Subscribe to our weekly International update on Health Policies
The weekly IHP newsletter offers a digest of key global health (policy, governance, research) reads.
Select a newsletter issue or browse the topics in the current issue.
Dear Colleagues,
This week, as you might have expected, we pay quite some attention to the 150th WHO Executive Board session – mostly referring you to the expert coverage and analysis of HPW, Devex, Geneva Health Files and TWN.
At the Board Meeting, dr Tedros (freshly nominated for a second term ) struck the right balance on the current state of the pandemic, saying that Covid-19 will be “with us for the foreseeable future” but that it’s very well possible “to end the acute phase of the pandemic” this year ( and thus “end it as a global health emergency”). If the world does what needs to be done, that is. That’s a big ‘if’, we know by now, sadly.
On a slightly related note, when watching the Netflix series ‘Suits’ this week, it suddenly dawned upon me whom Harvey Specter ( a rather confident top lawyer at a New York law firm and one of the main characters in the series), reminded me of in Global Health: Björn Kümmel ! Sure, Björn is far less cocky than Harvey, but he also has the heart in the right place, invariably looks impeccable and radiates professionalism as you’d expect from somebody in his position. I hope that, like Harvey tends to do at the end of every episode, Björn can also ‘close the deal’ – in his case: ensuring more sustainable funding for WHO – sooner rather than later. Unfortunately, in a seemingly ‘neverending WHO Funding season’, that’s a deal far more difficult to “close”, as was once again evident this week.
In planetary health related news, Ronald Labonté wrote a wide-ranging article on the need to ‘Build Back Differently’, in the slipstream of the 2022 PMAC conference, themed ‘The World We Want: Actions Towards a Sustainable, Fairer and Healthier Society” . On Wednesday, I managed to watch a session on 6 mega trends (most of which didn’t sound very appealing, frankly), and their likely implications on global health in the 21st century. True, a ‘romantically optimistic’ Labonté did his best to keep up spirits on the future in an SDG-related session on Thursday. And Horton added that, with the pandemic, we have actually the “best platform ever” (as health people) to talk to power about ‘The World we want’. He’s probably right about this window of opportunity.
But on the arduous road towards that “World We Want”, I’m not sure this week’s Board changes at the Gates Foundation (“more of the same” so far, mostly) will help much. The fact that two years into the pandemic, COVAX seems to be running out of cash, also bodes ill. Meanwhile, the TRIPS waiver “discussions” seem to be going nowhere, now that both Macron (at least in the “version 19 January 2022” ) and Germany’s new coalition are sending signals that they favour other options, in the run-up to the EU-Africa summit of mid-February. The “realist”/ugly ‘World as it is’, in a nutshell.
Coming back on the need to Build Back Differently, though, now that Thich Nhat Hanh passed away, at the blessed age of 95, perhaps we should all try to put into practice a few lessons from the monk. As the father of ‘engaged Buddhism’, he urged his followers to link mindfulness practice with social action. His plea for ‘monotasking instead of multi-tasking’ also seems like wise advice for our frantic times (yes, Twitter addict/webinar FOMO sufferer, while keeping a constant eye on your Outlook mail, I’m talking to you! 😊).
Unfortunately, we don’t live in ‘wise Buddhist’ times. Which is probably one reason why many people (including me) also like to watch another (tragicomic) Netflix series these days, Ricky Gervais’ ‘After life’. Having said that, I do hope Putin, Blinken & co show a bit of “zen wisdom” in the coming weeks, unlocking, harnessing or altogether unleashing their “inner Thich”.
So that one day we can perhaps all “party again like Boris Johnson”… instead of prematurely starting our own ‘After life’: )
Enjoy your reading.
Kristof Decoster
“The Bill & Melinda Gates Foundation has tapped a billionaire philanthropist, an economist, a co-founder of one of the world’s most prominent philanthropic advisory firms, and the foundation’s own CEO to join its new board of trustees and sit alongside co-chairs Bill Gates and Melinda French Gates at the top of the leading philanthropic foundation. The new trustees will add some geographic, racial, and gender diversity to the foundation’s leadership, though their backgrounds and previous work with global institutions don’t suggest they will bring markedly different points of view to the foundation….”
“The Gates Foundation announced Wednesday that it had appointed Zimbabwean billionaire businessman and philanthropist Strive Masiyiwa, London School of Economics Director Minouche Shafik, The Bridgespan Group’s co-founder and co-chair Thomas J. Tierney, and Gates Foundation CEO Mark Suzman to its board of trustees. They will join foundation co-chairs Gates and French Gates, who divorced last year and have been the only two trustees since the third trustee, billionaire philanthropist Warren Buffett, resigned from the post in June. …”
“… The selection of both Masiyiwa and Shafik appears to align with the Gates Foundation’s prioritization of pandemic preparedness and economic recovery. …. Meanwhile, Tierney’s selection reflects the growing prominence of The Bridgespan Group, whose client roster includes billionaire philanthropist MacKenzie Scott, the ex-wife of Amazon founder Jeff Bezos, as well as the Gates Foundation, Ford Foundation, and Rockefeller Foundation….”
“… One of the areas that Bill Gates has said he will remain focused on this year is pandemic preparedness. During the 2022 NORAD Conference Tuesday, he said that it would be among his top priorities along with addressing climate change….”
“… The new trustees will serve three-year terms with a limit of two consecutive terms. The board will meet three times per year and will approve an annual budget and four-year plan, as well as review the CEO’s performance and approve the CEO’s compensation….”
You might want to read it in full. A few excerpts perhaps, with some additional info:
“…The board could include up to nine total members, and we’re in active conversations about adding to our initial slate to enhance representation across gender, geography, and expertise….”
The letter also had some parts on how the Gates Foundation is evolving – “steadily increasing investments in low- and middle-income countries via universities, companies, and research networks,…”
“…While initially unsure that the foundation could add meaningful direct value in beneficiary countries rather than working through large intermediaries, we started to test some grants. My first big one was a $40 million initiative to support the growth of independent development policy think tanks in countries across Africa, Asia, and Latin America. Other teams started to trial and expand similar work, from new agricultural initiatives in India and Ethiopia to tobacco prevention programs in Southeast Asia and West Africa….. …. Soon after, they asked me to take on an expanded role to turn our HIV prevention programs in China and India into full-fledged offices that dealt with a range of issues and to explore establishing a presence in Africa. Those initial steps led to establishing offices in Abuja, Addis Ababa, and Johannesburg in addition to Beijing and Delhi. In all, we have more than 230 employees outside of the United States, the majority of whom are nationals of their respective regions….”
And on the future:
“…Last year, boosted by the additional commitments for COVID response, we paid out $6.7 billion. This doesn’t include hundreds of millions more in guarantees, forgivable loans, and other financing from our Strategic Investment Fund, which supports efforts like at-risk manufacturing of COVID vaccines. Since our founding 21 years ago, we have paid out more than $60 billion in grants. Every year for the past decade our payout has grown. With a more than $50 billion endowment, Bill and Melinda’s generous additional commitment of $15 billion last year, the expectation of future pledges, and the requirement to spend down our endowment after our co-founders’ deaths, we are uniquely positioned to maintain a major role in the field of philanthropy for decades to come….”
Let’s start the WHO 150 EB meeting coverage/discussion first with some analysis published ahead of the Board Meeting. In a second EB related section (see below) we then focus on the EB itself.
https://healthpolicy-watch.news/countries-stalled-over/
Must-read overall analysis of the agenda. “As the World Health Organization’s executive board meets this week, two major issues – reforming its finances and pandemic response – continue to defy easy consensus. “
On the US opposition re WHO financing reform:
“… US domestic politics, more than geopolitics, may be the bigger hitch for Washington in the negotiations, diplomatic sources in Geneva told Health Policy Watch, rebutting media reports that US hesitancy centres around fears that finance reform could somehow increase China’s influence in the organisation. On the eve of a critical WHO governing board meeting in Geneva that begins Monday, the US is engaging “constructively” over the proposed move to scale up fixed annual contributions by member states so that they eventually account for half of the organisation’s funding needs, the sources said. But any US agreement to raise the WHO’s fixed contributions, however modest, would have to win Congressional approval at a precarious time when President Joe Biden’s Democratic majority is razor thin. “
“… The WHO’s 34-member Executive Board, which meets twice a year, firstly to set the agenda for the World Health Assembly in May, and again after the WHA, appears likely to delay making a decision on two critical issues: the first on sustainable WHO finance and a second move to toughen the pandemic response. In light of the lack of consensus, typically required for member state decisions, the board will likely defer making any clear recommendations, leaving hard choices to be hashed out before the WHA, which brings together all 194 member states. …. … The new pandemic accord, as well as a scale-up in assessed contributions are viewed as the lynchpins in a series of broader reforms to the WHO proposed by a number of recent external reviews of global pandemic response – including an Independent Panel co-chaired by Helen Clark and Ellen Johnson-Sirleaf, former heads of New Zealand and Liberia respectively. “
The HPW article also gave a good overview of the other topics on the EB agenda.
“This week’s EB meeting, which lasts through Saturday, will also consider over two dozen other issues in the WHO’s three strategic priority areas. Those are: health emergencies, universal health coverage, and “healthier populations”, which includes preventive health and climate and environment measures….” Check them out.
P Patnaik; Geneva Health Files;
Last week’s Deep Dive, also “a primer on some of the most political issues at the WHO EB 150 (24-29 January) next week.”
A few excerpts & quotes:
“A Standing Committee on Pandemic and Emergency Preparedness and Response? An Austrian proposal on giving greater decision-making powers to select WHO member states while responding to emergencies, has raised concerns. This contentious proposal that seeks to improve the “effectiveness and responsiveness” of the governing body, will be taken up by the EB next week….”
“.. IHRs amendments and the WGPR: The Working Group on Strengthening WHO Preparedness and Response to Health Emergencies, is expected to be given an explicit mandate to work on the amendments to the IHRs…. …. … The expansion of the Global Influenza Surveillance and Response system (GISRS+): In an innocuous looking document on Influenza Preparedness, lies a plan to expand sharing of information on pathogens beyond existing frameworks….. The EB will consider this document next week and deliberate on “suggestions for expanding the Global Influenza Surveillance and Response System to include other respiratory viruses with epidemic and pandemic potential.”
“… GSPoA: The Global strategy and plan of action on public health, innovation and intellectual property: The EB will also consider a key report on extending the time frame of the global strategy and plan of action on public health, innovation and intellectual property beyond 2022. It is proposed that this be extended till 2030….. … Sustainable Financing: The EB is also likely to take forward the deliberations of the Sustainable Financing Working Group. The mandate of the working group is expected to be extended, although some member states reportedly have reservations against such an extension….
“… NCDs at the EB: A slew of important updates on NCDs will be considered at the EB, from the prevention and control of NCDs; on the global strategy to reduce the harmful use of alcohol; diabetes; oral health and cervical cancer, among others…
Analysis from last weekend. “The United States, the World Health Organization's top donor, is resisting proposals to make the agency more independent, four officials involved in the talks said, raising doubts about the Biden administration's long-term support for the U.N. agency. The proposal, made by the WHO's working group on sustainable financing, would increase each member state's standing annual contribution, according to a WHO document published online and dated Jan. 4. The plan is part of a wider reform process galvanised by the COVID-19 pandemic, which has highlighted the limitations of the WHO's power to intervene early in a crisis. But the U.S. government is opposing the reform because it has concerns about the WHO's ability to confront future threats, including from China, U.S. officials told Reuters. It is pushing instead for the creation of a separate fund, directly controlled by donors, that would finance prevention and control of health emergencies. … The proposal is to be discussed at the WHO's executive board meeting next week but the divisions mean no agreement is expected, three of the officials said. … …. The WHO confirmed there was currently no consensus among member states, and said talks were likely to continue until the annual meeting in May of the World Health Assembly, the agency's top decision-making body.”
PS: as mentioned above, domestic US concerns might play a bigger role, though (as Amanda Glassman pointed out on Twitter).
Background and Commentary on Items before EB150 January 2022, prepared by WHO Watch.
Over to all the action at the EB then. More or less in chronological order below, as the week progressed.
Coverage of Tedros’ opening speech at the EB meeting.
“Even though the end is not yet in sight for the COVID pandemic, the world can end it as a global health emergency in 2022, says WHO DG at the opening of the 150th sesssion of the World Health Organization Executive Board.”
“… He added that it is dangerous to assume that Omicron will be the last variant or that the world is in the end game for the pandemic while on the contrary, globally, the conditions are ideal for more variants to emerge. … According to Tedros, even if the virus becomes endemic, the world can end the pandemic this year – and reduce the risks of new variants emerging with more universal COVID vaccine coverage, and the deployment of other public health measures. “If countries use all of these strategies and tools in a comprehensive way, we can end the acute phase of the pandemic this year,” Tedros said. “We can end COVID-19 As a global health emergency, and we can do it this year.” “
PS: on other than Covid-related issues: “… Despite the strains on global health as a result of COVID-19, the WHO DG noted that several giant strides were still recorded on several health issues in different parts of the world. …”
“The head of the World Health Organization on Monday urged countries to work together to bring the acute phase of the pandemic to an end, saying that they now have all the tools available to do so.”
If you want to read the opening remarks of Tedros in full, see WHO. WHO Director-General outlines five priorities for world and for WHO going forward:
“First, to support countries to make an urgent paradigm shift towards promoting health and well-being and preventing disease by addressing its root causes. The pandemic has demonstrated that we must elevate protecting and promoting health as top priority, with significantly increased investment in countries, and at WHO. The second priority is to support a radical reorientation of health systems towards primary health care, as the foundation of universal health coverage. That means restoring, expanding and sustaining access to essential health services, especially for health promotion and disease prevention, and reducing out-of-pocket spending. The third priority is to urgently strengthen the systems and tools for epidemic and pandemic preparedness and response at all levels, underpinned by strong governance and financing to ignite and sustain those efforts, connected and coordinated globally by WHO. The fourth priority is to harness the power of science, research innovation, data and digital technologies as critical enablers of the other priorities – for health promotion and disease prevention, for early diagnosis and case management, and for the prevention, early detection, and rapid response to epidemics and pandemics. The fifth priority is to urgently strengthen WHO as the leading and directing authority on global health, at the centre of the global health architecture.”
Related links:
Guardian - ‘Paradigm shift’ needed in way WHO is funded, says director general
Reuters - With U.S. support in doubt, WHO chief praises top donor Germany
The Ethiopian government kicked a fuss just before (and also at the start of) the EB. “A World Health Organization (WHO) official said on Monday that the global body would postpone a decision on Ethiopia's request to investigate its leader for allegedly supporting rebellious forces fighting the Ethiopian government. WHO Executive Board chair Patrick Amoth made the statement at a meeting of the board in Geneva where current director-general Tedros Adhanom Ghebreyesus’ bid for a second term as head of the U.N. agency is due to be discussed. …… "This is an extremely complicated matter with political implications and outside the agreed procedural framework of this committee," said Amoth. "Accordingly, I’m inclined to the view that this request should be set aside and if appropriate addressed by those concerned as they see may deem appropriate." None of the WHO’s 34 board members objected.”
https://www.devex.com/news/bjorn-kummel-no-consensus-on-who-assessed-contribution-increase-102529
Over to WHO financing. “Countries have agreed to extend the work of the member state-led group set up to find a solution to the World Health Organization’s unsustainable financing until the 75th World Health Assembly, after talks to increase the agency’s assessed contributions failed to reach consensus. While there’s an understanding among member states that WHO’s current funding model is unsustainable, not everyone was in agreement to increase their assessed contributions to the organization, said Björn Kümmel, the German diplomat who chairs the WHO Working Group on Sustainable Financing, on Tuesday during the 150th session of the WHO Executive Board…”
“…. increasing WHO’s assessed contribution looks uncertain, with several member states expressing reservations for it given the ongoing COVID-19 pandemic and its impact on their own economies. Others have also underscored the need for reforms to match the significant increase in assessed contributions, and believe WHO can be more efficient and seek further savings….”
“… In his remarks, WHO Director-General Tedros Adhanom Ghebreyesus acknowledged member states’ ask for greater accountability and transparency within WHO, and reiterated his commitment to it. But he also hopes that it won’t be used as a precondition for increasing the agency’s assessed contributions. “Because since the accountability and transparency [efforts] we have already started. If it's taken as a precondition, we will move in a vicious circle,” he said, while adding that improving the agency’s transparency and accountability is “a must” even without conditions in place.”
· See also HPW - …. United States Sets Conditions for Increased Financing
“… Financing dominated the second day of the board meeting with Germany’s Bjorn Kummel, chair of the Working Group on Sustainable Financing (WGSF) describing the global body’s finances as “rotten and unsustainable for the future”. In the run-up to the board meeting, Kummel’s group had failed to reach consensus on the proposal that at least half of the WHO’s budget should come from assessed contributions. The board agreed on Tuesday to extend the group’s mandate until May in the hope that a contribution formula can be agreed on. … … The US and Japan are holdouts on increased member contributions unless the WHO guarantees to improve its financial governance….”
· HPW - Africa Calls for ‘Radical Disruption’ of WHO Funding, as EU Wants More Efficiency
“Unless a future pandemic ‘instrument’ is properly financed and legally binding, it will not be able to prevent health emergencies, numerous member states told the World Health Organization’s (WHO) 150th executive board meeting on Monday. ;… Speaking on behalf of Africa’s 47 member states, Kenya’s Dr Cleopa Mailu said there should be a “radical disruption” of the WHO’s programme budget, calling on the board to “take bold steps” to adopt recommendations that will improve the WHO’s financing place it “on a more stable footing as the lead UN agency for coordinating global health”. The WHO secretariat has requested an increase of $480 million for the emergency programme alone, he noted….”
· WP - WHO pushes for more cash, faces skeptical Biden administration
“…Loyce Pace, assistant secretary for global affairs at the Department of Health and Human Services, told a WHO executive board that the United States needed to “better understand the current funding mechanisms, efficiencies and decision-making” before any new funding. U.S. officials have concurrently pushed for a new fund, separate from the U.N., that would be directly controlled by the donors and focus on pandemic preparedness and other emergencies. Discussions for the fund are still in the early stages, but it could be housed at the World Bank and involve up to $10 billion, according to reports last year....”
“… Though there are other skeptics, the Biden administration’s hesitation has become a major point of contention. It holds considerable sway as it had long been the largest donor to the WHO. Now, it is at odds with many European and African nations that have pushed for reforms to WHO funding. One European official on the WHO executive board, speaking on condition of anonymity as they were not authorized to discuss the matter, said many other nations were upset about the United States pushing the idea of a separate fund. “A new structure is a sign of fragmentation,” the official said, adding that there would be a lack of inclusivity if wealthy donors were given full control….”
https://www.twn.my/title2/health.info/2022/hi220110.htm
“WHO Member States have reportedly arrived at a consensus to establish a Standing Committee on Health Emergency (Pandemic) Prevention, Preparedness and Response (SCPPR) of the Executive Board of the Organization. A draft decision in this regard was circulated on 21January 2022 ahead of the 150th Session of the WHO Executive Board (EB) that is taking place on 24-29 January 2022 in hybrid mode. However, Member States could not reach a consensus on the terms of reference (ToR) of the SCPPR. Therefore, the draft decision requests the WHO Director-General to facilitate informal consultations with Member States, with a view to submit the revised ToR to the 151st meeting of the EB….”
On Tuesday, Tedros was nominated for a second term.
“WHO Director-General Dr. Tedros Adhanom Ghebreyesus said the World Health Organization will “continue to be open for any scrutiny” in a bid to demonstrate the agency’s commitment to accountability and transparency following a recent abuse scandal. The comments came as Tedros, the sole nominee for the next term as WHO chief, laid out his vision for the agency over the next five years. He said the organization has already demonstrated its commitment to accountability by establishing an independent commission and hiring an external investigator following reports of sexual exploitation, abuse, and harassment during the Ebola response in the Democratic Republic of the Congo. … …Tedros was fielding questions from member states, during the 150th session of WHO’s executive board, as part of his reelection bid for director-general. Member states nominated him for the position Tuesday, and he stands unopposed. The election will take place in May.”
“…Other country representatives were keen to hear about his plans to deal with the effects of climate change on health, reduce illnesses and mortality from noncommunicable diseases, fix WHO’s financial constraints, and ensure the agency continues to play a central role in the global health architecture….”
See also HPW - WHO Board Supports Tedros Nomination, as US Sets Conditions for Increased Financing
“…. All WHO regions expressed their support for is nomination, including the African region which commended the global body for its clear nomination process…”
“… During his address, he appealed for “assessed member state contributions” to cover at least half of the WHO’s roughly $3.5 billion a year budget…”
Further analysis in Devex - Tedros is still standing
“…. Tedros’ first term as head of WHO must rank among the most tumultuous in the organization’s 70-plus year history. …. …. It’s understandable, then, that after a secret ballot on Tuesday confirmed near-unanimous support for Tedros, the embattled face of an embattled organization had to take a moment to gather himself. Tedros’ second term, all but assured now, doesn’t look like it’s going to be much easier. …”
Editorial by Caterina Giorgi, CEO, Foundation for Alcohol Research and Education (FARE) and Kristina Sperkova, President, Movendi International, on the alleged efforts of the alcohol industry to undermine WHO processes towards a Global Alcohol Action Plan. (Well worth a read)
Coverage of the NCD action on Wednesday.
“Only 14 countries are on track to achieve the Sustainable Development Goals to reduce premature mortality from non-communicable diseases (NCDs) by one third by 2030, the World Health Organization (WHO) revealed at its executive board meeting on Wednesday. After listening for over three hours to countries’ views on the WHO roadmap 2023–2030 to prevent and control NCDs, WHO Deputy Director-General Dr Zsuzsanna Jakab, warned that countries had less than 10 years to meet targets….” “The agenda item on NCDs was especially onerous as member countries had to consider a political declaration, that included the roadmap, plus 11 annexures – including one on curbing alcohol consumption….”
“Alcohol lobby exerted undue influence on WHO draft global action plan – critics charge: Last week, the Foundation for Alcohol and Research Education (Fare) accused the WHO of watering down proposals to contain alcohol consumption despite two years of negotiations. …”
“… Aside from the focus on alcohol, a number of member states and NGOs made calls for countries to step up action on “unhealthy environments” that are the norm in many polluted, traffic clogged cities, as well as “commercial” risk factors, like the proliferation of junk food and tobacco promotion, which together contribute to unhealthy lifestyles and the development of NCDs. …” “Such risks are highlighted in a draft WHO Road Map (2023-2030) for implementing a Global Action Plan for Prevention and Control of Noncommunicable diseases, under consideration by the EB. …”
And a link:
On Thursday’s discussions. “ In a long, and winding discussion Thursday at WHO’s Executive Board, low- and middle-income countries (LMICs) pledged to redouble their efforts against noncommunicable diseases such as diabetes and obesity, which are having increasing impacts on health and well-being – in addition to infectious diseases that have been at the forefront of health sector efforts for most of the past half century….”
“…The Thursday session focused on action plans to implement a 2018 political declaration of UN General Assembly on the prevention and control of noncommunicable diseases (NCDs), a cross section of African countries noted that the ongoing COVID-19 pandemic has made it even more difficult for them to combat both diseases and other NCDs….”
https://healthpolicy-watch.news/who-board-agrees-to-tighten-pandemic-regulations/
“… member states made slow progress in charting better alternatives at the executive board meeting on Wednesday. WHO members are considering three main proposals to improve the global body’s future pandemic preparedness: “
“ (1) Setting up a Standing Committee on Health Emergency (Pandemic) Prevention, Preparedness and Response to provide guidance and make recommendations to the Board “regarding ongoing work on policy proposals on pandemic and emergency preparedness and response” (proposed by Austria). (2) Modernising the International Health Regulations (IHR), last updated in 2005, which are the only legally binding rules in health emergencies (proposed by the US). (3) Fleshing out how the intergovernmental negotiating body (INB) to establish a ‘pandemic instrument’, agreed on at last year’s World Health Assembly Special Session, will function.”
As for (1), “the Standing Committee was Stalled”.
As for (2), … “The Working Ground on Pandemic Response (WGPR), chaired by the US and Indonesia, has been charged with overseeing the process of discussing targeted amendments to the IHR. IHR amendments are expected to address equity, technology governance other gaps.”
As for (3), “ … The key discussions on an effective pandemic instrument will take place in the intergovernmental negotiating body, which is in the process of being set up. The EU announced that a Dutch official would lead its region, which South Africa indicated it had been nominated for this task by the Africa region….”
PS: “A wide range of civil society groups breathed some reality into Wednesday’s discussions, reminding delegates that the world was still in the grips of a pandemic and that citizens of the world had been failed by intellectual property rights, bottlenecks in vaccine delivery, and health services that have been unable to deliver sexual and reproductive health services and ongoing treatment for people with non-communicable diseases….”
And some links:
TWN - WHO: Member States agree to work on International Health Regulations amendments
Devex - Austria's proposed new WHO executive board committee on emergencies
“ Austria has proposed the creation of a new standing committee on pandemic and emergency preparedness and response of the executive board of the World Health Organization. The goal: to strengthen the board’s “effectiveness and responsiveness.” While some member states expressed their support for its creation, some wanted more clarity on its work. Here’s what’s known so far about the committee…”
Coverage of a technical briefing at the WHO EB on Monday.
“With the delivery of its one billionth dose last week, COVAX, the WHO co-sponsored vaccine facility, has established itself as the main pillar of vaccine supplies to the world’s 92 poorest economies – providing 82% of the vaccines those nations have received so far. But even as vaccine supplies now ease up, huge disparities persist in vaccine uptake rate among low-income countries – with some accelerating their vaccine drives and others stagnating due both to logistical and bureaucratic barriers and slack vaccine demand. …” “And even while most of the focus had been put on vaccine delivery – equally large disparities exist in COVID testing capacity – with clusters of low capacity in parts of central Africa. And that increases the risks that new variants could emerge, under the radar, later spreading to the world. “ Those were among the main messages at a WHO technical briefing to the Executive Board….”
“… US $20 billion is cost of exit ticket out of pandemic – but journey may not be direct: Bruce Aylward called upon donors to step up to the bat in 2022, by responding to the new ACT-A ask for some US$ 20 billion. … But success for the accelerator would also require the continued application of more pressure on vaccine manufacturers, Aylward said – restating a longstanding point that reliance on donations of vaccines and supplies from rich countries is unpredictable and inefficient. “We need your support with pressure on manufacturers, let’s be honest, to get access to the new antivirals and specific vaccines that every country in this room wants, to be able to exit the pandemic.”….”
Cash shortages mean Covax cannot accept new doses, says executive | Financial Times (ft.com)
See also last week’s IHP news. “Gavi chief warns WHO-backed vaccine scheme needs $5.2bn to pay for syringes and other accessories.”
“The Covax vaccine initiative set up to ensure Covid-19 vaccines reach the world’s poorest people is unable to accept new dose donations because it has nearly exhausted the funds needed to buy crucial accessories including syringes, one of its leaders has warned….”
PS: “… About 86 countries continue to have vaccine coverage rates of below 40 per cent, the health body said last week. Covax can help the lower-income nations it serves reach coverage of about 45 per cent, Berkeley estimated…..”
(open access & must-read) “Ayoade Alakija has been one of the harshest critics of the international pandemic response effort – the ACT-Accelerator – for failing low-income countries. Now she is its Special Envoy. “ACT-A is the only mechanism the world has, as flawed as it is. It cannot be allowed to fail,” she says.”
“… There are no precise terms of reference for Alakija’s new position. But in a statement, Tedros refers to a dual role. Alakija joins former Prime Minister of Sweden Carl Bildt both as Special Envoy for ACT-A with the task of helping to mobilise support and resources for the mechanism and as co-chair of ACT-A supporting the various agencies that make up the alliance. “I have been told that they want me not only to advise but also to help steer,” she says. …. ….Only two weeks into the job, Alakija says that while most people in the global health world have welcomed her arrival, expressing hope that she can “shake things up,” she has also met with some resistance and hostility….”
“…ACT-A currently faces a desperate financial situation and one of the most pressing tasks is fund raising. Three full months have passed since the USD 23.4 billion budget for 2022 was launched, but the only significant contributions so far have come from two Nordic countries. The G20 has yet to step up. “That money must be raised. ACT-A is the only mechanism the world has, as flawed as it is. It cannot be allowed to fail,” she says….”
“… The new special envoy says it is necessary to nurture a “common identity” for the ACT-Accelerator. “This is going to become very important, especially when it comes to fund raising,” she says. Until now, vaccines have received 75 per cent of all funding provided by donors to the initiative. Moving forward, a priority for Alakija is to try to move away from this inordinate focus on vaccines to a broader perspective that gives equal importance to other tools: diagnostics, therapeutics (including medical oxygen) and health systems. “I actually want to move away from talking only about vaccine equity because that is sucking the air out of the other pillars,” she says….”
Related tweet: “This is an unpaid position. Alakija covers her own travelling expenses, and her daughter is her assistant, also unpaid. The situation is not sustainable, she says, symptomatic of the exclusion of voices from the Global South.”
M Pai also had an interview with Dr. Ayoade Alakija, Co-chair African Union’s African Vaccine Delivery Alliance & WHO Special Envoy for ACT-A. Aka ‘Yodi’ (see the piece above).
“…In this interview, she talks about her fears, frustrations and hopes. More importantly, she offers us a path forward to end the pandemic for everyone, everywhere….”
“The White House today confirmed the United States has donated 400 million COVID-19 vaccine doses—toward a goal of 1.1 billion—to low-income countries via COVAX, the global vaccine sharing program. …”
Still a near-criminal imitation of the “procession of Echternach”, this whole TRIPS waiver “discussion”…
R Kanth; https://www.twn.my/title2/health.info/2022/hi220112.htm
“The chair of the WTO General Council has decided to convene a dedicated open-ended informal meeting on 27 January on the issue of the WTO’s response to the pandemic, including the temporary TRIPS waiver, as India upped the ante for an expeditious decision on the waiver to combat the worsening COVID-19 pandemic. … … At an informal General Council (GC) meeting on 25 January, India expressed grave concern that, despite continued negotiations on the TRIPS waiver since October 2020, there has been no resolution to the issue even as the pandemic has wreaked havoc across countries, said people, who asked not to be quoted.”
“… It seems clear that the European Union, members of the Ottawa Group of countries led by Canada, and the United States want to link the TRIPS waiver with the controversial recommendations made by Walker’s report (on the WTO’s response to the pandemic), said people, who asked not to be quoted….”
Stay tuned for “… the first General Council of the year, which is scheduled for 23 and 24 February. “
See also WTO - Members discuss way forward in dedicated meeting on WTO pandemic response
Press statement after the meeting on 27 Jan.
“WTO members met on 27 January to discuss the WTO response to the COVID-19 pandemic. The informal meeting convened by the Chair of the General Council, Ambassador Dacio Castillo of Honduras, looked at issues related to cross-border trade flows and the proposal to waive certain intellectual property protections related to COVID-19 countermeasures. Director-General Ngozi Okonjo-Iweala called on members to move swiftly to try and reach a comprehensive outcome by the end of February.”
Apparently, “A holistic approach is needed…” Don’t hold your breath.
On a meeting on 21 Jan. “Trade ministers and senior officials from 28 countries issued sharply conflicting messages at a virtual meeting hosted by Switzerland on 21 January, with the majority of the developing country participants demanding an urgent resolution to the TRIPS waiver in the WTO’s response to the COVID-19 pandemic, said people familiar with the proceedings of the meeting. The trade ministers of India, South Africa, Cameroon on behalf of the African Group, Chad on behalf of the LDC group and a senior official from Indonesia among others flagged the TRIPS waiver as the most important issue to be resolved in the face of the worsening COVID-19 pandemic due to the new Omicron variant of the SARS-CoV-2 virus, said people, who asked not to be quoted…..”
“French President Emmanuel Macron proposed pressuring pharmaceutical companies to share their knowledge to fight vaccine shortages worldwide, as an alternative to waiving intellectual property (IP) rights. “ This was “version 19 January” of Macron’s stance on this issue, speaking before MEPs.
“The Cuban government has announced advanced plans to deliver 200 million doses of homegrown Covid-19 vaccines to the Global South, described as “lifesaving” by the head of the Progressive International’s delegation to the Caribbean nation.”
“…. At the briefing, the Cuban government announced its plan to get these doses into the arms of those who need them in the Global South, including: Solidarity prices for Covid-19 vaccines for low-income countries; Technology transfer where possible for production in low-income countries; Extending medical brigades to build medical capacity and training for vaccine distribution in partner countries. …”
https://www.southcentre.int/research-paper-144-27-january-2022/
“This paper considers legal implications that are likely to emerge from the implementation of a TRIPS Waiver decision. Assuming that a Waiver is adopted in the form presented in the May 2021 proposal by South Africa and India et al, we review the interaction between the Waiver and other commitments to protect IP rights under international IP and investment treaties. Our principal research question is to analyze whether domestic measures implementing the Waiver are compatible with the implementing State’s other obligations to protect IP rights established under multilateral IP treaties, IP and Investment Chapters of FTAs as well as BITs. In light of typical examples for such overlapping commitments, we first focus on (1) defences directly affecting compatibility with these treaty commitments (here referred to as ‘internal’ defences). In a second part, we review (2) potential defences under general international law that may serve to justify (in other words, to preclude the wrongfulness of) such measures. We conclude that often internal and/or general defences will operate to support the implementation of the Waiver despite overlapping commitments in international IP and investment law. This conclusion is reinforced by a purpose-oriented understanding of the TRIPS Waiver as authorizing measures necessary to achieve the goal of “unimpeded, timely and secure access” for all to covered medical technologies “for the prevention, treatment or containment of COVID-19”.”
“The world needs more resilient health infrastructure to face future threats – President Widodo called on the IMF to mobilize global health resources with support from advanced economies and G20.”
“the G20 and advanced economies must work together to create a more resilient and responsive global health architecture to face future threats and pandemics, said President Joko Widodo of Indonesia in his address to the Davos Agenda 2022. He said the International Monetary Fund should be tasked to mobilize resources to revitalize global health architecture. This should include a global contingency fund for medical supplies, building capacity in developing countries to manufacture vaccines and the creation of global health protocols and standards….”
In related “news” (though not confirmed) (France 24) - Indonesia to push for new global health agency, president says
“ Indonesia will push for the creation of a new global health agency while the country holds the presidency of the G20, President Joko Widodo said Thursday at the virtual Davos forum.” Might have been a mistranslation, though.
Press release on the meeting on 26 January. At this 2nd G20 Joint Finance and Health Task Force meeting, the task force reaffirmed its commitment to accelerating global COVID-19 vaccination and supported partnerships to address the finance and trade barriers to access to vaccines.
PS: “…As a joint task force, the Finance and Health Ministries of the G20 Countries with WHO and World Bank will carry out further identification in order to increase cooperation in the health and financial fields. In the establishment of the financing facility agenda, G20 countries expressed their perspectives on the importance of global financing mobility in efforts to prevent, detect, and respond to pandemics within the International Health Regulations (2005) framework. The JFHTF will consider the strategic assessment of health and finance collaboration options. The results of the discussions will be presented at the Finance Ministers and Central Bank Governors Meeting (FMCBG) on 17-18 February 2022, inviting the G20 Health Ministers to the meeting.”
“The World Health Organization (WHO) is in a funding crisis which has been caused, among other things, by the shift in the global balance of power in the course of the last 25 years. This is revealed by a new study conducted at the University of St.Gallen. Dr. Julian Eckl traced the development of the WHO’s finances and the change in the regulations of financial contributions during the last 25 years in a study funded by the Swiss National Science Foundation….”
“The study examines the change in so-called norms of differential treatment, which take into account economic differences between countries, among other things. The rise of emerging countries has led to a discussion at an international level about what change in expectations can be formulated vis-à-vis countries that are gaining economic strength, precisely how individual countries’ financial obligations should be calculated and what volume of economic resources is required to be able to continue to help needy countries. …. …. “ … The work shows that the political wrangling about contribution regulations resulted in a situation whereby countries’ financial burdens underwent a considerable shift. Firstly, there were changes with regard to the relative share in the compulsory budget which each member state must take on, and secondly, there were changes in the ratio between assessed and voluntary contributions….”
Do read what this entailed for Emerging countries.
Check the section “Healthy lives: strengthening global health with pandemic preparedness and response and an improved international health architecture.”
No Trips waiver to be seen, though…. (and probably also one of the reasons why Macron seems to have changed his view on this yet again (see above)).
“…. the [African] continent’s chief health leader is hoping to put the brain drain into reverse with a plan to persuade African expats to return. Dr John Nkengasong, the head of the Africa Centres for Disease Control and Prevention (Africa CDC), said they wer”e planning a programme to attract scientists, doctors and nurses back from the diaspora.
““The leadership of the continent must invest in strengthening health systems,” Nkengasong said, in an interview with the Observer. “We need a very deliberate programme that facilitates Africans in the diaspora to come back to the continent and do a rotation. …. … He said the Africa CDC would soon put forward a package of measures to the African Union commission to create a regional health treaty to govern the pandemic response, which would include support for expatriates…. … The Africa CDC set up seven working groups allowing doctors and scientists working in richer countries to give regular advice remotely. “They have been extremely useful during this pandemic,” Nkengasong said. “We need to formalise it and facilitate the return to the continent to support the public need.” … So far Africa CDC has launched 12 pandemic initiatives, he said. As well as genomic surveillance and vaccines, there are plans to secure diagnostics and testing kits, and medical supplies.”
“The Global Fund is pleased to announce that Shunsuke Mabuchi is joining the Global Fund as the new Head of Resilient and Sustainable Systems for Health, starting in March 2022. … …. A senior global health leader, Shun brings a unique combination of experience and leadership in health systems strengthening, pandemic preparedness, program delivery and emergency response. He joins the Global Fund at a critical time for the implementation of the new strategy, and will focus on maximizing people-centered, integrated systems for health to deliver impact, resilience and sustainability. … …. Shun spent three and a half years at the Bill & Melinda Gates Foundation as Deputy Director for Strategy, Planning & Management, Integrated Delivery, and Senior Advisor for Health Funds and Partnerships and for the Global Delivery Programs. He played a central role in the development of the Foundation’s Primary Healthcare and Integrated Delivery Strategies.”
“Shun began his career working for McKinsey, UNDP and the Japan International Cooperation Agency. He later served as a Senior Health Specialist at the World Bank, leading large projects from the Ebola Emergency Response in West Africa to health portfolios in Nigeria, Tanzania, Somalia, Liberia, and Sierra Leone….”
S Ogweno; Project Syndicate;
“The African health-care sector continues to struggle with a lack of resources and funding, but creative uses of technology offer new possibilities for improving access to medical treatment. Building on developments spurred by the pandemic, health tech on the continent is poised for explosive growth.”
N Gulrajami et al ; https://odi.org/en/publications/fixing-un-financing-a-pandoras-box-the-world-health-organization-should-open/
Some key messages: “The immediate steps needed to fix UN financing: Increase the share of assessed contributions to the WHO; Link discussions on UN funding reform to its desired global functions; Make the formula for assessed contributions fit for purpose; Penalise arrears.”
With key trends, WHO key messages, ….
https://www.ft.com/content/6cc877d3-b909-4200-b76b-cc23734136b4
From late last week. “Advisers recommend use of a third shot but want vulnerable people to have priority.” “The World Health Organization has recommended wider use of Covid-19 vaccine boosters, updating its previous guidance when it backed the use of a third shot only in very limited circumstances. The Strategic Advisory Group of Experts on Immunisation, an independent panel of experts, advised expanding booster programmes alongside the administration of primary doses, with the priority on vulnerable people, the WHO said on Friday. The new recommendations mark a shift in the WHO’s supply outlook after severe constraints last year that contributed to huge disparities in the rollout of vaccines around the world. Vaccine shortages plagued many countries during much of 2021, prompting the WHO to call for a moratorium on boosters to aid the global uptake of jabs. According to the new guidelines, countries with moderate-to-high coverage of inoculation in priority groups, such as older people and healthcare workers, should first focus on giving the booster to protect those groups against coronavirus before offering it to others. ….”
“Kate O’Brien, the WHO’s head of vaccines, told reporters the health body saw a “very positive outlook for supply” for 2022. However, she cautioned that this was predicated on dose sharing continuing and manufacturers continuing to honour deals brokered under Covax, the WHO-backed scheme to give people in poor countries equitable access to vaccines. O’Brien said unequal distribution could continue to complicate global access to vaccines, rather than upstream supply. “This does not mean giving boosters as a priority in all ages,” she said, clarifying the guidance. ….”
“… The WHO distinguishes between third shots, which are used to complete vaccination schedules in those who are immunocompromised or particularly vulnerable, and boosters, which are instead used on the general population…..”
· See also HPW – WHO Drops Opposition to Boosters – Recommends Third Pfizer Jab for Adults & Two Vaccines for Children Ages 5 & Up
Projections of sufficient global supply now – a WHO turnaround: “The remarks about sufficient global supplies available today run contrary to those aired by WHO Director General Tedros on 22 December, when Tedros warned that “blanket” booster campaigns could sap supplies from rollouts in low-income countries, saying that “only later in 2022 will supply be sufficient to extensive use of boosters in all adults.” At that time, WHO only recommended boosters for “high-risk groups”…”
· Devex Boost high-risk groups before first COVID doses for low risk, says WHO
“Countries that have achieved moderate to high levels of COVID-19 vaccinations among high-risk groups — including older people and health workers — should next prioritize giving these people booster shots rather than offering first doses to low-priority groups, said the World Health Organization…..”
· And for the full advice: WHO SAGE Roadmap for prioritizing uses of COVID-19 vaccines
https://healthpolicy-watch.news/mixed-reaction-in-africa-to-whos-new-position-on-booster-shots/
“The decision of the World Health Organization (WHO) to drop its opposition for COVID-19 vaccination booster shots has raised concerns in Africa about the potential depletion of COVID-19 vaccine doses available to African countries. ….”
“… Nigerian public health consultant, Ifeanyi Nsofor told Health Policy Watch the WHO’s new position still has provoked concerns about COVID-19 vaccination efforts in Africa after months of scarcity. “I’m absolutely worried that the new prioritization for boosters is going to affect Africa’s vaccine shipments with everyone now going for boosters,” he said. He added, however, that insofar as many low- and middle-income countries have already stockpiled vaccines for booster campaigns, then using the doses for boosters could also prevent wastage. “Giving boosters in low- and middle-income countries (LMICs) makes sense because of the likelihood of vaccines expiring thereby preventing wastage. Beyond that, full vaccination is no longer two doses. It is now plus a booster dose. So, LMICs have to be in line with global practice,” he told Health Policy Watch….”
“Moreover, the global health body’s new position on boosters also provides a signal to low-income countries that can thus prime their health systems accordingly, with support from COVAX and donors – and that will help citizens avoid future discrimination, e.g. in international travel. More foot-dragging on boosters, he added, could have further put LMICs at a disadvantage because of the changing definition of ‘fully vaccinated’ in many high-income countries to mean three jabs – regardless of WHO’s positions. “People from the global south could be denied entry to western countries because they have not been boosted,” he told Health Policy Watch. ….”
https://www.france24.com/en/live-news/20220120-spain-leads-calls-for-covid-19-to-be-treated-like-flu
From late last week. “With governments and populations worldwide desperate for an end to the pandemic, discussion about when the virus might be reclassified has intensified. "Spain wants to lead this debate because it is timely and necessary to do so," Health Minister Carolina Darias has said, adding that Spain asked the European Centre for Disease Prevention (ECDC) to "study new strategies" to deal with Covid.”
“… On Tuesday, however, World Health Organization chief Tedros Adhanom Ghebreyesus insisted that the pandemic was "nowhere near over", warning that new variants were still "likely to emerge". The UN health organisation also warned against the temptation to play down the seriousness of an endemic disease…..”
“UK regulators are working with the World Health Organization (WHO) to devise a central system to update Covid vaccines, much like the current process used for flu jabs, The Telegraph understands. Experts from the Medicines and Healthcare products Regulatory Agency (MHRA) joined a meeting with agencies from Europe, the US and beyond last week, where early plans for closer collaboration on variant-proof Covid jabs were discussed. The WHO is expected to be central to this process, emulating a system currently used to decide on “strain updates” for flu shots, which are updated every six months. The Telegraph understands that last week, the MHRA took part in a meeting under the umbrella of the International Coalition of Medicines Regulatory Authorities (ICMRA) – which has some 24 members – to discuss how these Sars-Cov-2 “strain updates” should take place. Other agencies involved in the roundtable include the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA). “
“Regulators hinted the WHO would take the lead on deciding “strain updates”, as happens for influenza. The UN health agency has already formed the Technical Advisory Group on Covid-19 Vaccine Composition – or Tag-Co-Vac – for this purpose. “
“… Dr Swaminathan said there are three main approaches for next generation vaccines: another ‘monovalent’ vaccine which targets a single variant; a ‘multivalent’ vaccine which could protect against several strains at once; or a pan-coronavirus vaccine. The last option, though the most complicated to develop, would be the “ideal”….”
https://www.ft.com/content/660a8d64-7e60-45fc-8fa9-fd59f543f815
“BioNTech (22UAy.DE) said it and partner Pfizer (PFE.N) may not be able to stick with their plan to launch an Omicron-targeting vaccine by the end of March, depending on how much clinical trial data regulators will require.”
https://www.nytimes.com/2022/01/25/health/long-covid-risk-factors.html
“If further study confirms the findings, they could lead to ways to prevent and treat the complex condition.”
A D Usher; https://www.development-today.com/
“The IMF Pandemic Response Task Force’s analysis of vaccine deliveries to developing countries through COVAX reveals grossly uneven distribution of the 880 million doses shipped so far. Seventeen countries in Sub-Saharan Africa have received doses that cover less than one-tenth of their populations; a dozen countries have received enough to vaccinate more than one-third. IMF argues that more attention must be given to problems of absorption capacity in recipient countries.”
https://www.washingtonpost.com/world/2022/01/24/vaccine-distribution-logistics-inequality-access/
“As vaccine shipments finally surge into poorer countries, the world is in danger of trading in one form of vaccine inequality for another, with disparities in access replaced by disparities in the ability to distribute them on the ground. … That’s in part, critics say, because there’s been a huge global focus on vaccine access — but not enough on how to deploy vaccines when they land. By late November, only 14 percent of the $5.8 billion spent by the World Bank on vaccine assistance went toward distribution, according to CARE’s research.”
“… Developing countries “don’t have the ability to distribute because there hasn’t been the corresponding investment, and if they were going to do that, they would have to make such serious tradeoffs in their health systems,” Emily Janoch, CARE’s director of knowledge management, told me.
Kate O’Brien, the World Health Organization’s vaccine director, told me last week that distribution funding “is absolutely an issue that we’re experiencing and hearing about from countries, that the funding that’s needed at the peripheral level where the funding is actually spent is not what it needs to be.” “
“… Officials at CARE say the actual cost for vaccine rollouts in developing countries has been vastly under-calculated by international donors. … Rachel Wolff, CARE’s Nepal director, told me that vaccine access ceased being a major problem for Nepal as far back as September. But distribution on the ground has been challenging — and expensive. Covax, she said, had estimated delivery costs there at $3.70 per person in the developing world. But a CARE analysis showed the average actual cost — including sending health-care workers into remote areas with portable cold storage — is actually above $8 for one dose….”
“Chief Executive Albert Bourla said on Saturday that an annual COVID-19 vaccine would be preferable to more frequent booster shots in fighting the coronavirus pandemic.”
“In an interview with Israel's N12 News, Bourla was asked whether he sees booster shots being administered every four to five months on a regular basis. "This will not be a good scenario. What I'm hoping (is) that we will have a vaccine that you will have to do once a year," Bourla said.
… "Once a year - it is easier to convince people to do it. It is easier for people to remember. "So from a public health perspective, it is an ideal situation. We are looking to see if we can create a vaccine that covers Omicron and doesn't forget the other variants and that could be a solution," Bourla said.”
https://www.politico.com/news/2022/01/27/trump-plan-favored-vaccines-isreal-taiwan-00002893
“As the U.S. prepared for authorization of the first Covid-19 vaccines, the administration prepared a secret list of which nations would get the doses first.”
Links:
· Reuters - J&J expects COVID vaccine sales to jump as much as 46% in 2022
“Johnson & Johnson on Tuesday forecast $3 billion-$3.5 billion in revenue for its COVID-19 vaccine this year, compared to $2.39 billion it generated in 2021, even as the drugmaker faces manufacturing issues and uneven demand for the shot.”
· Bloomberg - Covid-19: More Than 10 Billion Vaccine Doses Administered Across Globe - Bloomberg
“An influential consumer advocacy group is pressing Pfizer Inc (PFE.N) to supply more of its new COVID-19 pill Paxlovid to developing countries this year, concerned that access to the treatment will mirror inequalities in vaccines.”
“Public Citizen sent a letter to Pfizer Chief Executive Albert Bourla on Monday, asking the drugmaker to set aside at least two-thirds of its supply this year for developing countries at a reasonable price. Peter Maybarduk, director of Public Citizen's Access to Medicines program, said the letter was the opening salvo of what he expects will be a year-long campaign by the group. "This is going to be one of the top access to medicines issues of the coming year. It's going to be a tremendously discouraging repeat of vaccine inequity, at least initially, and many of us will be working to mitigate that," Maybarduk said….”
“….supply of Paxlovid is extremely limited in the short term. Pfizer has said it can produce 120 million courses of treatment this year, but that falls well short of the company's estimate of the 2022 market for antiviral pills of 250 million people globally….. …. Pfizer also will allow generic manufacturers to supply the pills in low and middle countries representing 48% of the world's population. But the company does not expect those generic companies to be able to provide significant supply until 2023.”
https://www.nature.com/articles/d41586-022-00112-8
“The first crop of antivirals against SARS-CoV-2 is promising. But new drugs will be needed to counter the looming threat of resistance.”
https://www.ft.com/content/f3eeeafc-62a5-4a50-997c-e478456bd56f
“The Covid rapid testing industry is racing to help thwart the spread of the Omicron variant, with manufacturers expanding production, hiring staff and splashing out on whole planes to send out millions of kits at a time. …. … The industry was not ready for such a huge spike in demand…..”
Fifa Rahman et al ; https://speakingofmedicine.plos.org/2022/01/24/covid-testing-equity-a-reflection-based-on-1-5-years-in-the-act-accelerator/
Hard-hitting blog & must-read. ACT-Accelerator civil society representatives call for quicker guideline development, among others. A few excerpts:
“Representing civil society on the diagnostics and therapeutics pillars of the ACT-Accelerator, we have participated in numerous weekly and biweekly discussions since July 2020 on access to COVID-19 tools. Our role has been to distil evidence and experience from CSOs globally and bring that to tables dominated by Global North agencies, clinicians, and epidemiologists, and to centre elements of what we think an equitable pandemic response should incorporate. At all times, we have insisted on equitable access of *all* available tools to communities that need them – including via letters to WHO leadership calling out disparity in testing equity in the Global North and the Global South, demanding that their guidelines more explicitly mention community-based testing, that the guidelines include recommendations for linkage to care with self-testing, and how individuals should react in an environment with long turnaround times for PCR tests. … We know that progress on self-tests at the ACT-Accelerator level have been extremely slow, and not for the tireless efforts of several global health agencies such as FIND and Global Fund who are trying to get rapid tests (both professional use and self-tests) to LMICs. At time of writing, we still do not have WHO guidelines on self-tests – an important prerequisite for global health agencies to deploy self-tests to LMICs at scale. The WHO has committed to establishing a Guideline Development Group (GDG) towards the development of self-test guidelines, after which companies will be invited to register to include their products under the Emergency Use Listing. Based on our discussions, our optimistic estimations on the timeline are as follows: …. …. When Global North countries are rapidly deploying these tests and making them accessible to all individuals, a delayed 2023 timescale for self-test deployment to the Global South is unacceptable. We will have many more deaths in LMICs from now until then….”
“…We note the comments by Ellen Johnson Sirleaf and Helen Clark in PLOS Global Public Health last year, that the ‘root cause’ of vaccine equity ‘was a lack of decisive leadership directed towards cooperation and solidarity.’ In access to testing, we continue to see this lack of decisive leadership in all spheres. Something must be done to expedite the procedures to enable deployment of community-based and self-tests now.”
“Abbott Laboratories (ABT.N) on Wednesday beat quarterly profit and sales estimates, aided by robust sales of COVID-19 test kits due to the spread of the Omicron variant and strong demand for its diagnostics products.”
R Labonté ; https://www.bmj.com/content/376/bmj-2021-068126
“A return to a business as usual economy would be a fatal mistake argues Ronald Labonté.”
Wide-ranging analysis, from WEF proposals (like the Great reset, stakeholder capitalism), over Mazzucato’s “mission approach”, to degrowth.
Key messages: “As the global pandemic recedes, “greening” economic growth and improved employment and social protection measures remain central to a more health equitable future; Proposed reforms such as harnessing private capital for social impact investments or a stakeholder model of capitalism are likely to be insufficient; More far reaching change is needed with governments shaping markets to ensure that economic activities achieve urgent social and environmental goals; A transformative shift to degrowth would avoid unsustainable and inequitable consumption of finite ecological resources and ensure human survival.”
K Kupferschmidt; https://www.science.org/content/article/after-omicron-some-scientists-foresee-period-quiet
“The variant’s modest toll in many countries has led to a sense of optimism. But new surprises are likely.”
“…Barely 2 months after it began, the Omicron wave is already ebbing in some countries. And although it has sickened huge numbers of people, caused massive disruption, and left many health care workers exhausted, it is also leaving something unusual in its wake: a sense of optimism about the pandemic’s trajectory. In countries where many people have been vaccinated or were infected, scientists say, the worst may finally be over. …. … The optimism is shared—although couched in caveats—even by some scientists and public health experts who have stressed the risks of the pandemic from the start and implored politicians to take stricter action. “ … … Still, researchers urge caution. Omicron has shown that even a relatively mild wave can put a tremendous burden on health systems and societies as a whole, and it’s unclear how long Omicron immunity will last, how the virus will evolve from here on, and how often breakthrough infections will lead to long-term health problems. …“
“… What the virus will do next is another wild card. …
“Our approach to pandemic response can’t react fast enough for a Covid-19 variant like omicron. That should scare us….”
“… We are incredibly lucky that omicron seems to be milder than previous strains of Covid-19 and that both vaccinations and previous exposure have built up immune resistance. The massive spike in cases around the world — while badly taxing health care systems — hasn’t been matched by an equal spike in hospitalizations and deaths. I think it’s hard to appreciate what a massive bullet we dodged: If omicron had been substantially more deadly, there is very little we could have done to stop the death toll….”
Report from last week. The toll on older people was heavy, also in Africa. Also with recommendations on what needs to be improved.
F Venter et al ; Op-ed Daily Maverick ;
Interesting op-ed, also worth reading with a view on other countries (than South-Africa).
“Almost two years on, we are entering a new phase of the pandemic. All over the world, including within the WHO, there is an assessment taking place of the measures that will be most suited to this phase. Top of the list is vaccination, good indoor ventilation, and close monitoring of the SARS-Cov-2 virus and other possible pandemic threats. South Africa needs to do this too. As scientists, our current understanding of the science, the building of immunity protecting against severe Covid-19, and experience with policy renders most state of disaster measures still in place unfit for purpose and requires tailoring of others. Being on permanent “Code Red” affords little protection against a hyper-transmissible SARS-CoV-2 variant such as Omicron and entails unacceptable societal costs. …”
M Osterholm et al; https://www.foreignaffairs.com/articles/world/2022-01-22/pandemic-unknowns?utm_medium=social
On reaching a New Normal in an Age of Uncertainty. Very interesting piece as well, gloomier though.
“Transparency International ranking reveals decade of standstill on tackling corruption, with many countries reaching historic lows in 2021.”
“The global fight against corruption has been at a standstill for a decade, with 86% of countries either worsening or making no progress in tackling the problem, and with numerous governments accused of using the pandemic to erode human rights and democracy, a report has found. Transparency International’s annual corruption ranking, published on Tuesday, also found countries that violate civil liberties consistently have low scores, underlining how failure to tackle corruption exacerbates human rights abuses and undermines democracy. First launched in 1995, the corruption perceptions index (CPI) has become one of the leading global trackers of public sector corruption, drawing data from 13 public sources, including the World Bank and the World Economic Forum. At least three sources are required to provide a ranking for each of the 180 countries included….”
“Progress in biotechnology will advance pandemic defenses even more in coming decades.”
https://www.bmj.com/content/376/bmj-2021-068123
“Mandeep Dhaliwal and colleagues call for urgent correction of the response to covid-19 to safeguard the development of children and young people.”
Also part of the ‘World We Want’ series.
Key messages: “The covid-19 pandemic is a long and multiwave event; Children and young people are at disproportionately higher risk of the effects of covid-19; A multilevel, intersectoral response is needed to mitigate the negative effects of the pandemic on children and young people, with a focus on long term planning, layering of effective interventions, and scaled investments; Evidence from other epidemics suggest investment in social protection, evidence based parenting support, education re-enrolment, and child health promotion can mitigate the effects of covid-19.”
“Despite a severe lack of COVID testing and serological data in Africa, available data suggests that most people on the continent have somehow already been exposed to SARS-CoV2, said the director of the influential Institute for Health Metrics and Evaluation on Thursday. And in light of that, and the fact that COVID vaccines do not prevent infection, but rather only serious cases, more investment should probably be placed into testing and anti-viral treatment for older, more vulnerable people, said Dr Chris Murray, whose Institute collaborates closely with the World Health Organization on many of its key global data studies….”
https://www.bloomberg.com/graphics/covid-resilience-ranking/
Update of Bloomberg’s Covid resilience ranking (as of 27 Jan). Now, with Omicron around the world. Top three this time: UAE, Saudi Arabia & Finland.
R Glover et al ; https://www.tandfonline.com/doi/full/10.1080/09581596.2022.2026296
“Antimicrobial resistance (AMR) is often characterised as a ‘crisis’, requiring action by public, private, and third-sector stakeholders to achieve strategic change. Crisis narratives are powerful and may be co-opted to privilege solutions promoted by influential groups. In relation to AMR, this applies particularly to the pharmaceutical and medical diagnostics industries. Given the associated risk of inefficient use of public funds, critical attention must be paid to how the promoted ‘solutions’ to the AMR crisis are constructed, and their symbolic and material effects on health policy. We conducted a critical discourse analysis (CDA) of the seventy-one written submissions to the UK House of Commons Health and Social Care Committee’s 2018 inquiry into AMR. ….We applied the Policy Dystopia Model to further analyse the proposed solutions and ascertain the discursive and instrumental arguments in the industry submissions to the Committee. We found that industry submissions deployed economic and governance discursive strategies, articulating three main ‘market paradoxical’ arguments: (i) interference but non-interference; (ii) power but powerlessness; and (iii) for-profit but not-for-profit. The industry submissions also drew upon instrumental strategies including: coalition management, information management, and direct involvement and influence in policymaking. Our analysis suggests that commercial interests deploy crisis narratives to advocate for solutions involving market deregulation and industry subsidies. Thus, the solutions presented to the Committee were heavily shaped by a technocratic-industrial complex. This contributes to influencing what is seen as possible and acceptable in the global AMR policy landscape.”
Link:
Cidrap News - AMR Action Fund head aims to boost innovation, funds for new antibiotics
Interview with AMR Action Fund CEO Henry Skinner. On the current state of antibiotic development, the need to fix the broken market for new antibiotics, and how to build a sustainable pipeline.
Rich countries' access to foreign nurses during Omicron raises ethical concerns, group says
“The Omicron-fuelled wave of COVID-19 infections has led wealthy countries to intensify their recruitment of nurses from poorer parts of the world, worsening dire staffing shortages in overstretched workforces there, the International Council of Nurses said.”
“Sickness, burnout and staff departures amid surging Omicron cases have driven absentee rates to levels not yet seen during the two-year pandemic, said Howard Catton, CEO of the Geneva-based group that represents 27 million nurses and 130 national organisations. To plug the gap, Western countries have responded by hiring army personnel as well as volunteers and retirees but many have also stepped up international recruitment as part of a trend that is worsening health inequity, he continued. "We have absolutely seen an increase in international recruitment to places like the UK, Germany, Canada and the United States," Catton said in a Reuters interview based on a report he co-authored on COVID-19 and the global nursing force. "I really fear this 'quick fix solution' – it's a bit similar to what we've been seeing with PPE (personal protective equipment) and vaccines where rich countries have used their economic might to buy and to hoard - if they do that with the nursing workforce it will just make the inequity even worse."
See also NYT - Rich Countries Lure Health Workers From Low-Income Nations to Fight Shortages
And a link:
“Scaling up nutrition interventions with appropriate financing is a vital part of achieving the universal health coverage agenda, nutrition experts say. Although adequate nutrition leads to healthier societies and builds human capital, it is too often missing from basic health packages or the priority health services that a population receives. As such, countries have a harder time prioritizing sustainable financing, said Juan Pablo Uribe, the global director for health, nutrition, and population at the World Bank and the director at the Global Financing Facility for Women, Children and Adolescents.;..”
“ “We need to redress this huge goal of guaranteeing universal health coverage with access to health care services with financial protection for households, and ensure that we take that opportunity to strengthen and mainstream nutrition in the core of progress to universal health coverage,” said Uribe, speaking Tuesday during a Nutrition for Growth webinar in the Nutrition Financing Week event series. “Nutrition has to be on the top list of [universal health] services.” The series of events this week are sponsored by the World Bank and GFF to discuss ways to increase financing and accountability for commitments made at last month’s Nutrition for Growth Summit, which was hosted by Japan….”
“… An investment framework developed by the World Bank and Results for Development found that meeting the six World Health Assembly nutrition targets by 2025 would require an average of $7 billion every year from 2016 to 2025. Major nutrition interventions, such as wasting treatment, are often led by international development organizations that are disconnected from countries’ health systems, Branca said. Nutrition must be part of the continuum of care if it is to both receive sufficient financing and be effective, he said….”
“… This month, the World Bank Group and GFF published a working paper to detail how improved nutrition coverage and quality can be delivered through the health system, as well as ways in which health financing can be used to do so while encouraging universal health coverage, or UHC. WHO provided its input on the research through a peer review process….”
I S Mohamed, J Sundewall et al; https://www.tandfonline.com/doi/full/10.1080/23288604.2021.2006587
“…. The first step on the road to UHC is to define and develop essential packages of health services (EPHSs), a list of clinical and public health services that a government has deemed a priority and is to provide. However, the nature of these lists of services in low- and lower-middle-income countries is largely unknown. This study examines the contents of 45 countries’ EPHSs to determine the inclusion of essential UHC (EUHC) services as defined by the Disease Control Priorities, which comprises 21 specific essential packages of interventions….” “….Findings show that there are large variations in the level of specificity among EPHSs and that though EUHC services are included to a large extent, variations exist regarding which services are included between countries…..”
D M Pelissari et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00564-7/fulltext
Comment linked to a new Lancet GH study.
“…. As considered by WHO in the End TB Strategy, UHC is one of the most feasible and effective interventions that could reduce the tuberculosis burden in low-income and middle-income countries, and an effective strategy to reach UHC could be the expansion of primary health care. Brazil has historically implemented one of the world's largest primary health care systems, the Family Health Strategy (FHS). Previous research in Brazil showed that increasing coverage of the FHS was associated with improvements in child mortality, among other outcomes. …. To convince governments of the importance of implementing a large and strong UHC strategy, there is an urgent need for more robust studies to help us understand the causal effect of UHC in tuberculosis morbidity and mortality….”
“In The Lancet Global Health, Gabriela Jesus and colleagues showed, for the first time to our knowledge, the impact of the FHS on indicators of tuberculosis morbidity and mortality in a cohort study with linkage of nationwide health and socioeconomic administrative datasets. …. As reported by Jesus and colleagues, primary health care is a crucial factor to reach the End TB Strategy goals and is particularly important in the context of the current global economic recession due to COVID-19. ….”
K Robin van Daalen, K Blanchet et al; https://gh.bmj.com/content/7/1/e007902
“…This systematic review evaluates the evidence on the effect of cash transfers on health outcomes and health service utilisation in humanitarian contexts….”
https://news.un.org/en/story/2022/01/1110652
“New insights into quality of care for girls and women facing medical complications due to unsafe abortion were published on Wednesday by the UN health agency and partners.”
“The WHO and HRP multi-country survey on abortion (MCS-A) gathered evidence on the provision, experience and quality of care, based on a study conducted across 17 countries in the African, Latin American and Caribbean regions. And in a special supplement, it highlights work covering 11 sub-Saharan African countries…..”
STAGE; https://adc.bmj.com/content/early/2021/12/27/archdischild-2021-323102
“The World Health Organization (WHO) has a mandate to promote maternal and child health and welfare through support to governments in the form of technical assistance, standards, epidemiological and statistical services, promoting teaching and training of healthcare professionals and providing direct aid in emergencies. The Strategic and Technical Advisory Group of Experts (STAGE) for maternal, newborn, child and adolescent health and nutrition (MNCAHN) was established in 2020 to advise the Director-General of WHO on issues relating to MNCAHN. STAGE comprises individuals from multiple low-income and middle-income and high-income countries, has representatives from many professional disciplines and with diverse experience and interests….”
https://www.bbc.com/news/world-africa-60039138
“South African scientists - praised internationally for first detecting the Omicron variant - have accused Western nations of ignoring early evidence that the new Covid variant was "dramatically" milder than those which drove previous waves of the pandemic…..”
M Hellowell et al; https://gh.bmj.com/content/7/1/e006924
“Calls to ‘decolonise’ global health have intensified in recent years, as reflected in the rapid growth of the academic literature on this concept. Despite its increasing prominence, this literature has not been critically assessed. Our assessment focuses on three tendencies in this literature—which relate to knowledge, universalism and purpose in global health. We consider the implications of these tendencies for the future of the discipline and its ability to deliver worldwide improvements in health. We argue that the decolonisation agenda has the potential to stimulate a needed redistribution of decision-making power in global health. Yet, we also identify a number of potential harms—by undermining confidence in scientific knowledge; accentuating inter-group and international antagonisms; and curtailing the opportunies for redistributive change in the future.”
See a related tweet by Seye Abimbola: “3 responses to 'let's decolonise global health' 1. 'let's get going already' (plenty) 2. 'you're not going far enough' (growing) 3. 'you're going way too far' (rare) An example of no3 in @GlobalHealthBMJ by @hellowell_mark & @trishnayna…”
“At the beginning of 2021, The Lancet Global Health invited readers, particularly those who are not regular contributors to our pages, to share their expertise and experiences with us in the form of Correspondence, Viewpoints, and Comments on the theme: What is wrong with global health? This page presents a collection of all published responses….” 18 Contributions so far.
R Kamau et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02502-2/fulltext
“As a Collective, we are expressing our deep concern over the language used in the Perspective on Periods on Display and the colonial implications from the position in which the concerns were addressed. Over the past two decades, the menstrual health movement has made progressive policy changes, and improved menstrual health for all individuals that menstruate. In the Perspective, Sophia Davis led with an example from the UK, when in fact this movement emerged from low-income and middle-income countries. We ask that authors are encouraged to adopt the decolonising global health movement, particularly when discussing menstrual health, which has become saturated by voices from high-income countries….”
Check out also Sophia Davis’ Author's reply.
https://www.bmj.com/content/376/bmj-2021-068124
“Kent Buse and colleagues argue that unlocking the potential for intersectoral action on climate and health requires thinking politically about its facilitators and barriers.”
“…. We argue that the key to making climate-health intersectoral action work, hinges on thinking politically about it .” See their box 2 on “the three I’s”…
And some key messages: “Emphasising the co-benefits to health of actions to counter environmental change in other sectors could help to motivate more ambitious intersectoral action; Intersectoral action is beset by political challenges, as evidenced by the watered down commitments that emerged from the COP26 summit in Glasgow; Barriers to intersectoral action include outdated institutions, the influence of vested interests, and limited ability of evidence and technocratic approaches to shift the political dial; Enablers include political demands arising from social movements that are pressuring governments to confront climate breakdown and its impacts on human health; The key to unlocking the potential for intersectoral action will be visionary leaders defining ambitious, long term shared goals that motivate civil society action, and independent monitoring.”
PS: Full collection BMJ – The World We want The world we want: Actions towards a sustainable, fairer and healthier society
“This collection of articles analyses the ‘mega trends’ that will shape the rest of this century and the complex interplay between them, including how they are reshaping our global health landscape….”
https://www.iisd.org/publications/health-global-environment-agenda-policy-guide
“While there is growing awareness of the steep health impacts of global environmental changes—including the climate crisis, accelerating biodiversity loss, and an increasing saturation of plastic and chemical wastes—bringing the health and environment sectors together for joint action is easier said than done. …. … This is an insider’s landscape view to bringing health into the global environmental agenda. It is a technical guide on sustainable development focused on the health–environment nexus, written with the perspective that a microphone within the negotiations is more powerful than a megaphone at its margins”
“…This guide dissects the decision-making bodies, issues, and implementation frameworks of key MEAs (multilateral environmental agreements) using a health lens. Its purpose is to facilitate common understanding and build a bridge between the health and environmental sectors in global policy-making on sustainable development. Written jointly by health and environmental policy experts, this document reviews and analyzes the global governance landscape for biodiversity, climate change, pollution, and food systems, with a view to informing policy and events beginning in 2022. …. “
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00161-1/fulltext
“2022 sees the tenth anniversary of the London Declaration on Neglected Tropical Diseases (NTDs), a pivotal event at which governments, pharmaceutical companies, foundations, and NGOs committed to collaborate in their efforts to stop NTDs. This initiative was inspired by the WHO NTD Roadmap 2012–2020, a plan for the control, elimination, and eradication of 17 neglected tropical diseases by 2020. … …. In 2020, 600 million fewer people required interventions against NTDs than in 2010, and 42 countries eliminated at least one NTD. But controlling this diverse group of 20 conditions, which affect 20% of the world's population, will require attention to neglected populations, not just neglected diseases. The agenda to end NTDs has an important role in reducing poverty and prioritising the needs and rights of underserved populations in countries across the income spectrum. The production of a new Roadmap, and the emergence of new challenges to NTDs, make this World NTD Day, on Jan 30, an important opportunity to reconsider and revitalise this agenda….”
“Fulfilling the new agenda will require a move away from siloed disease-specific approaches to cross-cutting efforts, including coordinated NTD programmes and the integration of such programmes into national health systems. … … These changes will require a shift towards country ownership of NTD programmes….”
“… The COVID-19 pandemic has been an unprecedented setback to the NTD agenda. …”
On an interesting new initiative for independent clinical trials. See also Protas.
“A group of scientists who did more than perhaps any other to test new treatments for Covid, including establishing that the steroid dexamethasone can save lives, is now turning its focus to the rest of medicine. The first step, announced today: a partnership with the Paris-based drug giant, Sanofi. Sanofi will give the U.K. non-profit Protas $6.8 million to begin its work to accelerate how clinical trials are done and make them far cheaper. It aims to build on what the researchers learned studying treatments against Covid-19 to test medicines for heart disease, cancer, depression, Alzheimer’s, and other common ailments.”
https://news.un.org/en/story/2022/01/1110292
“At a time when “the only certainty is more uncertainty”, countries must unite to forge a new, more hopeful and equal path, UN Secretary-General António Guterres told the General Assembly on Friday, laying out his priorities for 2022. “We face a five-alarm global fire that requires the full mobilization of all countries,” he said, referring to the raging COVID-19 pandemic, a morally bankrupt global financial system, the climate crisis, lawlessness in cyberspace, and diminished peace and security. “
“People in 20 countries will face severe food shortages if urgent action is not taken, the report found. Four countries are facing “starvation and death” due to famine, with a mix of violence, climate shocks and the pandemic threatening many more across the globe, the United Nations has warned. In the latest ‘hunger hotspots’ report, the Food and Agriculture Organization (FAO) and World Food Programme (WFP) said 20 countries will face “a significant deterioration of acute food security” in the next three months without urgent action. Four are already deteriorating into famine-like conditions: Nigeria, South Sudan, Yemen and Ethiopia – which is of the greatest concern. …”
https://healthpolicy-watch.news/infectious-disease-funding-unchanged/
“Despite the strains of COVID-19, global funding for poverty-related infectious diseases, such as HIV/AIDS, TB, and malaria, remains virtually unchanged at US $3.937 billion, with investment dropping only 4% in 2020, according to the fourteenth annual G-FINDER Report. The report, released by Australia-based Policy Cures Research group on Thursday, showed a drop of only US $172 million from 2019. This year’s funding remains the third highest ever seen by the group for neglected diseases. …”
“But though the decline may be a marginal one, funding for neglected tropical diseases (NTDs) continued a decade of relative stagnation, with only snakebite envenoming seeing an increased investment in 2020….” Do check out the key findings.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00121-0/fulltext
By Chris Beyrer, for the International AIDS Society–Lancet Commission on Health and Human Rights.
“…The International AIDS Society–Lancet Commission on Health and Human Rights has called for a revitalisation of the health and human rights agenda in health contexts, including inequity in the global distribution of COVID-19 vaccines. Activists have described inadequate vaccine access across Africa as “vaccine apartheid”. In the Commission's work, a recurring theme has emerged around universality, a foundational principle of the modern human rights movement which seeks to establish the rights and protections that all human beings share. The Commission is documenting the rising and widespread abrogation of this universalist principle. Nationalism, xenophobia, populist and authoritarian regimes with explicit programmes of discrimination against minorities, particularly against immigrants and refugees, and the assertion of national sovereignty above human rights principles are all threats to shared rights and to health. As we mourn the death of Archbishop Tutu and extend our condolences to his immediate family and to his global family, his legacy of universal inclusion has become more relevant than ever…”
R Borst et al; https://www.sciencedirect.com/science/article/abs/pii/S0277953622000387
“Knowledge translation platforms (KTPs) are seen as an important collaborative arrangement between researchers, policymakers, and practitioners. Yet, their ‘sustainability’ is a recurring issue. Several studies describe what makes KTPs sustainable, and focus on the role of institutional and contextual factors therein, yet few studies show how sustaining of KTPs is done in practice. We therefore performed an ethnographic case-study on ‘sustaining work’ of KTPs in Jordan, Cameroon, and Nigeria. This approach focusses on what KTP actors do to make and keep their platforms productive…..”
https://peoplesdispatch.org/2022/01/21/health-crises-in-fragile-states-need-urgent-attention/
“While the world remains focused on the COVID-19 pandemic, a pandemic of conflict continues to undermine the health of billions of people around the globe.”
“… Recently, international bodies have been devising two-fold strategies to address the crises of fragile states. First, they have come together to craft a coordinated response in tackling health calamities. This attempt is represented by the Partnership Framework for Crisis-Affected Situations, signed between the United Nations (UN) and the World Bank in 2017 to put forth joint operational commitments for enhanced ground-level impact in 50 conflict-affected contexts. Secondly, multilateral and bilateral partners have been crafting a new form of aid coordination to accommodate humanitarian relief, development programs and peace making in one frame. In this regard, the aid harmonization mechanism called “humanitarian-development-peace nexus,” developed in 2019, is envisaged to address the “vulnerability of people before, during and after crises.” Nonetheless, there is only fragmentary evidence how these experimental mechanisms are addressing the root causes of state fragility and embarking on the path of revival of the state structure….
“The GatesFoundation is promoting its commitment to diversity with its new board of trustees, who oversee its campaign to help poor people in the global south. Here's the board by the numbers--you decide: 50% billionaires, 66% white, 66% men, 100% based in the global north.”
“The German Economy Minister reverses his position on the TRIPS waiver. After talking to pharma companies, he now believes that (1) asking them to sell mRNA vaccines to poor countries at cost and (2) providing funds to those countries to buy them is a more effective strategy.”
“As a follow-up to the G20 Italia Summit and the 1st JFHTF Meeting, the #G20Indonesia 2022 will hold the 2nd JFHTF (Joint Finance-Health Taskforce) Meeting virtually, today Wednesday, January 26, 2022. The meeting will be attended by G20 member countries and international institutions.”
https://www.graduateinstitute.ch/sites/internet/files/2022-01/taxonomy-paper.pdf
Related tweet: “The negotiating body established by the WHA will soon address the challenging task of drafting a new instrument on #pandemic #preparedness. In order to provide support to Member States, we just published a study on the proposals raised during the #WHA.”
Abstract: “The proposals for a new WHO “pandemic treaty” have been put forward since late 2020. In May 2021, however, the decision by the 74th World Health Assembly to consider the benefits of negotiating a new instrument on pandemic preparedness and response brought the discussions into WHO’s governance. Rather than broaching the possible subject matters that could benefit from inclusion in a new international instrument, the discussions at the Working Group established by the Assembly, and those that took place during the Assembly’s second special session, have mostly focused on the pros and cons of various legal instruments. Meanwhile, the Intergovernmental Negotiating Body established by the Assembly on 1 December 2021 will soon address the challenging task of drafting and negotiating a new instrument. In order to provide support to member states and other actors concerned, this paper contributes a taxonomy of the main substantive proposals raised by member states and the European Union before and during the second special session of the World Health Assembly. The proposals, often formulated in the context of broader comments on the future of pandemic preparedness and response and the role of WHO in it, have been organized along the categories and sub-categories reflected in the table below. We have organized proposals into seven main categories for ease of reference and in attempt to ensure a measure of conceptual coherence. For each sub-category in the table, we identify the actors who mentioned them in their statements and proposals (see also: Annex I – Statements mentioning substantive proposals)”
https://www.devex.com/news/tech-entrepreneurs-bring-new-approaches-challenges-to-philanthropy-102174
“Philanthropists from the tech industry are shaking up the philanthropic sector with fresh approaches to giving that prioritize data and transparency. While many of their predecessors set up large foundations, this new wave of megadonors is coming up with novel ways to direct their money toward social impact. .. Amid the rising number of tech donors turning their attention to global development causes, which often see more impact for every dollar invested, Devex spoke with experts about what drives tech donors who are pivoting from making money to giving it away.
“A few trends and ideologies have emerged among tech-oriented philanthropists that are now “battling for supremacy,” said Stephanie Ellis-Smith, a philanthropy adviser and co-founder at Giving Gap, which helps connect donors to Black-led nonprofits. The first is the idea that people who have made significant wealth from tech have found “the winning formula for success,” she said. As a result, they feel like everything they touch will also turn to gold, she added. “These first-generation wealth creators are not part of multigenerational wealth constructs where wealth is the norm and preservation of capital is the set point.” “This group of tech philanthropists tend to be hands-on, deadeye-focused on impact, and want a quantifiable [return on investment]…”
“… Meanwhile, Twitter co-founder Jack Dorsey and MacKenzie Scott, ex-wife of Amazon founder Jeff Bezos, represent “trust-based philanthropy” — a second school of thought gaining popularity among the tech crowd, according to Ellis-Smith. She said these donors want to give money and then get out of the way, recognizing that they lack experience with the racial justice, climate change, and other intractable issues that they are funding….”
E Dairon et al ; https://www.globalpolicyjournal.com/articles/global-governance/understanding-international-organizations-headquarters-ecosystems-case
« The objective of this article is to explore the spatial and temporal dynamics of an important but often neglected space of global governance: the cities in which the headquarters of international organizations (IOs) are located…. …. For this purpose, this article proposes a conceptualization and an empirical application of the concept of ‘ecosystem’. … …. As a result, it is a space characterized by specific geographical and temporal features that can be qualified as spatial and temporal proximity between the elements composing the ecosystem. Based on original empirical sources, we apply this concept to the so-called International Geneva. We argue that conceptualizing headquarters as ecosystems helps to consider how HQs’ location influences the daily work of IOs. »
From a special issue - Time and Space in the Study of International Organizations
From the same issue, check out also: Focal Times and Spaces: How Ethnography Foregrounds the Spatiotemporality of International Organizations and Global Governance (by Julian Eckl)
“On December 16, 2021, the Council of Councils (CoC) convened its fourth virtual conference to discuss the COVID-19 pandemic at the end of its second year, what multilateral diplomacy achieved in 2021 on preparing the world for future pandemics, and the challenges COVID-19 creates for 2022. This policy brief summarizes issues that representatives of CoC members discussed on these topics during the conference.”
See also last week’s IHP newsletter. “The People’s Working Group on Multistakeholderism published new report on corporate takeover of multilateral institutions, reducing people’s chances of safeguarding essential human rights.”
A Gilder; https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.13056
“This Policy Insight suggests the UN must account for a diverse range of conflict drivers, including health insecurity, and that UN peace operations can play a role in countries of deployment to counter health crises. Insecurity is experienced in a variety of different ways in a complex world where threats are multifaceted. COVID-19 is merely the latest health crisis which has impacted populations around the globe in both developed and developing countries. However, UN peace operations have not typically played a major role in addressing health insecurity nor have they undergone any major shifts in their focus to provide direct health-related assistance during the COVID-19 pandemic. With health insecurity likely to persist, there should not need to be a global pandemic for the UN Security Council to use peace operations to undertake further preventative work in this area.”
And a link:
· ODI - What the privatisation of vaccine innovation tells us about Global Britain
“Last November, the Financial Times reported that the UK was putting up for sale the Vaccine Manufacturing and Innovation Centre. On its creation in 2018, the publicly owned centre was touted by the business secretary at the time as a ‘major commercial opportunity’ and ‘a new front line in the nation’s defence against global pandemic threats’. The proposed privatisation exposes the hollowness of the stated vision of Global Britain. Putting the centre into private hands is likely to undermine global resilience to future pandemics. It will also limit opportunities to use the UK’s successful life-sciences industry as a force for good in the world. The decision to sell is symptomatic of an approach to economic policy that continues to prioritise short-term fiscal targets over addressing the long-term social and economic challenges faced in the UK and globally.”
R Gilardino, S Rifkin et al ; https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-022-00793-7
“Seven years after the commitment to United Nations’ call for Universal Health Coverage, healthcare services in Argentina, Brazil, Colombia, Mexico are generally accessible and affordable; but they still struggle to meet population health demands and address the rising health care costs. We aim to describe measures taken by these four countries to commit by Universal Health Coverage, addressing their barriers and challenges….”
https://www.theguardian.com/environment/2022/jan/25/transformation-global-economy-net-zero-mckinsey
“$9tn of annual investment required to avoid most catastrophic climate impacts, consultancy says.”
“Reaching net zero climate emissions by 2050 will require a “fundamental transformation of the global economy”, according to a report by McKinsey, one of the world’s most influential consulting firms. It estimates that $9.2tn will need to be invested every year for decades to limit the global temperature rise to 1.5C and end the climate emergency. The sum is a 40% increase on current investment levels and equivalent to half of global corporate profits….”
“A coalition of Indigenous rights and conservation groups has created a new fund so that major philanthropic donors, such as the Bezos Earth Fund, can more easily channel funds to local communities and get money directly into the hands of those working on the front line to protect the world’s forests. Rights and Resources Initiative and Campaign for Nature this month announced the establishment of the Community Land Rights and Conservation Finance Initiative. The groups said CLARIFI would help deploy government and philanthropic funding to “scale up the legal recognition of Indigenous Peoples’, Afro-descendant Peoples’, and local communities’ rights” and support them in conserving forestland and natural resources. … …. Rights and Resources Initiative represents more than 150 Indigenous and local organizations globally….”
https://www.nature.com/articles/s41591-021-01658-2
“The Glasgow Climate Pact reaffirms countries’ commitments to limiting global heating to 1.5 °C, but without prioritizing health, equity and multisectoral engagement within climate action, the health of the planet and the future of humanity remain at grave risk.”
“…. The World Health Organization (WHO) COP26 special report — The Health Argument for Climate Action — launched at a dedicated session on health and climate at COP26, underscores the direct and indirect effects of climate change on human health. Although the arguments presented are not new, the report calls for the integration of health as a central component of global climate action and alignment of the goals of the Paris Agreement with those of the WHO Manifesto, through leveraging of efforts in the global recovery from COVID-19. …”
A De Menezes et al ; https://www.ajtmh.org/view/journals/tpmd/aop/article-10.4269-ajtmh.21-0619/article-10.4269-ajtmh.21-0619.xml?rskey=W5yT58&result=4&tab_body=abstract
« Gender intersects with healthcare systems; this is equally true for arboviral vector control efforts. However, there is as yet no comprehensive analysis as to how vector control is gendered. Hence, our objective is to provide the first thematic scoping and spatial distribution of the literature on gender, community health workers, and vector control. … »
C Hodgins et al ; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003861
“To characterize the population of men who pay for sex in sub-Saharan Africa (SSA), we analyzed population size, HIV prevalence, and use of HIV prevention and treatment….”
AP;
“ Guinea worm infections dropped to just over a dozen worldwide last year, getting closer to fulfilling former President Jimmy Carter’s dream of completely eradicating the disease during his lifetime. The Carter Center reported Wednesday that only 14 human cases of Guinea worm disease were reported in all of 2021, the result of years of public health campaigns to improve access to safe drinking water in Africa. … …. That’s a decline of nearly half compared to the previous year, when 27 cases were reported in seven African countries. And it’s a staggering drop from when The Carter Center began leading the global eradication effort in 1986, when the parasitic disease infected 3.5 million people….”
T Collins, L Allen et al ; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00790-5
“…. Implementation Research (IR) is emerging as a potent tool for gearing the international response, providing a scientific approach to study the processes used to implement policies and interventions and the contextual factors that affect these processes. Amidst growing interest from policymakers, we identify four main areas for action: high-level engagement with IR among international NCD leaders; domestic investment in technical capacity-building; the creation of new financing streams for IR research; and the development of multi-stakeholder engagement mechanisms that can convene and leverage the perspectives and resources of multiple actors with overlapping aims.”
“But rich countries have problems too.”
“…Most of the world scores poorly in Transparency International’s annual corruption index. Using the assessments of business pundits and analysts, including figures from the World Bank and the World Economic Forum, the NGO scores countries from 0 to 100 based on perceptions of corruption in the public sector, with 100 indicating a squeaky clean record. In the latest ranking, released on January 25th, almost 70% of countries score below 50….”
See also FP2P blog - The links between corruption and human rights – top new report from Transparency International
“…. Transparency International’s annual ‘Corruption Perceptions Index’ …. makes an important link between corruption and human rights: ‘The 2021 CPI results show that countries with well-protected civil and political liberties generally control corruption better.’ Here’s the relevant section, which argues that the causation runs both ways – corrupt regimes need to repress protests against their corruption, and repressive regimes have fewer checks and balances to stop people stealing….”
“The OECD today launched a new digital hub to improve transparency around the taxation of development aid by presenting approaches taken by participating donor countries to claiming tax exemptions on goods and services funded by official development assistance (ODA). The Tax Treatment of Aid: Digital Transparency Hub compares policies for how ODA is taxed from 12 members of the OECD Development Assistance Committee (DAC), who voluntarily provided details on their tax approaches of foreign aid. Participating members include Australia, European Commission, France, Greece, Hungary, Japan, Netherlands, Norway, Poland, Spain, Sweden and the United States. It aims to help both donors and recipient countries clarify the tax status of ODA, which totalled USD 161 billion in 2020….”
https://www.thelancet.com/discovery-science?dgcid=product%20homepage-carousel_feature_TLDSlaunch
“The Lancet Discovery Science is a suite of open access journals–eBioMedicine and eClinicalMedicine–that spans basic, translational, clinical, and health systems research. These journals publish essential, early evidence that helps researchers and clinicians alike to identify new opportunities with the potential to improve the health and wellbeing of people around the world. Essential — high-quality research that has the potential for clinical importance; Early — early-stage, clinically-relevant research that poses promising, interesting questions that could lead to important answers; Evidence — preliminary findings or novel results grounded by their relevance to human health.”
“Saudi Arabia's Ministry of Investment signed an agreement with GSK (GSK.L) on Monday to boost the kingdom's healthcare and life sciences sector, it said on Twitter.”
https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000053
“In this study we examined whether subnational (urban-rural) prioritization may affect the cumulative two-year impact on disease transmission and burden of a vaccination campaign using an agent-based model of COVID-19 in a representative COVID-19 Vaccines Global Access (COVAX) Advanced Market Commitment (AMC) setting. We simulated a range of vaccination strategies that differed by urban-rural prioritization, age group prioritization, timing of introduction, and final coverage level….”
“…The objective of this paper is to understand the nature and extent of the changes in health systems triggered by the COVID-19 crisis. The paper examines changes in the role of governments in (1) sector coordination, (2) service provision, (3) financing, (4) payment, and (5) regulations. It outlines broad trends and reforms underway prior to the pandemic and highlights likely trajectories in these aspects in the future. The paper argues that while the pandemic has accelerated changes already underway before the crisis, it has made little headway in clearing the path for other or deeper health policy reforms. The reform window that COVID-19 opened has not been wide enough to overcome the entrenched path dependency and structural interests that characterize the sector….”
J Clemens et al ; https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00534-4/fulltext
“The availability and use of vaccines for the coronavirus disease 2019 (COVID-19) in low and middle-income countries (L/MICs) lags far behind more affluent countries, and vaccines currently used in L/MICs are predominantly of lower efficacy. As vaccines continue to be rolled out in L/MICs, successful control of COVID-19 by vaccines requires monitoring both of vaccine protection of vaccinees (effectiveness) and of the entire targeted populations, including vaccine herd protection of non-vaccinees (impact). To be of greatest relevance to L/MICs, there is the need to address the distinctive medical and demographic features of populations, health systems, and demography that may greatly affect vaccine performance in these settings. We identified 58 published studies that included 85 evaluations of the effectiveness of different COVID-19 vaccines globally. Only three were done in L/MICs, and no impact studies were identified in these settings. Post-deployment studies of the protection by COVID-19 vaccines rolled out in L/MICs constitute an important but currently neglected global priority.”
https://www.nature.com/articles/d41586-022-00177-5
“People who’ve both been vaccinated and had COVID-19 are less likely to report fatigue and other health problems than unvaccinated people.”
“Hong Kong’s hamsters are far from the only unlucky species.” With info on SARS-CoV-2 and a range of animals.
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003891
Perspective linked to the new Plos Med study: Overall and cause-specific hospitalisation and death after COVID-19 hospitalisation in England: A cohort study using linked primary care, secondary care, and death registration data in the OpenSAFELY platform
https://www.nature.com/articles/d41586-022-00191-7
“With Omicron or Delta outbreaks already in multiple provinces, scientists say next week’s Winter Olympics will present a major test of China’s zero-tolerance approach. …. China’s stringent zero-COVID strategy is likely to face its toughest test yet in the next few weeks, as millions of people travel around the country for Chinese New Year, and the Winter Olympics begin in Beijing….”
Globalization & Health - The challenges of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in low-middle income countries and possible cost-effective measures in resource-limited settings