Climate Shift Index™ (CSI) for 16 August 2023, the day when climate-related heat abnormalities peaked with some 4.2 billion people experiencing extreme heat at CSI level 3 or higher. High CSI values mean climate change made the temperatures more likely.

Climate change increased temperatures for nearly every human being on the planet between June-August, 2023  

On the eve of the G20 summit in Delhi, a group of independent climate scientists has reported that human-induced climate change increased temperatures for nearly every human being in the world for at least one day between June and August, 2023. 

They measure this increased exposure using a Climate Shift Index (CSI) which assesses on a daily basis the influence of human-caused climate change on daily average temperatures experienced across
the globe. The assessment from June 1, 2023 to August 31 covered the world’s 202 countries and territories.

According to the analysis, Over 3.8 billion people — or 48% of the global population — experienced at least 30 days during June-August with a CSI level 3 or higher. A CSI level 3 indicates that human-caused
climate change made those higher temperatures at least three times more likely. 

At least 1.5 billion people experienced very high levels of climate change-induced heat (CSI level 3 or higher) on every single day of the  June-August period analyzed. Global exposures peaked on August 16, 2023, when 4.2 billion people worldwide experienced extreme heat at CSI level 3 or higher.

The Climate Shift Index™ (CSI) for daily average temperatures between June and August 2023. High CSI values mean climate change made the temperatures more likely.

Carbon pollution boosted heat for billions during Earth’s hottest summer: Climate Central

The report was has produced by the Princeton New Jersey-based non-profit, Climate Central,  along with the World Weather Attribution initiative of Imperial College, London. Their common aim is to provide scientific evidence of links between extreme weather events and climate change ‘when the world is watching,’ that is, while an event is still making headlines rather than several months later. 

From the massive fires in Canada to the well-above normal temperatures in parts of the southern hemisphere, where it was winter in the June-August period, the effect of climate change has been unprecedented, the scientists say.

The report also brings into sharp focus the inequity of climate change. The poorest, the most vulnerable, those countries and communities least responsible for carbon emissions have suffered the most, the scientists point out. For instance, people living in the United Nations’ Least Developed countries (47 days) and Small Island Developing States (65) were exposed to far more days of CSI level-3 or above on the Climate Shift Index, despite being responsible for less than 1% of global greenhouse gas emissions. Countries with the lowest historical emissions experienced three to four times more June-August days with CSI-3 or higher than G20 countries. 

Appeal to G20: ‘Stop killing vulnerable people’

Firefighters battle wildfires in the western United States. Poor countries, however, are even more vulnerable to the ravages of extreme heat.

In a press release on Thursday, the group’s leaders appealed to the G20, whose countries control about 80% of the global economy, to stop burning fossil fuels. Responding to a question by Health Policy Watch on what  message they would like to deliver to the heads of state, meeting this weekend in New Delhi is, Dr Friederike Otto, an Imperial College climatologist said, “As long as these countries, the G20, continue policies that subsidise fossil fuels, that have strong influence from fossil fuel lobby groups, and make policies that benefit the fossil fuel industry, they kill their populations, they kill the vulnerable people in the world and make their lives extremely difficult. So we have to stop burning fossil fuels.”

The current extreme heat is happening when temperatures are already 1.2°C, on average, above pre-industrial times of 150 years ago. Beyond 1.5°C degrees scientists expect the destruction of ecosystems and intensity and frequency of extreme weather to be far worse than what the world is experiencing already today.

No Place to Escape

Young woman looks over slum on periphery of Lima, Peru during a heat wave in April 2022. While the impacts of wildfires, droughts and extreme heat receive extensive coverage in the media of North America, Europe and other high-income countries, it gets scant attention in media of the global south, scientists found.

Dr Andrew Pershing, vice president for science at Climate Central, added, “One of the big lessons from this summer is that there’s no break and there’s no escape. I think we’d all like to imagine that we could move somewhere, and everything would be great, but every place is feeling that impact. The unusual climate-driven heat was so persistent just day after day after day. Changes are happening much faster than the societies are changing.”

The longer term effects of climate change have been exacerbated by this year’s onset of the El Nino weather pattern. El Niño occurs every few years when sea temperatures in the tropical eastern Pacific rise 0.5 °C above the long-term average, which pushes up temperatures even further and reduces rainfall in some regions of the world, leading to even more dangerous levels of heat. 

In India, the five states which suffered the highest CSI levels between June and August also are among India’s top-most destinations for both domestic and foreign tourists – Kerala, Andaman and Nicobar, Puducherry, Meghalaya and Goa. The heatwaves in cities like Delhi, of course, began months earlier in March or April compounded by the urban heat-island effect of its vast expanses of concrete. 

Inequality in Media Reporting: Global South Suffering Stronger Impact

The scientists also urged more reporting in the global media on the effects of climate change from places like Africa. During their study, they observed that extreme weather events in the African continent were rarely the focus of extensive media reports, whereas “everything that happens” in the US or Europe gets reported, in the words of Pershing. 

“We’re not surprised that we’re seeing stronger climate fingerprints in the global South than we are in the northern hemisphere. Some of that is just physics. That’s sort of what we expect. But it’s really shocking to see the difference between the [reported] experience of somebody living in Africa, Puerto Rico or Central America versus somebody living in Oslo, Norway, or London,” Pershing said.

Image Credits: Climate Central, Climate Central, Daria Devyatkina/Flickr, Paula Dupraz-Dobias.

Accra, Ghana: Traffic, waste burning and desert dust all combine to make air pollution a burgeoning problem in this fast-growing city.

The World Health Organization (WHO) will host a summit on air pollution in Accra, Ghana in 2024, the organization announced on Thursday. The summit will be the second ever to address air pollution, which is responsible for millions of premature deaths each year, and the first to be held in Africa.

The announcement was made on Thursday by Dr Maria Neira, Director of the Public Health, Environment and Social Determinants of Health Department at WHO. The UN health agency considers air pollution “one of the biggest public health emergencies” facing the world, said Neira. 

“Every single day we have news, scientific evidence and papers published demonstrating even more damage caused by exposure to air pollution,” said Neira. “In addition to the death, which is already horribly dramatic, we need to keep in mind that we are talking about chronic diseases… [that] take away quality of life and bring costs for health systems.” 

The announcement of the summit was made on the International Day of Clean Air and Blue Skies, established by the UN General Assembly in 2019 to raise awareness of the health risks of air pollution. 

Air pollution is responsible for nearly 7 million premature deaths each year.

The high-level meeting planned for Accra reflects the growing global recognition that air pollution, once seen as an environmental issue, is now a serious health concern. The summit is expected to be attended by government representatives, businesses, civil society organizations and other stakeholders from around the world.

“Every year, air pollution is killing more people than COVID killed,” Dr Ardvind Kumar, a lung specialist based in New Delhi and founder of the Lung Care Foundation, told a World Bank Panel on Thursday. “COVID caused death immediately, directly. Air pollution causes slow, indirect death, and hence does not get the attention.” 

“The world needs to respond to air pollution in the same that that we responded to COVID,” said Kumar. 

Air pollution will be high on the agenda at the upcoming UN climate summit in Dubai, which will kick off in November. The summit will be the first UN climate negotiation to directly consider health as a factor in the climate crisis. 

G20 to tackle air pollution

A thick layer of smog hangs over the Indian capital, New Delhi, which will be the site of the G20 summit that begins on Saturday.

Air pollution is also expected to be a topic of discussion at the G20 summit in New Dehli which will take place this weekend.

Ten Indian cities are in the world’s top 15 cities with the highest levels of air pollution, according to IQ Air, an air quality platform based on official and crowdsourced data. The health effects on Indian citizens have become a critical political issue in the host country as it grapples with reducing pollution in its cities. 

“Thirty years back when I started as a lung cancer surgeon, I would see 95% smokers,” said Kumar. “But today, 50% of my patients are ‘so-called’ non-smokers. I use the words ‘so-called’ because I believe that in a polluted country, there is no true non-smoker.”

The WHO estimates that 99% of people globally breathe unsafe air. South Asia faces the world’s heaviest health toll from air pollution. This cuts the life expectancy of the average South Asian by about five years, leading to annual costs estimated at more than 10% of regional GDP.

“Everyone has a right to live in a clean and healthy environment, and air pollution violates this right for 99% of the world’s population,” said UN Environment Programme Director Inger Andersen. 

The air shared by countries in the Indo-Gangetic Plain and Himalayan foothills – including India, Pakistan, Nepal and Bangladesh – is the most harmful worldwide, according to the World Bank. In some of the region’s most populated cities, air pollution is up to 20 times the WHO guideline.

“In Delhi, a nebulizer has become ubiquitous in every household,” Kumar told the World Bank panel. “I never heard this term when I was a child. But today, when they start getting breathless, every child says to themselves, ‘Oh, I’m going to get the nebulizer’.”

PM2.5, the primary harmful form of air pollution, is generated from a variety of sources, including car emissions, forest fires, and industrial activity. It can enter the lungs and bloodstream, causing a range of health problems, including respiratory infections, heart disease, and cancer.

Global air pollution heat map published by Swiss air quality technology company IQAir.

Black carbon, another major type of air pollution made up of soot and other particles that can enter the lungs and bloodstream, is produced by the incomplete combustion of fossil fuels such as coal, oil and wood.

“We’ve tended to express health impacts through the number of premature deaths. But our day-to-day quality of life is affected, too,” said Martina Otto, who leads the Climate and Clean Air Coalition convened by the UN Environment Programme. “Exposure at any level can have health implications that impair quality of life and come with costs for the individual, our societies and our economies.”  

Air pollution disproportionately impacts women, children and the elderly. Low- and middle-income countries also suffer the highest exposures. 

The air pollution crisis affects everyone – even children who have not yet entered the world, said Kumar. 

“The bad effects of air pollution do not wait for us to be born, it actually starts even before we are born,” said Kumar. “Pregnant mothers who are in polluted cities, when they breathe polluted air, the pollutants go through to the foetus through the placenta.

“Newborns start smoking, figuratively, from the very first breath of their life,” he said. 

Nairobi kicks off World Clean Air Day with a new wall mural by local artist @bankslaveone highlighting the importance of clean transport and improved air quality for children’s health.

Image Credits: WHO/Blink Media, Nana Kofi Acquah, Jean-Etienne Minh-Duy, Clean Air Fund/@bankslaveone.

The WHO has fired Maurizio Barbeschi (left) for sexual misconduct.

The World Health Organization (WHO) has dismissed Dr Maurizio Barbeschi, former head of its Health Security Unit, for sexual misconduct after a three-year investigation that started in January 2020, according to The Telegraph.

Barbeschi had been on administrative leave since late 2021 as the global body investigated complaints against him, including that he removed his trousers during a meeting with a female colleague in a hotel room.

The Italian national and biosecurity expert has worked for WHO for the past 20 years and is also an adjunct professor in the Faculty of Medicine of Flinders University in Adelaide, Australia, according to his LinkedIn profile, which still reflects that he works for the WHO.

Earlier in the year, The Telegraph broke the story about the complaints against Maurizio after speaking to some of the women involved as well as some of his colleagues.

Allegations include that Maurizio “rested his hand on women’s thighs if they sat next to him in meetings”, tried to kiss a WHO consultant and urged women to “go and put their bikinis on” during a meeting.

WHO spokesperson Marcia Poole confirmed Maurizio’s dismissal “following findings of sexual misconduct against him and corresponding disciplinary process”.

“He was informed of the decision yesterday (6 September),” Poole told Health Policy Watch via email.

She added that perpetrators of sexual misconduct are entered into the UN “ClearCheck” screening database “as a matter of standard process to avoid their hiring or re-hiring by UN agencies”.

“Sexual misconduct of any kind by anyone working for WHO – be it as staff, consultant, partner – is unacceptable. Over the past two years WHO has been implementing a comprehensive programme of reform across the entire organisation to prevent sexual misconduct and ensure that there is no impunity if it happens,” said Poole, and encouraged anyone who may have been affected by sexual misconduct to “come forward through our confidential reporting mechanisms”.

Dr Gaya Gamhewage, Director of the WHO’s Prevention & Response to Sexual Exploitation, Abuse and Harassment.

More decisive action

The WHO has been trying to deal more decisively with sexual misconduct allegations within its staff following a huge sexual abuse scandal in the Democratic Republic of Congo (DRC) during the 2018-2020 Ebola outbreak.

A WHO independent commission concluded that 83 emergency responders, including 21 WHO employees and consultants, had likely abused dozens of Congolese women, obtaining sex in exchange for promises of jobs – also raping nine women outright. 

In the wake of that scandal, the WHO appointed Dr Gaya Gamhewage as its director of Prevention and Response to Sexual Misconduct and it has since hired more investigators for its Internal Oversight Services (IOS) department.

Earlier this year, Gamhewage told Health Policy Watch that her unit had terminated the contracts of four staff or consultants as a result of sexual misconduct allegations in the last quarter of 2022 – the most of any year so far. The contracts of a further three people were terminated between January and March.

New sexual misconduct policy

WHO’s new policy on Preventing and Addressing Sexual Misconduct (PASM) came into effect on 8 March this year, with the aim of enhancing WHO’s legal and accountability frameworks “for achieving zero tolerance for sexual misconduct and inaction against it”.

In April, the WHO dismissed a senior manager at its Geneva Headquarters, Temo Waqanivalu, on charges of sexual misconduct. This followed a six-month investigation into allegations that Waqanivalu, who was in the running to be the Western Pacific’s regional director, had harassed a British doctor at the World Health Summit in Berlin last October. 

“In the last year, our investigation team acted on not just the cases that were highlighted in the media, but have completed 120 investigations into sexual misconduct, and 72 other investigations are ongoing,” Gamhewage told a media briefing in April.

In May, the global body dismissed scientist Peter Ben Embarek, one of the leaders of the independent team of scientists sent to Wuhan to investigate the origins of COVID-19.

He was dismissed “following findings of sexual misconduct against him and corresponding disciplinary process,” said WHO spokeswoman Marcia Poole told Associated Press.“The findings concern allegations relating to 2015 and 2017 that were first received by the WHO investigations team in 2018.”

Image Credits: United Nations, Israel in Geneva/ Nathan Chicheportiche.

Kenyan President William Ruto announced the adoption of the Nairobi Declaration.

Over 20 African countries unanimously adopted the Nairobi Declaration on Wednesday, a document that sets out the continent’s demands for climate finance and debt relief ahead of the United Nations climate negotiations in Dubai later this year. 

The declaration calls for a global carbon tax on the use and trade of fossil fuels, low-interest loans for green energy projects in Africa, and reform of the world financial system that forces debt-laden African countries to pay more to borrow money and hampers foreign investment on the continent. 

The AU declaration circulated in Nairobi hours after the summit ended has not yet been made available online, raising concerns about possible revisions.

Kenyan President William Ruto, who hosted the summit and presided over Wednesday’s high-level proceedings, said that $23 billion in green investments was secured during the three-day event. This included hundreds of millions of dollars for African carbon credits, which Ruto and US climate envoy John Kerry highlighted as key to addressing the continent’s massive climate finance gap.

Africa will need at least $2.8 trillion to meet its climate targets by 2030, according to a joint African Union Commission and UN Economic Commission for Africa report released on the opening day of the summit.

Meanwhile, African governments currently spend almost as much on debt payments as they receive in energy investments, the International Energy Agency said on Monday. 

Debt crisis looms over Africa’s energy transition

Debt servicing costs were just 20% lower than total energy investment in Africa between 2014 and 2022, according to the IAEA.

More than 30 of the world’s most indebted countries are in Africa. With debt repayment levels at a 25-year high – the world’s poorest countries spend 16% of government revenue on debt – Africa is heavily reliant on investment from the private sector and foreign governments to build momentum for its energy transition. 

The paradox, as African leaders see it, is that debt is cited by private and multinational lenders – alongside concerns of instability, conflict and government corruption – as creating a risky environment for investment. As a result, the cost of capital in Africa is up to eight times higher than elsewhere, limiting the continent’s ability to attract much-needed investment, said Ruto. 

At the summit’s closing ceremony, Ruto criticized the “unjust configuration of multilateral institutional frameworks that perpetually place African nations on the back foot.”

Africa’s ability to respond and adapt to the climate crisis is hamstrung by this “costly financing which plunges our economies into debt traps and denies them resources needed to mitigate and adapt,” said Ruto. 

Exorbitant borrowing costs hamper clean energy investments in Africa

Around 30,000 delegates attended the inaugural Africa Climate Summit, the first-ever held by African leaders to address climate change.

Exorbitant borrowing costs have limited green energy investment in Africa to just 2% of the global total. In many cases, no money is available at all.

More than 80% of green investments in developed countries, where borrowing costs are low, are funded by private finance. In developing countries, that figure falls to 14%.

“The stock of public debt in sub-Saharan Africa at the end of 2022 was estimated at 1,140 billion dollars,” said African Union Commission President Moussa Faki Mahmat. “In light of these staggering figures and many others, it is clear that there can be no relevant global intervention in favour of Africa without a credible solution to the crippling debt challenge.” 

Some of Africa’s largest economies were notably absent from the inaugural summit in Nairobi, with the heads of state of Nigeria, South Africa, Ethiopia, and Egypt failing to attend. 

China, the world’s largest emitter of greenhouse gases, Africa’s largest trade partner, and one of its largest creditors, declined to make a public statement at the conference, although senior Chinese officials were in attendance.

The declaration also called on the world’s biggest emitters to meet their $100 billion pledge in annual climate finance to developing countries, which has gone unfulfilled since its announcement 14 years ago.

Critics question focus on carbon credits

“Kenya and Africa look forward to a successful COP 28 that is a turning point in the Climate Change conversation,” said Ruto.

Hundreds of millions of dollars for African carbon credits were announced at the summit, including a $450 million commitment by the United Arab Emirates (UAE).

The UAE, one of the world’s largest oil producers, is leading a campaign to reframe its image as a leader in green energy ahead of the UN climate summit in Dubai in November. It committed an additional $4 billion to green investments in Africa, albeit in the form of a “non-binding letter of intent”.

The focus on carbon credits at the Nairobi summit was met with criticism from environmentalists and African politicians who view them as an excuse for major polluters to continue polluting.

African carbon credits are already widely sold to Western companies and governments, such as airlines and energy companies. Critics of carbon markets say that their voluntary nature makes them an easy way for companies and countries to offset their emissions without actually reducing them.

However, carbon credits could help to lower the cost of capital standing in the way of green investment in Africa by providing an additional financial incentive to unlock private sector interest.

Ruto described the African carbon market as “an unparalleled economic gold mine”, adding: “GDP is about capitalising what you have. We have the carbon sinks that serve the world.”

The African carbon market, where a ton of carbon is worth less than $10 compared to over $100 in wealthier nations, is seen by critics as an easy dumping ground for countries and companies seeking to offset their emissions.

The IAEA estimates that African carbon credit sales to governments – similar to the deal agreed by Ghana and Switzerland in 2022 – could raise even more money than sales to private companies.

‘Agents of change’ – recasting Africa’s role in the energy transition 

The Nairobi declaration seeks to recast Africa’s population of 1.3 billion people – set to double by 2050 – as agents of change in the global climate fight, rather than helpless victims. 

“[Africa] is more than ever called upon to rely first and foremost on its own efforts, on its own genius,” said Mahmat.

Africa is home to 60% of the world’s renewable energy potential and 30% of the critical minerals needed for low-carbon technologies, said Ruto. Despite this, over 600 million people do not have access to electricity.

“It’s becoming increasingly difficult to explain to our people, particularly to our youth, the contradiction: resource-rich continent and poor people,” said Ethiopian President Sahle-Work Zewde. “Africa cannot be nature-rich and cash-poor.”

Involving youth, health sector

Health sector leaders, however, expressed dismay that health was not more prominent in the Summit proceedings and outcomes – particularly in light of the huge toll fossil fuel emissions and climate change are taking in terms of more heat-related illnesses; drought, flooding and food insecurity; and poor urban air quality.  An appeal for a greater focus on  health-related climate issues was circulated at the Summit by WHO and a number of development partners earlier this week.

But in the final declaration, “health” was only mentioned once – in reference to the disproportionate impacts of climate change on the continent on “economies, health, education, peace and security, among other risks.”

“Sadly, the organisers seem to have overlooked the urgency of this health crisis, as it remains conspicuously absent from the summit’s agenda,” CEO of Amref Health Africa Githinji Gitahi was quoted as saying. “This isn’t merely an oversight; it’s a haunting omission that risks squandering a golden opportunity to amplify Africa’s voice on a global stage, especially with the 78th Session of the United Nations General Assembly and COP28 looming on the horizon.”

Ruto, in his remarks, also emphasized the importance of involving Africa’s youth in climate discussions. Africa is the world’s youngest continent, with 40% of its population under the age of 15. 

“We are the last frontier of untapped potential in the form of hundreds of millions of young men and women who are educated, skilled, motivated, innovative, ready and willing to drive the enterprises and industries that will unlock the possibilities promised by our immense endowments of natural assets, mineral resources, and green energy potential in order to unleash opportunities and prosperity for Africa and the world on an unprecedented scale,” said Ruto.

“If the voice of the youth is missing, our efforts to achieve prosperity will not succeed.”

Dr Tedros Adhanom Ghebreyesus.

There are “concerning trends for COVID-19 ahead of the winter season in the northern hemisphere”, including increased ICU admissions and hospitalisation in Europe, and case increases in the Middle East and Asia, according to World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyesus.

However, the WHO’s ability to assess the threat of new COVID-19 variants is hamstrung by member countries’ lack of monitoring of the virus, Tedros told a global media briefing on Wednesday.

“Only 43 countries, less than a quarter of WHO member states, are reporting [COVID-19 cases] to WHO and only 20 provide information on hospitalizations globally,” Tedros noted.

“The increase in hospitalizations and deaths shows that COVID is here to stay and that we will continue to need tools to fight it,” he added.

Meanwhile, Dr Maria van Kerkhove, WHO’s COVID-19 lead, said that while the data was limited ‘hospitalisations are increasing in the Americas and Europe in what we call our southeast Asia region”.

“That is a worry given that, when we get to colder months in some countries, people tend to spend more time indoors aggregated together and viruses that transmit through the air like COVID will take advantage of that.”

She added that only 11 countries had shared information with the WHO’s technical advisory group for virus evolution (TAG VE) about BA.2.86, the latest “variant under monitoring”.

“Given that BA.2.86 has been detected in 11 countries since late July, that indicates to us that it is circulating,” added Van Kerkhove, but added that there were three other “variants of interests” – EG.5 (also called Eris) and two sub-lineages of XBB, which itself developed from Omicron.

Dr Maria van Kerkhove

“EG.5 accounts for about 30% of global sequences that are globally and was not out-competing any of the variants of interest or other variants that are in circulation,” she added.

“It is quite a complex picture globally in terms of how these variants behave because different variants circulated in different countries at different times. So what we’re trying to do is look at transmissibility. Right now we have very limited information, but we’re also looking at immune escape,” said Van Kerkhove.

Van Kerkhove added that the global influenza monitoring system is “pretty incredible”, and it was also assisting in keeping tabs on SARS-CoV2, the virus that causes COVID-19. In addition, some countries were also using wastewater monitoring for SARS-CoV2.

“What we are working on right now in this transition period of COVID is where can we integrate the systems for surveillance, integrate systems for clinical care and clinical care pathways and what needs to be standalone,” she said.

“That’s what countries are working on right now. We can’t keep up the same systems with a COVID lens only COVID needs to be dealt with in the context of all of these other circulating pathogens including flu.”

Health workers in Cape Town, South Africa, getting vaccinated against COVID-19 in March 2021.

Pharmaceutical giant Janssen/Johnson & Johnson (J&J) and generic manufacturer Serum Institute of India (SII) charged the South African government more than the European Union for COVID-19 vaccines – and South Africa assumed all the risk in ‘take-it-or-leave-it’ contracts with Pfizer, J&J and SII.

This is according to an analysis of the contracts led by Health Justice Initiative (HJI), a South African NGO that won a court challenge last month to get access to all South Africa’s COVID-19 vaccine contracts.

J&J charged South Africa $10 a dose, 15% more than the company charged the European Union (EU), and the government was required to pay a non-refundable down payment of $27.5 million.

Pfizer also charged $10 a dose, which is 32.5% more than the $6.75 “cost price” it reportedly charged the African Union. South Africa was required to pay $40 million in advance, only half of which was refundable.

SII was to have charged South Africa $5.35 a dose for Covishield, its generic version of  AstraZeneca – which was 2.5 times more than it charged the EU. However, South Africa suspended its order over safety concerns related to the vaccine.

This is according to a media release issued on Tuesday by HJI and a group of medicines access advocates that analysed the first batch of contracts given to HJI since the court judgment.

Meanwhile, the exact price of vaccines supplied via the global COVID-19 vaccine access programme, COVAX, administered by Gavi, was “unclear” according to the group, but COVAX’s “all-inclusive weighted average estimated cost per dose” was $10.55.

In total, South Africa would have been liable for $734 million for COVID-19 vaccines including advance payments of $ 94 million.

‘Ransom negotiations’

HJI director Fatima Hassan

“The terms and conditions in these contracts and agreements are so one-sided, and so in favour of multinational corporations that they beggar belief,” said HJI director Fatima Hassan at a media briefing on Tuesday. 

“[The contracts] has placed governments, including South Africa and other countries in the Global South, in the unenviable position of having to secure scarce supplies in a global emergency in a manner which basically can only be described as a set of ransom negotiations,” added Hassan. 

“There was so much secrecy, no transparency, and very little leverage against late or no delivery of supplies when South Africa was really waiting for supplies and needing them.”

Vague delivery terms for J&J 

Jay Kruuse, director of South Africa’s Public Service Accountability Monitor (PSAM), said that the J&J vaccine contracts – which also involved Belgian company Janssen – were characterised by “very vague delivery terms”, which meant that South Africa had “very little leverage over the arrival time of doses”.

In addition, there were “extensive confidentiality conditions” and indemnity clauses, said Kruuse. 

The J&J vaccines were the first vaccines South Africa was able to buy and were prioritised for health workers and delivered via a mass clinical trial before the vaccine was authorised in the country.

Jay Kruuse, director of the Public Service Accountability Monitor (PSAM) in South Africa.

Pfizer’s ‘sweeping indemnity provisions’

Addressing the Pfizer contract, Canadian professor Mathew Herder said that the provisions “shift virtually all of the risk, all of the cost, and all of the burden onto the South African government, which at the time this deal was struck back in early 2021 had virtually no vaccines for the country’s people”.

Herder, who directs the Health Law Institute at Dalhousie University, described some of the contract’s provisions as “extreme” and “far more in Pfizer’s favour compared to some of the other deals I’m familiar with”.

“The contract does not guarantee that Pfizer will actually deliver any vaccines to South Africa and in the event that they don’t actually deliver, the most the South African government can recoup is 50% of the advance payment they were required to make under the contract,” said Herder. 

The contract refers to Pfizer making “commercially reasonable efforts” to deliver the vaccine whereas EU agreements refer to “best reasonable standard”, which is a higher standard to be met. 

“Why? Because the commercially reasonable thing to do is the most profitable thing to do so if it generates more returns to deliver elsewhere first, that is perfectly fine under the Pfizer-SA contract,” said Herder.

Mathew Herder, director of the Health Law Institute at Dalhousie University in Canada.

“Sweeping indemnification provisions” required the South African government to hold Pfizer ‘harmless of any and all claims against it’ and to “bear the costs of any product recalls if that needed to happen down the road”, said Herder. 

Pfizer also required the South African government to “set up a vaccine injury compensation programme as a condition precedent for delivering any of the vaccines that were contracted for”, he added. 

“These provisions shift virtually all of the risk all of the cost all of the burden onto the South African government, which at the time this deal was struck back in early 2021. had virtually no vaccines for the country’s people. So that certainly feeds into this very strong impression we have from reading the contract says as a group, that it was a very one-sided endeavour in the company’s favour.

COVAX ‘failed’ South Africa

“The COVAX programme was set up to equalise access and to be equal it needed to be both timely and in sufficient quantity. And if we look at what happened with Gavi’s COVAX programme, we would say that, particularly in South Africa, it failed in virtually every respect,” said US professor Brook Baker from Northeastern University School of Law, and  senior policy analyst at Health GAP Global Access Project.

“South Africa was one of the first countries to recognise the urgency and even promoted the TRIPS waiver proposal at the WTO to try to expand the number of manufacturers and overcome the monopoly barriers that companies had on products,” he added.

Brook Baker

“That urgency was met with protracted delay. Gavi had promised or at least projected – I guess we should say projected because Gavi never really made wholly committed promises –  to supply 20 million doses by the end of 2021, and it fell far, far short. At the end of the day, South Africa got somewhat over a million doses from COVAX. That was all that it was actually able to deliver.”

Challenge for pandemic accord negotiations

Nic Dearden, director of the UK-based Global Justice Now, said that had global COVID-19 vaccine negotiations been conducted openly and the terms of contracts been disclosed, such inequitable terms “would not have happened”.

“How can it possibly have been that South Africa was charged two and a half times what my country, the UK, and many European governments were paying for what was effectively the same AstraZeneca Serum Institute dose? That cannot be right, it shouldn’t have been allowed to happen,” said Dearden.

The group stressed that the problem of one-sided contracts favouring pharmaceutical companies requires a regional and global solution.

’Unless acted upon with clear, legally binding international agreement, we will arrive at the next pandemic with little more to enforce fair terms than platitudes and scathing press statements from the [health] minister and president in South Africa and other world leaders in the Global South,” the group asserted.

“This must be deliberated upon in pandemic accord negotiations and revisions of the International Health Regulations currently underway and at the upcoming United Nations General Assembly (UNGA).”

Meanwhile, Baker added that, if equitable access to vaccines and other pandemic-related medicines is to be achieved in future, the terms of contracts with pharmaceutical companies have to change.

Currently, “we give intellectual property monopolies to companies that maximise their commercial interests and profiteer to the maximum”, said Baker.

“It gives them the right to artificially control supplies because they don’t share the technology with other producers. We let them unilaterally set prices and different prices for different countries – sometimes more advantageous to some and less advantageous to others, and they get to decide who they distribute to and when.

Baker added that “when you invest all of their power over essential public goods in the hands of private companies, with no governments, other multi-stakeholders or international institutions that can override those commercial decisions,  you get exactly what we got in this pandemic”.

“Unless the pandemic accord is willing to address intellectual property monopolies and power over the supply price and distribution, we will have exactly the same thing in the future,” he added.

Lives were saved

The South African Department of Health responded to the HJI analysis saying it had “entered into these agreements to secure vaccine doses to protect the lives of South Africans against the deadly virus which claimed more than 100,000 lives in South Africa, and almost seven million globally”.

“There is no argument that low and middle-income countries around the world, including South Africa, had limited bargaining power to secure vaccine doses and negotiate the price of vaccines due to a number of reasons including the limited number of manufacturers and vaccine hoarding and nationalism by high and upper middle-income countries. The unequal distribution of vaccines has undoubtedly contributed to more deaths which could have been prevented.

“Given the uncertain circumstances at the time, the government took a difficult decision and prioritised saving the lives of the citizens. There is no doubt that this decision to make vaccines available despite the difficulties has saved lives.”

The department added that South Africa had recently deliberated with a number of local and global organisations – including the Africa Centre for Disease Control and Prevention – “on a potential African Union and BRICS framework of cooperation for pandemic, preparedness, prevention, resource and recovery” to address future inequity of access and distribution of pandemic products.

This story was updated to include the response from the South African Department of Health.

Image Credits: Western Cape government.

“All countries and virtually all children” are affected by substantially heightened risks brought on by climate change, the UN Children’s Fund said.

The health, development and safety of children in 98% of African countries are severely threatened by the effects of climate change, according to a new report by UNICEF. 

The report, published ahead of the start of the Africa Climate Summit in Nairobi on Monday, found that children in 48 of the 49 African countries for which data is available are at “high” or “extremely high” risk from the extreme weather, illnesses, pollution, and environmental degradation caused by climate change. 

Children living in the Central African Republic, Chad, Nigeria, Guinea, Somalia and Guinea-Bissau face the highest threat, according to the report. In Somalia, over 20,000 children under the age of five died last year amid the extended drought in the country, according to UN estimates. In Chad, nearly 40% of children under five are stunted, according to the World Food Programme. 

The countries most at risk from climate change also have weak health, nutrition, and water, sanitation, and hygiene (WASH) services, according to the report. This makes children in these countries even more vulnerable to the effects of climate change, as they are less able to access basic services such as safe drinking water, education, and protective services during extreme weather events.

“It is clear that the youngest members of African society are bearing the brunt of the harsh effects of climate change,” said Lieke van de Wiel, Deputy Director of UNICEF’s Eastern and Southern Africa region. “They are the least able to cope, due to physiological vulnerability and poor access to essential social services.” 

The report follows revelations made by the Children’s Environmental Rights Initiative, which includes UNICEF, in June, which found that just 2.4% of investments by multilateral climate funds (MCFs) in Africa directly support children.

UNICEF estimates that one billion children globally are at “extremely high” risk of suffering from the impacts of the climate crisis, which the organization has called a “children’s rights crisis”.

Weather extremes threaten children from all sides 

Overall Children Climate Risk Index (CCR) score by country in Africa.

Children are disproportionately vulnerable to the impacts of climate change, as their developing immune systems, behavioural characteristics and developmental needs make them more susceptible to diseases, food insecurity, water scarcity and air pollution. 

In the northern part of Africa, children are more exposed to risks related to water scarcity and air pollution, according to the report. In the western and eastern parts of the continent, children are more exposed to risks related to vector-borne diseases, heatwaves and riverine flooding.

Water and soil pollution, meanwhile, affects children across the entire continent. The risks of tropical cyclones and coastal flooding, however, are concentrated in specific coastal regions, the report said.

Climate change is also driving child labour, child marriage, extremism and forced migration, which can expose children to human trafficking, gender-based violence, abuse and exploitation, the report said. 

“Children and their families hit by one crisis may be able to absorb the shock provided the crisis is not too severe,” said UNICEF. “However, when they are hit by a second, a third and other subsequent shocks within a short span of time their coping mechanisms can become exhausted.”

A UN Development Programme report published earlier this year found that the promise of economic opportunity, not religious ideology, is the leading driver of violent extremist groups in Sub-Saharan Africa. Climate change is accelerating the expansion of these groups, with devastating impacts on the rights and security of women and children.

Extreme weather has destroyed crops and fish populations around Lake Chad, pushing young men in the region to turn to extremist groups like Boko Haram in search of income to feed themselves and their families.

The lake, which straddles the borders of Nigeria, Niger, Chad and Cameroon, has shrunk by more than 90% in the past 40 years due to climate change, overfishing and pollution. This has led to widespread food insecurity and poverty in the region.

“Present and future generations of children will bear the brunt of the intensifying effects of the climate crisis over the course of their lifetime,” said UNICEF. “These impacts are already occurring.”

Children must be heard in the climate conversation

The right of children to participate in climate decisions that will affect their future is enshrined in the UN Declaration on the Rights of the Child.

Africa has contributed very little to the carbon emissions that are at the root of the climate crisis. As of 2022, Africa as a whole has emitted just under 50 billion metric tons of CO2, less than 3% of the 1.73 trillion metric tons emitted since the turn of the twentieth century.

This is especially true of the continent’s children: around 40% of Africa’s population was under the age of 15 in 2022, making it the world’s youngest continent. Another 20% of Africa’s population is under the age of 25.

This youth is Africa’s “greatest natural resource” in the fight against climate change, according to UNICEF. The agency added that the right of children to participate in decision-making that affects their future is recognised under the UN Convention on the Rights of the Child.

“Children are not only victims,” said UNICEF. “Despite this, children’s voices and perspectives are rarely heard or considered in the decision-making processes fundamentally shaping their future.”

“Their ideas, creativity, and skills need to be taken seriously and become integral parts of the solutions, including policy and financing,” the agency said. “The time to act is now.”

Chance for action in Nairobi at the inaugural Africa Climate Summit

African leaders will have a chance to act on UNICEF’s findings at the inaugural Africa Climate Summit, which opened Monday in Nairobi, Kenya, under the auspices of the African Union.

Over 20 African heads of state are expected to attend the summit, Kenyan Environment Cabinet Secretary Soipan Tuya told Al Jazeera. The summit, which is running in parallel to Africa Climate Week, expects around 30,000 delegates to be in attendance.

Kenyan President William Ruto billed the summit as a chance for Africa to define its position on the ways “humanity should engage in effective action to save this planet from a climate catastrophe” and “lift hundreds of millions out of poverty.”

Ruto said he hopes to rally African leaders around the Nairobi Declaration on Green Growth and Climate Finance, which is set to be the key outcome of the summit. The declaration is a blueprint for a “new green industrial age” in Africa based on an “ambitious green growth agenda and climate finance solutions”.

Securing new financial commitments from wealthy nations and holding them to their $100 billion climate finance goal set out in 2009 at COP15 in Copenhagen will be a major focus of the summit.

The list of high-profile attendees of the Africa Climate Summit includes UN Secretary-General Antonio Guterres, US climate envoy John Kerry, COP28 Director-General Majid Al Suwaidi, and COP28 President Sultan Al Jaber.

“Climate action is not a Global North issue or a Global South issue,” said Ruto. “It is our collective challenge, and it affects all of us.”

Image Credits: UNICEF.

United Nations Headquarters in New York.

A draft political declaration on pandemics, due to be adopted by the United Nations General Assembly later this month, offers “little hope” that the UN process will make a difference in global pandemic preparedness, global health experts said on Friday.

The document, made public on Thursday, is long on words but short on commitments. The only specific action the text commits to is to convene another high-level meeting on pandemics in 2026 – and even this is problematic.

“The three-year timeline is far, far too long,” one expert told Health Policy Watch. “A new pandemic threat could arise at any time.”

The draft declaration does not include any numbers or financing targets for global and domestic health spending to prevent and prepare for pandemics.

Earlier proposals for the UN to create an independent monitoring body to assess member state compliance with the pandemic treaty have been scrapped, and no enforcement or independent review mechanisms remain in the draft. 

The draft requests that countries commit to removing trade barriers and strengthening medical supply chains, “especially during pandemics and other health emergencies”, and to support “technology transfer hubs and intellectual property sharing mechanisms”.

“The document is mired in platitudes,” Nina Schwalbe, a public health expert and professor at the Columbia School of Public Health, wrote in the Financial Times on Friday. “The political declaration for this [UN] meeting suggests that pandemic amnesia has already set in,” 

General Assembly kicks the pandemic preparedness back to WHO

The lack of concrete commitments in the draft political declaration on pandemics may reflect a feeling within the United Nations General Assembly that the real action on pandemic preparedness lies in the hands of the World Health Organization (WHO).

The draft commits member states to providing “adequate and predictable funding” for the WHO, which struggled to keep up with the demands of the COVID-19 pandemic on its shoestring budget. It also stresses the importance of funding for the WHO Contingency Fund for Emergencies, which would allow the UN health body to respond quickly to future pandemics.

“The ball is kicked squarely back to WHO and the joint treaty and international health regulation negotiations to actually figure out how to make anything happen,” Suerie Moon, a global health expert and professor at the Graduate Institute in Geneva, told Health Policy Watch.

The draft is due to be adopted by the UN General Assembly on September 21. Global health officials are calling on member states to step up to the plate and make real commitments to pandemic preparedness.

“The UN General Assembly High-Level Meeting’s Political Declaration offers a one-time and historic opportunity to commit to lasting and transformative change to pandemic preparedness and response,” Ellen Johnson Sirleaf and Helen Clark, co-chairs of the Independent Panel for Pandemic Preparedness and former heads of state of Libera and New Zealand, respectively, wrote in an open letter to UN delegates last month. “We call on leaders and decision-makers to make this moment count.” 

In its current state, the draft declaration offers “little hope” of making a difference in the next pandemic, said Schwalbe. “History is on track to repeat itself – in the form of more pandemics which could have been avoided.”

The draft text addresses key issues, but no numbers to be found

United Nations Headquarters, New York

The vague language and lack of real commitments in the UN’s draft pandemic declaration are emblematic of the reasons for public frustration with the organization.

“The document contains almost no concrete commitments to anything transformative, is weak, and has low ambition,” another expert told Health Policy Watch. “If this is indeed the outcome, it represents a missed opportunity to make high-level commitments to better protect the world against pandemic threats.”

The draft calls for countries to spend a “sufficient” amount on domestic health spending and asks governments to “maximise efficiency” in distributing this indeterminate amount of funds. On global health spending, it calls for “solidarity” through “enhanced official development assistance and financial and technical support” for developing countries, especially in Africa and for Small Island Developing States.

The technology transfer and intellectual property rules in international public health emergencies are addressed in similarly general terms in the draft declaration. Despite the lack of new commitments by the General Assembly declaration, steps to improve technology transfer have been made since the pandemic. 

The WHO mRNA vaccine hub in Cape Town, South Africa, began operating at full capacity last year, following its announcement in 2021. The facility, which celebrated its official launch in April, aims to support mRNA technology transfer and provide equitable access to vaccines and other medicines in low- and middle-income countries.

Pharmaceutical giants, such as Moderna and Pfizer, have declined to provide the technical knowledge necessary to replicate the COVID-19 vaccines to the WHO mRNA hub. However, both Pfizer and Moderna have set up new vaccine production hubs of their own in Africa in partnership with local governments and the private sector. 

Despite its failure to commit to any specific actions, the draft text does hit most of the key points that must be addressed to prepare for the next pandemic.

“The draft is very short on concrete commitments, long on aspiration,” said Moon. “It does flag what are clearly the high political priorities of many countries in the pandemic treaty and IHR negotiations: Medicines access, publicly funded R&D, IP, local production, tech transfer, and pathogen access and benefit sharing, get a lot of air time, as does One Health and financing.”

“There’s some good language on some of these issues that could perhaps, eventually, make it into one of the binding agreements,” Moon added.

Calls for “solidarity” recall failures of COVID-19 response

Vials of Pfizer´s COVID-19 vaccine. COVID vaccines mostly reached in or around the regions they were produced, a WHO report finds.

Calls for solidarity proved to not be worth much at the height of the pandemic. In June 2020, the WHO and 30 low-income countries priced out of the vaccine supply race issued a “Solidarity Call to Action” that accompanied the launch of the UN health body’s COVID-19 Technology Access Pool (C-TAP) initiative.

The hope for C-TAP was that it would become a ‘one-stop shop’ where patent holders of COVID-19 vaccines, treatments and technologies could license their products for worldwide use. The initiative called on key pharmaceutical stakeholders to “advance the pooling of knowledge, intellectual property and data that will benefit all of humanity”.

Just two institutions – the Spanish National Research Council (CSIC) and the National Institutes of Health (NIH) – responded to the call, entering into licensing agreements for diagnostic tests.

Pfizer, BioNTech and Moderna rebuffed C-TAP when their vaccines hit the market, while rich governments with the ability to afford their vaccines elected to prioritize securing domestic supplies over global solidarity.

Earlier this week, Taiwanese vaccine manufacturer Medigen Biologics Corp. became the first private pharmaceutical company to share its vaccine technology with C-TAP.

Waiting on WHO?

Tedros addressing the opening of the 73rd WHO Africa regional meeting on Monday.

The Pandemic Accord process, launched by WHO in 2021, is scheduled to conclude in May 2024 at the World Health Assembly, the top decision-making forum of the UN health body.

Negotiations at the WHO, however, have also proven difficult. WHO Director-General Dr Tedros Adhanom Ghebreyesus warned on Monday that the slow pace of negotiations has put the pandemic accord at risk of missing the May 2024 deadline.  

“This is a unique opportunity that we must not miss to put in place a comprehensive accord that addresses all of the lessons learnt during the pandemic with a particular emphasis on equity,” Tedros said at the WHO Africa regional meeting. “As the COVID-19 pandemic laid bare, there are serious gaps in compliance and implementation which must be addressed.” 

Tedros has chafed at the power of pharmaceutical companies over the final outcome of negotiations. At a heated press briefing in July, Tedros called out “groups with vested interests” for spreading “lies” about the pandemic treaty that are “endangering the health and safety of future generations”. 

Despite the expansion of vaccine manufacturing worldwide – which now totals over 90 manufacturers – fewer than ten companies control the vast majority of global vaccine supplies, the WHO found in its vaccine market report released in May. 

“The new global architecture cannot be designed, built or managed by those with the most power, money and influence,” Tedros said on Monday. 

Whether the companies and governments with the power, money and influence to make that determination will choose to play ball remains an open question. 

Image Credits: UN, United States Mission Geneva, UN Photo/Manuel Elias, Photo by Mat Napo on Unsplash.

Methane, a colorless gas, is released from a rig during oil and gas extraction – other key human-made sources include agriculture, livestock production and poor waste management.

International climate targets cannot be met without rapid and drastic cuts to global methane emissions, according to a series of reports published on Wednesday by the Global Climate and Health Alliance (GCHA).

The reports found that reducing methane emissions by 45% by 2030 would avert nearly 0.3C degrees of global warming by 2045, a margin that could prove critical to global ambitions to keep temperature rise at or below 1.5C degrees.

Methane is a powerful greenhouse gas that is 80 times more effective at trapping heat than carbon dioxide over a 20-year period. It is emitted by livestock production, rice cultivation and from uncontrolled waste dumping, as well as gas flaring and leaks from fossil fuel extraction, as well as from natural sources like peat bogs. Overall, methane emissions are estimated to have caused more than 30% of global warming to date.

But since it´s lifespan in the atmosphere is limited, reducing methane emissions would deliver quick gains for climate as well as health – where methane is a key contributor to ground level ozone levels. The adverse health outcomes of ground-level ozone include cardiovascular diseases, asthma, and respiratory illnesses which result in roughly one million premature deaths every year.

“Every pathway to limiting climate warming to close to 1.5C demands rapid, substantial cuts to methane,” said Dr Jeni Miller, Executive Director of the GCHA, which is a network of health professional and health civil society organizations addressing climate change. The pathway to limit global warming to 1.5C  set out by scientists from the Intergovernmental Panel on Climate Change (IPCC) also includes substantial cuts to methane emissions as a key component of its roadmap. 

Low hanging fruit ?

Livestock production is another key source of human-produced methane emissions.

Reducing methane emissions has long been seen as ¨low-hanging fruit¨ in climate policy circles – although political action has lagged behind its mitigation potential. While carbon dioxide remains in the atmosphere for centuries after it is emitted, methane has an atmospheric lifespan of just 12 years. This makes methane an ideal target to achieve rapid reduction of the impact of the greenhouse gas effect on global temperatures.

“Methane mitigation offers a quick win, while tackling CO2 is the long game – at this stage in the climate crisis, we need both,” said Miller. “Fortunately, both offer opportunities that could improve people’s health.”

Global momentum building – but COP28 host UAE fails to report methane emissions

Methane emissions are set to be a key topic of discussion at the UN climate summit, COP28, set to take place in the United Arab Emirates in December later this year.

Around 150 countries have signed the Global Methane Pledge since its launch at COP26 in Glasgow in 2021. The pledge commits countries to reduce methane emissions by 30% by 2030.  See related story:

Africa’s Methane Gamble – Can A Climate-Warming Gas Become An Asset to Health?

The UAE has said that it will work with NGOs and governments on a plan to slash methane emissions ahead of the arrival of delegates in Dubai. However, the host nation has also been charged with failing to report its own methane emissions for around a decade.

The fossil fuel, agricultural and waste management sectors are the major sources of human-produced methane emissions, according to GCHA.

“We’re constantly learning more about the extent and impact of methane sources,” said Miller. “Methane leaks from fossil fuel production and use are far greater than previously thought, and leaks are occurring at every stage in the fossil fuel life cycle.”

The extent of the UAE’s commitment to reducing methane emissions and acting as a shepherd of international climate goals remains questionable, given that the president of COP28, Sultan al Jaber, is also the CEO of the UAE’s state oil giant.

Agriculture, energy, and waste management systems must change

Birds scavenge for food scraps at a landfill in Connecticut. Landfills and sewage pools are another major source of methane emissions; the gas is released as disposed organic materials – including paper, food scraps, and human waste, biodegrade.

The technology to slash methane emissions already exists, but it will take individual and system changes to make it happen, said GCHA.

One important way to slash methane emissions would be to plug leaks during fossil fuel extraction to prevent methane gas escape,  employing the latest technologyies. Shifting away from fossil fuels to renewable energy at a faster rate would also make an impact, but the reports concede that eliminating fossil fuels from the global energy system is not likely in the immediate future.

“Cutting methane emissions from fossil fuel production, distribution, and end use through readily available, cost-effective solutions is a powerful lever for reducing near-term warming and avoiding dangerous warming tipping points, while also yielding benefits for people’s health,” the reports say.

Source: Climate and Clean Air Coalition.

Other ways to reduce methane emissions include rapidly moving towards regenerative agriculture, improving access to nutritious, plant-rich whole foods diets, and making existing livestock healthier. Improved waste management by composting or, better yet, developing industrial-scale biogas digesters to handle  food, farm, and human waste will also deliver big benefits, harnessing methane for fuel, which can then be used for energy production, in what is an almost climate-neutral process.

Biogas plant, South Africa. Pilots abound but largescale harnessing of methane has yet to take place.

“Methane’s effects on the environment are extensive and well understood,” said Amanda Quintana, the project director for Abt Associates who was involved with the reports. “What we need now is to mobilize the health community and help people understand that, because methane has both indirect and direct impacts on human health, there are direct health benefits to reducing methane emissions, both in the short- and long-term.”

Quintana added that the evidence in the reports is not new but puts the focus on the extreme health impacts of methane. “The report highlights these health impacts and linkages to make it easier for people to understand the important role the health community can play in methane mitigation.”

Stefan Anderson contributed reporting for this story. 

Image Credits: Clean Air Task Force , Evan Schneider, United Nations multimedia , SuSanA Secretariat/Flickr.

Vaccine access groups praised the agreement as a long-overdue victory for vaccine equality in low-income countries but called out major pharmaceutical companies for putting profit over people.

Three years after the launch of its COVID-19 Technology Access Pool (C-TAP) initiative, the World Health Organization (WHO) has secured its first COVID-19 vaccine license from a private pharmaceutical company, the UN health body announced on Tuesday.

The agreement with Medigen Vaccine Biologics Corp., a private vaccine manufacturer based in Taiwan, is a welcome but underwhelming landmark for C-TAP, whose initial launch was accompanied by ambitions of ensuring equitable access to COVID-19 vaccines, treatments and technologies around the world.

“This is not just about COVID-19, it is about setting a precedent for future global health challenges,” said Charles Chen, Medigen’s CEO. “We hope to inspire other organizations to follow suit.”

The agreement with the Taiwanese manufacturer is one of three new licences acquired this week by the WHO through the Medicines Patent Pool. The other two agreements are with the Spanish National Research Council (CSIC) and the University of Chile. CSIC is sharing a licence for a COVID-19 vaccine prototype, and the University of Chile is sharing its technology for a test used to measure COVID-19 antibody levels.

CSIC became the first entity to share technology with C-TAP in November 2021, when it signed a worldwide license for its COVID-19 antibody diagnostic test.

“COVID-19 is here to stay, and the world will continue to need tools to prevent it, test for it and treat it,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “WHO and our partners are committed to making those tools accessible to everyone, everywhere.”

C-TAP ambitions not shared by pharma 

C-TAP launched at the height of the pandemic in June 2020 to promote technology sharing based on “equity, strong science, open collaboration and solidarity”. The call to action was supported by 30 WHO member states, all of which were low-income countries without access to vaccines.

However, without the backing of major pharmaceutical companies and powerful governments, C-tap only secured two licencing agreements during the peak years of the pandemic – neither of which were vaccines. With the agreements announced this week, a total of just five licences – including two provided by CSIC – have been shared on C-TAP.

“It is shameful that, despite receiving unprecedented public funding and advance purchases, not even one of the major pharmaceutical companies has shared vaccine technology with C-TAP,” said Julia Kosgei, policy co-lead for campaign group the People’s Vaccine Alliance.

The WHO and its Director-General, Tedros Adhanom Ghebreyesus, have repeatedly called out the outsize power of pharmaceutical giants over the global vaccine market. This issue is once again in the spotlight as ongoing negotiations over the international Pandemic Treaty highlight the world’s dependence on a small number of companies to ensure equitable vaccine distribution for future pandemics.

In May, the WHO’s vaccine market report found that global vaccine supply is concentrated in fewer than a dozen manufacturers, leading WHO officials to call out the vaccine market for being controlled by “oligopolies”. Without “predefined and binding rules for vaccine distribution in times of scarcity” to prevent vaccine distribution from being guided by profits, the story of inequality borne out during the COVID-19 pandemic is destined to repeat itself, Tedros wrote in the foreword to the report.

Pfizer, BioNTech and Moderna refused to join C-TAP once their vaccines hit the market, citing research and development costs and the high risks associated with vaccine development.

In its press release accompanying the new license agreements this week, the WHO credited C-TAP with “raising awareness” for the need for wider sharing of patents for critical medicines – a tacit admission it has fallen well short of its ambitions to spur solidarity in the boardrooms of pharma giants.

Image Credits: Photo by Mat Napo on Unsplash.