for future pandemics. A properly funded, transparent WHO could make the IHRs the centerpiece of global health architecture, expanding the role of the treaty in building a coordinated and participatory system. While revising IHRs is vitally important, it will take time. In the near-term, we encourage the WHO and member states to use current authorities to ensure transparency, expand funding, and improve preparedness. We also urge the WHO to position the IHRs, and the public health recommendations made under its auspices, as an anchor instrument on which public, private, and civil society organizations can rely in making their own plans to prepare and respond to the next pandemic.”
https://www.theguardian.com/world/2021/nov/01/global-covid-19-death-toll-passes-5m
“The global death toll from Covid-19 has passed 5 million, 19 months after the pandemic was first declared, according to figures released by Johns Hopkins University. Some experts, including those from the World Health Organization, believe the true toll may be two to three times higher than official figures suggest. … US, Brazil, India, Mexico and the UK together account for more than half of total, which is based on official figures….”
https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates
Daily updated estimate. “…Although the official number of deaths caused by covid-19 is now 5m, our single best estimate is that the actual toll is 16.7m people. We find that there is a 95% chance that the true value lies between 10.3m and 19.4m additional deaths….”
And via HPW: Global COVID-19 Deaths: 5 Million and Counting
“…. the largest decrease in new weekly cases was reported in Africa (21%), followed by the Western Pacific Region (17%). …. However, while Africa reports decreased cases, the region remains the world’s least vaccinated region, with only 6% of Africans – 77 million people – fully vaccinated, while over 70% of high-income countries have already vaccinated more than 40% of their people. Only five African countries are likely to reach a WHO global goal of vaccinating 40% of their populations by the end of the year. “….”
“global cases are rising again, following several weeks of decline. “ “… COVID-19 cases rose slightly last week for the second week in a row, up 3% from the week before, mainly driven by another round of surges in some European countries, the WHO said yesterday in its latest weekly update. Deaths were also up, with an 8% rise compared with the previous week, mainly led by rises in Southeast Asia, Europe, and the Western Pacific regions. The five countries reporting the most cases are the United States, the United Kingdom, Russia, Turkey, and Ukraine. Though cases generally declined in many world regions, many still have continuing or emerging COVID-19 hot spots. For example, in Africa, Rwanda, Comoros, and Eritrea reported sharp spikes, and in the Americas, the largest increases were reported in the Cayman Islands, Uruguay, and Puerto Rico….”
And a few links:
Guardian – Europe once again at centre of Covid pandemic, says WHO (cfr press conference Hans Kluge on Thursday)
See also UN News - COVID-19: Europe and Central Asia, epicentre of new rise
Tedros & Mike Ryan later in the evening, see HPW coverage - Europe’s Surging COVID-19 Cases Provide Lessons for Rest of World
“…In the last seven days, 56 countries, from all regions, reported an increase in deaths of more than 10 per cent. “
“Europe is now the epicentre of the COVID-19 pandemic and what it is experiencing now provides lessons for the rest of the world, according to World Health Organization (WHO) officials addressing a media briefing on Thursday….”
“…Ryan said that Europe’s cases had been fuelled by increased summer social mixing, more indoor activities as the weather cooled, a reduction in restrictions and – crucially – “the onus has been put back on individuals to continue into individual risk management with little support from the governments”….”
‘Ensuring access to vaccines for all people on the move” was one of three points advocated by WHO ahead of the G20 summit.
“…Ensure access to vaccines for all people on the move: We call on every country to ensure that everyone on its territory regardless of legal status – including refugees, migrants, internally displaced people, asylum-seekers, and others on the move – have access to COVID-19 vaccines, tests and treatment for COVID-19. They should adopt concrete measures to remove barriers to vaccination for everyone on their territory — for example the need for specific documents, geographical barriers, the requirement in some settings that health care seekers are reported to immigration authorities, high fees — and fight misinformation that fuels vaccine hesitancy. “
“ The World Health Organization called on Thursday for vaccine makers to prioritise deliveries of COVID-19 jabs to the COVAX dose-sharing facility for poorer countries and said that no more doses should go to countries with more than 40% coverage.” “Tedros Adhanom Ghebreyesus, WHO Director-General, said that boosters should not be administered except to people who are immunocompromised.”
“As the devastating Delta variant surge eases in many regions of the world, scientists are charting when, and where, COVID-19 will transition to an endemic disease in 2022 and beyond, according to Reuters interviews with over a dozen leading disease experts. They expect that the first countries to emerge from the pandemic will have had some combination of high rates of vaccination and natural immunity among people who were infected with the coronavirus, such as the United States, the UK, Portugal and India. But they warn that SARS-CoV-2 remains an unpredictable virus that is mutating as it spreads through unvaccinated populations. None would completely rule out what some called a "doomsday scenario," in which the virus mutates to the point that it evades hard-won immunity. Yet they expressed increasing confidence that many countries will have put the worst of the pandemic behind them in the coming year….”
“ "We think between now and the end of 2022, this is the point where we get control over this virus ... where we can significantly reduce severe disease and death," Maria Van Kerkhove, an epidemiologist leading the World Health Organization's (WHO) COVID-19 response, told Reuters. The agency's view is based on work with disease experts who are mapping out the probable course of the pandemic over the next 18 months. By the end of 2022, the WHO aims for 70% of the world's population to be vaccinated. … … COVID-19 is still expected to remain a major contributor to illness and death for years to come, much like other endemic illnesses such as malaria. Endemic does not mean benign," Van Kerkhove said….”
https://www.nature.com/articles/d41586-021-02995-5
“In a bid to stave off looming disaster, scientists are trying to repurpose drugs used for malaria and other diseases, but infrastructure and recruitment challenges stymie progress.”
“Covid has caused the loss of 28m years of life, according to the largest-ever survey to assess the scale of the impact of the pandemic. The enormous toll was revealed in research, led by the University of Oxford, which calculated the years of life lost (YLL) in 37 countries. The study measured the number of deaths and the age at which they occurred, making it the most detailed assessment yet of the impact of Covid-19. Alongside significant falls in life expectancy in most countries, the number of years lost from premature deaths soared. Researchers said the true toll was likely to be even higher as they did not include most countries from Asia, Africa and Latin America in the study, due to a lack of data….”
And a link: Science - Why is Delta so infectious? New lab tool spotlights little noticed mutation that speeds viral spread
https://www.ft.com/content/782a6283-2694-49b4-b4dc-387fb46ecfab
“Novavax and its partner the Serum Institute of India have received authorisation for their Covid-19 vaccine in Indonesia, marking the first such global approval for a jab that could boost immunisation efforts in the developing world. The US biotech said on Monday it had also submitted applications to regulators in Canada and the EU for authorisation of its protein-based vaccine, which has faced lengthy delays due to manufacturing issues. Last week, it applied for approval in the UK.
… it could prove hugely important for lower-income countries and Covax, the vaccine access scheme backed by World Health Organization that has struggled to deliver doses. …. … Kelechi Chikere, an analyst at Jefferies, said the authorisation in Indonesia was good news for the company but cautioned that upcoming decisions by other regulators would be key to the vaccine’s commercial success. “For us, we are keenly awaiting approvals from the WHO and UK as we believe sign-off by these agencies will facilitate a rapid global roll out,” she said. Novavax has signed contracts for more than 1bn doses of its vaccine, which could be worth $6bn and $10bn in sales, Chikere added.”
“More people have received a Covid booster vaccination in the UK per head of population than are reported to have had their first shot in Africa, according to the latest available data. By 26 October, 9.4% of the UK’s population had received a booster dose, compared with 8.5% of Africa’s population who had received their first dose, according to Our World in Data, with 5.6% fully vaccinated across the continent as of the same date. The data reveals the state of vaccine inequality between high and low-income countries, particularly in Africa, with the UK among those accused of hoarding vaccines at the expense of more vulnerable populations….”
https://www.theguardian.com/business/2021/nov/02/pfizer-covid-19-vaccine-sales-2021-biontech
“US drugmaker expects to manufacture 3bn doses of vaccine with BioNTech this year.”
“Moderna Inc (MRNA.O) on Thursday cut its 2021 sales forecast for its COVID-19 vaccine by as much as $5 billion, as it struggles to ramp up production of its two-dose inoculation, sending its shares down 11% in premarket trading. … The US biotech said on Thursday it expects to realise product sales of $15bn to $18bn in 2021, down from an earlier estimate of $20bn in August. The company now expects to deliver 700m to 800m doses this year, compared to earlier estimates of 800m to 1bn. …” Moderna blames delays in international shipping and temporary issues related to manufacturing capacity.
Links:
Reuters - Moderna to supply 56.5 mln more doses of its COVID-19 shot to vaccine alliance GAVI
“Moderna Inc (MRNA.O) [last week] on Friday announced a pact with the GAVI vaccine alliance to supply a further 56.5 million doses of its COVID-19 vaccine in the second quarter of next year to low- and middle-income countries. The vaccine maker said the doses will be in addition to an earlier commitment to supply 60 million doses in the second quarter of 2022 to GAVI, which co-leads the COVAX facility for equitable distribution of COVID-19 shots around the world. … Moderna said the doses will be offered at a low price and GAVI continues to retain the option to procure 233 million additional doses in 2022, for a potential total of 500 million doses between this year and next….”
“Merck (MRK.N) has signed eight deals to sell more than a total of 2 million courses of its experimental COVID-19 pill molnupiravir to governments around the world as countries scramble to tame the virus.”
“Chinese companies have applied to produce generic versions of Merck’s molnupiravir pill under UN-backed MPP programme. China has switched roles from wanting to get cheap health products to being a major producer, MPP chief points out.”
And a few links:
· Estimated cost-based generic prices for molnupiravir for the treatment of COVID-19 infection (Melissa Barber)
Cfr tweet by the author: “We analyzed costs of production for @Merck #molnupiravir: -Cost of production using active ingredients currently sold in global markets: $17.74/course. -Adding a profit margin to estimate a sustainable generic price: $19.99/course.”
“The UK medicines regulator has granted the first authorisation to Merck’s antiviral pill for Covid-19, a drug that has been hailed by public health experts as an important new tool to combat the pandemic….”
· The Straits Times: Gates Foundation offers $5 million to fix syringe shortage for Covid-19 shots – The foundation aims to help Kenyan manufacturer Revital Healthcare more than triple production.
S Alkire et al ; https://www.sciencedirect.com/science/article/pii/S0277953621007899
“According to the global Multidimensional Poverty Index (MPI), an internationally comparable measure, poverty in developing countries has fallen substantially over the last 15 years. The COVID-19 pandemic and associated economic contraction are negatively impacting multiple dimensions of poverty and jeopardising this progress. This paper uses recent assessments of food insecurity and school closures made by UN agencies to inform microsimulations of potential short-term impacts of the pandemic under alternative scenarios. … …. Aggregating results across 70 countries that account for 89% of the global poor according to the 2020 global MPI, we find that the potential setback to multidimensional poverty reduction is between 3.6 and 9.9 years under the alternative scenarios….”
D Venkatesth; Geneva Health Files;
Last week’s Deep Dive & interesting analysis. Some excerpts to give you a flavor:
“In a pandemic, the sharing of pathogen samples - and associated data such as genetic sequences and epidemiological information are critical for effective public health response - both globally and locally. This is particularly important for the development of medical countermeasures, such as vaccines and diagnostics. … …. Nominally, the sharing of pathogen samples is governed by the Convention on Biological Diversity (1992), specifically through its supplementary agreement - the Nagoya Protocol which came into effect in 2014. …”
“… In practice however most scientists, even in low and middle-income countries (LMICs) do not know or use the protocol when sharing samples with collaborators in high-income countries (HICs). Most often, it appears that the sharing of samples occurs through informal agreements between research groups. It really depends on how the parties can negotiate the terms and this is complicated by the power-differential that arises from the fact that funding for projects in such collaborations largely come from HICs. As a result, the experience of sharing pathogens is very uneven and unpredictable. “ “…. During this pandemic, there has been an unprecedented level of sharing of SARS-CoV-2 sequences from across the world. … ….”
“… But should we still be linking the sharing of pathogen samples or even its genome sequences to “benefits” arising from their use, in this context - medical countermeasures or technology transfer to enable their production? Mark Eccleston-Turner, a UK-based lecturer in international law does not think so. His main contention is that “access and benefit sharing” has linked together two public goods into a transactional mechanism. …” “…. Despite all of these concerns, further initiatives for pandemic preparedness by the WHO (such as the Swiss Biohub) as well as the discussions towards a pandemic treaty continue to focus on improving “access” to pathogen samples, while discussions and commitments to “benefits” remain vague.”
M-O Barton, G Yamey, J Lazarus et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00494-0/fulltext
Interesting read with the view of a number of experts. “There is increasing evidence that elimination strategies have resulted in better outcomes for public health, the economy, and civil liberties than have mitigation strategies throughout the first year of the COVID-19 pandemic. With vaccines that offer high protection against severe forms of COVID-19, and increasing vaccination coverage, policy makers have had to reassess the trade-offs between different options. The desirability and feasibility of eliminating SARS-CoV-2 compared with other strategies should also be re-evaluated from the perspective of different fields, including epidemiology, public health, and economics. To end the pandemic as soon as possible—be it through elimination or reaching an acceptable endemic level—several key topics have emerged centring around coordination, both locally and internationally, and vaccine distribution. Without coordination it is difficult if not impossible to sustain elimination, which is particularly relevant in highly connected regions, such as Europe. Regarding vaccination, concerns remain with respect to equitable distribution, and the risk of the emergence of new variants of concern. Looking forward, it is crucial to overcome the dichotomy between elimination and mitigation, and to jointly define a long-term objective that can accommodate different political and societal realities.
“Revelations of poor practices at a contract research company helping to carry out Pfizer’s pivotal covid-19 vaccine trial raise questions about data integrity and regulatory oversight. Paul D Thacker reports.”
“The world is at risk of fracturing into a “great divide” with richer, vaccinated nations recovering at a much faster rate from the pandemic than poorer nations who have no access to jabs, a report has warned. Africa – where less than six per cent of the population is fully vaccinated compared to 55 per cent in Europe – faces a “long and difficult” road out of the pandemic, a report by the Tony Blair Institute says. …”
N Kapitsinis; https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-07169-7
“This paper explores the geography of excess mortality and its underlying factors in 2020, highlighting the effects of health policies pre-pandemic and strategies devised by governments to cope with Covid-19. Excess mortality is estimated for 79 high, medium and low-income countries. …”
Results: “Health privatization, healthcare underfunding, and late implementation of containment and mitigation strategies were powerful drivers of excess mortality. By contrast, the results suggest a negative association of excess mortality with health expenditure, number of doctors and hospital beds, share of population covered by health insurance and test and trace capacity….”
C Bhanu et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003826
Conclusions: “ In this systematic review, we found that factors influencing vaccination uptake involve healthcare provider and system, patient-related, and governance-level factors that are specific to the older ethnic minority community being served. The evidence included in this review is supported by high or moderate certainty and can be translated to practice and policy. A tailored, multi-level approach combining increased education, access, and culturally competent discussions with trusted healthcare professionals to address health beliefs can maximise the potential impact of widespread vaccination policies.”
Yi-Ling Chi et al ; https://www.cgdev.org/blog/collateral-health-impacts-covid-19-disproportionate-impact-girls-and-women
“In this recent policy paper, we examined 247 studies published between January and March 2021 that contained empirical analyses and covered gender-focused aspects of mental health, COVID-19 knowledge, attitudes and practices, COVID-19 clinical outcomes, maternal and child health, and sexual and reproductive health. We find that the pandemic causes disproportionate negative impacts on the well-being of women and girls relative to that of men and boys. This blog summarises the main considerations….”
https://www.nytimes.com/2021/10/28/health/polio-measles-vaccinations-covid.html?smid=tw-share
“The pandemic dealt a serious setback to global efforts to immunize children against diseases like measles and polio, the Centers for Disease Control and Prevention reported on Thursday, reducing worldwide coverage for some vaccines to levels not seen since more than a decade ago. The proportion of eligible children who received a polio vaccine fell to 83 percent in 2020 from 86 percent the year before, as did coverage with the third dose of the diphtheria-tetanus-pertussis vaccine, known as DTP3. Coverage with the measles vaccine also dipped slightly, to 84 percent last year from 86 percent in 2019. Those setbacks, while seemingly small, meant that millions more children missed out on routine immunizations during the pandemic, putting them and their communities at risk….”
“West and Central Africa could see a rise in HIV infections and AIDS-related deaths in a few years due to disruptions in health services because of the coronavirus pandemic, the executive director of the U.N. AIDS agency said. …. … Byanyima said the jury was still out on the extent of the impact of the coronavirus pandemic on HIV, but the agency is seeing examples of disruptions. "We are quite worried that when all the data comes in for this year (2021), that we might see a spike in new infections, and over a few years we might see more deaths," Byanyima told Reuters on the sidelines of a health summit late on Tuesday….”
“… "We are seeing across countries, a decrease in people receiving prevention, a decrease in people testing, and increasing numbers people falling out of treatments. These are not good signs, but we don't yet know what the impact will be on new infections and deaths," she said. “
https://www.nytimes.com/2019/12/25/health/antibiotics-new-resistance.html?smid=tw-share
“First Big Pharma fled the field, and now start-ups are going belly up, threatening to stifle the development of new drugs.”
K Lee et al ; https://journals.sagepub.com/doi/10.1177/00207314211044992
“The commercial determinants of health (CDoH) describe the adverse health effects associated with for-profit actors and their actions. Despite efforts to advance the definition, conceptualization, and empirical analyses of CDoH, the term's practical application to mitigate these effects requires the capacity to measure the influences of specific components of CDoH and the cumulative impacts of CDoH on the health and well-being of specific populations. Building on the Global Burden of Disease Study, we begin by conceptualizing CDoH as risk factor exposures that span agency and structural influences. We identify 6 components of these influences and propose an initial set of indicators and datasets to rank exposures as high, medium, or low. These are combined into a commercial determinants of health index (CDoHi) and illustrated by 3 countries. Although now a proof of concept, comparative analysis of CDoH exposures by population, over time and space, and their associated health outcomes will become possible with further development of indicators and datasets. …”
https://exposetobacco.org/news/global-tobacco-index-2021/
“Civil society groups find clear increase in industry lobbying and donations.”
“A new report from tobacco industry watchdog STOP reveals that the tobacco industry embraced the COVID-19 pandemic as an opportunity to gain influence, meddle in life-saving health policies and secure preferential treatment. Reports from civil society organizations in 80 countries, analyzed in the Global Tobacco Industry Interference Index 2021, show that no country was immune to the industry’s efforts to use lobbying and donations, often connected to pandemic response, to its advantage….”
“Indonesia, Japan, Switzerland and Dominican Republic least able to prevent industry meddling; Botswana, Chile, India and Spain among countries making progress…”
See also HPW coverage - Tobacco Industry ‘Used COVID-19’ to Influence Governments Especially in Switzerland, Index Finds
Another link related to Big Tobacco:
Devex - Opinion: Why commitments to tobacco control at COP 9 are critical
“COP 9 — the ninth session of the conference of the parties to the World Health Organization’s Framework Convention on Tobacco Control, or FCTC — [will] address the devastating and disproportionate impact that tobacco has on health, the environment, and the economy. … …. With nearly 200 parties to the convention, the FCTC outlines articles that are proven to prevent people from taking up tobacco, promote cessation, and protect the wider population from the secondhand effects of smoking. At COP 9 — taking place virtually this year because of the COVID-19 pandemic — governments and advocates will come together to reaffirm their commitment to this critical mandate, 16 years after it entered into force.”
“…. To combat the challenges presented by the tobacco industry, there is an urgent need to ensure that the FCTC has the resources for proper implementation. This means investment from governments and the international community to address the current funding gap of over $27 billion. Governments also need the necessary evidence, resources, and information to push through tobacco control policies, supported and emboldened by an effective civil society that can hold them and the industry to account….”
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00486-1/fulltext
Comment linked to a new Lancet GH study - Palliative care and catastrophic costs in Malawi after a diagnosis of advanced cancer: a prospective cohort study
“A new report is calling on researchers, vaccine developers, and funders to speed up the development of a vaccine for Group B streptococcus, or GBS, a common bacterial infection that pregnant women can transmit to their babies in the womb or during labor — leading to the death of 150,000 babies globally every year. The report by the World Health Organization and the London School of Hygiene & Tropical Medicine also found that, in 2020, the bacterium caused more than half a million preterm births, and led 40,000 infants to suffer from neurological impairments such as cerebral palsy, as well as loss of hearing and vision. Given data gaps, however, the true burden of GBS may be higher, according to the report. …”
See also UN News - Step up vaccines against Group B strep, linked to baby deaths and disability
M E Cruickshank et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02396-5/fulltext
Comment related to new UK study in the Lancet.
See also coverage of this new study in the Guardian - It’s incredible’: HPV vaccine saves thousands of women from cervical cancer, UK study shows
“Rates have fallen 62% in women offered the HPV jab between the age of 14 and 16, and 34% for older teenagers.”
Susan Rifkin et al ; https://gh.bmj.com/content/6/11/e007721
« … In a recent issue of the Bulletin of the WHO, Rasanathan and Evans have reviewed the history of implementing the PHC vision highlighting the challenges to adapt the objectives of Astana. Their clear and precise analysis addresses how global organisations and national governments need to pursue these objectives, and the policies and objectives of the Sustainable Development Goals (SDG). Building on their contributions, this paper identifies how the challenges can be met in practice. It identifies three silos of healthcare provision—service delivery, UHC and community participation—which have blocked health improvements. It shows how breaking these silos by strengthening public health systems contributes to effective responses to COVID-19 and to improving population health in the future….”
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01828-6/fulltext
Comment linked to a new Lancet Study.
“In The Lancet, Gloria Ikilezi and colleagues estimated annual spending on immunisation by governments, households, and donors for 135 low-income and middle-income countries (LMICs) between 2000 and 2017. …. The study found that governments contributed the largest share of funding—consistent with previous studies —providing between 60·0% (95% uncertainty interval 57·7–61·9) and 79·3% (73·8–81·4) of the total immunisation spending each year. The study also found that spending on immunisation increased over the period analysed, from US$5·9 billion (5·6–6·2) in 2010 to $9·6 billion (9·2–10·1) in 2017, even after adjusting for changing price levels….”
The authors of this comment conclude: “… Understanding the current funding model for immunisation services is essential for attempts to restore and extend the reach of these services. The study by Ikilezi and colleagues provides a detailed, historical account of immunisation spending, by payer and by activity, as more LMICs move towards transitioning from donor support. As additional data become available, future research should investigate how funding has changed in the post-COVID-19 era. To work towards IA2030 and universal coverage of essential vaccines over the next decade, the next step is thoughtful investment to build sustainable infrastructure for equitable vaccine delivery.”
R Horton; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02428-4/fulltext
“The Lancet's inaugural issue was published on Oct 5, 1823. In his opening editorial, Thomas Wakley, our founding Editor, described the journal's intended audience: London's physicians and surgeons; country practitioners; medical students; and, rather ambitiously, “every individual in these realms”. Wakley also hoped to reach a fifth category of readers—“Colonial Practitioners”. The Lancet was born as a product of colonialism and, at least in part, as an instrument to support and advance British imperial objectives. This history is important to recall because of the growing movement to decolonise medicine and global health… …”
Horton concludes: “…Medicine and global health continue to be entangled with colonial attitudes, structures, and practices—from scientific journals to research funders, from top universities to respected academies, and from influential philanthropies to multilateral agencies. Decolonisation seems an urgent obligation if those who advocate for equity wish to be taken seriously and retain even a vestige of moral conscience. But the project of decolonising global health possesses a tragic flaw. For when an Empire falls, it does so only to be replaced by another Empire, one often more insidious and dangerous than its predecessor. The idea that one can purge global health of colonialism is a comforting but deceptive myth. The modern age of colonialism is embodied in a powerful group of nations, together with the organisations that represent them—the permanent five members of the UN Security Council, the G7, the G20, EU27, the World Bank, and the International Monetary Fund. Kwame Nkrumah, after leading Ghana to independence from the UK in 1957, wrote that “The neocolonialism of today represents imperialism in its final and perhaps its most dangerous stage.” As medicine and global health struggle over decolonisation, we need to undertake a more realistic and rigorous analysis of where power lies politically, economically, militarily, and culturally. Changing the names of buildings and removing statues of scientists whose pasts we now deem unacceptable, as important as these symbolic measures might seem, risk becoming illusions of action, veiling the truth concerning new regimes of authority, dominance, and privilege. Decolonisation must mean much more.”
“Modern medicine is an artifact of colonialism because the science that underpins modern medicine emerged from Western knowledge structures based on a history of colonialism. The author suggests the colonial roots of Western-based modern medicine must be reexamined….”
https://www.bmj.com/content/375/bmj.n2658
By A Binagwaho, A M Ekström, K Martin et al.
https://tdr.who.int/global-health-matters-podcast
« What opportunities are health researchers discovering with the COVID-19 pandemic? Can we promote gender equality in global health leadership in ways that aren't patronizing? What innovative tools are scientists using to tackle the impact of climate change on health? In the Global Health Matters podcast, host Garry Aslanyan is joined by some of the world's leading scientists who share experiences and views on different aspects of global health research, with a focus on low- and middle-income country perspectives….”
Latest episode (October 17) : https://tdr.who.int/global-health-matters-podcast/communicating-science-not-fiction . Check out previous episodes as well. https://tdr.who.int/global-health-matters-podcast
https://www.youtube.com/channel/UC0-SiBy7iKGXGxDS4mIgqag
The APO had a day-long virtual research forum with the Dept. of Health in the Philippines on the 28th of October ’21. Check out these discussions from the Philippines Department of Health & APO special research forum with presentations by different HPSR researchers from the Asia Pacific region. You find the Playlist of all the panel discussions here.
“Out of 224 health centers in the Tigray region, only 40 were functional, according to an investigation into allegations of human rights violations during Ethiopia’s war. Facilities have seen significant structural damage from shellings, looting of medicines and equipment, and an absence of medical personnel. The investigation was conducted by UN Human Rights and the government’s Ethiopian Human Rights Commission, covering the period of November 2020 through June 2021. …”
https://www.ft.com/content/499debf2-4643-449c-83e4-20a532624bbd
“Isomorphic Labs will build on DeepMind’s research and will be headed by Demis Hassabis”
“… Google owner Alphabet has launched an artificial intelligence company to discover new drugs. UK-registered Isomorphic Labs will use technology from its sister company DeepMind to “to accelerate drug discovery, and ultimately, find cures for some of humanity’s most devastating diseases,” said Demis Hassabis, the head of DeepMind, in a blog post. He added that he would also become the chief executive of Isomorphic Labs….
“… DeepMind said it would use the technology to try to find treatments for Chagas disease and Leishmaniasis, two of the most deadly diseases in the world….”
https://news.un.org/en/story/2021/11/1104552
“People who use drugs should not be criminalized, UNAIDS said on Monday, in calling for greater funding for community-led harm reduction programmes….”
https://www.ncbi.nlm.nih.gov/pmc/issues/392423/
“…. This theme issue of the Bulletin of the World Health Organization focuses on behavioural science and its application to understand individual and community behaviours through the analysis of cognitive, social and environmental drivers and barriers.”
Start with the two editorials:
· Harnessing the power of behavioural science to improve health
“The international health community has set ambitious goals for health: eliminating or reducing communicable and noncommunicable diseases, ensuring appropriate use of antibiotics, increasing the uptake of vaccines and other preventive measures, and responding appropriately to epidemics, among others. Behavioural science can help in achieving these goals; more systematic use of behavioural science is needed to accelerate progress towards the sustainable development goals. The World Health Organization (WHO), as part of its transformation, is scaling up the use of behavioural science to support its Member States in achieving better health and well-being for their populations….”
· Using behavioural science for better health (by Dr Tedros)
“As the global public health leader, the World Health Organization (WHO) cannot achieve its ambitious goal of transforming global health and the health of more than 7 billion people without a clear understanding of people’s health-related behaviours. We have therefore established a behavioural science unit at WHO and dedicate this theme issue of the Bulletin of the World Health Organization to this field….”
“Boys and young men neglected in efforts to tackle mortality in 10- to 24-year-olds, Lancet report says, with a failure to address violence, substance use and accidents.”
“Boys and men are more likely than women to die as teenagers or young adults, according to new research that warns the gender gap in mortality rates for that age group is widening in many countries….”
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00237-1/fulltext
“…. While a safe and healthy childhood are fundamental to physical, mental, and social development, globally, it is estimated that one out of two children aged 2–17 years suffer some form of violence each year. Adverse childhood experiences (ACEs) encompass a range of potentially traumatising events and are associated with the risk of developing health-harming behaviours in adulthood and greater susceptibility to ill health. ACEs include exposure to sexual, physical, or emotional violence; childhood neglect and household disfunction; deprivations and poverty; and traumatic shocks, such as the death of a parent. Importantly, children from more deprived backgrounds are more likely to experience multiple hardships, and the cumulative stresses from multiple ACEs are associated with an even greater risk of negative outcomes. In this issue of The Lancet Public Health, a selection of Articles and Comments document the profound degree to which early life adversities detrimentally affect health outcomes among children and into adulthood, but also highlight the immense potential benefits of preventing ACEs and mitigating their impact….”
Fran Baum ; https://journals.sagepub.com/doi/10.1177/17579759211044074
“Health promotion has evolved over the last decades from a primary focus on behaviour change to establishing an ambitious goal of creating healthy, fair and sustainable environments in a manner which realises the rights of all people to health and well-being while protecting the health of our planet and its ecosystems. This paper argues that in order to contribute to this ambitious goal, health promotion must address three key tasks. The first is the need to take planetary health more seriously and move away from reductionist thinking to an approach that sees the planet as a complex system and values more harmony with nature, protects biodiversity and prevents global warming. The second task is to advocate and support governments to govern for health. The key to doing this is putting health and equity before profit, creating healthy urban environments, encouraging participatory decision-making, advocating for healthy economic models and assessing the ways in which corporate determinants of health operate. The third task is to ensure that moves to professionalise health promotion do not come at the expense of health promotion advocacy to powerful people and organisations. Health promotion is well placed to support civil society movements arguing for social and economic change that will benefit health such as the Black Lives Matter and environment movements.”
S D Taylor-Robinson et el; https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01575-3
“We argue commercial sex workers have rights to healthcare and psychosocial support. While decriminalization is not legally enacted in most countries, we would suggest these workers rights include freedom from harassment and opportunities to lead healthy lives. The need for healthcare access for all is heightened in the COVID-19 pandemic where some people flout rules on lockdown by engaging with commercial sex workers and may unwittingly spread SARS-CoV-2 in so doing. Unrestricted healthcare access without stigma for commercial sex workers protects them, and has a beneficial societal effect on those who engage with them and on their contacts.”
M Piatti et al ; https://blogs.worldbank.org/health/are-development-partners-using-government-systems
“…. Despite repeated commitments of development partners to make greater use of country systems, today, there remains a lack of clarity of what ‘country systems’ means, misperceptions on what can be done to strengthen them, and lack of progress in using them. Furthermore, it remains unclear what drives the use of country systems. While one would expect that better Public Financial Management (PFM) systems would invite Development Partners (DPs) to also make use of these systems, this does not seem to be the case. Quality of PFM systems and share of DAH channeled through the government appear to be largely uncorrelated …. … A new World Bank study takes a fresh look at the donor alignment question through a PFM lens. It argues that using country systems is a spectrum, not a binary choice, and that identifying specifically where and how development partners (DPs) are making use of country PFM systems in that spectrum can help inform a constructive dialogue. The report breaks the donor alignment question down to four stages in the budget cycle…”
“A new paper, “A Changing Landscape: Trends in Official Financial Flows and the Aid Architecture,” analyzes the trends between 2000 and 2019. …” Check out the main findings.
“Bill Gates at #COP26 being interviewed on Sky. When I ask him about why he has blocked the Covid vaccine patent waiver his minders hurry him away. A shame. If he supported WHO, Biden, France, India, S Africa, millions more wd receive a vaccine. So far >180,000 health workers died.”
“US intel (with all resources) unable to discover #COVID19 origin, end up right where @WHO landed. Several rumors on #lableak discarded. definitive evid needs more science & transparency. Big take away: diplomacy needed, but undermined by conspiracy theories + geopolitics.”
Re a FT chart on vaccine inequity (boosters in HICs vs LMIcs):
“… breathtaking chart. We’ve re-learned reality that biggest determinant of access to health tech is control of production. North-based companies do not prioritize lives in South over markets and political priorities in the North. Pandemic preparedness requires sharing tech. period”
“One of my companies, Procure-Net, supplies COVID-19 products to some of the largest organizations in the world. The biggest scam right now is the PCR and Antigen testing required for travel. The cost is $200 to $300 per test. The cost of material is less than $5 per test. (1/2)”
“Going to the COP has been instructive in as much as it has taught me that I never want to go to a COP again, ever. All of you humble bragging attendees on twitter would be much better placed outside with the demonstrators - I mean, if you actually wanted to change anything.”
“Put simply, it is more profitable to sell third & fourth doses to rich countries than first doses to poor countries, so this is what Pfizer prioritises.”
“Long COVID disproportionately affects women and sex hormones likely play a significant role. Research on sex and gender-specific outcomes in Long COVID is urgently needed. Funding this research is one of the key next steps.”
The next Global Fund Board meeting takes place between 8 and 10 November. Check out this pre-GF Board issue.
With among others: How will the Global Fund move from one-off support to sustainable health system strengthening?
“The Technical Review Panel and the Technical Evaluation Reference Group regret that investments are fragmented, ad hoc and insufficiently aligned with country strategic plans and call on the Secretariat to develop a refined and visionary Strategy.” “ … …The Technical Review Panel and the Technical Evaluation Reference Group have synthesized the various analyses produced over the past two years into two recently released documents. They identify numerous difficulties that have limited the implementation of activities and the achievement of the desired impact and make recommendations for the new Strategy, the next phase of funding mechanism (NFM4) tools and for impact measurement….”
“A treaty establishing the African Medicines Agency will enter into force Friday, bringing the agency into existence at a critical time for the continent, which remains the most unvaccinated against Covid and is trying to build its own vaccine manufacturing capacity. Eighteen countries have ratified the treaty, including Algeria, Cameroon, Burkina Faso, Ghana, Namibia, Rwanda and Zimbabwe. African heavyweights Nigeria and South Africa have not…. …. African leaders should decide in February where the agency should be located after countries submit bids to host it.”
Among others, with some more COP 26 related news.
A Costello et al; https://www.bmj.com/content/375/bmj.n2649
An understatement, as you know, certainly on the climate crisis. “Tackling climate change and the pandemic are necessary to regain their trust.”
PS: excerpt: “… A global summit for adolescents: In 2023, a Global Forum for Adolescents will be held, where we hope countries will endorse a clear call to action and commit to investments that can be closely monitored. All countries need stronger public health systems, vaccine equity, social safety nets, protection of education, environmental resilience, and involvement of adolescents in decision making and in finding creative, adaptive solutions to climate change….”
https://www.lshtm.ac.uk/media/54621
“Preliminary fndings from a global survey of urban young people on the air they breathe and a child health co-benefits analysis of radical decarbonisation of 16 global cities.” Check out the five emerging headlines from the research.
https://www.nature.com/articles/d44148-021-00103-3
“Proactive personal, collective and generational actions are vital.”
“Creating an international price for carbon emissions could reduce global greenhouse gases by 12% at a cost of less than 1% of global GDP, according to a new report from the World Economic Forum (WEF) and PwC. The report found that if global governments agreed together to set a price for pollution to help cut carbon emissions the cost would be less than the economic losses triggered by the fallout of a runaway climate crisis. The “carbon revenues” raked in to government coffers from the world’s most-polluting companies could also be used to help hard-pressed households or ploughed back into green industries which help reduce emissions while creating jobs and economic growth, the report found….”
G Monbiot; https://www.theguardian.com/commentisfree/2021/nov/03/cop26-fossil-fuels
G Monbiot nailing it, as usual. “The handwaving and complexity obscure a simple truth: nation states must stop funding dirty industries.”
“Lofting iron-salt aerosols could eat up methane and buy time on climate change.”
https://www.weforum.org/agenda/2021/11/climate-change-rising-temperatures-may-force-humans-move/
“Almost a third of all humans may have to leave their homes and migrate to cooler climates to avoid extreme heat if we don’t act to halt climate change or mitigate its effects, a new report warns. This latest estimate of the potential number of people who may be forced to become climate refugees dwarfs all previous forecasts. As recently as September 2021, the World Bank put the likely figure at 216 million. But now an international team of scientists have produced a report that warns that, if nothing is done to slow climate change, 3.5 billion people may have to leave their homes in the next 50 years to escape average temperatures of over 29C. They say that even if global warming is restricted to 2C – which is 0.5C above the target set in the 2015 Paris climate agreement – around 1.5 billion people could be driven to become climate refugees from the hottest parts of the world….”
“Annual cuts of 2.5% would keep aviation’s contribution to global warming at about 0.04C, new research suggests.”
“$11tn fossil fuel asset crash could cause 2008-style financial crisis, warns new study.”
· Among others, via Climate Change news :
“Annual NDCs? - UN boss António Guterres has urged all countries to submit annual climate plans “if commitments fall short by the end of this Cop” - endorsing a call made by the Climate Vulnerable Forum. Under the Paris Agreement, countries agreed to a five-year ambition cycle with the next ratchet-up moment in 2025. But countries can up their national climate contributions at any time. The issue is critical in Glasgow.”
“Net zero standards - Guterres further announced that he will establish a group of experts to propose “clear standards to measure and analyse net zero commitments from non-state actors” - effectively a watchdog against corporate greenwashing.”
· Guardian - US rejoins coalition to achieve 1.5C goal at UN climate talks
“The US has rejoined the High Ambition Coalition at the UN climate talks, the group of developed and developing countries that ensured the 1.5C goal was a key plank of the Paris agreement. The decision by the world’s biggest economy and second biggest emitter, after China, to return to the High Ambition Coalition group of countries marks a significant boost to attempts to focus the Cop26 summit on limiting temperature rises to 1.5C, the tougher of the two goals of the Paris agreement….”
https://www.premise.com/sentiments-on-the-malaria-vaccine-in-sub-saharan-africa/
“On October 6, 2021, the World Health Organization recommended using the recently approved malaria vaccine RTS, S for use among children in sub-Saharan Africa and other regions with moderate to high levels of malaria transmission. Premise ran a survey in eight countries: six of which account for about half of deaths caused by malaria globally (Burkina Faso, the Democratic Republic of Congo (DRC), Mozambique, Niger, Nigeria, Tanzania) as well as two countries where trials for the vaccine were held (Ghana and Kenya)….” Check out findings.
N Shafiq et al ; https://gh.bmj.com/content/6/11/e006961
“The lack of access to safe and effective antimicrobials for human populations is a threat to global health security and a contributor to the emergence and spread of antimicrobial resistance (AMR). The increasingly common shortages of antimicrobials are an additional threat to the emergence of AMR. While the threat of such drug shortages is most acutely experienced in low-income and middle-income settings, their consequences impact the quality and effectiveness of antimicrobials worldwide. Furthermore, there is a need for robustly conducted studies examining the impact of these increasingly prevalent shortages on patient outcomes and on the emergence and spread of AMR. In this review, we have mapped common drivers for antimicrobial shortages and propose strategies for rethinking the regulation, supply and pricing of antimicrobials to secure their sustainable access across diverse healthcare systems and to help minimise the unintended consequences of weak and ineffective supply chains. …”
Link:
Lancet Regional Health – Association between Ambient Temperature and Hospitalization for Renal Diseases in Brazil during 2000–2015: A Nationwide Case-Crossover Study
On the rise of kidney disease in Brazil, among others due to rising temperatures.
Link: BMJ GH - Spatial patterns and inequalities in skilled birth attendance and caesarean delivery in sub-Saharan Africa
“Europe is at risk of being hit by a tide of migration from the Sahel region of Africa, as a population boom hits a part of the continent already plagued by terror, hunger and failing governments, a major report has warned. Researchers at the Atlantic Council, a think tank based in Washington DC, have made grim predictions for the vast region south of the Sahara, which is already home to deadly jihadist insurgencies and is widely seen as “ground zero” for climate change. The report – overseen by Matthew J Burrows, a former CIA analyst who for nearly a decade led long-term forecasting for the US National Security Council – warns that urgent steps must be taken to reduce the birth rate and increase women's prospects and reproductive rights. …”
https://www.nature.com/articles/d41586-021-02991-9
“The pan-African science academy is in turmoil. Funders and fellows must jointly own the crisis, and work to stop it happening again.”
“The African Academy of Sciences (AAS) is facing its worst crisis since its foundation 36 years ago. The Nairobi-based organization has lost more than half of its staff after key international funders, including the Bill & Melinda Gates Foundation, the UK government and the UK charity Wellcome withdrew from a flagship funding partnership. African researchers and scientific institutions are horror-struck at the resulting devastation of the continent’s apex science academy. This did not need to happen….”
L Spinney; https://www.theguardian.com/commentisfree/2021/oct/29/how-does-covid-end-uk-virus-endemic
“The virus won’t disappear – it will just become endemic. But it could still put pressure on health systems in years to come.” Ready why the world is watching the UK to see how this might evolve.
Related link – NPR - COVID's endgame: Scientists have a clue about where SARS-CoV-2 is headed
A few excerpts:
“… Last month, Kistler and her colleagues at the University of Washington published a new metric to measure how quickly SARS-CoV-2 is evolving as it adapts to living inside humans. When Kistler first saw the value, she was shocked. "SARS-CoV-2's rate of adaptation is remarkably high right now," she says, "like roughly four times higher for SARS-CoV-2 than it is for seasonal flu."
Remember, the flu changes so fast that people can be vulnerable to it each year. "I don't think SARS-CoV-2 will stop adapting," Kistl er says. "It may slow down, but viruses that evolve adaptively tend to keep doing that. They don't tend to hit the limit of evolution." This fast evolution has immense implications, many scientists say. It essentially dashes the hopes of eradicating SARS-CoV-2 in the U.S. or even in smaller communities. As with the flu, the coronavirus will likely be able to reinfect people over and over again. It will keep returning year after year….”
Still, “… Although Karan predicts that SARS-CoV-2 will circulate in the U.S. indefinitely, he says that COVID-19, the dreadful disease, as we now know it, will likely go away. "When you're fully vaccinated [or been exposed several times], you're dealing with a very, very different disease and a very different process," Karan says. In fact, you're likely dealing with a disease that many of us have already had, perhaps dozens of times, in our lifetimes….” The common cold, that is. (though not everybody agrees)
“…But he more that researchers learn about our immune response to SARS-CoV-2, says Bieniasz, the Rockefeller University virologist, the more optimistic he becomes that this endgame scenario (or a variation of it) will come true. "Based on what we're finding, it does look like the immune system is eventually going to have the edge over this virus.”
https://www.theatlantic.com/health/archive/2021/10/pfizer-moderna-dose-which-vaccine-best/620501/
“It’s possible that a good deal of the difference in the shots’ performance can be summed up with a simple phrase: More is better.”
https://www.bmj.com/content/375/bmj.n2571
“As countries reopen while the pandemic continues, “passports” indicating a person’s covid or vaccination status are the only obvious way to leave lockdowns behind, say Kirsty Innes and Daniel Sleat. But the risks are big—and if we start down that road we may struggle to go back, argues Imogen Parker.”
C Riley et al ; https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-021-00783-1
“A variety of policies have been implemented around the world in response to the COVID-19 pandemic. This study originally aimed to identify and compare policy responses of different countries and their effects on the pandemic. It quickly evolved into an identification of the heterogeneity among existing policies and the challenges in making meaningful comparisons of the impact of these policies….”
https://www.nature.com/articles/d41586-021-02989-3
“To respond better to future pandemics, we must understand how the SARS-CoV-2 virus dispersed so rapidly. A model of COVID-19 spread sheds light on cryptic transmission, undetected by surveillance efforts, in early 2020.”