Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. WHO Denies it Abandoned Investigation of COVID-19 Origins – But Way Forward Unclear 15/02/2023 Megha Kaveri Dr Maria Van Kerkhove, speaking at Wednesday’s media briefing. A senior World Health Organization (WHO) official has emphatically denied that abandoned its investigation of the origins of the virus that caused the COVID-19 pandemic. The comment by Dr Maria Van Kerkhove, COVID-19 technical lead, was in response to a report published on Tuesday by Nature which stated that the agency has “quietly shelved” its plans to continue with its investigation of SARS-CoV2’s origins. due to the barriers to plans to conduct further, crucial studies in China. A controversial report by a joint Chinese and international mission to Wuhan, covering the first phase of the investigation was published in March 2021, But critics said glossed over China’s omission of key patient data from the early days of the outbreak in Wuhan. The report also declared that it was “extremely unlikely” that the virus could have escaped from a local research laboratory, without sufficient data or evidence to make such a determination, critics said. Subsequently, WHO laid plans for an extensive set of on-site, follow-up studies over the summer of 2021, including further assessment of Wuhan wild markets, the lab escape theory, and closer examination of early transmission patterns, based on blood samples from anonymized patient data. But China rejected those plans outright, and has remained unwilling to release further patient data or to let teams of researchers visit the country. In the Nature report, Van Kerkhove was quoted saying that WHO had in fact abandoned its plans for a Phase II of the COVID origin studies: “There is no phase two,” she reportedly said. While WHO protocols had called for extensive follow-up studies in China, “that plan has changed”, she added, saying: “The politics across the world of this really hampered progress on understanding the origins.” Speaking at Wednesday’s briefing, Van Kerkhove appeared to walk back on her comments, stating: “I think we need to be perfectly clear that WHO has not abandoned studying the origins of Covid 19. We have not, and we will not.” However, she also admitted that WHO’s “updated” plans for a second phase would have to take a more generalized approach to the origins question: “In a sense, phase two became the Scientific Advisory Group for the Origins of novel pathogens (SAGO),” she clarified. SAGO held its first meeting in November 2021 and was established as a permanent advisory group to work on drawing up a framework to understand the origins of not just COVID-19 but any future outbreaks. “So the creation of SAGO was in effect, our best effort to move this work forward.” China has evaded WHO’s requests for cooperation China continues to refuse WHO’s requests to release more data or to open its borders to scientific teams for further on-site investigations, Kerkhove also admitted. “Studies that were recommended from the March 2021-WHO report, from the June 2022-SAGO report and studies that we’ve been recommending at the animal human interface and markets, on farms need to be conducted in China. We need cooperation from our colleagues there to advance our understanding,” she added. Over the past year, WHO repeatedly called on China to cooperate in further SARS-CoV2 origin studies. Last month, WHO Director General Dr Tedros Adhanom Gheyebresus also appealed to Beijing to share more data about death rates and SARS-CoV2 variants ciculating in the country as the country was swept by a fresh COVID wave after removing its controversial “zero COVID” policy measures. Dr Tedros added that it remains crucial to understand the origins of the pandemic for scientific and moral reasons. “Millions of people lost their lives and many suffered. The whole world was taken hostage by a virus. It’s morally very important to know how we lost our loved ones. “Recently, seven weeks ago, I sent a letter to a top official in China, asking for cooperation because we need cooperation and transparency and the information we ask in order to know how this started,” he stated. But apparently so far, there has been no return mail. Image Credits: Megha Kaveri. ‘I Couldn’t Just Stand By’: Syrians Step up With Earthquake Aid Despite Pressures 15/02/2023 Safaa Sallal Bakier Soulo (right), 28, and his younger brother sleep rough with their families in a public square in the old city of Gaziantep. DAMASCUS/JABLEH – One week on from last week’s massive earthquakes, ordinary people across Syria – including in the large parts controlled by President Bashar al-Assad’s forces – have been scrambling to marshal whatever help they can for survivors, offering up their homes, supplies, and skills. While many of the areas al-Assad controls are further from the epicentres than the rebel-held northwest, the government-run region has still reported 1,414 deaths, and more than 92,000 people are staying in shelters there, according to UN figures. By Wednesday, the overall death toll across Türkiye and Syria had exceeded 40,000. Nearly 12 years of conflict, and a crippling economic crisis compounded by Western sanctions, are complicating citizen-led aid efforts. There are limits to what people dealing with spiralling inflation, mass poverty, and record fuel shortages can do to help each other. But – as is the case in Türkiye, where a rapid community response has been key to getting people through the first wintry days and nights after the earthquakes – that hasn’t stopped many Syrians from trying. Nour Othman, 29, works for a marketing company in Damascus. Hours after the first earthquake struck on 6 February, she found herself staring at heart-wrenching images of families buried under slabs of concrete, and wanted to do something. Othman took to a 360,000-strong Syrian Facebook group usually used for job opportunities, home rentals, and community announcements. She placed a different sort of post: She asked for clothing, medicine, blankets, and canned food, using the Arabic hashtag #OneHeart. The response was overwhelming. Within a few hours, donations began pouring in to her Damascus office, which she had posted as the drop-off point. She stopped working, converted the office into a makeshift warehouse, and within a day had collected 3,000 pieces of clothing, 15 boxes of medicine, and stacks of blankets. By the second day, Othman said, the total amount of aid weighed five tonnes. Volunteers have offered to drive them to those in need. “I felt sad and totally helpless watching what the media was reporting… There were women and children screaming, and others trapped under the rubble. I couldn’t just stand by,” Othman told The New Humanitarian. “The initiative is called ‘One Heart’ because Syrians have learned to support each other and be of one heart through thick and thin,” she added. Conflict fault lines and geopolitics Despite the initiative’s name, after more than a decade of war, the reality is that Syrians live in a deeply divided country. Parts – like Damascus, where Othman lives – are controlled by al-Assad and his forces. Much of the quake-hit northwest is controlled by rebel groups, including the terrorist-designated Hayat Tahrir al-Sham. The northeast, meanwhile, is run by Türkiye, Turkish-backed rebels, and Kurdish groups. All of this has an impact on how international and local aid flows, or doesn’t flow, through the country. UN-coordinated aid to the northwest arrives across the border from Türkiye, while Damascus is the main hub for assistance within the rest of government-controlled Syria. Getting aid from Damascus to rebel-held territory has been extremely slow or a non-starter, although al-Assad officials and the Syrian Arab Red Crescent (SARC) have said they are willing to deliver aid across the country. Late last week, the government approved an aid delivery across front lines to areas controlled by rebels in the northwest, but it is reportedly held up. Another of the issues that could delay direct relief to Syrians across the country is Western sanctions, although last week the United States said it was granting a temporary exemption to “all transactions related to earthquake relief” that would otherwise be banned by sanctions meant to target al-Assad and those close to him. Dozens of white tents have been erected outside Gaziantep’s train station to host hundreds of Turks and Syrians whose homes were destroyed by the earthquakes. A surge in support For civilians collecting aid – like Othman – all of this means that the supplies she’s giving out will head only to the large parts of the country controlled by al-Assad. That includes Jableh, a coastal city about 25 kilometres south of Latakia, where Nada al-Halabi lived in a four-storey building – until it crumbled in the earthquakes. Standing outside her building on 9 February, a few days after disaster struck, she told The New Humanitarian she was still in shock. Rescue teams had pulled 10 dead bodies from the heap of rubble; two children of families in the building were missing. “At the moment of the earthquake, I was asleep. I only heard the sound of the earth roaring,” said al-Halabi, wiping away a tear with a handkerchief. In an 8 February news conference, Hussein Makhlouf, Syria’s minister of local administration and environment – the man charged with overseeing the government’s response – said 180 shelters would be set up across the country. Local NGOs, the SARC, and UN agencies have been handing out hot meals and various relief supplies, but much of the early aid effort has been spearheaded by ordinary citizens like Othman. In light of the country’s economic crisis, this is especially notable: Between 2010 and 2019, Syria’s GDP shrunk by more than half. The local currency lost 44% of its value in 2022, and food prices have nearly doubled over the past year. More than 90% of Syrians now live below the poverty line. While people living in northern Syria have been the most impacted by the economic collapse, the situation has now become so bad that Syrians in places across the country that had been doing relatively well are now also feeling the pain. While some help with goods, others are assisting with their professional skills. Over the past week, Syrian civil engineers launched a group to provide free consultations for buildings damaged by the earthquake. They’re offering on-site inspections to assess if cracked structures are still safe to live in. For concerned residents looking for quick answers, the engineers are rushing to assess any photos they can send in. The war, and years of sanctions, have decimated Syria’s stock of construction equipment and other machinery that may have helped with search and rescue, or later with reconstruction efforts. Fuel prices are also at an all-time high, and shortages mean there might not be enough to run the little equipment that is available. To do his part, Jableh resident Abu Ayman al-Khaminsi gave his 30-year-old son his tractor and a demand: “Go clear rubble and find survivors!” To power it amid the fuel shortages, al-Khaminsi syphoned off the diesel that was meant to heat his home. “I can’t use this diesel for warmth and keep my tractor parked here when there are people suffering,” al-Khaminsi said. “I’m not healthy enough to help the rescue efforts, but I’ll give everything I have.” ‘We’re meant to support one another’ Not everyone has a tractor or extra food to give, so they are doing what they can. Twenty-year-old Walaa Tamin has opened up her home in Latakia, the port city that was badly damaged by the earthquake. “If anyone has no place to go, our house is open. We’re meant to support one another, and you are welcome here,” Tamin posted on Facebook. Similar offers are popping up across the country. Two families are now sleeping in Tamin’s living room, choosing to sleep closest to the exit in case there’s another earthquake. There have also been locally-led blood drives, and one Damascus-based relief organisation said it was receiving money from expatriates to buy aid supplies. In Latakia, Ghazwan Muhammed, 34, set up a soup kitchen with three of his friends to get food out to hungry survivors. “We are all grieving right now,” he said. This instinct to pitch in is shared by many. While walking through the Damascus streets, Khaled Abu Wissam, 30, spotted the bustling “One Heart” drop site set up by Othman. He had nothing to hand so he took off his winter jacket and tossed it in, despite the wintry weather and ice-cold rain. “When I saw people handing over bags of donations, I couldn’t just go on my way,” Abu Wissam explained. “My Syrian brothers are freezing in the cold.” This story was originally published by The New Humanitarian. This article was produced in collaboration with Egab, which connects journalists from the Middle East and North Africa with news organisations worldwide. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Abdulsalam Jarroud/TNH. WHO Aims to Accelerate Trials of Vaccine Candidates for Marburg Disease as Equatorial Guinea Reports Nine Deaths 14/02/2023 Megha Kaveri Health workers in protective gear during the Marburg outbreak in Guinea in 2021. Following a first-ever outbreak of deadly Marburg virus disease in Equatorial Guinea, the World Health Organization (WHO) on Tuesday called an emergency meeting of the Marburg virus vaccine consortium (MARVAC) to receive an urgent update on possible vaccine candidates for the filovirus that can have an 80% fatality rate. At the meeting, the agency received updates from five vaccine developers who have been working on candidate vaccines. WHO experts said that they will soon convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. So far the virus has claimed nine lives, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. “The critical next steps include getting full sequence information on the virus, which is being detected in Equatorial Guinea to use that for a number of different purposes,” said Philip R. Krause, chair of the WHO Covid Vaccines Research Expert Group, who led the meeting. In parallel, WHO will “rapidly” convene a vaccine prioritization committee, Krause said, to “consider updated information from vaccine developers and to simplify, which really means extract relevant sections from the vaccine clinical protocol for potentially use in Equatorial Guinea,” Krause said. He was referring to an already-approved WHO clinical trial protocol for Marburg vaccines, which would likely need adaptation to the context of the current outbreak. “Assuming we’ll proceed with clinical studies, and of course this is pending agreement and support from local authorities in Equatorial Guinea, assuming that such a study were to be done, it would be important to convene the prioritization committee to look at these in the context of most up-to-date information – to make decisions about which of these should be included in in such a study,” Krause said. Phil Krause at the WHO-led MARVAC meeting on Tuesday. The meeting came only a day after WHO officially confirmed the first-ever outbreak of Marburg haemorrhagic fever in Equatorial Guinea. That confirmation came a week after the country’s Health Ministry notified WHO of a suspected case that had first been reported on 7 January in the country’s Kie Ntem province. Vaccines in the pipeline At the meeting, the WHO experts reviewed the status of five active vaccine candidates against the virus. Two of the candidates, one developed by the Sabin Vaccine Institute and one by Janssen are in the Phase 1 clinical trials. The other three vaccine candidates being developed by International AIDS Vaccine Initiative (IAVI), Public Health Vaccines (PHV) and Auro Vaccines, are still in the pre-clinical stage of development. The five active vaccine candidates that are in development for Marburg disease. Babajide Keshinro of Janssen said that the company could mobilise 3500 doses of its Marburg vaccine candidate for WHO-led trials immediately in Equatorial Guinea. However, he stressed that the trials would have to begin within the next two months. Beyond that, the company does not yet have a firm estimate on the length of time the Janssen vaccine candidate remains stable. Matthew Duchars, speaking on behalf of the Sabin Vaccine Institute, told the committee that the Institute has up to 20,000 doses of active vaccine ingredient, which it was already planning to use for its own Phase2/3 trials later this year. “We have quite a reasonable amount of drug substance, which has been manufactured and is awaiting to be filled, and is probably up to about 20,000 doses from the bulk that’s currently made.” The Institute also had reserved “slots” with a number of vaccine manufacturers which could be “repurposed” to rapidly produce several hundred finished vials of the vaccine candidate for deployment in Equatorial Guinea. he added. Joan Fusco, of PHV, said that their vaccine candidate had just recently secured FDA approval for clinical testing and that they have around 350 vials ready for use. But they do not have further active manufacturing of the product planned at present. As for IAVI, Andi Kilansk said that the organization does not have “any available bulk drug, substance or field drug product.” Similarly, Auro Vaccines said it had no Clinical Trial Material (CTM) available at present, and that its own clinical trials had been planned only for later in the year. In relation to therapeutics, Dr Simon GP Funnell from the United Kingdom’s Health Security Agency, referred to a recent study that found a combination treatment of monoclonal antibodies and remdesivir performed better against the virus than individual drug agents. “A combination of monoclonal antibodies and remdesivir was better than either alone at Day 6. And that’s going to be a theme that’s carried forward,” he said. Index case on 7 January The index case of Marburg virus disease occurred on 7 January 2023, Dr George Ameh, country representative of WHO to Equatorial Guinea, told the meeting. However, the Country’s Health Ministry only notified WHO of the case on 7 February, with a definitive lab confirmation of the disease from a Senegalese laboratory on 13 February. “In total, there have been nine deaths associated with this outbreak, with established epidemiological links. Close family members, those who attended burials of these close family members…nine confirmed deaths as of today. We also have 16 suspected cases in quarantine and 15 asymptomatic contacts being closely followed up from their homes,” he said. Equatorial Guinea is located in west central Africa. Despite the month-long lag between the report of the suspected first case and notification to WHO, Dr Matshidiso Moeti, WHO Regional Director for Africa, praised the “rapid and decisive” action by Equatorial Guinean health authorities. “Marburg is highly infectious. Thanks to the rapid and decisive action by the Equatorial Guinean authorities in confirming the disease, emergency response can get to full steam quickly so that we save lives and halt the virus as soon as possible,” said Moeti. Marburg virus disease, also known as MVD, is a highly infectious disease that has a fatality ratio that can range between 24% and 88%. The virus, named after a town in Germany where the virus was first identified in 1967 after causing 29 infections and 7 deaths, belongs to the same family of filoviruses as Ebola. The virus is typically transmitted to humans by fruit bats, and then spread between humans through direct contact with bodily fluids of infected people, surfaces and materials. In Africa, outbreaks have been reported peridically in the Democratic Republic of Congo, Angola, Uganda – but never before in Equatorial Guinea. Common symptoms of Marburg disease include fever, fatigue, blood-stained vomit and diarrhoea, according to WHO. “Efforts are also underway to rapidly mount emergency response, with WHO deploying health emergency experts in epidemiology, case management, infection prevention, laboratory and risk communication to support the national response efforts and secure community collaboration in the outbreak control,” stated a WHO press release, published on Monday. “WHO is also facilitating the shipment of laboratory glove tents for sample testing as well as one viral haemorrhagic fever kit that includes personal protective equipment that can be used by 500 health workers.” Image Credits: WHO, Megha Kaveri, Alvaro1984 18, Public domain, via Wikimedia Commons. Five Priorities for Global Pandemic Preparedness 14/02/2023 Thomas B. Cueni The fourth Intergovernmental Negotiating Body (INB) meeting takes place 27 February; portrayed here, WHO member states at the second meeting 18-22 July 2022. On 27 February, World Health Organization member states will meet to commence formal negotiations on a global pandemic preparedness agreement – unofficially turning the page from responding to COVID-19 to readying ourselves for future health emergencies. While the Intergovernmental Negotiating Body (INB) of member states have already held a series of meetings, as well as stakeholder briefings, the negotiations at the end of the month hold special significance as they follow on from the publication of the “zero draft” of the envisioned international legal instrument. And with the aim of concluding a draft instrument by May 2024, the clock is already counting down. This is a huge undertaking, and millions of lives depend on learning the right lessons from our collective response to the COVID-19 pandemic. The pharmaceutical industry, which played an indispensable role in defeating COVID-19, recommends focusing on five priorities. Sustaining a thriving innovation ecosystem R&D of COVID-19 vaccines took place in record time. The first must be to maintain and reinforce the policies and systems that worked well these past three years – the innovation ecosystem undergirding our industry and the immediate unhindered access to pathogens and their genetic sequences. It was no accident that we had tests and potential vaccines and treatments in development within days of the sequence of the novel coronavirus published online – a record-breaking pace that saved an estimated 20 million lives in year one of the pandemic. Everything from the viral vector or mRNA technology behind the vaccines to the global supply chains that enabled unprecedented manufacturing scale-up wouldn’t have been possible without decades of large, risky investments in the international pharmaceutical sector. Yet today, the very system that allowed collaboration and innovation to thrive and deliver the solutions for the COVID-19 pandemic, is under attack. The World Trade Organization’s (WTO) June 2022 decision to waive international patent protections on the COVID-19 vaccines, and the ongoing discussions on extending this waiver to COVID-19 therapeutics and diagnostics, risk undermining the system, which was critical for the success in the fight against COVID-19. Attacks on IP at the WTO or in the zero draft of the accord fail to recognize the critical role that intellectual property frameworks play to incentivize research and facilitate voluntary partnerships, business-to-business agreements, and technology transfers. Proponents of these proposals oversimplify what the notion of “tech transfer” entails, and risk undermining, rather than facilitating our collective ability to rapidly develop and scale-up countermeasures. Furthermore, some countries seek to twist the UN’s Nagoya Protocol – a roughly decade-old pact that gives countries more rights and incentives over their native flora and fauna with the intention of protecting biodiversity – to restrict the flow of information about pathogens. The deliberate twisting of the protocol giving value to pathogens instead of protecting global health security is a bizarre and unprecedented threat to global health. Lest we forget, the system we had in place when COVID-19 arrived created multiple safe, effective vaccines against a novel, deadly contagion in a matter of months, produced billions of doses within a year, and has now delivered at least one dose to over 69% of the world’s 8 billion people. This is a record to build on, not to attack. Innovation and immediate access to pathogens should be at the center of all pandemic preparedness and response plan. Shaping a new ‘social contract’ Second, the world’s wealthiest nations must adopt a new framework for more equitable global distribution of vaccines and therapies. National leaders, morally accountable to their own citizens, can now nonetheless appreciate the value of global preparedness. As wave after wave of COVID-19 variants have taught wealthy nations, viruses do not respect economic advantage any more than they do geographic borders. Amidst a global contagion, none of us are safe until we all are. The framework that best reconciles different regions’ interests is one familiar to all democracies: the social contract under which citizens balance rights with responsibilities, independence with interdependence. Under a global pandemic preparedness “social contract”, pharmaceutical companies set aside stores of vaccines, treatments, and tests, based on real time production, for priority populations in lower-income countries. But for this to work, manufacturing countries need to allow part of what is produced in their territories to be exported to low-income countries in real-time. And of course, we need adequate funding upfront for organizations such as Gavi, the Vaccine Alliance, to sign contracts early on. Fostering sustainable manufacturing globally Third, Covid-19 showed how broad a global vaccine production program must be – and how much such a program depends on a stable legal and policy framework, which gives the confidence to parties to join forces, and share technology and know-how. The record is clear. By the end of 2022, pharmaceutical companies signed 381 vaccine manufacturing and production partnerships, and 150 more to produce COVID treatments – the vast majority of both involving technology transfer. To facilitate access and equity for the developing world, those partnerships included facilities based in India, Bangladesh, Egypt, and South Africa. The right enabling environment to attract sustainable investments and predictable demand will be critical to maintain existing capacity and introduce new capacity in other regions. Removing trade restrictions Fourth, the COVID-19 experience showed that when it comes to the development, manufacturing, and distribution of goods around the world, there is no substitute for free trade. Whatever arguments might exist for protectionist trade barriers in other sectors of the global economy, it is now obvious that those arguments do not apply to public health necessities in the middle of pandemics. Open trade saves lives. Ensuring greater country readiness And fifth, when it comes to global equity, the ability of less developed nations to absorb supplies is also paramount. These countries need help in strengthening their healthcare systems and making huge investments in health infrastructure to prevent, detect and respond to future threats while maintaining access to routine and essential services during a crisis. Later this month, WHO negotiators will be looking at all of the above – efficacy and equity, supply and demand, economic incentives and moral responsibilities – as members work to revise the current zero draft of a global pandemic Accord. Taking the time, here in this middle hour between crises, to get the policies and incentives right will yield the public health community the coordination, collaboration, and innovation we will need to overcome the inevitable next pandemic. ____________________ Thomas B Cueni, is the director general director general of the International Federation of Pharmaceutical Manufacturers and Associations. Image Credits: Pfizer, IFPMA . Vaccine Alliance Gavi Appoints Former Nigerian Health Minister as New CEO 13/02/2023 Kerry Cullinan Dr Muhammad Ali Pate, incoming Gavi CEO The global vaccine alliance, Gavi, has appointed former Nigerian health minister, Dr Muhammad Ali Pate, as its new CEO. Pate was Minister of State for Health in Nigeria between 2011 and 2013, where he led a national campaign to “revive routine immunisation and primary health care, chaired a presidential taskforce to eradicate polio and introduced new vaccines into the country”, according to Gavi. “It will be my privilege to lead Gavi and continue to support countries to scale up critical routine immunisation programmes, reach more zero-dose children, expand access to new vaccines, transform primary health care systems, and help fight outbreaks and future pandemics,” said Pate in a media release on Monday. He will join Gavi in August, replacing Dr Seth Berkley who has led the alliance for the past 12 years. Pate is a medical doctor trained in both internal medicine and infectious diseases who also has an MBA from Duke University in US. Between 2019 and 2021, he was the World Bank’s Global Director for Health, Nutrition and Population and headed the Global Financing Facility at the World Bank where he led the Bank’s $ 18 billion COVID-19 global health response. He is currently the Julio Frenk Professor of Public Health Leadership at Harvard Chan School of Public Health and has served on several health-focused boards and expert panels in the public, private and not-for-profit sectors during his career. Gavi undertook a year-long search for Berley’s replacement which was led by its board chair, Professor José Manuel Barroso. “Dr Pate stood out in a field of world-class candidates. With his knowledge and experience of both national immunization programming and international emergency response and global finance, I am confident that Gavi will continue to build on its vision and mission, as well as navigate the many challenges and opportunities we will face,” said Barroso. Meanwhile, Berkley described “leading Gavi and helping the alliance to continually surpass itself in terms of saving lives, protecting children and supporting countries during global health emergencies” as “the greatest honour of my career”. “I am confident in its future under Muhammad’s leadership. Having worked with him during his time as Minister and at the World Bank, I know he understands intimately the landscape we work in and will be uncompromising in his drive for public health equity,” added Berkley. Some important personal news: After leading @Gavi for the last 11+ yrs & for more than half of Gavi’s existence my term as @Gavi CEO will end in August. As a result, I’m delighted that today our Board confirmed @muhammadpate as our Alliance’s next leader https://t.co/EB06y2pcmM — Seth Berkley (@DrSethBerkley) February 13, 2023 Berkley has led Gavi since 2011, and during his tenure the alliance estimates that it has averted 11.8 million future deaths (compared to 4.5 million between 2000 and 2010); and has helped immunise more than 676 million children – more than double the 305 million children reached between 2000 and 2010. During his tenure, the alliance has added a number of new vaccines to its portfolio, including to prevent HPV, polio, cholera and malaria, and in its current strategy cycle is focusing on reaching zero-dose children across marginalised communities. “The economic result of Gavi’s expansion of activities during [Berkley’s] tenure has been profound, unlocking over $160 billion of economic benefits compared to $24 billion in its first 10 years.” Top 24 Multinational Companies’ Climate Pledges ‘Lack Integrity’ 13/02/2023 Kerry Cullinan The world’s biggest multinational companies are failing to meet the bold climate change pledges they have made – and are obfuscating their failures through “ambiguous commitments, offsetting plans that lack credibility and emission scope exclusions”. This is according to the Corporate Climate Responsibility Monitor 2023, which was released on Monday by Carbon Market Watch and NewClimate Institute. The report focuses on 24 multinational companies that have endorsed the Paris Agreement to ensure global warming does not exceed 1.5 degrees Celsius. Greenhouse gas and carbon emissions need to be cut by 43% and 48% respectively between 2019 and 2030 to limit the global temperature increase to 1.5°C, according to the Intergovernmental Panel on Climate Change (IPCC, 2022). But the companies’ targets only amount to a 15% reduction in “full value chain emissions between 2019 and 2030”. ‘Low integrity’ companies The climate strategies of American Airlines, Samsung Electronics, meat company JBS and retail and grocery multinational Carrefour were described as “very low integrity”. One rung up were the “low integrity” companies, including Amazon, DHL, Foxconn, Mercedes Benz, Pepsico, Volkswagen and Walmart. Their poor ratings were the result of “inadequacy or complete lack of explicit emission reduction commitments alongside ambiguous net-zero pledges”, according to the report. Apple, Arcelor Mittal, Google, H&M and Microsoft were some of the companies described as having “moderate integrity”, while shipping company Maersk was rated “reasonable” – the top rating of the companies. Together the 24 companies account for about 4% of all global greenhouse emissions. Substantial ‘greenwashing’ Warning of substantial “greenwashing”, the report called on “regulatory oversight at international, national and sectoral levels”. Speaking at the launch, Carbon Market Watch’s Lindsay Otis said that it had taken a team of accomplished researchers “a number of months” to understand the companies’ pledges and strategies. “Companies’ climate change commitments do not add up to what their pledges might suggest,” according to the report. Their 2030 targets can “rarely be taken at face value”, mainly because they focus on direct emissions or emissions from procured energy but exclude indirect emission categories that account for “over 90% of the greenhouse gas emission footprints for most of the companies we have assessed”. For others, 2030 targets are misleading due to reliance on offsetting. “The findings in our report suggest that many companies only plan to reduce a small share of their full emission footprint, relying instead on offsetting their remaining emissions with contentious carbon credits,” according to the report. “We find that at least three-quarters of the 24 sampled companies rely on forestry and land-use-related offsets. The demand for such carbon dioxide removals would exceed the potential of the world’s natural resource base by around two to four times if these practices would be replicated by other companies,” the report notes. “Moreover, these plans demonstrate the widespread lack of awareness that the biological storage of carbon is fundamentally unsuitable for offsetting claims due to the non-permanence of the climate impact.” Regulation “Companies must play a central role in finding and scaling up solutions for deep decarbonisation, but their efforts need urgent acceleration and appropriate regulatory frameworks,” according to the report. It cites the European Union’s Corporate Sustainability Reporting Directive, which enters into force this year 2023 and will introduce “tighter requirements for corporate climate strategies”. However, it calls for close monitored “to ensure a high standard of compliance”. ‘Be Loud’ About the Link Between Alcohol and Cancer 10/02/2023 Kristina Sperkova & Pubudu Sumanasekara Alcohol is linked to seven cancers, but public awareness of the links is low. Alcohol is the second biggest cause of cancer after tobacco, and Movendi is mobilizing communities worldwide to publicize the link At the WHO’s 152th Executive Board, an updated list of policy “best buys” to prevent and control non-communicable diseases (NCDs) was presented. The EB decided unanimously to adopt the updated list of cost-effective interventions in response to the lack of progress to prevent and reduce NCDs, as Health Policy Watch reported. Higher taxes and warning labels on unhealthy food, cigarettes and alcohol, and better screening for cancers, are some of the new “best buys” to accelerate action on NCDs, such as cancer, heart disease, diabetes, lung disease, and mental health conditions. No country is currently on track to achieve the 2030 global targets set by the World Health Assembly back in 2013, and the declaration by the UN General Assembly High-Level Meeting on NCDs in 2018 – including the 10% reduction of population-level alcohol use. One major public health problem that is worsening due to the lack of implementation of the NCDs best buys is cancer. Cancer kills nearly 10 million people a year, but the risk of dying from cancer varies greatly across the world. About 70% of these deaths are in low- and middle-income countries – and the disparity is worsening. For example, in Africa, cancer deaths are expected to more than double, reaching roughly 1.4 million deaths annually by 2040. Make a noise On World Cancer Day on 4 February, Movendi International launched an ambitious new campaign, “Be Loud For Change”. We are mobilizing communities around the world to make a noise about the direct link between alcohol and cancer, the low public recognition of the fact that alcohol causes seven types of cancer, and the unique opportunity for our governments to bring change through proven solutions. People want to know.People have a right to know.Alcohol causes 7 types of cancer.#loudforchange #WorldCancerDay #AlcoholHarms #CancerAwareness pic.twitter.com/jhaS9jJYdW — Movendi International (@Movendi_Int) February 4, 2023 Since 1988, alcohol – like tobacco and asbestos – has been scientifically proven to be a group one carcinogen. When humans consume ethanol in beer, wine, and liquor, the byproduct attacks the DNA. But the media found it difficult to report properly on the real effects of alcohol and instead helped the alcohol industry to keep people in the dark. After tobacco, alcohol is the second biggest cause of cancer – before other risk factors such as infections, physical inactivity, or sunlight. Globally, 740,000 people get cancer due to alcohol, each year. The alcohol industry wants to keep people in the dark about the fact that their products are as carcinogenic as cigarettes and asbestos. Research has shown that awareness of the link between alcohol and cancer is very low internationally. Alcohol companies are afraid of people becoming aware of the fact that ethanol in beer, wine, and liquor causes at least seven types of cancer. And so they fight tooth and nail against scientific studies, warning labels on alcohol products, and other alcohol policy solutions contained in the recently updated list of NCD best buys. The wide support of the WHO Executive Board and growing momentum for addressing cancer risk factors, such as alcohol, mean something significant: The world is experiencing a shift in awareness about alcohol harm, driven by growing awareness that alcohol causes cancer. And the world is experiencing a shift in perception of alcohol policy solutions. The alcohol policy best buys – raising alcohol taxes, banning alcohol advertising, limiting alcohol availability – help prevent diseases such as cancer and heart disease; they help strengthen health systems; and they boost economic growth. Alcohol taxes and warning labels This means, our governments can do a lot to bring about change. They can develop alcohol taxation systems that effectively protect people from alcohol harm, including cancer. For example, reducing total alcohol consumption by 10% would lead to a 9% reduction in alcohol-related cancer deaths. That means ca. 57.000 fewer deaths. Our governments can also put warning labels on alcoholic products informing about cancer, heart disease, and other alcohol harms. They can fund mass media campaigns to increase public recognition of the real harm due to alcohol. They can ban alcohol advertising, sponsorship, and promotion. And our governments can put in place common sense limits on the presence of alcohol in our communities. Our governments have proven solutions at their disposal. There has never been a better time for an ambitious approach to protect our societies from cancer caused by alcohol. Such an initiative will protect and improve the health and well-being of people and communities, it will strengthen our health systems as alcohol harms, such as cancer cases and deaths, decline, and will unlock fresh resources for investment in health promotion and disease prevention. Kristina Sperkova is International President of Movendi International Pubudu Sumanasekara is International Vice President of Movendi International Image Credits: Taylor Brandon/ Unsplash. Ukraine War Sparks Global Health Crisis 10/02/2023 Editorial team Over eight million Ukrainians have fled the country. Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues. “The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute. “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. “Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said. ‘Defend Europe’ Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”. “A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare. At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging. International food security Ukraine food crisis The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa. “Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt. The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added. While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found. “We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked. The role of international actors In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. Looking forward, international cooperation is also going to be crucial after the war ends. “[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.” First priority Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January. “Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” “We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged. Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted. “I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” “The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed. Mental health emergency People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges. “One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face. Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.” The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues. Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers. “It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. “Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.” “There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.” Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter . Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
WHO Denies it Abandoned Investigation of COVID-19 Origins – But Way Forward Unclear 15/02/2023 Megha Kaveri Dr Maria Van Kerkhove, speaking at Wednesday’s media briefing. A senior World Health Organization (WHO) official has emphatically denied that abandoned its investigation of the origins of the virus that caused the COVID-19 pandemic. The comment by Dr Maria Van Kerkhove, COVID-19 technical lead, was in response to a report published on Tuesday by Nature which stated that the agency has “quietly shelved” its plans to continue with its investigation of SARS-CoV2’s origins. due to the barriers to plans to conduct further, crucial studies in China. A controversial report by a joint Chinese and international mission to Wuhan, covering the first phase of the investigation was published in March 2021, But critics said glossed over China’s omission of key patient data from the early days of the outbreak in Wuhan. The report also declared that it was “extremely unlikely” that the virus could have escaped from a local research laboratory, without sufficient data or evidence to make such a determination, critics said. Subsequently, WHO laid plans for an extensive set of on-site, follow-up studies over the summer of 2021, including further assessment of Wuhan wild markets, the lab escape theory, and closer examination of early transmission patterns, based on blood samples from anonymized patient data. But China rejected those plans outright, and has remained unwilling to release further patient data or to let teams of researchers visit the country. In the Nature report, Van Kerkhove was quoted saying that WHO had in fact abandoned its plans for a Phase II of the COVID origin studies: “There is no phase two,” she reportedly said. While WHO protocols had called for extensive follow-up studies in China, “that plan has changed”, she added, saying: “The politics across the world of this really hampered progress on understanding the origins.” Speaking at Wednesday’s briefing, Van Kerkhove appeared to walk back on her comments, stating: “I think we need to be perfectly clear that WHO has not abandoned studying the origins of Covid 19. We have not, and we will not.” However, she also admitted that WHO’s “updated” plans for a second phase would have to take a more generalized approach to the origins question: “In a sense, phase two became the Scientific Advisory Group for the Origins of novel pathogens (SAGO),” she clarified. SAGO held its first meeting in November 2021 and was established as a permanent advisory group to work on drawing up a framework to understand the origins of not just COVID-19 but any future outbreaks. “So the creation of SAGO was in effect, our best effort to move this work forward.” China has evaded WHO’s requests for cooperation China continues to refuse WHO’s requests to release more data or to open its borders to scientific teams for further on-site investigations, Kerkhove also admitted. “Studies that were recommended from the March 2021-WHO report, from the June 2022-SAGO report and studies that we’ve been recommending at the animal human interface and markets, on farms need to be conducted in China. We need cooperation from our colleagues there to advance our understanding,” she added. Over the past year, WHO repeatedly called on China to cooperate in further SARS-CoV2 origin studies. Last month, WHO Director General Dr Tedros Adhanom Gheyebresus also appealed to Beijing to share more data about death rates and SARS-CoV2 variants ciculating in the country as the country was swept by a fresh COVID wave after removing its controversial “zero COVID” policy measures. Dr Tedros added that it remains crucial to understand the origins of the pandemic for scientific and moral reasons. “Millions of people lost their lives and many suffered. The whole world was taken hostage by a virus. It’s morally very important to know how we lost our loved ones. “Recently, seven weeks ago, I sent a letter to a top official in China, asking for cooperation because we need cooperation and transparency and the information we ask in order to know how this started,” he stated. But apparently so far, there has been no return mail. Image Credits: Megha Kaveri. ‘I Couldn’t Just Stand By’: Syrians Step up With Earthquake Aid Despite Pressures 15/02/2023 Safaa Sallal Bakier Soulo (right), 28, and his younger brother sleep rough with their families in a public square in the old city of Gaziantep. DAMASCUS/JABLEH – One week on from last week’s massive earthquakes, ordinary people across Syria – including in the large parts controlled by President Bashar al-Assad’s forces – have been scrambling to marshal whatever help they can for survivors, offering up their homes, supplies, and skills. While many of the areas al-Assad controls are further from the epicentres than the rebel-held northwest, the government-run region has still reported 1,414 deaths, and more than 92,000 people are staying in shelters there, according to UN figures. By Wednesday, the overall death toll across Türkiye and Syria had exceeded 40,000. Nearly 12 years of conflict, and a crippling economic crisis compounded by Western sanctions, are complicating citizen-led aid efforts. There are limits to what people dealing with spiralling inflation, mass poverty, and record fuel shortages can do to help each other. But – as is the case in Türkiye, where a rapid community response has been key to getting people through the first wintry days and nights after the earthquakes – that hasn’t stopped many Syrians from trying. Nour Othman, 29, works for a marketing company in Damascus. Hours after the first earthquake struck on 6 February, she found herself staring at heart-wrenching images of families buried under slabs of concrete, and wanted to do something. Othman took to a 360,000-strong Syrian Facebook group usually used for job opportunities, home rentals, and community announcements. She placed a different sort of post: She asked for clothing, medicine, blankets, and canned food, using the Arabic hashtag #OneHeart. The response was overwhelming. Within a few hours, donations began pouring in to her Damascus office, which she had posted as the drop-off point. She stopped working, converted the office into a makeshift warehouse, and within a day had collected 3,000 pieces of clothing, 15 boxes of medicine, and stacks of blankets. By the second day, Othman said, the total amount of aid weighed five tonnes. Volunteers have offered to drive them to those in need. “I felt sad and totally helpless watching what the media was reporting… There were women and children screaming, and others trapped under the rubble. I couldn’t just stand by,” Othman told The New Humanitarian. “The initiative is called ‘One Heart’ because Syrians have learned to support each other and be of one heart through thick and thin,” she added. Conflict fault lines and geopolitics Despite the initiative’s name, after more than a decade of war, the reality is that Syrians live in a deeply divided country. Parts – like Damascus, where Othman lives – are controlled by al-Assad and his forces. Much of the quake-hit northwest is controlled by rebel groups, including the terrorist-designated Hayat Tahrir al-Sham. The northeast, meanwhile, is run by Türkiye, Turkish-backed rebels, and Kurdish groups. All of this has an impact on how international and local aid flows, or doesn’t flow, through the country. UN-coordinated aid to the northwest arrives across the border from Türkiye, while Damascus is the main hub for assistance within the rest of government-controlled Syria. Getting aid from Damascus to rebel-held territory has been extremely slow or a non-starter, although al-Assad officials and the Syrian Arab Red Crescent (SARC) have said they are willing to deliver aid across the country. Late last week, the government approved an aid delivery across front lines to areas controlled by rebels in the northwest, but it is reportedly held up. Another of the issues that could delay direct relief to Syrians across the country is Western sanctions, although last week the United States said it was granting a temporary exemption to “all transactions related to earthquake relief” that would otherwise be banned by sanctions meant to target al-Assad and those close to him. Dozens of white tents have been erected outside Gaziantep’s train station to host hundreds of Turks and Syrians whose homes were destroyed by the earthquakes. A surge in support For civilians collecting aid – like Othman – all of this means that the supplies she’s giving out will head only to the large parts of the country controlled by al-Assad. That includes Jableh, a coastal city about 25 kilometres south of Latakia, where Nada al-Halabi lived in a four-storey building – until it crumbled in the earthquakes. Standing outside her building on 9 February, a few days after disaster struck, she told The New Humanitarian she was still in shock. Rescue teams had pulled 10 dead bodies from the heap of rubble; two children of families in the building were missing. “At the moment of the earthquake, I was asleep. I only heard the sound of the earth roaring,” said al-Halabi, wiping away a tear with a handkerchief. In an 8 February news conference, Hussein Makhlouf, Syria’s minister of local administration and environment – the man charged with overseeing the government’s response – said 180 shelters would be set up across the country. Local NGOs, the SARC, and UN agencies have been handing out hot meals and various relief supplies, but much of the early aid effort has been spearheaded by ordinary citizens like Othman. In light of the country’s economic crisis, this is especially notable: Between 2010 and 2019, Syria’s GDP shrunk by more than half. The local currency lost 44% of its value in 2022, and food prices have nearly doubled over the past year. More than 90% of Syrians now live below the poverty line. While people living in northern Syria have been the most impacted by the economic collapse, the situation has now become so bad that Syrians in places across the country that had been doing relatively well are now also feeling the pain. While some help with goods, others are assisting with their professional skills. Over the past week, Syrian civil engineers launched a group to provide free consultations for buildings damaged by the earthquake. They’re offering on-site inspections to assess if cracked structures are still safe to live in. For concerned residents looking for quick answers, the engineers are rushing to assess any photos they can send in. The war, and years of sanctions, have decimated Syria’s stock of construction equipment and other machinery that may have helped with search and rescue, or later with reconstruction efforts. Fuel prices are also at an all-time high, and shortages mean there might not be enough to run the little equipment that is available. To do his part, Jableh resident Abu Ayman al-Khaminsi gave his 30-year-old son his tractor and a demand: “Go clear rubble and find survivors!” To power it amid the fuel shortages, al-Khaminsi syphoned off the diesel that was meant to heat his home. “I can’t use this diesel for warmth and keep my tractor parked here when there are people suffering,” al-Khaminsi said. “I’m not healthy enough to help the rescue efforts, but I’ll give everything I have.” ‘We’re meant to support one another’ Not everyone has a tractor or extra food to give, so they are doing what they can. Twenty-year-old Walaa Tamin has opened up her home in Latakia, the port city that was badly damaged by the earthquake. “If anyone has no place to go, our house is open. We’re meant to support one another, and you are welcome here,” Tamin posted on Facebook. Similar offers are popping up across the country. Two families are now sleeping in Tamin’s living room, choosing to sleep closest to the exit in case there’s another earthquake. There have also been locally-led blood drives, and one Damascus-based relief organisation said it was receiving money from expatriates to buy aid supplies. In Latakia, Ghazwan Muhammed, 34, set up a soup kitchen with three of his friends to get food out to hungry survivors. “We are all grieving right now,” he said. This instinct to pitch in is shared by many. While walking through the Damascus streets, Khaled Abu Wissam, 30, spotted the bustling “One Heart” drop site set up by Othman. He had nothing to hand so he took off his winter jacket and tossed it in, despite the wintry weather and ice-cold rain. “When I saw people handing over bags of donations, I couldn’t just go on my way,” Abu Wissam explained. “My Syrian brothers are freezing in the cold.” This story was originally published by The New Humanitarian. This article was produced in collaboration with Egab, which connects journalists from the Middle East and North Africa with news organisations worldwide. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Abdulsalam Jarroud/TNH. WHO Aims to Accelerate Trials of Vaccine Candidates for Marburg Disease as Equatorial Guinea Reports Nine Deaths 14/02/2023 Megha Kaveri Health workers in protective gear during the Marburg outbreak in Guinea in 2021. Following a first-ever outbreak of deadly Marburg virus disease in Equatorial Guinea, the World Health Organization (WHO) on Tuesday called an emergency meeting of the Marburg virus vaccine consortium (MARVAC) to receive an urgent update on possible vaccine candidates for the filovirus that can have an 80% fatality rate. At the meeting, the agency received updates from five vaccine developers who have been working on candidate vaccines. WHO experts said that they will soon convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. So far the virus has claimed nine lives, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. “The critical next steps include getting full sequence information on the virus, which is being detected in Equatorial Guinea to use that for a number of different purposes,” said Philip R. Krause, chair of the WHO Covid Vaccines Research Expert Group, who led the meeting. In parallel, WHO will “rapidly” convene a vaccine prioritization committee, Krause said, to “consider updated information from vaccine developers and to simplify, which really means extract relevant sections from the vaccine clinical protocol for potentially use in Equatorial Guinea,” Krause said. He was referring to an already-approved WHO clinical trial protocol for Marburg vaccines, which would likely need adaptation to the context of the current outbreak. “Assuming we’ll proceed with clinical studies, and of course this is pending agreement and support from local authorities in Equatorial Guinea, assuming that such a study were to be done, it would be important to convene the prioritization committee to look at these in the context of most up-to-date information – to make decisions about which of these should be included in in such a study,” Krause said. Phil Krause at the WHO-led MARVAC meeting on Tuesday. The meeting came only a day after WHO officially confirmed the first-ever outbreak of Marburg haemorrhagic fever in Equatorial Guinea. That confirmation came a week after the country’s Health Ministry notified WHO of a suspected case that had first been reported on 7 January in the country’s Kie Ntem province. Vaccines in the pipeline At the meeting, the WHO experts reviewed the status of five active vaccine candidates against the virus. Two of the candidates, one developed by the Sabin Vaccine Institute and one by Janssen are in the Phase 1 clinical trials. The other three vaccine candidates being developed by International AIDS Vaccine Initiative (IAVI), Public Health Vaccines (PHV) and Auro Vaccines, are still in the pre-clinical stage of development. The five active vaccine candidates that are in development for Marburg disease. Babajide Keshinro of Janssen said that the company could mobilise 3500 doses of its Marburg vaccine candidate for WHO-led trials immediately in Equatorial Guinea. However, he stressed that the trials would have to begin within the next two months. Beyond that, the company does not yet have a firm estimate on the length of time the Janssen vaccine candidate remains stable. Matthew Duchars, speaking on behalf of the Sabin Vaccine Institute, told the committee that the Institute has up to 20,000 doses of active vaccine ingredient, which it was already planning to use for its own Phase2/3 trials later this year. “We have quite a reasonable amount of drug substance, which has been manufactured and is awaiting to be filled, and is probably up to about 20,000 doses from the bulk that’s currently made.” The Institute also had reserved “slots” with a number of vaccine manufacturers which could be “repurposed” to rapidly produce several hundred finished vials of the vaccine candidate for deployment in Equatorial Guinea. he added. Joan Fusco, of PHV, said that their vaccine candidate had just recently secured FDA approval for clinical testing and that they have around 350 vials ready for use. But they do not have further active manufacturing of the product planned at present. As for IAVI, Andi Kilansk said that the organization does not have “any available bulk drug, substance or field drug product.” Similarly, Auro Vaccines said it had no Clinical Trial Material (CTM) available at present, and that its own clinical trials had been planned only for later in the year. In relation to therapeutics, Dr Simon GP Funnell from the United Kingdom’s Health Security Agency, referred to a recent study that found a combination treatment of monoclonal antibodies and remdesivir performed better against the virus than individual drug agents. “A combination of monoclonal antibodies and remdesivir was better than either alone at Day 6. And that’s going to be a theme that’s carried forward,” he said. Index case on 7 January The index case of Marburg virus disease occurred on 7 January 2023, Dr George Ameh, country representative of WHO to Equatorial Guinea, told the meeting. However, the Country’s Health Ministry only notified WHO of the case on 7 February, with a definitive lab confirmation of the disease from a Senegalese laboratory on 13 February. “In total, there have been nine deaths associated with this outbreak, with established epidemiological links. Close family members, those who attended burials of these close family members…nine confirmed deaths as of today. We also have 16 suspected cases in quarantine and 15 asymptomatic contacts being closely followed up from their homes,” he said. Equatorial Guinea is located in west central Africa. Despite the month-long lag between the report of the suspected first case and notification to WHO, Dr Matshidiso Moeti, WHO Regional Director for Africa, praised the “rapid and decisive” action by Equatorial Guinean health authorities. “Marburg is highly infectious. Thanks to the rapid and decisive action by the Equatorial Guinean authorities in confirming the disease, emergency response can get to full steam quickly so that we save lives and halt the virus as soon as possible,” said Moeti. Marburg virus disease, also known as MVD, is a highly infectious disease that has a fatality ratio that can range between 24% and 88%. The virus, named after a town in Germany where the virus was first identified in 1967 after causing 29 infections and 7 deaths, belongs to the same family of filoviruses as Ebola. The virus is typically transmitted to humans by fruit bats, and then spread between humans through direct contact with bodily fluids of infected people, surfaces and materials. In Africa, outbreaks have been reported peridically in the Democratic Republic of Congo, Angola, Uganda – but never before in Equatorial Guinea. Common symptoms of Marburg disease include fever, fatigue, blood-stained vomit and diarrhoea, according to WHO. “Efforts are also underway to rapidly mount emergency response, with WHO deploying health emergency experts in epidemiology, case management, infection prevention, laboratory and risk communication to support the national response efforts and secure community collaboration in the outbreak control,” stated a WHO press release, published on Monday. “WHO is also facilitating the shipment of laboratory glove tents for sample testing as well as one viral haemorrhagic fever kit that includes personal protective equipment that can be used by 500 health workers.” Image Credits: WHO, Megha Kaveri, Alvaro1984 18, Public domain, via Wikimedia Commons. Five Priorities for Global Pandemic Preparedness 14/02/2023 Thomas B. Cueni The fourth Intergovernmental Negotiating Body (INB) meeting takes place 27 February; portrayed here, WHO member states at the second meeting 18-22 July 2022. On 27 February, World Health Organization member states will meet to commence formal negotiations on a global pandemic preparedness agreement – unofficially turning the page from responding to COVID-19 to readying ourselves for future health emergencies. While the Intergovernmental Negotiating Body (INB) of member states have already held a series of meetings, as well as stakeholder briefings, the negotiations at the end of the month hold special significance as they follow on from the publication of the “zero draft” of the envisioned international legal instrument. And with the aim of concluding a draft instrument by May 2024, the clock is already counting down. This is a huge undertaking, and millions of lives depend on learning the right lessons from our collective response to the COVID-19 pandemic. The pharmaceutical industry, which played an indispensable role in defeating COVID-19, recommends focusing on five priorities. Sustaining a thriving innovation ecosystem R&D of COVID-19 vaccines took place in record time. The first must be to maintain and reinforce the policies and systems that worked well these past three years – the innovation ecosystem undergirding our industry and the immediate unhindered access to pathogens and their genetic sequences. It was no accident that we had tests and potential vaccines and treatments in development within days of the sequence of the novel coronavirus published online – a record-breaking pace that saved an estimated 20 million lives in year one of the pandemic. Everything from the viral vector or mRNA technology behind the vaccines to the global supply chains that enabled unprecedented manufacturing scale-up wouldn’t have been possible without decades of large, risky investments in the international pharmaceutical sector. Yet today, the very system that allowed collaboration and innovation to thrive and deliver the solutions for the COVID-19 pandemic, is under attack. The World Trade Organization’s (WTO) June 2022 decision to waive international patent protections on the COVID-19 vaccines, and the ongoing discussions on extending this waiver to COVID-19 therapeutics and diagnostics, risk undermining the system, which was critical for the success in the fight against COVID-19. Attacks on IP at the WTO or in the zero draft of the accord fail to recognize the critical role that intellectual property frameworks play to incentivize research and facilitate voluntary partnerships, business-to-business agreements, and technology transfers. Proponents of these proposals oversimplify what the notion of “tech transfer” entails, and risk undermining, rather than facilitating our collective ability to rapidly develop and scale-up countermeasures. Furthermore, some countries seek to twist the UN’s Nagoya Protocol – a roughly decade-old pact that gives countries more rights and incentives over their native flora and fauna with the intention of protecting biodiversity – to restrict the flow of information about pathogens. The deliberate twisting of the protocol giving value to pathogens instead of protecting global health security is a bizarre and unprecedented threat to global health. Lest we forget, the system we had in place when COVID-19 arrived created multiple safe, effective vaccines against a novel, deadly contagion in a matter of months, produced billions of doses within a year, and has now delivered at least one dose to over 69% of the world’s 8 billion people. This is a record to build on, not to attack. Innovation and immediate access to pathogens should be at the center of all pandemic preparedness and response plan. Shaping a new ‘social contract’ Second, the world’s wealthiest nations must adopt a new framework for more equitable global distribution of vaccines and therapies. National leaders, morally accountable to their own citizens, can now nonetheless appreciate the value of global preparedness. As wave after wave of COVID-19 variants have taught wealthy nations, viruses do not respect economic advantage any more than they do geographic borders. Amidst a global contagion, none of us are safe until we all are. The framework that best reconciles different regions’ interests is one familiar to all democracies: the social contract under which citizens balance rights with responsibilities, independence with interdependence. Under a global pandemic preparedness “social contract”, pharmaceutical companies set aside stores of vaccines, treatments, and tests, based on real time production, for priority populations in lower-income countries. But for this to work, manufacturing countries need to allow part of what is produced in their territories to be exported to low-income countries in real-time. And of course, we need adequate funding upfront for organizations such as Gavi, the Vaccine Alliance, to sign contracts early on. Fostering sustainable manufacturing globally Third, Covid-19 showed how broad a global vaccine production program must be – and how much such a program depends on a stable legal and policy framework, which gives the confidence to parties to join forces, and share technology and know-how. The record is clear. By the end of 2022, pharmaceutical companies signed 381 vaccine manufacturing and production partnerships, and 150 more to produce COVID treatments – the vast majority of both involving technology transfer. To facilitate access and equity for the developing world, those partnerships included facilities based in India, Bangladesh, Egypt, and South Africa. The right enabling environment to attract sustainable investments and predictable demand will be critical to maintain existing capacity and introduce new capacity in other regions. Removing trade restrictions Fourth, the COVID-19 experience showed that when it comes to the development, manufacturing, and distribution of goods around the world, there is no substitute for free trade. Whatever arguments might exist for protectionist trade barriers in other sectors of the global economy, it is now obvious that those arguments do not apply to public health necessities in the middle of pandemics. Open trade saves lives. Ensuring greater country readiness And fifth, when it comes to global equity, the ability of less developed nations to absorb supplies is also paramount. These countries need help in strengthening their healthcare systems and making huge investments in health infrastructure to prevent, detect and respond to future threats while maintaining access to routine and essential services during a crisis. Later this month, WHO negotiators will be looking at all of the above – efficacy and equity, supply and demand, economic incentives and moral responsibilities – as members work to revise the current zero draft of a global pandemic Accord. Taking the time, here in this middle hour between crises, to get the policies and incentives right will yield the public health community the coordination, collaboration, and innovation we will need to overcome the inevitable next pandemic. ____________________ Thomas B Cueni, is the director general director general of the International Federation of Pharmaceutical Manufacturers and Associations. Image Credits: Pfizer, IFPMA . Vaccine Alliance Gavi Appoints Former Nigerian Health Minister as New CEO 13/02/2023 Kerry Cullinan Dr Muhammad Ali Pate, incoming Gavi CEO The global vaccine alliance, Gavi, has appointed former Nigerian health minister, Dr Muhammad Ali Pate, as its new CEO. Pate was Minister of State for Health in Nigeria between 2011 and 2013, where he led a national campaign to “revive routine immunisation and primary health care, chaired a presidential taskforce to eradicate polio and introduced new vaccines into the country”, according to Gavi. “It will be my privilege to lead Gavi and continue to support countries to scale up critical routine immunisation programmes, reach more zero-dose children, expand access to new vaccines, transform primary health care systems, and help fight outbreaks and future pandemics,” said Pate in a media release on Monday. He will join Gavi in August, replacing Dr Seth Berkley who has led the alliance for the past 12 years. Pate is a medical doctor trained in both internal medicine and infectious diseases who also has an MBA from Duke University in US. Between 2019 and 2021, he was the World Bank’s Global Director for Health, Nutrition and Population and headed the Global Financing Facility at the World Bank where he led the Bank’s $ 18 billion COVID-19 global health response. He is currently the Julio Frenk Professor of Public Health Leadership at Harvard Chan School of Public Health and has served on several health-focused boards and expert panels in the public, private and not-for-profit sectors during his career. Gavi undertook a year-long search for Berley’s replacement which was led by its board chair, Professor José Manuel Barroso. “Dr Pate stood out in a field of world-class candidates. With his knowledge and experience of both national immunization programming and international emergency response and global finance, I am confident that Gavi will continue to build on its vision and mission, as well as navigate the many challenges and opportunities we will face,” said Barroso. Meanwhile, Berkley described “leading Gavi and helping the alliance to continually surpass itself in terms of saving lives, protecting children and supporting countries during global health emergencies” as “the greatest honour of my career”. “I am confident in its future under Muhammad’s leadership. Having worked with him during his time as Minister and at the World Bank, I know he understands intimately the landscape we work in and will be uncompromising in his drive for public health equity,” added Berkley. Some important personal news: After leading @Gavi for the last 11+ yrs & for more than half of Gavi’s existence my term as @Gavi CEO will end in August. As a result, I’m delighted that today our Board confirmed @muhammadpate as our Alliance’s next leader https://t.co/EB06y2pcmM — Seth Berkley (@DrSethBerkley) February 13, 2023 Berkley has led Gavi since 2011, and during his tenure the alliance estimates that it has averted 11.8 million future deaths (compared to 4.5 million between 2000 and 2010); and has helped immunise more than 676 million children – more than double the 305 million children reached between 2000 and 2010. During his tenure, the alliance has added a number of new vaccines to its portfolio, including to prevent HPV, polio, cholera and malaria, and in its current strategy cycle is focusing on reaching zero-dose children across marginalised communities. “The economic result of Gavi’s expansion of activities during [Berkley’s] tenure has been profound, unlocking over $160 billion of economic benefits compared to $24 billion in its first 10 years.” Top 24 Multinational Companies’ Climate Pledges ‘Lack Integrity’ 13/02/2023 Kerry Cullinan The world’s biggest multinational companies are failing to meet the bold climate change pledges they have made – and are obfuscating their failures through “ambiguous commitments, offsetting plans that lack credibility and emission scope exclusions”. This is according to the Corporate Climate Responsibility Monitor 2023, which was released on Monday by Carbon Market Watch and NewClimate Institute. The report focuses on 24 multinational companies that have endorsed the Paris Agreement to ensure global warming does not exceed 1.5 degrees Celsius. Greenhouse gas and carbon emissions need to be cut by 43% and 48% respectively between 2019 and 2030 to limit the global temperature increase to 1.5°C, according to the Intergovernmental Panel on Climate Change (IPCC, 2022). But the companies’ targets only amount to a 15% reduction in “full value chain emissions between 2019 and 2030”. ‘Low integrity’ companies The climate strategies of American Airlines, Samsung Electronics, meat company JBS and retail and grocery multinational Carrefour were described as “very low integrity”. One rung up were the “low integrity” companies, including Amazon, DHL, Foxconn, Mercedes Benz, Pepsico, Volkswagen and Walmart. Their poor ratings were the result of “inadequacy or complete lack of explicit emission reduction commitments alongside ambiguous net-zero pledges”, according to the report. Apple, Arcelor Mittal, Google, H&M and Microsoft were some of the companies described as having “moderate integrity”, while shipping company Maersk was rated “reasonable” – the top rating of the companies. Together the 24 companies account for about 4% of all global greenhouse emissions. Substantial ‘greenwashing’ Warning of substantial “greenwashing”, the report called on “regulatory oversight at international, national and sectoral levels”. Speaking at the launch, Carbon Market Watch’s Lindsay Otis said that it had taken a team of accomplished researchers “a number of months” to understand the companies’ pledges and strategies. “Companies’ climate change commitments do not add up to what their pledges might suggest,” according to the report. Their 2030 targets can “rarely be taken at face value”, mainly because they focus on direct emissions or emissions from procured energy but exclude indirect emission categories that account for “over 90% of the greenhouse gas emission footprints for most of the companies we have assessed”. For others, 2030 targets are misleading due to reliance on offsetting. “The findings in our report suggest that many companies only plan to reduce a small share of their full emission footprint, relying instead on offsetting their remaining emissions with contentious carbon credits,” according to the report. “We find that at least three-quarters of the 24 sampled companies rely on forestry and land-use-related offsets. The demand for such carbon dioxide removals would exceed the potential of the world’s natural resource base by around two to four times if these practices would be replicated by other companies,” the report notes. “Moreover, these plans demonstrate the widespread lack of awareness that the biological storage of carbon is fundamentally unsuitable for offsetting claims due to the non-permanence of the climate impact.” Regulation “Companies must play a central role in finding and scaling up solutions for deep decarbonisation, but their efforts need urgent acceleration and appropriate regulatory frameworks,” according to the report. It cites the European Union’s Corporate Sustainability Reporting Directive, which enters into force this year 2023 and will introduce “tighter requirements for corporate climate strategies”. However, it calls for close monitored “to ensure a high standard of compliance”. ‘Be Loud’ About the Link Between Alcohol and Cancer 10/02/2023 Kristina Sperkova & Pubudu Sumanasekara Alcohol is linked to seven cancers, but public awareness of the links is low. Alcohol is the second biggest cause of cancer after tobacco, and Movendi is mobilizing communities worldwide to publicize the link At the WHO’s 152th Executive Board, an updated list of policy “best buys” to prevent and control non-communicable diseases (NCDs) was presented. The EB decided unanimously to adopt the updated list of cost-effective interventions in response to the lack of progress to prevent and reduce NCDs, as Health Policy Watch reported. Higher taxes and warning labels on unhealthy food, cigarettes and alcohol, and better screening for cancers, are some of the new “best buys” to accelerate action on NCDs, such as cancer, heart disease, diabetes, lung disease, and mental health conditions. No country is currently on track to achieve the 2030 global targets set by the World Health Assembly back in 2013, and the declaration by the UN General Assembly High-Level Meeting on NCDs in 2018 – including the 10% reduction of population-level alcohol use. One major public health problem that is worsening due to the lack of implementation of the NCDs best buys is cancer. Cancer kills nearly 10 million people a year, but the risk of dying from cancer varies greatly across the world. About 70% of these deaths are in low- and middle-income countries – and the disparity is worsening. For example, in Africa, cancer deaths are expected to more than double, reaching roughly 1.4 million deaths annually by 2040. Make a noise On World Cancer Day on 4 February, Movendi International launched an ambitious new campaign, “Be Loud For Change”. We are mobilizing communities around the world to make a noise about the direct link between alcohol and cancer, the low public recognition of the fact that alcohol causes seven types of cancer, and the unique opportunity for our governments to bring change through proven solutions. People want to know.People have a right to know.Alcohol causes 7 types of cancer.#loudforchange #WorldCancerDay #AlcoholHarms #CancerAwareness pic.twitter.com/jhaS9jJYdW — Movendi International (@Movendi_Int) February 4, 2023 Since 1988, alcohol – like tobacco and asbestos – has been scientifically proven to be a group one carcinogen. When humans consume ethanol in beer, wine, and liquor, the byproduct attacks the DNA. But the media found it difficult to report properly on the real effects of alcohol and instead helped the alcohol industry to keep people in the dark. After tobacco, alcohol is the second biggest cause of cancer – before other risk factors such as infections, physical inactivity, or sunlight. Globally, 740,000 people get cancer due to alcohol, each year. The alcohol industry wants to keep people in the dark about the fact that their products are as carcinogenic as cigarettes and asbestos. Research has shown that awareness of the link between alcohol and cancer is very low internationally. Alcohol companies are afraid of people becoming aware of the fact that ethanol in beer, wine, and liquor causes at least seven types of cancer. And so they fight tooth and nail against scientific studies, warning labels on alcohol products, and other alcohol policy solutions contained in the recently updated list of NCD best buys. The wide support of the WHO Executive Board and growing momentum for addressing cancer risk factors, such as alcohol, mean something significant: The world is experiencing a shift in awareness about alcohol harm, driven by growing awareness that alcohol causes cancer. And the world is experiencing a shift in perception of alcohol policy solutions. The alcohol policy best buys – raising alcohol taxes, banning alcohol advertising, limiting alcohol availability – help prevent diseases such as cancer and heart disease; they help strengthen health systems; and they boost economic growth. Alcohol taxes and warning labels This means, our governments can do a lot to bring about change. They can develop alcohol taxation systems that effectively protect people from alcohol harm, including cancer. For example, reducing total alcohol consumption by 10% would lead to a 9% reduction in alcohol-related cancer deaths. That means ca. 57.000 fewer deaths. Our governments can also put warning labels on alcoholic products informing about cancer, heart disease, and other alcohol harms. They can fund mass media campaigns to increase public recognition of the real harm due to alcohol. They can ban alcohol advertising, sponsorship, and promotion. And our governments can put in place common sense limits on the presence of alcohol in our communities. Our governments have proven solutions at their disposal. There has never been a better time for an ambitious approach to protect our societies from cancer caused by alcohol. Such an initiative will protect and improve the health and well-being of people and communities, it will strengthen our health systems as alcohol harms, such as cancer cases and deaths, decline, and will unlock fresh resources for investment in health promotion and disease prevention. Kristina Sperkova is International President of Movendi International Pubudu Sumanasekara is International Vice President of Movendi International Image Credits: Taylor Brandon/ Unsplash. Ukraine War Sparks Global Health Crisis 10/02/2023 Editorial team Over eight million Ukrainians have fled the country. Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues. “The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute. “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. “Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said. ‘Defend Europe’ Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”. “A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare. At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging. International food security Ukraine food crisis The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa. “Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt. The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added. While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found. “We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked. The role of international actors In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. Looking forward, international cooperation is also going to be crucial after the war ends. “[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.” First priority Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January. “Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” “We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged. Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted. “I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” “The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed. Mental health emergency People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges. “One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face. Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.” The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues. Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers. “It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. “Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.” “There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.” Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter . Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
‘I Couldn’t Just Stand By’: Syrians Step up With Earthquake Aid Despite Pressures 15/02/2023 Safaa Sallal Bakier Soulo (right), 28, and his younger brother sleep rough with their families in a public square in the old city of Gaziantep. DAMASCUS/JABLEH – One week on from last week’s massive earthquakes, ordinary people across Syria – including in the large parts controlled by President Bashar al-Assad’s forces – have been scrambling to marshal whatever help they can for survivors, offering up their homes, supplies, and skills. While many of the areas al-Assad controls are further from the epicentres than the rebel-held northwest, the government-run region has still reported 1,414 deaths, and more than 92,000 people are staying in shelters there, according to UN figures. By Wednesday, the overall death toll across Türkiye and Syria had exceeded 40,000. Nearly 12 years of conflict, and a crippling economic crisis compounded by Western sanctions, are complicating citizen-led aid efforts. There are limits to what people dealing with spiralling inflation, mass poverty, and record fuel shortages can do to help each other. But – as is the case in Türkiye, where a rapid community response has been key to getting people through the first wintry days and nights after the earthquakes – that hasn’t stopped many Syrians from trying. Nour Othman, 29, works for a marketing company in Damascus. Hours after the first earthquake struck on 6 February, she found herself staring at heart-wrenching images of families buried under slabs of concrete, and wanted to do something. Othman took to a 360,000-strong Syrian Facebook group usually used for job opportunities, home rentals, and community announcements. She placed a different sort of post: She asked for clothing, medicine, blankets, and canned food, using the Arabic hashtag #OneHeart. The response was overwhelming. Within a few hours, donations began pouring in to her Damascus office, which she had posted as the drop-off point. She stopped working, converted the office into a makeshift warehouse, and within a day had collected 3,000 pieces of clothing, 15 boxes of medicine, and stacks of blankets. By the second day, Othman said, the total amount of aid weighed five tonnes. Volunteers have offered to drive them to those in need. “I felt sad and totally helpless watching what the media was reporting… There were women and children screaming, and others trapped under the rubble. I couldn’t just stand by,” Othman told The New Humanitarian. “The initiative is called ‘One Heart’ because Syrians have learned to support each other and be of one heart through thick and thin,” she added. Conflict fault lines and geopolitics Despite the initiative’s name, after more than a decade of war, the reality is that Syrians live in a deeply divided country. Parts – like Damascus, where Othman lives – are controlled by al-Assad and his forces. Much of the quake-hit northwest is controlled by rebel groups, including the terrorist-designated Hayat Tahrir al-Sham. The northeast, meanwhile, is run by Türkiye, Turkish-backed rebels, and Kurdish groups. All of this has an impact on how international and local aid flows, or doesn’t flow, through the country. UN-coordinated aid to the northwest arrives across the border from Türkiye, while Damascus is the main hub for assistance within the rest of government-controlled Syria. Getting aid from Damascus to rebel-held territory has been extremely slow or a non-starter, although al-Assad officials and the Syrian Arab Red Crescent (SARC) have said they are willing to deliver aid across the country. Late last week, the government approved an aid delivery across front lines to areas controlled by rebels in the northwest, but it is reportedly held up. Another of the issues that could delay direct relief to Syrians across the country is Western sanctions, although last week the United States said it was granting a temporary exemption to “all transactions related to earthquake relief” that would otherwise be banned by sanctions meant to target al-Assad and those close to him. Dozens of white tents have been erected outside Gaziantep’s train station to host hundreds of Turks and Syrians whose homes were destroyed by the earthquakes. A surge in support For civilians collecting aid – like Othman – all of this means that the supplies she’s giving out will head only to the large parts of the country controlled by al-Assad. That includes Jableh, a coastal city about 25 kilometres south of Latakia, where Nada al-Halabi lived in a four-storey building – until it crumbled in the earthquakes. Standing outside her building on 9 February, a few days after disaster struck, she told The New Humanitarian she was still in shock. Rescue teams had pulled 10 dead bodies from the heap of rubble; two children of families in the building were missing. “At the moment of the earthquake, I was asleep. I only heard the sound of the earth roaring,” said al-Halabi, wiping away a tear with a handkerchief. In an 8 February news conference, Hussein Makhlouf, Syria’s minister of local administration and environment – the man charged with overseeing the government’s response – said 180 shelters would be set up across the country. Local NGOs, the SARC, and UN agencies have been handing out hot meals and various relief supplies, but much of the early aid effort has been spearheaded by ordinary citizens like Othman. In light of the country’s economic crisis, this is especially notable: Between 2010 and 2019, Syria’s GDP shrunk by more than half. The local currency lost 44% of its value in 2022, and food prices have nearly doubled over the past year. More than 90% of Syrians now live below the poverty line. While people living in northern Syria have been the most impacted by the economic collapse, the situation has now become so bad that Syrians in places across the country that had been doing relatively well are now also feeling the pain. While some help with goods, others are assisting with their professional skills. Over the past week, Syrian civil engineers launched a group to provide free consultations for buildings damaged by the earthquake. They’re offering on-site inspections to assess if cracked structures are still safe to live in. For concerned residents looking for quick answers, the engineers are rushing to assess any photos they can send in. The war, and years of sanctions, have decimated Syria’s stock of construction equipment and other machinery that may have helped with search and rescue, or later with reconstruction efforts. Fuel prices are also at an all-time high, and shortages mean there might not be enough to run the little equipment that is available. To do his part, Jableh resident Abu Ayman al-Khaminsi gave his 30-year-old son his tractor and a demand: “Go clear rubble and find survivors!” To power it amid the fuel shortages, al-Khaminsi syphoned off the diesel that was meant to heat his home. “I can’t use this diesel for warmth and keep my tractor parked here when there are people suffering,” al-Khaminsi said. “I’m not healthy enough to help the rescue efforts, but I’ll give everything I have.” ‘We’re meant to support one another’ Not everyone has a tractor or extra food to give, so they are doing what they can. Twenty-year-old Walaa Tamin has opened up her home in Latakia, the port city that was badly damaged by the earthquake. “If anyone has no place to go, our house is open. We’re meant to support one another, and you are welcome here,” Tamin posted on Facebook. Similar offers are popping up across the country. Two families are now sleeping in Tamin’s living room, choosing to sleep closest to the exit in case there’s another earthquake. There have also been locally-led blood drives, and one Damascus-based relief organisation said it was receiving money from expatriates to buy aid supplies. In Latakia, Ghazwan Muhammed, 34, set up a soup kitchen with three of his friends to get food out to hungry survivors. “We are all grieving right now,” he said. This instinct to pitch in is shared by many. While walking through the Damascus streets, Khaled Abu Wissam, 30, spotted the bustling “One Heart” drop site set up by Othman. He had nothing to hand so he took off his winter jacket and tossed it in, despite the wintry weather and ice-cold rain. “When I saw people handing over bags of donations, I couldn’t just go on my way,” Abu Wissam explained. “My Syrian brothers are freezing in the cold.” This story was originally published by The New Humanitarian. This article was produced in collaboration with Egab, which connects journalists from the Middle East and North Africa with news organisations worldwide. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Abdulsalam Jarroud/TNH. WHO Aims to Accelerate Trials of Vaccine Candidates for Marburg Disease as Equatorial Guinea Reports Nine Deaths 14/02/2023 Megha Kaveri Health workers in protective gear during the Marburg outbreak in Guinea in 2021. Following a first-ever outbreak of deadly Marburg virus disease in Equatorial Guinea, the World Health Organization (WHO) on Tuesday called an emergency meeting of the Marburg virus vaccine consortium (MARVAC) to receive an urgent update on possible vaccine candidates for the filovirus that can have an 80% fatality rate. At the meeting, the agency received updates from five vaccine developers who have been working on candidate vaccines. WHO experts said that they will soon convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. So far the virus has claimed nine lives, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. “The critical next steps include getting full sequence information on the virus, which is being detected in Equatorial Guinea to use that for a number of different purposes,” said Philip R. Krause, chair of the WHO Covid Vaccines Research Expert Group, who led the meeting. In parallel, WHO will “rapidly” convene a vaccine prioritization committee, Krause said, to “consider updated information from vaccine developers and to simplify, which really means extract relevant sections from the vaccine clinical protocol for potentially use in Equatorial Guinea,” Krause said. He was referring to an already-approved WHO clinical trial protocol for Marburg vaccines, which would likely need adaptation to the context of the current outbreak. “Assuming we’ll proceed with clinical studies, and of course this is pending agreement and support from local authorities in Equatorial Guinea, assuming that such a study were to be done, it would be important to convene the prioritization committee to look at these in the context of most up-to-date information – to make decisions about which of these should be included in in such a study,” Krause said. Phil Krause at the WHO-led MARVAC meeting on Tuesday. The meeting came only a day after WHO officially confirmed the first-ever outbreak of Marburg haemorrhagic fever in Equatorial Guinea. That confirmation came a week after the country’s Health Ministry notified WHO of a suspected case that had first been reported on 7 January in the country’s Kie Ntem province. Vaccines in the pipeline At the meeting, the WHO experts reviewed the status of five active vaccine candidates against the virus. Two of the candidates, one developed by the Sabin Vaccine Institute and one by Janssen are in the Phase 1 clinical trials. The other three vaccine candidates being developed by International AIDS Vaccine Initiative (IAVI), Public Health Vaccines (PHV) and Auro Vaccines, are still in the pre-clinical stage of development. The five active vaccine candidates that are in development for Marburg disease. Babajide Keshinro of Janssen said that the company could mobilise 3500 doses of its Marburg vaccine candidate for WHO-led trials immediately in Equatorial Guinea. However, he stressed that the trials would have to begin within the next two months. Beyond that, the company does not yet have a firm estimate on the length of time the Janssen vaccine candidate remains stable. Matthew Duchars, speaking on behalf of the Sabin Vaccine Institute, told the committee that the Institute has up to 20,000 doses of active vaccine ingredient, which it was already planning to use for its own Phase2/3 trials later this year. “We have quite a reasonable amount of drug substance, which has been manufactured and is awaiting to be filled, and is probably up to about 20,000 doses from the bulk that’s currently made.” The Institute also had reserved “slots” with a number of vaccine manufacturers which could be “repurposed” to rapidly produce several hundred finished vials of the vaccine candidate for deployment in Equatorial Guinea. he added. Joan Fusco, of PHV, said that their vaccine candidate had just recently secured FDA approval for clinical testing and that they have around 350 vials ready for use. But they do not have further active manufacturing of the product planned at present. As for IAVI, Andi Kilansk said that the organization does not have “any available bulk drug, substance or field drug product.” Similarly, Auro Vaccines said it had no Clinical Trial Material (CTM) available at present, and that its own clinical trials had been planned only for later in the year. In relation to therapeutics, Dr Simon GP Funnell from the United Kingdom’s Health Security Agency, referred to a recent study that found a combination treatment of monoclonal antibodies and remdesivir performed better against the virus than individual drug agents. “A combination of monoclonal antibodies and remdesivir was better than either alone at Day 6. And that’s going to be a theme that’s carried forward,” he said. Index case on 7 January The index case of Marburg virus disease occurred on 7 January 2023, Dr George Ameh, country representative of WHO to Equatorial Guinea, told the meeting. However, the Country’s Health Ministry only notified WHO of the case on 7 February, with a definitive lab confirmation of the disease from a Senegalese laboratory on 13 February. “In total, there have been nine deaths associated with this outbreak, with established epidemiological links. Close family members, those who attended burials of these close family members…nine confirmed deaths as of today. We also have 16 suspected cases in quarantine and 15 asymptomatic contacts being closely followed up from their homes,” he said. Equatorial Guinea is located in west central Africa. Despite the month-long lag between the report of the suspected first case and notification to WHO, Dr Matshidiso Moeti, WHO Regional Director for Africa, praised the “rapid and decisive” action by Equatorial Guinean health authorities. “Marburg is highly infectious. Thanks to the rapid and decisive action by the Equatorial Guinean authorities in confirming the disease, emergency response can get to full steam quickly so that we save lives and halt the virus as soon as possible,” said Moeti. Marburg virus disease, also known as MVD, is a highly infectious disease that has a fatality ratio that can range between 24% and 88%. The virus, named after a town in Germany where the virus was first identified in 1967 after causing 29 infections and 7 deaths, belongs to the same family of filoviruses as Ebola. The virus is typically transmitted to humans by fruit bats, and then spread between humans through direct contact with bodily fluids of infected people, surfaces and materials. In Africa, outbreaks have been reported peridically in the Democratic Republic of Congo, Angola, Uganda – but never before in Equatorial Guinea. Common symptoms of Marburg disease include fever, fatigue, blood-stained vomit and diarrhoea, according to WHO. “Efforts are also underway to rapidly mount emergency response, with WHO deploying health emergency experts in epidemiology, case management, infection prevention, laboratory and risk communication to support the national response efforts and secure community collaboration in the outbreak control,” stated a WHO press release, published on Monday. “WHO is also facilitating the shipment of laboratory glove tents for sample testing as well as one viral haemorrhagic fever kit that includes personal protective equipment that can be used by 500 health workers.” Image Credits: WHO, Megha Kaveri, Alvaro1984 18, Public domain, via Wikimedia Commons. Five Priorities for Global Pandemic Preparedness 14/02/2023 Thomas B. Cueni The fourth Intergovernmental Negotiating Body (INB) meeting takes place 27 February; portrayed here, WHO member states at the second meeting 18-22 July 2022. On 27 February, World Health Organization member states will meet to commence formal negotiations on a global pandemic preparedness agreement – unofficially turning the page from responding to COVID-19 to readying ourselves for future health emergencies. While the Intergovernmental Negotiating Body (INB) of member states have already held a series of meetings, as well as stakeholder briefings, the negotiations at the end of the month hold special significance as they follow on from the publication of the “zero draft” of the envisioned international legal instrument. And with the aim of concluding a draft instrument by May 2024, the clock is already counting down. This is a huge undertaking, and millions of lives depend on learning the right lessons from our collective response to the COVID-19 pandemic. The pharmaceutical industry, which played an indispensable role in defeating COVID-19, recommends focusing on five priorities. Sustaining a thriving innovation ecosystem R&D of COVID-19 vaccines took place in record time. The first must be to maintain and reinforce the policies and systems that worked well these past three years – the innovation ecosystem undergirding our industry and the immediate unhindered access to pathogens and their genetic sequences. It was no accident that we had tests and potential vaccines and treatments in development within days of the sequence of the novel coronavirus published online – a record-breaking pace that saved an estimated 20 million lives in year one of the pandemic. Everything from the viral vector or mRNA technology behind the vaccines to the global supply chains that enabled unprecedented manufacturing scale-up wouldn’t have been possible without decades of large, risky investments in the international pharmaceutical sector. Yet today, the very system that allowed collaboration and innovation to thrive and deliver the solutions for the COVID-19 pandemic, is under attack. The World Trade Organization’s (WTO) June 2022 decision to waive international patent protections on the COVID-19 vaccines, and the ongoing discussions on extending this waiver to COVID-19 therapeutics and diagnostics, risk undermining the system, which was critical for the success in the fight against COVID-19. Attacks on IP at the WTO or in the zero draft of the accord fail to recognize the critical role that intellectual property frameworks play to incentivize research and facilitate voluntary partnerships, business-to-business agreements, and technology transfers. Proponents of these proposals oversimplify what the notion of “tech transfer” entails, and risk undermining, rather than facilitating our collective ability to rapidly develop and scale-up countermeasures. Furthermore, some countries seek to twist the UN’s Nagoya Protocol – a roughly decade-old pact that gives countries more rights and incentives over their native flora and fauna with the intention of protecting biodiversity – to restrict the flow of information about pathogens. The deliberate twisting of the protocol giving value to pathogens instead of protecting global health security is a bizarre and unprecedented threat to global health. Lest we forget, the system we had in place when COVID-19 arrived created multiple safe, effective vaccines against a novel, deadly contagion in a matter of months, produced billions of doses within a year, and has now delivered at least one dose to over 69% of the world’s 8 billion people. This is a record to build on, not to attack. Innovation and immediate access to pathogens should be at the center of all pandemic preparedness and response plan. Shaping a new ‘social contract’ Second, the world’s wealthiest nations must adopt a new framework for more equitable global distribution of vaccines and therapies. National leaders, morally accountable to their own citizens, can now nonetheless appreciate the value of global preparedness. As wave after wave of COVID-19 variants have taught wealthy nations, viruses do not respect economic advantage any more than they do geographic borders. Amidst a global contagion, none of us are safe until we all are. The framework that best reconciles different regions’ interests is one familiar to all democracies: the social contract under which citizens balance rights with responsibilities, independence with interdependence. Under a global pandemic preparedness “social contract”, pharmaceutical companies set aside stores of vaccines, treatments, and tests, based on real time production, for priority populations in lower-income countries. But for this to work, manufacturing countries need to allow part of what is produced in their territories to be exported to low-income countries in real-time. And of course, we need adequate funding upfront for organizations such as Gavi, the Vaccine Alliance, to sign contracts early on. Fostering sustainable manufacturing globally Third, Covid-19 showed how broad a global vaccine production program must be – and how much such a program depends on a stable legal and policy framework, which gives the confidence to parties to join forces, and share technology and know-how. The record is clear. By the end of 2022, pharmaceutical companies signed 381 vaccine manufacturing and production partnerships, and 150 more to produce COVID treatments – the vast majority of both involving technology transfer. To facilitate access and equity for the developing world, those partnerships included facilities based in India, Bangladesh, Egypt, and South Africa. The right enabling environment to attract sustainable investments and predictable demand will be critical to maintain existing capacity and introduce new capacity in other regions. Removing trade restrictions Fourth, the COVID-19 experience showed that when it comes to the development, manufacturing, and distribution of goods around the world, there is no substitute for free trade. Whatever arguments might exist for protectionist trade barriers in other sectors of the global economy, it is now obvious that those arguments do not apply to public health necessities in the middle of pandemics. Open trade saves lives. Ensuring greater country readiness And fifth, when it comes to global equity, the ability of less developed nations to absorb supplies is also paramount. These countries need help in strengthening their healthcare systems and making huge investments in health infrastructure to prevent, detect and respond to future threats while maintaining access to routine and essential services during a crisis. Later this month, WHO negotiators will be looking at all of the above – efficacy and equity, supply and demand, economic incentives and moral responsibilities – as members work to revise the current zero draft of a global pandemic Accord. Taking the time, here in this middle hour between crises, to get the policies and incentives right will yield the public health community the coordination, collaboration, and innovation we will need to overcome the inevitable next pandemic. ____________________ Thomas B Cueni, is the director general director general of the International Federation of Pharmaceutical Manufacturers and Associations. Image Credits: Pfizer, IFPMA . Vaccine Alliance Gavi Appoints Former Nigerian Health Minister as New CEO 13/02/2023 Kerry Cullinan Dr Muhammad Ali Pate, incoming Gavi CEO The global vaccine alliance, Gavi, has appointed former Nigerian health minister, Dr Muhammad Ali Pate, as its new CEO. Pate was Minister of State for Health in Nigeria between 2011 and 2013, where he led a national campaign to “revive routine immunisation and primary health care, chaired a presidential taskforce to eradicate polio and introduced new vaccines into the country”, according to Gavi. “It will be my privilege to lead Gavi and continue to support countries to scale up critical routine immunisation programmes, reach more zero-dose children, expand access to new vaccines, transform primary health care systems, and help fight outbreaks and future pandemics,” said Pate in a media release on Monday. He will join Gavi in August, replacing Dr Seth Berkley who has led the alliance for the past 12 years. Pate is a medical doctor trained in both internal medicine and infectious diseases who also has an MBA from Duke University in US. Between 2019 and 2021, he was the World Bank’s Global Director for Health, Nutrition and Population and headed the Global Financing Facility at the World Bank where he led the Bank’s $ 18 billion COVID-19 global health response. He is currently the Julio Frenk Professor of Public Health Leadership at Harvard Chan School of Public Health and has served on several health-focused boards and expert panels in the public, private and not-for-profit sectors during his career. Gavi undertook a year-long search for Berley’s replacement which was led by its board chair, Professor José Manuel Barroso. “Dr Pate stood out in a field of world-class candidates. With his knowledge and experience of both national immunization programming and international emergency response and global finance, I am confident that Gavi will continue to build on its vision and mission, as well as navigate the many challenges and opportunities we will face,” said Barroso. Meanwhile, Berkley described “leading Gavi and helping the alliance to continually surpass itself in terms of saving lives, protecting children and supporting countries during global health emergencies” as “the greatest honour of my career”. “I am confident in its future under Muhammad’s leadership. Having worked with him during his time as Minister and at the World Bank, I know he understands intimately the landscape we work in and will be uncompromising in his drive for public health equity,” added Berkley. Some important personal news: After leading @Gavi for the last 11+ yrs & for more than half of Gavi’s existence my term as @Gavi CEO will end in August. As a result, I’m delighted that today our Board confirmed @muhammadpate as our Alliance’s next leader https://t.co/EB06y2pcmM — Seth Berkley (@DrSethBerkley) February 13, 2023 Berkley has led Gavi since 2011, and during his tenure the alliance estimates that it has averted 11.8 million future deaths (compared to 4.5 million between 2000 and 2010); and has helped immunise more than 676 million children – more than double the 305 million children reached between 2000 and 2010. During his tenure, the alliance has added a number of new vaccines to its portfolio, including to prevent HPV, polio, cholera and malaria, and in its current strategy cycle is focusing on reaching zero-dose children across marginalised communities. “The economic result of Gavi’s expansion of activities during [Berkley’s] tenure has been profound, unlocking over $160 billion of economic benefits compared to $24 billion in its first 10 years.” Top 24 Multinational Companies’ Climate Pledges ‘Lack Integrity’ 13/02/2023 Kerry Cullinan The world’s biggest multinational companies are failing to meet the bold climate change pledges they have made – and are obfuscating their failures through “ambiguous commitments, offsetting plans that lack credibility and emission scope exclusions”. This is according to the Corporate Climate Responsibility Monitor 2023, which was released on Monday by Carbon Market Watch and NewClimate Institute. The report focuses on 24 multinational companies that have endorsed the Paris Agreement to ensure global warming does not exceed 1.5 degrees Celsius. Greenhouse gas and carbon emissions need to be cut by 43% and 48% respectively between 2019 and 2030 to limit the global temperature increase to 1.5°C, according to the Intergovernmental Panel on Climate Change (IPCC, 2022). But the companies’ targets only amount to a 15% reduction in “full value chain emissions between 2019 and 2030”. ‘Low integrity’ companies The climate strategies of American Airlines, Samsung Electronics, meat company JBS and retail and grocery multinational Carrefour were described as “very low integrity”. One rung up were the “low integrity” companies, including Amazon, DHL, Foxconn, Mercedes Benz, Pepsico, Volkswagen and Walmart. Their poor ratings were the result of “inadequacy or complete lack of explicit emission reduction commitments alongside ambiguous net-zero pledges”, according to the report. Apple, Arcelor Mittal, Google, H&M and Microsoft were some of the companies described as having “moderate integrity”, while shipping company Maersk was rated “reasonable” – the top rating of the companies. Together the 24 companies account for about 4% of all global greenhouse emissions. Substantial ‘greenwashing’ Warning of substantial “greenwashing”, the report called on “regulatory oversight at international, national and sectoral levels”. Speaking at the launch, Carbon Market Watch’s Lindsay Otis said that it had taken a team of accomplished researchers “a number of months” to understand the companies’ pledges and strategies. “Companies’ climate change commitments do not add up to what their pledges might suggest,” according to the report. Their 2030 targets can “rarely be taken at face value”, mainly because they focus on direct emissions or emissions from procured energy but exclude indirect emission categories that account for “over 90% of the greenhouse gas emission footprints for most of the companies we have assessed”. For others, 2030 targets are misleading due to reliance on offsetting. “The findings in our report suggest that many companies only plan to reduce a small share of their full emission footprint, relying instead on offsetting their remaining emissions with contentious carbon credits,” according to the report. “We find that at least three-quarters of the 24 sampled companies rely on forestry and land-use-related offsets. The demand for such carbon dioxide removals would exceed the potential of the world’s natural resource base by around two to four times if these practices would be replicated by other companies,” the report notes. “Moreover, these plans demonstrate the widespread lack of awareness that the biological storage of carbon is fundamentally unsuitable for offsetting claims due to the non-permanence of the climate impact.” Regulation “Companies must play a central role in finding and scaling up solutions for deep decarbonisation, but their efforts need urgent acceleration and appropriate regulatory frameworks,” according to the report. It cites the European Union’s Corporate Sustainability Reporting Directive, which enters into force this year 2023 and will introduce “tighter requirements for corporate climate strategies”. However, it calls for close monitored “to ensure a high standard of compliance”. ‘Be Loud’ About the Link Between Alcohol and Cancer 10/02/2023 Kristina Sperkova & Pubudu Sumanasekara Alcohol is linked to seven cancers, but public awareness of the links is low. Alcohol is the second biggest cause of cancer after tobacco, and Movendi is mobilizing communities worldwide to publicize the link At the WHO’s 152th Executive Board, an updated list of policy “best buys” to prevent and control non-communicable diseases (NCDs) was presented. The EB decided unanimously to adopt the updated list of cost-effective interventions in response to the lack of progress to prevent and reduce NCDs, as Health Policy Watch reported. Higher taxes and warning labels on unhealthy food, cigarettes and alcohol, and better screening for cancers, are some of the new “best buys” to accelerate action on NCDs, such as cancer, heart disease, diabetes, lung disease, and mental health conditions. No country is currently on track to achieve the 2030 global targets set by the World Health Assembly back in 2013, and the declaration by the UN General Assembly High-Level Meeting on NCDs in 2018 – including the 10% reduction of population-level alcohol use. One major public health problem that is worsening due to the lack of implementation of the NCDs best buys is cancer. Cancer kills nearly 10 million people a year, but the risk of dying from cancer varies greatly across the world. About 70% of these deaths are in low- and middle-income countries – and the disparity is worsening. For example, in Africa, cancer deaths are expected to more than double, reaching roughly 1.4 million deaths annually by 2040. Make a noise On World Cancer Day on 4 February, Movendi International launched an ambitious new campaign, “Be Loud For Change”. We are mobilizing communities around the world to make a noise about the direct link between alcohol and cancer, the low public recognition of the fact that alcohol causes seven types of cancer, and the unique opportunity for our governments to bring change through proven solutions. People want to know.People have a right to know.Alcohol causes 7 types of cancer.#loudforchange #WorldCancerDay #AlcoholHarms #CancerAwareness pic.twitter.com/jhaS9jJYdW — Movendi International (@Movendi_Int) February 4, 2023 Since 1988, alcohol – like tobacco and asbestos – has been scientifically proven to be a group one carcinogen. When humans consume ethanol in beer, wine, and liquor, the byproduct attacks the DNA. But the media found it difficult to report properly on the real effects of alcohol and instead helped the alcohol industry to keep people in the dark. After tobacco, alcohol is the second biggest cause of cancer – before other risk factors such as infections, physical inactivity, or sunlight. Globally, 740,000 people get cancer due to alcohol, each year. The alcohol industry wants to keep people in the dark about the fact that their products are as carcinogenic as cigarettes and asbestos. Research has shown that awareness of the link between alcohol and cancer is very low internationally. Alcohol companies are afraid of people becoming aware of the fact that ethanol in beer, wine, and liquor causes at least seven types of cancer. And so they fight tooth and nail against scientific studies, warning labels on alcohol products, and other alcohol policy solutions contained in the recently updated list of NCD best buys. The wide support of the WHO Executive Board and growing momentum for addressing cancer risk factors, such as alcohol, mean something significant: The world is experiencing a shift in awareness about alcohol harm, driven by growing awareness that alcohol causes cancer. And the world is experiencing a shift in perception of alcohol policy solutions. The alcohol policy best buys – raising alcohol taxes, banning alcohol advertising, limiting alcohol availability – help prevent diseases such as cancer and heart disease; they help strengthen health systems; and they boost economic growth. Alcohol taxes and warning labels This means, our governments can do a lot to bring about change. They can develop alcohol taxation systems that effectively protect people from alcohol harm, including cancer. For example, reducing total alcohol consumption by 10% would lead to a 9% reduction in alcohol-related cancer deaths. That means ca. 57.000 fewer deaths. Our governments can also put warning labels on alcoholic products informing about cancer, heart disease, and other alcohol harms. They can fund mass media campaigns to increase public recognition of the real harm due to alcohol. They can ban alcohol advertising, sponsorship, and promotion. And our governments can put in place common sense limits on the presence of alcohol in our communities. Our governments have proven solutions at their disposal. There has never been a better time for an ambitious approach to protect our societies from cancer caused by alcohol. Such an initiative will protect and improve the health and well-being of people and communities, it will strengthen our health systems as alcohol harms, such as cancer cases and deaths, decline, and will unlock fresh resources for investment in health promotion and disease prevention. Kristina Sperkova is International President of Movendi International Pubudu Sumanasekara is International Vice President of Movendi International Image Credits: Taylor Brandon/ Unsplash. Ukraine War Sparks Global Health Crisis 10/02/2023 Editorial team Over eight million Ukrainians have fled the country. Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues. “The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute. “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. “Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said. ‘Defend Europe’ Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”. “A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare. At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging. International food security Ukraine food crisis The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa. “Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt. The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added. While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found. “We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked. The role of international actors In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. Looking forward, international cooperation is also going to be crucial after the war ends. “[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.” First priority Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January. “Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” “We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged. Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted. “I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” “The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed. Mental health emergency People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges. “One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face. Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.” The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues. Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers. “It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. “Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.” “There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.” Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter . Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Bakier Soulo (right), 28, and his younger brother sleep rough with their families in a public square in the old city of Gaziantep. DAMASCUS/JABLEH – One week on from last week’s massive earthquakes, ordinary people across Syria – including in the large parts controlled by President Bashar al-Assad’s forces – have been scrambling to marshal whatever help they can for survivors, offering up their homes, supplies, and skills. While many of the areas al-Assad controls are further from the epicentres than the rebel-held northwest, the government-run region has still reported 1,414 deaths, and more than 92,000 people are staying in shelters there, according to UN figures. By Wednesday, the overall death toll across Türkiye and Syria had exceeded 40,000. Nearly 12 years of conflict, and a crippling economic crisis compounded by Western sanctions, are complicating citizen-led aid efforts. There are limits to what people dealing with spiralling inflation, mass poverty, and record fuel shortages can do to help each other. But – as is the case in Türkiye, where a rapid community response has been key to getting people through the first wintry days and nights after the earthquakes – that hasn’t stopped many Syrians from trying. Nour Othman, 29, works for a marketing company in Damascus. Hours after the first earthquake struck on 6 February, she found herself staring at heart-wrenching images of families buried under slabs of concrete, and wanted to do something. Othman took to a 360,000-strong Syrian Facebook group usually used for job opportunities, home rentals, and community announcements. She placed a different sort of post: She asked for clothing, medicine, blankets, and canned food, using the Arabic hashtag #OneHeart. The response was overwhelming. Within a few hours, donations began pouring in to her Damascus office, which she had posted as the drop-off point. She stopped working, converted the office into a makeshift warehouse, and within a day had collected 3,000 pieces of clothing, 15 boxes of medicine, and stacks of blankets. By the second day, Othman said, the total amount of aid weighed five tonnes. Volunteers have offered to drive them to those in need. “I felt sad and totally helpless watching what the media was reporting… There were women and children screaming, and others trapped under the rubble. I couldn’t just stand by,” Othman told The New Humanitarian. “The initiative is called ‘One Heart’ because Syrians have learned to support each other and be of one heart through thick and thin,” she added. Conflict fault lines and geopolitics Despite the initiative’s name, after more than a decade of war, the reality is that Syrians live in a deeply divided country. Parts – like Damascus, where Othman lives – are controlled by al-Assad and his forces. Much of the quake-hit northwest is controlled by rebel groups, including the terrorist-designated Hayat Tahrir al-Sham. The northeast, meanwhile, is run by Türkiye, Turkish-backed rebels, and Kurdish groups. All of this has an impact on how international and local aid flows, or doesn’t flow, through the country. UN-coordinated aid to the northwest arrives across the border from Türkiye, while Damascus is the main hub for assistance within the rest of government-controlled Syria. Getting aid from Damascus to rebel-held territory has been extremely slow or a non-starter, although al-Assad officials and the Syrian Arab Red Crescent (SARC) have said they are willing to deliver aid across the country. Late last week, the government approved an aid delivery across front lines to areas controlled by rebels in the northwest, but it is reportedly held up. Another of the issues that could delay direct relief to Syrians across the country is Western sanctions, although last week the United States said it was granting a temporary exemption to “all transactions related to earthquake relief” that would otherwise be banned by sanctions meant to target al-Assad and those close to him. Dozens of white tents have been erected outside Gaziantep’s train station to host hundreds of Turks and Syrians whose homes were destroyed by the earthquakes. A surge in support For civilians collecting aid – like Othman – all of this means that the supplies she’s giving out will head only to the large parts of the country controlled by al-Assad. That includes Jableh, a coastal city about 25 kilometres south of Latakia, where Nada al-Halabi lived in a four-storey building – until it crumbled in the earthquakes. Standing outside her building on 9 February, a few days after disaster struck, she told The New Humanitarian she was still in shock. Rescue teams had pulled 10 dead bodies from the heap of rubble; two children of families in the building were missing. “At the moment of the earthquake, I was asleep. I only heard the sound of the earth roaring,” said al-Halabi, wiping away a tear with a handkerchief. In an 8 February news conference, Hussein Makhlouf, Syria’s minister of local administration and environment – the man charged with overseeing the government’s response – said 180 shelters would be set up across the country. Local NGOs, the SARC, and UN agencies have been handing out hot meals and various relief supplies, but much of the early aid effort has been spearheaded by ordinary citizens like Othman. In light of the country’s economic crisis, this is especially notable: Between 2010 and 2019, Syria’s GDP shrunk by more than half. The local currency lost 44% of its value in 2022, and food prices have nearly doubled over the past year. More than 90% of Syrians now live below the poverty line. While people living in northern Syria have been the most impacted by the economic collapse, the situation has now become so bad that Syrians in places across the country that had been doing relatively well are now also feeling the pain. While some help with goods, others are assisting with their professional skills. Over the past week, Syrian civil engineers launched a group to provide free consultations for buildings damaged by the earthquake. They’re offering on-site inspections to assess if cracked structures are still safe to live in. For concerned residents looking for quick answers, the engineers are rushing to assess any photos they can send in. The war, and years of sanctions, have decimated Syria’s stock of construction equipment and other machinery that may have helped with search and rescue, or later with reconstruction efforts. Fuel prices are also at an all-time high, and shortages mean there might not be enough to run the little equipment that is available. To do his part, Jableh resident Abu Ayman al-Khaminsi gave his 30-year-old son his tractor and a demand: “Go clear rubble and find survivors!” To power it amid the fuel shortages, al-Khaminsi syphoned off the diesel that was meant to heat his home. “I can’t use this diesel for warmth and keep my tractor parked here when there are people suffering,” al-Khaminsi said. “I’m not healthy enough to help the rescue efforts, but I’ll give everything I have.” ‘We’re meant to support one another’ Not everyone has a tractor or extra food to give, so they are doing what they can. Twenty-year-old Walaa Tamin has opened up her home in Latakia, the port city that was badly damaged by the earthquake. “If anyone has no place to go, our house is open. We’re meant to support one another, and you are welcome here,” Tamin posted on Facebook. Similar offers are popping up across the country. Two families are now sleeping in Tamin’s living room, choosing to sleep closest to the exit in case there’s another earthquake. There have also been locally-led blood drives, and one Damascus-based relief organisation said it was receiving money from expatriates to buy aid supplies. In Latakia, Ghazwan Muhammed, 34, set up a soup kitchen with three of his friends to get food out to hungry survivors. “We are all grieving right now,” he said. This instinct to pitch in is shared by many. While walking through the Damascus streets, Khaled Abu Wissam, 30, spotted the bustling “One Heart” drop site set up by Othman. He had nothing to hand so he took off his winter jacket and tossed it in, despite the wintry weather and ice-cold rain. “When I saw people handing over bags of donations, I couldn’t just go on my way,” Abu Wissam explained. “My Syrian brothers are freezing in the cold.” This story was originally published by The New Humanitarian. This article was produced in collaboration with Egab, which connects journalists from the Middle East and North Africa with news organisations worldwide. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org.
WHO Aims to Accelerate Trials of Vaccine Candidates for Marburg Disease as Equatorial Guinea Reports Nine Deaths 14/02/2023 Megha Kaveri Health workers in protective gear during the Marburg outbreak in Guinea in 2021. Following a first-ever outbreak of deadly Marburg virus disease in Equatorial Guinea, the World Health Organization (WHO) on Tuesday called an emergency meeting of the Marburg virus vaccine consortium (MARVAC) to receive an urgent update on possible vaccine candidates for the filovirus that can have an 80% fatality rate. At the meeting, the agency received updates from five vaccine developers who have been working on candidate vaccines. WHO experts said that they will soon convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. So far the virus has claimed nine lives, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. “The critical next steps include getting full sequence information on the virus, which is being detected in Equatorial Guinea to use that for a number of different purposes,” said Philip R. Krause, chair of the WHO Covid Vaccines Research Expert Group, who led the meeting. In parallel, WHO will “rapidly” convene a vaccine prioritization committee, Krause said, to “consider updated information from vaccine developers and to simplify, which really means extract relevant sections from the vaccine clinical protocol for potentially use in Equatorial Guinea,” Krause said. He was referring to an already-approved WHO clinical trial protocol for Marburg vaccines, which would likely need adaptation to the context of the current outbreak. “Assuming we’ll proceed with clinical studies, and of course this is pending agreement and support from local authorities in Equatorial Guinea, assuming that such a study were to be done, it would be important to convene the prioritization committee to look at these in the context of most up-to-date information – to make decisions about which of these should be included in in such a study,” Krause said. Phil Krause at the WHO-led MARVAC meeting on Tuesday. The meeting came only a day after WHO officially confirmed the first-ever outbreak of Marburg haemorrhagic fever in Equatorial Guinea. That confirmation came a week after the country’s Health Ministry notified WHO of a suspected case that had first been reported on 7 January in the country’s Kie Ntem province. Vaccines in the pipeline At the meeting, the WHO experts reviewed the status of five active vaccine candidates against the virus. Two of the candidates, one developed by the Sabin Vaccine Institute and one by Janssen are in the Phase 1 clinical trials. The other three vaccine candidates being developed by International AIDS Vaccine Initiative (IAVI), Public Health Vaccines (PHV) and Auro Vaccines, are still in the pre-clinical stage of development. The five active vaccine candidates that are in development for Marburg disease. Babajide Keshinro of Janssen said that the company could mobilise 3500 doses of its Marburg vaccine candidate for WHO-led trials immediately in Equatorial Guinea. However, he stressed that the trials would have to begin within the next two months. Beyond that, the company does not yet have a firm estimate on the length of time the Janssen vaccine candidate remains stable. Matthew Duchars, speaking on behalf of the Sabin Vaccine Institute, told the committee that the Institute has up to 20,000 doses of active vaccine ingredient, which it was already planning to use for its own Phase2/3 trials later this year. “We have quite a reasonable amount of drug substance, which has been manufactured and is awaiting to be filled, and is probably up to about 20,000 doses from the bulk that’s currently made.” The Institute also had reserved “slots” with a number of vaccine manufacturers which could be “repurposed” to rapidly produce several hundred finished vials of the vaccine candidate for deployment in Equatorial Guinea. he added. Joan Fusco, of PHV, said that their vaccine candidate had just recently secured FDA approval for clinical testing and that they have around 350 vials ready for use. But they do not have further active manufacturing of the product planned at present. As for IAVI, Andi Kilansk said that the organization does not have “any available bulk drug, substance or field drug product.” Similarly, Auro Vaccines said it had no Clinical Trial Material (CTM) available at present, and that its own clinical trials had been planned only for later in the year. In relation to therapeutics, Dr Simon GP Funnell from the United Kingdom’s Health Security Agency, referred to a recent study that found a combination treatment of monoclonal antibodies and remdesivir performed better against the virus than individual drug agents. “A combination of monoclonal antibodies and remdesivir was better than either alone at Day 6. And that’s going to be a theme that’s carried forward,” he said. Index case on 7 January The index case of Marburg virus disease occurred on 7 January 2023, Dr George Ameh, country representative of WHO to Equatorial Guinea, told the meeting. However, the Country’s Health Ministry only notified WHO of the case on 7 February, with a definitive lab confirmation of the disease from a Senegalese laboratory on 13 February. “In total, there have been nine deaths associated with this outbreak, with established epidemiological links. Close family members, those who attended burials of these close family members…nine confirmed deaths as of today. We also have 16 suspected cases in quarantine and 15 asymptomatic contacts being closely followed up from their homes,” he said. Equatorial Guinea is located in west central Africa. Despite the month-long lag between the report of the suspected first case and notification to WHO, Dr Matshidiso Moeti, WHO Regional Director for Africa, praised the “rapid and decisive” action by Equatorial Guinean health authorities. “Marburg is highly infectious. Thanks to the rapid and decisive action by the Equatorial Guinean authorities in confirming the disease, emergency response can get to full steam quickly so that we save lives and halt the virus as soon as possible,” said Moeti. Marburg virus disease, also known as MVD, is a highly infectious disease that has a fatality ratio that can range between 24% and 88%. The virus, named after a town in Germany where the virus was first identified in 1967 after causing 29 infections and 7 deaths, belongs to the same family of filoviruses as Ebola. The virus is typically transmitted to humans by fruit bats, and then spread between humans through direct contact with bodily fluids of infected people, surfaces and materials. In Africa, outbreaks have been reported peridically in the Democratic Republic of Congo, Angola, Uganda – but never before in Equatorial Guinea. Common symptoms of Marburg disease include fever, fatigue, blood-stained vomit and diarrhoea, according to WHO. “Efforts are also underway to rapidly mount emergency response, with WHO deploying health emergency experts in epidemiology, case management, infection prevention, laboratory and risk communication to support the national response efforts and secure community collaboration in the outbreak control,” stated a WHO press release, published on Monday. “WHO is also facilitating the shipment of laboratory glove tents for sample testing as well as one viral haemorrhagic fever kit that includes personal protective equipment that can be used by 500 health workers.” Image Credits: WHO, Megha Kaveri, Alvaro1984 18, Public domain, via Wikimedia Commons. Five Priorities for Global Pandemic Preparedness 14/02/2023 Thomas B. Cueni The fourth Intergovernmental Negotiating Body (INB) meeting takes place 27 February; portrayed here, WHO member states at the second meeting 18-22 July 2022. On 27 February, World Health Organization member states will meet to commence formal negotiations on a global pandemic preparedness agreement – unofficially turning the page from responding to COVID-19 to readying ourselves for future health emergencies. While the Intergovernmental Negotiating Body (INB) of member states have already held a series of meetings, as well as stakeholder briefings, the negotiations at the end of the month hold special significance as they follow on from the publication of the “zero draft” of the envisioned international legal instrument. And with the aim of concluding a draft instrument by May 2024, the clock is already counting down. This is a huge undertaking, and millions of lives depend on learning the right lessons from our collective response to the COVID-19 pandemic. The pharmaceutical industry, which played an indispensable role in defeating COVID-19, recommends focusing on five priorities. Sustaining a thriving innovation ecosystem R&D of COVID-19 vaccines took place in record time. The first must be to maintain and reinforce the policies and systems that worked well these past three years – the innovation ecosystem undergirding our industry and the immediate unhindered access to pathogens and their genetic sequences. It was no accident that we had tests and potential vaccines and treatments in development within days of the sequence of the novel coronavirus published online – a record-breaking pace that saved an estimated 20 million lives in year one of the pandemic. Everything from the viral vector or mRNA technology behind the vaccines to the global supply chains that enabled unprecedented manufacturing scale-up wouldn’t have been possible without decades of large, risky investments in the international pharmaceutical sector. Yet today, the very system that allowed collaboration and innovation to thrive and deliver the solutions for the COVID-19 pandemic, is under attack. The World Trade Organization’s (WTO) June 2022 decision to waive international patent protections on the COVID-19 vaccines, and the ongoing discussions on extending this waiver to COVID-19 therapeutics and diagnostics, risk undermining the system, which was critical for the success in the fight against COVID-19. Attacks on IP at the WTO or in the zero draft of the accord fail to recognize the critical role that intellectual property frameworks play to incentivize research and facilitate voluntary partnerships, business-to-business agreements, and technology transfers. Proponents of these proposals oversimplify what the notion of “tech transfer” entails, and risk undermining, rather than facilitating our collective ability to rapidly develop and scale-up countermeasures. Furthermore, some countries seek to twist the UN’s Nagoya Protocol – a roughly decade-old pact that gives countries more rights and incentives over their native flora and fauna with the intention of protecting biodiversity – to restrict the flow of information about pathogens. The deliberate twisting of the protocol giving value to pathogens instead of protecting global health security is a bizarre and unprecedented threat to global health. Lest we forget, the system we had in place when COVID-19 arrived created multiple safe, effective vaccines against a novel, deadly contagion in a matter of months, produced billions of doses within a year, and has now delivered at least one dose to over 69% of the world’s 8 billion people. This is a record to build on, not to attack. Innovation and immediate access to pathogens should be at the center of all pandemic preparedness and response plan. Shaping a new ‘social contract’ Second, the world’s wealthiest nations must adopt a new framework for more equitable global distribution of vaccines and therapies. National leaders, morally accountable to their own citizens, can now nonetheless appreciate the value of global preparedness. As wave after wave of COVID-19 variants have taught wealthy nations, viruses do not respect economic advantage any more than they do geographic borders. Amidst a global contagion, none of us are safe until we all are. The framework that best reconciles different regions’ interests is one familiar to all democracies: the social contract under which citizens balance rights with responsibilities, independence with interdependence. Under a global pandemic preparedness “social contract”, pharmaceutical companies set aside stores of vaccines, treatments, and tests, based on real time production, for priority populations in lower-income countries. But for this to work, manufacturing countries need to allow part of what is produced in their territories to be exported to low-income countries in real-time. And of course, we need adequate funding upfront for organizations such as Gavi, the Vaccine Alliance, to sign contracts early on. Fostering sustainable manufacturing globally Third, Covid-19 showed how broad a global vaccine production program must be – and how much such a program depends on a stable legal and policy framework, which gives the confidence to parties to join forces, and share technology and know-how. The record is clear. By the end of 2022, pharmaceutical companies signed 381 vaccine manufacturing and production partnerships, and 150 more to produce COVID treatments – the vast majority of both involving technology transfer. To facilitate access and equity for the developing world, those partnerships included facilities based in India, Bangladesh, Egypt, and South Africa. The right enabling environment to attract sustainable investments and predictable demand will be critical to maintain existing capacity and introduce new capacity in other regions. Removing trade restrictions Fourth, the COVID-19 experience showed that when it comes to the development, manufacturing, and distribution of goods around the world, there is no substitute for free trade. Whatever arguments might exist for protectionist trade barriers in other sectors of the global economy, it is now obvious that those arguments do not apply to public health necessities in the middle of pandemics. Open trade saves lives. Ensuring greater country readiness And fifth, when it comes to global equity, the ability of less developed nations to absorb supplies is also paramount. These countries need help in strengthening their healthcare systems and making huge investments in health infrastructure to prevent, detect and respond to future threats while maintaining access to routine and essential services during a crisis. Later this month, WHO negotiators will be looking at all of the above – efficacy and equity, supply and demand, economic incentives and moral responsibilities – as members work to revise the current zero draft of a global pandemic Accord. Taking the time, here in this middle hour between crises, to get the policies and incentives right will yield the public health community the coordination, collaboration, and innovation we will need to overcome the inevitable next pandemic. ____________________ Thomas B Cueni, is the director general director general of the International Federation of Pharmaceutical Manufacturers and Associations. Image Credits: Pfizer, IFPMA . Vaccine Alliance Gavi Appoints Former Nigerian Health Minister as New CEO 13/02/2023 Kerry Cullinan Dr Muhammad Ali Pate, incoming Gavi CEO The global vaccine alliance, Gavi, has appointed former Nigerian health minister, Dr Muhammad Ali Pate, as its new CEO. Pate was Minister of State for Health in Nigeria between 2011 and 2013, where he led a national campaign to “revive routine immunisation and primary health care, chaired a presidential taskforce to eradicate polio and introduced new vaccines into the country”, according to Gavi. “It will be my privilege to lead Gavi and continue to support countries to scale up critical routine immunisation programmes, reach more zero-dose children, expand access to new vaccines, transform primary health care systems, and help fight outbreaks and future pandemics,” said Pate in a media release on Monday. He will join Gavi in August, replacing Dr Seth Berkley who has led the alliance for the past 12 years. Pate is a medical doctor trained in both internal medicine and infectious diseases who also has an MBA from Duke University in US. Between 2019 and 2021, he was the World Bank’s Global Director for Health, Nutrition and Population and headed the Global Financing Facility at the World Bank where he led the Bank’s $ 18 billion COVID-19 global health response. He is currently the Julio Frenk Professor of Public Health Leadership at Harvard Chan School of Public Health and has served on several health-focused boards and expert panels in the public, private and not-for-profit sectors during his career. Gavi undertook a year-long search for Berley’s replacement which was led by its board chair, Professor José Manuel Barroso. “Dr Pate stood out in a field of world-class candidates. With his knowledge and experience of both national immunization programming and international emergency response and global finance, I am confident that Gavi will continue to build on its vision and mission, as well as navigate the many challenges and opportunities we will face,” said Barroso. Meanwhile, Berkley described “leading Gavi and helping the alliance to continually surpass itself in terms of saving lives, protecting children and supporting countries during global health emergencies” as “the greatest honour of my career”. “I am confident in its future under Muhammad’s leadership. Having worked with him during his time as Minister and at the World Bank, I know he understands intimately the landscape we work in and will be uncompromising in his drive for public health equity,” added Berkley. Some important personal news: After leading @Gavi for the last 11+ yrs & for more than half of Gavi’s existence my term as @Gavi CEO will end in August. As a result, I’m delighted that today our Board confirmed @muhammadpate as our Alliance’s next leader https://t.co/EB06y2pcmM — Seth Berkley (@DrSethBerkley) February 13, 2023 Berkley has led Gavi since 2011, and during his tenure the alliance estimates that it has averted 11.8 million future deaths (compared to 4.5 million between 2000 and 2010); and has helped immunise more than 676 million children – more than double the 305 million children reached between 2000 and 2010. During his tenure, the alliance has added a number of new vaccines to its portfolio, including to prevent HPV, polio, cholera and malaria, and in its current strategy cycle is focusing on reaching zero-dose children across marginalised communities. “The economic result of Gavi’s expansion of activities during [Berkley’s] tenure has been profound, unlocking over $160 billion of economic benefits compared to $24 billion in its first 10 years.” Top 24 Multinational Companies’ Climate Pledges ‘Lack Integrity’ 13/02/2023 Kerry Cullinan The world’s biggest multinational companies are failing to meet the bold climate change pledges they have made – and are obfuscating their failures through “ambiguous commitments, offsetting plans that lack credibility and emission scope exclusions”. This is according to the Corporate Climate Responsibility Monitor 2023, which was released on Monday by Carbon Market Watch and NewClimate Institute. The report focuses on 24 multinational companies that have endorsed the Paris Agreement to ensure global warming does not exceed 1.5 degrees Celsius. Greenhouse gas and carbon emissions need to be cut by 43% and 48% respectively between 2019 and 2030 to limit the global temperature increase to 1.5°C, according to the Intergovernmental Panel on Climate Change (IPCC, 2022). But the companies’ targets only amount to a 15% reduction in “full value chain emissions between 2019 and 2030”. ‘Low integrity’ companies The climate strategies of American Airlines, Samsung Electronics, meat company JBS and retail and grocery multinational Carrefour were described as “very low integrity”. One rung up were the “low integrity” companies, including Amazon, DHL, Foxconn, Mercedes Benz, Pepsico, Volkswagen and Walmart. Their poor ratings were the result of “inadequacy or complete lack of explicit emission reduction commitments alongside ambiguous net-zero pledges”, according to the report. Apple, Arcelor Mittal, Google, H&M and Microsoft were some of the companies described as having “moderate integrity”, while shipping company Maersk was rated “reasonable” – the top rating of the companies. Together the 24 companies account for about 4% of all global greenhouse emissions. Substantial ‘greenwashing’ Warning of substantial “greenwashing”, the report called on “regulatory oversight at international, national and sectoral levels”. Speaking at the launch, Carbon Market Watch’s Lindsay Otis said that it had taken a team of accomplished researchers “a number of months” to understand the companies’ pledges and strategies. “Companies’ climate change commitments do not add up to what their pledges might suggest,” according to the report. Their 2030 targets can “rarely be taken at face value”, mainly because they focus on direct emissions or emissions from procured energy but exclude indirect emission categories that account for “over 90% of the greenhouse gas emission footprints for most of the companies we have assessed”. For others, 2030 targets are misleading due to reliance on offsetting. “The findings in our report suggest that many companies only plan to reduce a small share of their full emission footprint, relying instead on offsetting their remaining emissions with contentious carbon credits,” according to the report. “We find that at least three-quarters of the 24 sampled companies rely on forestry and land-use-related offsets. The demand for such carbon dioxide removals would exceed the potential of the world’s natural resource base by around two to four times if these practices would be replicated by other companies,” the report notes. “Moreover, these plans demonstrate the widespread lack of awareness that the biological storage of carbon is fundamentally unsuitable for offsetting claims due to the non-permanence of the climate impact.” Regulation “Companies must play a central role in finding and scaling up solutions for deep decarbonisation, but their efforts need urgent acceleration and appropriate regulatory frameworks,” according to the report. It cites the European Union’s Corporate Sustainability Reporting Directive, which enters into force this year 2023 and will introduce “tighter requirements for corporate climate strategies”. However, it calls for close monitored “to ensure a high standard of compliance”. ‘Be Loud’ About the Link Between Alcohol and Cancer 10/02/2023 Kristina Sperkova & Pubudu Sumanasekara Alcohol is linked to seven cancers, but public awareness of the links is low. Alcohol is the second biggest cause of cancer after tobacco, and Movendi is mobilizing communities worldwide to publicize the link At the WHO’s 152th Executive Board, an updated list of policy “best buys” to prevent and control non-communicable diseases (NCDs) was presented. The EB decided unanimously to adopt the updated list of cost-effective interventions in response to the lack of progress to prevent and reduce NCDs, as Health Policy Watch reported. Higher taxes and warning labels on unhealthy food, cigarettes and alcohol, and better screening for cancers, are some of the new “best buys” to accelerate action on NCDs, such as cancer, heart disease, diabetes, lung disease, and mental health conditions. No country is currently on track to achieve the 2030 global targets set by the World Health Assembly back in 2013, and the declaration by the UN General Assembly High-Level Meeting on NCDs in 2018 – including the 10% reduction of population-level alcohol use. One major public health problem that is worsening due to the lack of implementation of the NCDs best buys is cancer. Cancer kills nearly 10 million people a year, but the risk of dying from cancer varies greatly across the world. About 70% of these deaths are in low- and middle-income countries – and the disparity is worsening. For example, in Africa, cancer deaths are expected to more than double, reaching roughly 1.4 million deaths annually by 2040. Make a noise On World Cancer Day on 4 February, Movendi International launched an ambitious new campaign, “Be Loud For Change”. We are mobilizing communities around the world to make a noise about the direct link between alcohol and cancer, the low public recognition of the fact that alcohol causes seven types of cancer, and the unique opportunity for our governments to bring change through proven solutions. People want to know.People have a right to know.Alcohol causes 7 types of cancer.#loudforchange #WorldCancerDay #AlcoholHarms #CancerAwareness pic.twitter.com/jhaS9jJYdW — Movendi International (@Movendi_Int) February 4, 2023 Since 1988, alcohol – like tobacco and asbestos – has been scientifically proven to be a group one carcinogen. When humans consume ethanol in beer, wine, and liquor, the byproduct attacks the DNA. But the media found it difficult to report properly on the real effects of alcohol and instead helped the alcohol industry to keep people in the dark. After tobacco, alcohol is the second biggest cause of cancer – before other risk factors such as infections, physical inactivity, or sunlight. Globally, 740,000 people get cancer due to alcohol, each year. The alcohol industry wants to keep people in the dark about the fact that their products are as carcinogenic as cigarettes and asbestos. Research has shown that awareness of the link between alcohol and cancer is very low internationally. Alcohol companies are afraid of people becoming aware of the fact that ethanol in beer, wine, and liquor causes at least seven types of cancer. And so they fight tooth and nail against scientific studies, warning labels on alcohol products, and other alcohol policy solutions contained in the recently updated list of NCD best buys. The wide support of the WHO Executive Board and growing momentum for addressing cancer risk factors, such as alcohol, mean something significant: The world is experiencing a shift in awareness about alcohol harm, driven by growing awareness that alcohol causes cancer. And the world is experiencing a shift in perception of alcohol policy solutions. The alcohol policy best buys – raising alcohol taxes, banning alcohol advertising, limiting alcohol availability – help prevent diseases such as cancer and heart disease; they help strengthen health systems; and they boost economic growth. Alcohol taxes and warning labels This means, our governments can do a lot to bring about change. They can develop alcohol taxation systems that effectively protect people from alcohol harm, including cancer. For example, reducing total alcohol consumption by 10% would lead to a 9% reduction in alcohol-related cancer deaths. That means ca. 57.000 fewer deaths. Our governments can also put warning labels on alcoholic products informing about cancer, heart disease, and other alcohol harms. They can fund mass media campaigns to increase public recognition of the real harm due to alcohol. They can ban alcohol advertising, sponsorship, and promotion. And our governments can put in place common sense limits on the presence of alcohol in our communities. Our governments have proven solutions at their disposal. There has never been a better time for an ambitious approach to protect our societies from cancer caused by alcohol. Such an initiative will protect and improve the health and well-being of people and communities, it will strengthen our health systems as alcohol harms, such as cancer cases and deaths, decline, and will unlock fresh resources for investment in health promotion and disease prevention. Kristina Sperkova is International President of Movendi International Pubudu Sumanasekara is International Vice President of Movendi International Image Credits: Taylor Brandon/ Unsplash. Ukraine War Sparks Global Health Crisis 10/02/2023 Editorial team Over eight million Ukrainians have fled the country. Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues. “The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute. “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. “Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said. ‘Defend Europe’ Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”. “A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare. At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging. International food security Ukraine food crisis The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa. “Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt. The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added. While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found. “We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked. The role of international actors In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. Looking forward, international cooperation is also going to be crucial after the war ends. “[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.” First priority Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January. “Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” “We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged. Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted. “I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” “The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed. Mental health emergency People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges. “One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face. Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.” The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues. Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers. “It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. “Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.” “There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.” Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter . Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Five Priorities for Global Pandemic Preparedness 14/02/2023 Thomas B. Cueni The fourth Intergovernmental Negotiating Body (INB) meeting takes place 27 February; portrayed here, WHO member states at the second meeting 18-22 July 2022. On 27 February, World Health Organization member states will meet to commence formal negotiations on a global pandemic preparedness agreement – unofficially turning the page from responding to COVID-19 to readying ourselves for future health emergencies. While the Intergovernmental Negotiating Body (INB) of member states have already held a series of meetings, as well as stakeholder briefings, the negotiations at the end of the month hold special significance as they follow on from the publication of the “zero draft” of the envisioned international legal instrument. And with the aim of concluding a draft instrument by May 2024, the clock is already counting down. This is a huge undertaking, and millions of lives depend on learning the right lessons from our collective response to the COVID-19 pandemic. The pharmaceutical industry, which played an indispensable role in defeating COVID-19, recommends focusing on five priorities. Sustaining a thriving innovation ecosystem R&D of COVID-19 vaccines took place in record time. The first must be to maintain and reinforce the policies and systems that worked well these past three years – the innovation ecosystem undergirding our industry and the immediate unhindered access to pathogens and their genetic sequences. It was no accident that we had tests and potential vaccines and treatments in development within days of the sequence of the novel coronavirus published online – a record-breaking pace that saved an estimated 20 million lives in year one of the pandemic. Everything from the viral vector or mRNA technology behind the vaccines to the global supply chains that enabled unprecedented manufacturing scale-up wouldn’t have been possible without decades of large, risky investments in the international pharmaceutical sector. Yet today, the very system that allowed collaboration and innovation to thrive and deliver the solutions for the COVID-19 pandemic, is under attack. The World Trade Organization’s (WTO) June 2022 decision to waive international patent protections on the COVID-19 vaccines, and the ongoing discussions on extending this waiver to COVID-19 therapeutics and diagnostics, risk undermining the system, which was critical for the success in the fight against COVID-19. Attacks on IP at the WTO or in the zero draft of the accord fail to recognize the critical role that intellectual property frameworks play to incentivize research and facilitate voluntary partnerships, business-to-business agreements, and technology transfers. Proponents of these proposals oversimplify what the notion of “tech transfer” entails, and risk undermining, rather than facilitating our collective ability to rapidly develop and scale-up countermeasures. Furthermore, some countries seek to twist the UN’s Nagoya Protocol – a roughly decade-old pact that gives countries more rights and incentives over their native flora and fauna with the intention of protecting biodiversity – to restrict the flow of information about pathogens. The deliberate twisting of the protocol giving value to pathogens instead of protecting global health security is a bizarre and unprecedented threat to global health. Lest we forget, the system we had in place when COVID-19 arrived created multiple safe, effective vaccines against a novel, deadly contagion in a matter of months, produced billions of doses within a year, and has now delivered at least one dose to over 69% of the world’s 8 billion people. This is a record to build on, not to attack. Innovation and immediate access to pathogens should be at the center of all pandemic preparedness and response plan. Shaping a new ‘social contract’ Second, the world’s wealthiest nations must adopt a new framework for more equitable global distribution of vaccines and therapies. National leaders, morally accountable to their own citizens, can now nonetheless appreciate the value of global preparedness. As wave after wave of COVID-19 variants have taught wealthy nations, viruses do not respect economic advantage any more than they do geographic borders. Amidst a global contagion, none of us are safe until we all are. The framework that best reconciles different regions’ interests is one familiar to all democracies: the social contract under which citizens balance rights with responsibilities, independence with interdependence. Under a global pandemic preparedness “social contract”, pharmaceutical companies set aside stores of vaccines, treatments, and tests, based on real time production, for priority populations in lower-income countries. But for this to work, manufacturing countries need to allow part of what is produced in their territories to be exported to low-income countries in real-time. And of course, we need adequate funding upfront for organizations such as Gavi, the Vaccine Alliance, to sign contracts early on. Fostering sustainable manufacturing globally Third, Covid-19 showed how broad a global vaccine production program must be – and how much such a program depends on a stable legal and policy framework, which gives the confidence to parties to join forces, and share technology and know-how. The record is clear. By the end of 2022, pharmaceutical companies signed 381 vaccine manufacturing and production partnerships, and 150 more to produce COVID treatments – the vast majority of both involving technology transfer. To facilitate access and equity for the developing world, those partnerships included facilities based in India, Bangladesh, Egypt, and South Africa. The right enabling environment to attract sustainable investments and predictable demand will be critical to maintain existing capacity and introduce new capacity in other regions. Removing trade restrictions Fourth, the COVID-19 experience showed that when it comes to the development, manufacturing, and distribution of goods around the world, there is no substitute for free trade. Whatever arguments might exist for protectionist trade barriers in other sectors of the global economy, it is now obvious that those arguments do not apply to public health necessities in the middle of pandemics. Open trade saves lives. Ensuring greater country readiness And fifth, when it comes to global equity, the ability of less developed nations to absorb supplies is also paramount. These countries need help in strengthening their healthcare systems and making huge investments in health infrastructure to prevent, detect and respond to future threats while maintaining access to routine and essential services during a crisis. Later this month, WHO negotiators will be looking at all of the above – efficacy and equity, supply and demand, economic incentives and moral responsibilities – as members work to revise the current zero draft of a global pandemic Accord. Taking the time, here in this middle hour between crises, to get the policies and incentives right will yield the public health community the coordination, collaboration, and innovation we will need to overcome the inevitable next pandemic. ____________________ Thomas B Cueni, is the director general director general of the International Federation of Pharmaceutical Manufacturers and Associations. Image Credits: Pfizer, IFPMA . Vaccine Alliance Gavi Appoints Former Nigerian Health Minister as New CEO 13/02/2023 Kerry Cullinan Dr Muhammad Ali Pate, incoming Gavi CEO The global vaccine alliance, Gavi, has appointed former Nigerian health minister, Dr Muhammad Ali Pate, as its new CEO. Pate was Minister of State for Health in Nigeria between 2011 and 2013, where he led a national campaign to “revive routine immunisation and primary health care, chaired a presidential taskforce to eradicate polio and introduced new vaccines into the country”, according to Gavi. “It will be my privilege to lead Gavi and continue to support countries to scale up critical routine immunisation programmes, reach more zero-dose children, expand access to new vaccines, transform primary health care systems, and help fight outbreaks and future pandemics,” said Pate in a media release on Monday. He will join Gavi in August, replacing Dr Seth Berkley who has led the alliance for the past 12 years. Pate is a medical doctor trained in both internal medicine and infectious diseases who also has an MBA from Duke University in US. Between 2019 and 2021, he was the World Bank’s Global Director for Health, Nutrition and Population and headed the Global Financing Facility at the World Bank where he led the Bank’s $ 18 billion COVID-19 global health response. He is currently the Julio Frenk Professor of Public Health Leadership at Harvard Chan School of Public Health and has served on several health-focused boards and expert panels in the public, private and not-for-profit sectors during his career. Gavi undertook a year-long search for Berley’s replacement which was led by its board chair, Professor José Manuel Barroso. “Dr Pate stood out in a field of world-class candidates. With his knowledge and experience of both national immunization programming and international emergency response and global finance, I am confident that Gavi will continue to build on its vision and mission, as well as navigate the many challenges and opportunities we will face,” said Barroso. Meanwhile, Berkley described “leading Gavi and helping the alliance to continually surpass itself in terms of saving lives, protecting children and supporting countries during global health emergencies” as “the greatest honour of my career”. “I am confident in its future under Muhammad’s leadership. Having worked with him during his time as Minister and at the World Bank, I know he understands intimately the landscape we work in and will be uncompromising in his drive for public health equity,” added Berkley. Some important personal news: After leading @Gavi for the last 11+ yrs & for more than half of Gavi’s existence my term as @Gavi CEO will end in August. As a result, I’m delighted that today our Board confirmed @muhammadpate as our Alliance’s next leader https://t.co/EB06y2pcmM — Seth Berkley (@DrSethBerkley) February 13, 2023 Berkley has led Gavi since 2011, and during his tenure the alliance estimates that it has averted 11.8 million future deaths (compared to 4.5 million between 2000 and 2010); and has helped immunise more than 676 million children – more than double the 305 million children reached between 2000 and 2010. During his tenure, the alliance has added a number of new vaccines to its portfolio, including to prevent HPV, polio, cholera and malaria, and in its current strategy cycle is focusing on reaching zero-dose children across marginalised communities. “The economic result of Gavi’s expansion of activities during [Berkley’s] tenure has been profound, unlocking over $160 billion of economic benefits compared to $24 billion in its first 10 years.” Top 24 Multinational Companies’ Climate Pledges ‘Lack Integrity’ 13/02/2023 Kerry Cullinan The world’s biggest multinational companies are failing to meet the bold climate change pledges they have made – and are obfuscating their failures through “ambiguous commitments, offsetting plans that lack credibility and emission scope exclusions”. This is according to the Corporate Climate Responsibility Monitor 2023, which was released on Monday by Carbon Market Watch and NewClimate Institute. The report focuses on 24 multinational companies that have endorsed the Paris Agreement to ensure global warming does not exceed 1.5 degrees Celsius. Greenhouse gas and carbon emissions need to be cut by 43% and 48% respectively between 2019 and 2030 to limit the global temperature increase to 1.5°C, according to the Intergovernmental Panel on Climate Change (IPCC, 2022). But the companies’ targets only amount to a 15% reduction in “full value chain emissions between 2019 and 2030”. ‘Low integrity’ companies The climate strategies of American Airlines, Samsung Electronics, meat company JBS and retail and grocery multinational Carrefour were described as “very low integrity”. One rung up were the “low integrity” companies, including Amazon, DHL, Foxconn, Mercedes Benz, Pepsico, Volkswagen and Walmart. Their poor ratings were the result of “inadequacy or complete lack of explicit emission reduction commitments alongside ambiguous net-zero pledges”, according to the report. Apple, Arcelor Mittal, Google, H&M and Microsoft were some of the companies described as having “moderate integrity”, while shipping company Maersk was rated “reasonable” – the top rating of the companies. Together the 24 companies account for about 4% of all global greenhouse emissions. Substantial ‘greenwashing’ Warning of substantial “greenwashing”, the report called on “regulatory oversight at international, national and sectoral levels”. Speaking at the launch, Carbon Market Watch’s Lindsay Otis said that it had taken a team of accomplished researchers “a number of months” to understand the companies’ pledges and strategies. “Companies’ climate change commitments do not add up to what their pledges might suggest,” according to the report. Their 2030 targets can “rarely be taken at face value”, mainly because they focus on direct emissions or emissions from procured energy but exclude indirect emission categories that account for “over 90% of the greenhouse gas emission footprints for most of the companies we have assessed”. For others, 2030 targets are misleading due to reliance on offsetting. “The findings in our report suggest that many companies only plan to reduce a small share of their full emission footprint, relying instead on offsetting their remaining emissions with contentious carbon credits,” according to the report. “We find that at least three-quarters of the 24 sampled companies rely on forestry and land-use-related offsets. The demand for such carbon dioxide removals would exceed the potential of the world’s natural resource base by around two to four times if these practices would be replicated by other companies,” the report notes. “Moreover, these plans demonstrate the widespread lack of awareness that the biological storage of carbon is fundamentally unsuitable for offsetting claims due to the non-permanence of the climate impact.” Regulation “Companies must play a central role in finding and scaling up solutions for deep decarbonisation, but their efforts need urgent acceleration and appropriate regulatory frameworks,” according to the report. It cites the European Union’s Corporate Sustainability Reporting Directive, which enters into force this year 2023 and will introduce “tighter requirements for corporate climate strategies”. However, it calls for close monitored “to ensure a high standard of compliance”. ‘Be Loud’ About the Link Between Alcohol and Cancer 10/02/2023 Kristina Sperkova & Pubudu Sumanasekara Alcohol is linked to seven cancers, but public awareness of the links is low. Alcohol is the second biggest cause of cancer after tobacco, and Movendi is mobilizing communities worldwide to publicize the link At the WHO’s 152th Executive Board, an updated list of policy “best buys” to prevent and control non-communicable diseases (NCDs) was presented. The EB decided unanimously to adopt the updated list of cost-effective interventions in response to the lack of progress to prevent and reduce NCDs, as Health Policy Watch reported. Higher taxes and warning labels on unhealthy food, cigarettes and alcohol, and better screening for cancers, are some of the new “best buys” to accelerate action on NCDs, such as cancer, heart disease, diabetes, lung disease, and mental health conditions. No country is currently on track to achieve the 2030 global targets set by the World Health Assembly back in 2013, and the declaration by the UN General Assembly High-Level Meeting on NCDs in 2018 – including the 10% reduction of population-level alcohol use. One major public health problem that is worsening due to the lack of implementation of the NCDs best buys is cancer. Cancer kills nearly 10 million people a year, but the risk of dying from cancer varies greatly across the world. About 70% of these deaths are in low- and middle-income countries – and the disparity is worsening. For example, in Africa, cancer deaths are expected to more than double, reaching roughly 1.4 million deaths annually by 2040. Make a noise On World Cancer Day on 4 February, Movendi International launched an ambitious new campaign, “Be Loud For Change”. We are mobilizing communities around the world to make a noise about the direct link between alcohol and cancer, the low public recognition of the fact that alcohol causes seven types of cancer, and the unique opportunity for our governments to bring change through proven solutions. People want to know.People have a right to know.Alcohol causes 7 types of cancer.#loudforchange #WorldCancerDay #AlcoholHarms #CancerAwareness pic.twitter.com/jhaS9jJYdW — Movendi International (@Movendi_Int) February 4, 2023 Since 1988, alcohol – like tobacco and asbestos – has been scientifically proven to be a group one carcinogen. When humans consume ethanol in beer, wine, and liquor, the byproduct attacks the DNA. But the media found it difficult to report properly on the real effects of alcohol and instead helped the alcohol industry to keep people in the dark. After tobacco, alcohol is the second biggest cause of cancer – before other risk factors such as infections, physical inactivity, or sunlight. Globally, 740,000 people get cancer due to alcohol, each year. The alcohol industry wants to keep people in the dark about the fact that their products are as carcinogenic as cigarettes and asbestos. Research has shown that awareness of the link between alcohol and cancer is very low internationally. Alcohol companies are afraid of people becoming aware of the fact that ethanol in beer, wine, and liquor causes at least seven types of cancer. And so they fight tooth and nail against scientific studies, warning labels on alcohol products, and other alcohol policy solutions contained in the recently updated list of NCD best buys. The wide support of the WHO Executive Board and growing momentum for addressing cancer risk factors, such as alcohol, mean something significant: The world is experiencing a shift in awareness about alcohol harm, driven by growing awareness that alcohol causes cancer. And the world is experiencing a shift in perception of alcohol policy solutions. The alcohol policy best buys – raising alcohol taxes, banning alcohol advertising, limiting alcohol availability – help prevent diseases such as cancer and heart disease; they help strengthen health systems; and they boost economic growth. Alcohol taxes and warning labels This means, our governments can do a lot to bring about change. They can develop alcohol taxation systems that effectively protect people from alcohol harm, including cancer. For example, reducing total alcohol consumption by 10% would lead to a 9% reduction in alcohol-related cancer deaths. That means ca. 57.000 fewer deaths. Our governments can also put warning labels on alcoholic products informing about cancer, heart disease, and other alcohol harms. They can fund mass media campaigns to increase public recognition of the real harm due to alcohol. They can ban alcohol advertising, sponsorship, and promotion. And our governments can put in place common sense limits on the presence of alcohol in our communities. Our governments have proven solutions at their disposal. There has never been a better time for an ambitious approach to protect our societies from cancer caused by alcohol. Such an initiative will protect and improve the health and well-being of people and communities, it will strengthen our health systems as alcohol harms, such as cancer cases and deaths, decline, and will unlock fresh resources for investment in health promotion and disease prevention. Kristina Sperkova is International President of Movendi International Pubudu Sumanasekara is International Vice President of Movendi International Image Credits: Taylor Brandon/ Unsplash. Ukraine War Sparks Global Health Crisis 10/02/2023 Editorial team Over eight million Ukrainians have fled the country. Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues. “The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute. “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. “Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said. ‘Defend Europe’ Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”. “A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare. At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging. International food security Ukraine food crisis The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa. “Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt. The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added. While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found. “We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked. The role of international actors In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. Looking forward, international cooperation is also going to be crucial after the war ends. “[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.” First priority Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January. “Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” “We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged. Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted. “I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” “The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed. Mental health emergency People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges. “One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face. Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.” The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues. Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers. “It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. “Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.” “There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.” Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter . Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Vaccine Alliance Gavi Appoints Former Nigerian Health Minister as New CEO 13/02/2023 Kerry Cullinan Dr Muhammad Ali Pate, incoming Gavi CEO The global vaccine alliance, Gavi, has appointed former Nigerian health minister, Dr Muhammad Ali Pate, as its new CEO. Pate was Minister of State for Health in Nigeria between 2011 and 2013, where he led a national campaign to “revive routine immunisation and primary health care, chaired a presidential taskforce to eradicate polio and introduced new vaccines into the country”, according to Gavi. “It will be my privilege to lead Gavi and continue to support countries to scale up critical routine immunisation programmes, reach more zero-dose children, expand access to new vaccines, transform primary health care systems, and help fight outbreaks and future pandemics,” said Pate in a media release on Monday. He will join Gavi in August, replacing Dr Seth Berkley who has led the alliance for the past 12 years. Pate is a medical doctor trained in both internal medicine and infectious diseases who also has an MBA from Duke University in US. Between 2019 and 2021, he was the World Bank’s Global Director for Health, Nutrition and Population and headed the Global Financing Facility at the World Bank where he led the Bank’s $ 18 billion COVID-19 global health response. He is currently the Julio Frenk Professor of Public Health Leadership at Harvard Chan School of Public Health and has served on several health-focused boards and expert panels in the public, private and not-for-profit sectors during his career. Gavi undertook a year-long search for Berley’s replacement which was led by its board chair, Professor José Manuel Barroso. “Dr Pate stood out in a field of world-class candidates. With his knowledge and experience of both national immunization programming and international emergency response and global finance, I am confident that Gavi will continue to build on its vision and mission, as well as navigate the many challenges and opportunities we will face,” said Barroso. Meanwhile, Berkley described “leading Gavi and helping the alliance to continually surpass itself in terms of saving lives, protecting children and supporting countries during global health emergencies” as “the greatest honour of my career”. “I am confident in its future under Muhammad’s leadership. Having worked with him during his time as Minister and at the World Bank, I know he understands intimately the landscape we work in and will be uncompromising in his drive for public health equity,” added Berkley. Some important personal news: After leading @Gavi for the last 11+ yrs & for more than half of Gavi’s existence my term as @Gavi CEO will end in August. As a result, I’m delighted that today our Board confirmed @muhammadpate as our Alliance’s next leader https://t.co/EB06y2pcmM — Seth Berkley (@DrSethBerkley) February 13, 2023 Berkley has led Gavi since 2011, and during his tenure the alliance estimates that it has averted 11.8 million future deaths (compared to 4.5 million between 2000 and 2010); and has helped immunise more than 676 million children – more than double the 305 million children reached between 2000 and 2010. During his tenure, the alliance has added a number of new vaccines to its portfolio, including to prevent HPV, polio, cholera and malaria, and in its current strategy cycle is focusing on reaching zero-dose children across marginalised communities. “The economic result of Gavi’s expansion of activities during [Berkley’s] tenure has been profound, unlocking over $160 billion of economic benefits compared to $24 billion in its first 10 years.” Top 24 Multinational Companies’ Climate Pledges ‘Lack Integrity’ 13/02/2023 Kerry Cullinan The world’s biggest multinational companies are failing to meet the bold climate change pledges they have made – and are obfuscating their failures through “ambiguous commitments, offsetting plans that lack credibility and emission scope exclusions”. This is according to the Corporate Climate Responsibility Monitor 2023, which was released on Monday by Carbon Market Watch and NewClimate Institute. The report focuses on 24 multinational companies that have endorsed the Paris Agreement to ensure global warming does not exceed 1.5 degrees Celsius. Greenhouse gas and carbon emissions need to be cut by 43% and 48% respectively between 2019 and 2030 to limit the global temperature increase to 1.5°C, according to the Intergovernmental Panel on Climate Change (IPCC, 2022). But the companies’ targets only amount to a 15% reduction in “full value chain emissions between 2019 and 2030”. ‘Low integrity’ companies The climate strategies of American Airlines, Samsung Electronics, meat company JBS and retail and grocery multinational Carrefour were described as “very low integrity”. One rung up were the “low integrity” companies, including Amazon, DHL, Foxconn, Mercedes Benz, Pepsico, Volkswagen and Walmart. Their poor ratings were the result of “inadequacy or complete lack of explicit emission reduction commitments alongside ambiguous net-zero pledges”, according to the report. Apple, Arcelor Mittal, Google, H&M and Microsoft were some of the companies described as having “moderate integrity”, while shipping company Maersk was rated “reasonable” – the top rating of the companies. Together the 24 companies account for about 4% of all global greenhouse emissions. Substantial ‘greenwashing’ Warning of substantial “greenwashing”, the report called on “regulatory oversight at international, national and sectoral levels”. Speaking at the launch, Carbon Market Watch’s Lindsay Otis said that it had taken a team of accomplished researchers “a number of months” to understand the companies’ pledges and strategies. “Companies’ climate change commitments do not add up to what their pledges might suggest,” according to the report. Their 2030 targets can “rarely be taken at face value”, mainly because they focus on direct emissions or emissions from procured energy but exclude indirect emission categories that account for “over 90% of the greenhouse gas emission footprints for most of the companies we have assessed”. For others, 2030 targets are misleading due to reliance on offsetting. “The findings in our report suggest that many companies only plan to reduce a small share of their full emission footprint, relying instead on offsetting their remaining emissions with contentious carbon credits,” according to the report. “We find that at least three-quarters of the 24 sampled companies rely on forestry and land-use-related offsets. The demand for such carbon dioxide removals would exceed the potential of the world’s natural resource base by around two to four times if these practices would be replicated by other companies,” the report notes. “Moreover, these plans demonstrate the widespread lack of awareness that the biological storage of carbon is fundamentally unsuitable for offsetting claims due to the non-permanence of the climate impact.” Regulation “Companies must play a central role in finding and scaling up solutions for deep decarbonisation, but their efforts need urgent acceleration and appropriate regulatory frameworks,” according to the report. It cites the European Union’s Corporate Sustainability Reporting Directive, which enters into force this year 2023 and will introduce “tighter requirements for corporate climate strategies”. However, it calls for close monitored “to ensure a high standard of compliance”. ‘Be Loud’ About the Link Between Alcohol and Cancer 10/02/2023 Kristina Sperkova & Pubudu Sumanasekara Alcohol is linked to seven cancers, but public awareness of the links is low. Alcohol is the second biggest cause of cancer after tobacco, and Movendi is mobilizing communities worldwide to publicize the link At the WHO’s 152th Executive Board, an updated list of policy “best buys” to prevent and control non-communicable diseases (NCDs) was presented. The EB decided unanimously to adopt the updated list of cost-effective interventions in response to the lack of progress to prevent and reduce NCDs, as Health Policy Watch reported. Higher taxes and warning labels on unhealthy food, cigarettes and alcohol, and better screening for cancers, are some of the new “best buys” to accelerate action on NCDs, such as cancer, heart disease, diabetes, lung disease, and mental health conditions. No country is currently on track to achieve the 2030 global targets set by the World Health Assembly back in 2013, and the declaration by the UN General Assembly High-Level Meeting on NCDs in 2018 – including the 10% reduction of population-level alcohol use. One major public health problem that is worsening due to the lack of implementation of the NCDs best buys is cancer. Cancer kills nearly 10 million people a year, but the risk of dying from cancer varies greatly across the world. About 70% of these deaths are in low- and middle-income countries – and the disparity is worsening. For example, in Africa, cancer deaths are expected to more than double, reaching roughly 1.4 million deaths annually by 2040. Make a noise On World Cancer Day on 4 February, Movendi International launched an ambitious new campaign, “Be Loud For Change”. We are mobilizing communities around the world to make a noise about the direct link between alcohol and cancer, the low public recognition of the fact that alcohol causes seven types of cancer, and the unique opportunity for our governments to bring change through proven solutions. People want to know.People have a right to know.Alcohol causes 7 types of cancer.#loudforchange #WorldCancerDay #AlcoholHarms #CancerAwareness pic.twitter.com/jhaS9jJYdW — Movendi International (@Movendi_Int) February 4, 2023 Since 1988, alcohol – like tobacco and asbestos – has been scientifically proven to be a group one carcinogen. When humans consume ethanol in beer, wine, and liquor, the byproduct attacks the DNA. But the media found it difficult to report properly on the real effects of alcohol and instead helped the alcohol industry to keep people in the dark. After tobacco, alcohol is the second biggest cause of cancer – before other risk factors such as infections, physical inactivity, or sunlight. Globally, 740,000 people get cancer due to alcohol, each year. The alcohol industry wants to keep people in the dark about the fact that their products are as carcinogenic as cigarettes and asbestos. Research has shown that awareness of the link between alcohol and cancer is very low internationally. Alcohol companies are afraid of people becoming aware of the fact that ethanol in beer, wine, and liquor causes at least seven types of cancer. And so they fight tooth and nail against scientific studies, warning labels on alcohol products, and other alcohol policy solutions contained in the recently updated list of NCD best buys. The wide support of the WHO Executive Board and growing momentum for addressing cancer risk factors, such as alcohol, mean something significant: The world is experiencing a shift in awareness about alcohol harm, driven by growing awareness that alcohol causes cancer. And the world is experiencing a shift in perception of alcohol policy solutions. The alcohol policy best buys – raising alcohol taxes, banning alcohol advertising, limiting alcohol availability – help prevent diseases such as cancer and heart disease; they help strengthen health systems; and they boost economic growth. Alcohol taxes and warning labels This means, our governments can do a lot to bring about change. They can develop alcohol taxation systems that effectively protect people from alcohol harm, including cancer. For example, reducing total alcohol consumption by 10% would lead to a 9% reduction in alcohol-related cancer deaths. That means ca. 57.000 fewer deaths. Our governments can also put warning labels on alcoholic products informing about cancer, heart disease, and other alcohol harms. They can fund mass media campaigns to increase public recognition of the real harm due to alcohol. They can ban alcohol advertising, sponsorship, and promotion. And our governments can put in place common sense limits on the presence of alcohol in our communities. Our governments have proven solutions at their disposal. There has never been a better time for an ambitious approach to protect our societies from cancer caused by alcohol. Such an initiative will protect and improve the health and well-being of people and communities, it will strengthen our health systems as alcohol harms, such as cancer cases and deaths, decline, and will unlock fresh resources for investment in health promotion and disease prevention. Kristina Sperkova is International President of Movendi International Pubudu Sumanasekara is International Vice President of Movendi International Image Credits: Taylor Brandon/ Unsplash. Ukraine War Sparks Global Health Crisis 10/02/2023 Editorial team Over eight million Ukrainians have fled the country. Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues. “The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute. “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. “Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said. ‘Defend Europe’ Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”. “A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare. At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging. International food security Ukraine food crisis The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa. “Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt. The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added. While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found. “We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked. The role of international actors In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. Looking forward, international cooperation is also going to be crucial after the war ends. “[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.” First priority Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January. “Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” “We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged. Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted. “I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” “The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed. Mental health emergency People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges. “One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face. Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.” The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues. Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers. “It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. “Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.” “There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.” Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter . Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Top 24 Multinational Companies’ Climate Pledges ‘Lack Integrity’ 13/02/2023 Kerry Cullinan The world’s biggest multinational companies are failing to meet the bold climate change pledges they have made – and are obfuscating their failures through “ambiguous commitments, offsetting plans that lack credibility and emission scope exclusions”. This is according to the Corporate Climate Responsibility Monitor 2023, which was released on Monday by Carbon Market Watch and NewClimate Institute. The report focuses on 24 multinational companies that have endorsed the Paris Agreement to ensure global warming does not exceed 1.5 degrees Celsius. Greenhouse gas and carbon emissions need to be cut by 43% and 48% respectively between 2019 and 2030 to limit the global temperature increase to 1.5°C, according to the Intergovernmental Panel on Climate Change (IPCC, 2022). But the companies’ targets only amount to a 15% reduction in “full value chain emissions between 2019 and 2030”. ‘Low integrity’ companies The climate strategies of American Airlines, Samsung Electronics, meat company JBS and retail and grocery multinational Carrefour were described as “very low integrity”. One rung up were the “low integrity” companies, including Amazon, DHL, Foxconn, Mercedes Benz, Pepsico, Volkswagen and Walmart. Their poor ratings were the result of “inadequacy or complete lack of explicit emission reduction commitments alongside ambiguous net-zero pledges”, according to the report. Apple, Arcelor Mittal, Google, H&M and Microsoft were some of the companies described as having “moderate integrity”, while shipping company Maersk was rated “reasonable” – the top rating of the companies. Together the 24 companies account for about 4% of all global greenhouse emissions. Substantial ‘greenwashing’ Warning of substantial “greenwashing”, the report called on “regulatory oversight at international, national and sectoral levels”. Speaking at the launch, Carbon Market Watch’s Lindsay Otis said that it had taken a team of accomplished researchers “a number of months” to understand the companies’ pledges and strategies. “Companies’ climate change commitments do not add up to what their pledges might suggest,” according to the report. Their 2030 targets can “rarely be taken at face value”, mainly because they focus on direct emissions or emissions from procured energy but exclude indirect emission categories that account for “over 90% of the greenhouse gas emission footprints for most of the companies we have assessed”. For others, 2030 targets are misleading due to reliance on offsetting. “The findings in our report suggest that many companies only plan to reduce a small share of their full emission footprint, relying instead on offsetting their remaining emissions with contentious carbon credits,” according to the report. “We find that at least three-quarters of the 24 sampled companies rely on forestry and land-use-related offsets. The demand for such carbon dioxide removals would exceed the potential of the world’s natural resource base by around two to four times if these practices would be replicated by other companies,” the report notes. “Moreover, these plans demonstrate the widespread lack of awareness that the biological storage of carbon is fundamentally unsuitable for offsetting claims due to the non-permanence of the climate impact.” Regulation “Companies must play a central role in finding and scaling up solutions for deep decarbonisation, but their efforts need urgent acceleration and appropriate regulatory frameworks,” according to the report. It cites the European Union’s Corporate Sustainability Reporting Directive, which enters into force this year 2023 and will introduce “tighter requirements for corporate climate strategies”. However, it calls for close monitored “to ensure a high standard of compliance”. ‘Be Loud’ About the Link Between Alcohol and Cancer 10/02/2023 Kristina Sperkova & Pubudu Sumanasekara Alcohol is linked to seven cancers, but public awareness of the links is low. Alcohol is the second biggest cause of cancer after tobacco, and Movendi is mobilizing communities worldwide to publicize the link At the WHO’s 152th Executive Board, an updated list of policy “best buys” to prevent and control non-communicable diseases (NCDs) was presented. The EB decided unanimously to adopt the updated list of cost-effective interventions in response to the lack of progress to prevent and reduce NCDs, as Health Policy Watch reported. Higher taxes and warning labels on unhealthy food, cigarettes and alcohol, and better screening for cancers, are some of the new “best buys” to accelerate action on NCDs, such as cancer, heart disease, diabetes, lung disease, and mental health conditions. No country is currently on track to achieve the 2030 global targets set by the World Health Assembly back in 2013, and the declaration by the UN General Assembly High-Level Meeting on NCDs in 2018 – including the 10% reduction of population-level alcohol use. One major public health problem that is worsening due to the lack of implementation of the NCDs best buys is cancer. Cancer kills nearly 10 million people a year, but the risk of dying from cancer varies greatly across the world. About 70% of these deaths are in low- and middle-income countries – and the disparity is worsening. For example, in Africa, cancer deaths are expected to more than double, reaching roughly 1.4 million deaths annually by 2040. Make a noise On World Cancer Day on 4 February, Movendi International launched an ambitious new campaign, “Be Loud For Change”. We are mobilizing communities around the world to make a noise about the direct link between alcohol and cancer, the low public recognition of the fact that alcohol causes seven types of cancer, and the unique opportunity for our governments to bring change through proven solutions. People want to know.People have a right to know.Alcohol causes 7 types of cancer.#loudforchange #WorldCancerDay #AlcoholHarms #CancerAwareness pic.twitter.com/jhaS9jJYdW — Movendi International (@Movendi_Int) February 4, 2023 Since 1988, alcohol – like tobacco and asbestos – has been scientifically proven to be a group one carcinogen. When humans consume ethanol in beer, wine, and liquor, the byproduct attacks the DNA. But the media found it difficult to report properly on the real effects of alcohol and instead helped the alcohol industry to keep people in the dark. After tobacco, alcohol is the second biggest cause of cancer – before other risk factors such as infections, physical inactivity, or sunlight. Globally, 740,000 people get cancer due to alcohol, each year. The alcohol industry wants to keep people in the dark about the fact that their products are as carcinogenic as cigarettes and asbestos. Research has shown that awareness of the link between alcohol and cancer is very low internationally. Alcohol companies are afraid of people becoming aware of the fact that ethanol in beer, wine, and liquor causes at least seven types of cancer. And so they fight tooth and nail against scientific studies, warning labels on alcohol products, and other alcohol policy solutions contained in the recently updated list of NCD best buys. The wide support of the WHO Executive Board and growing momentum for addressing cancer risk factors, such as alcohol, mean something significant: The world is experiencing a shift in awareness about alcohol harm, driven by growing awareness that alcohol causes cancer. And the world is experiencing a shift in perception of alcohol policy solutions. The alcohol policy best buys – raising alcohol taxes, banning alcohol advertising, limiting alcohol availability – help prevent diseases such as cancer and heart disease; they help strengthen health systems; and they boost economic growth. Alcohol taxes and warning labels This means, our governments can do a lot to bring about change. They can develop alcohol taxation systems that effectively protect people from alcohol harm, including cancer. For example, reducing total alcohol consumption by 10% would lead to a 9% reduction in alcohol-related cancer deaths. That means ca. 57.000 fewer deaths. Our governments can also put warning labels on alcoholic products informing about cancer, heart disease, and other alcohol harms. They can fund mass media campaigns to increase public recognition of the real harm due to alcohol. They can ban alcohol advertising, sponsorship, and promotion. And our governments can put in place common sense limits on the presence of alcohol in our communities. Our governments have proven solutions at their disposal. There has never been a better time for an ambitious approach to protect our societies from cancer caused by alcohol. Such an initiative will protect and improve the health and well-being of people and communities, it will strengthen our health systems as alcohol harms, such as cancer cases and deaths, decline, and will unlock fresh resources for investment in health promotion and disease prevention. Kristina Sperkova is International President of Movendi International Pubudu Sumanasekara is International Vice President of Movendi International Image Credits: Taylor Brandon/ Unsplash. Ukraine War Sparks Global Health Crisis 10/02/2023 Editorial team Over eight million Ukrainians have fled the country. Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues. “The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute. “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. “Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said. ‘Defend Europe’ Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”. “A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare. At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging. International food security Ukraine food crisis The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa. “Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt. The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added. While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found. “We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked. The role of international actors In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. Looking forward, international cooperation is also going to be crucial after the war ends. “[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.” First priority Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January. “Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” “We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged. Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted. “I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” “The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed. Mental health emergency People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges. “One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face. Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.” The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues. Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers. “It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. “Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.” “There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.” Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter . Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
‘Be Loud’ About the Link Between Alcohol and Cancer 10/02/2023 Kristina Sperkova & Pubudu Sumanasekara Alcohol is linked to seven cancers, but public awareness of the links is low. Alcohol is the second biggest cause of cancer after tobacco, and Movendi is mobilizing communities worldwide to publicize the link At the WHO’s 152th Executive Board, an updated list of policy “best buys” to prevent and control non-communicable diseases (NCDs) was presented. The EB decided unanimously to adopt the updated list of cost-effective interventions in response to the lack of progress to prevent and reduce NCDs, as Health Policy Watch reported. Higher taxes and warning labels on unhealthy food, cigarettes and alcohol, and better screening for cancers, are some of the new “best buys” to accelerate action on NCDs, such as cancer, heart disease, diabetes, lung disease, and mental health conditions. No country is currently on track to achieve the 2030 global targets set by the World Health Assembly back in 2013, and the declaration by the UN General Assembly High-Level Meeting on NCDs in 2018 – including the 10% reduction of population-level alcohol use. One major public health problem that is worsening due to the lack of implementation of the NCDs best buys is cancer. Cancer kills nearly 10 million people a year, but the risk of dying from cancer varies greatly across the world. About 70% of these deaths are in low- and middle-income countries – and the disparity is worsening. For example, in Africa, cancer deaths are expected to more than double, reaching roughly 1.4 million deaths annually by 2040. Make a noise On World Cancer Day on 4 February, Movendi International launched an ambitious new campaign, “Be Loud For Change”. We are mobilizing communities around the world to make a noise about the direct link between alcohol and cancer, the low public recognition of the fact that alcohol causes seven types of cancer, and the unique opportunity for our governments to bring change through proven solutions. People want to know.People have a right to know.Alcohol causes 7 types of cancer.#loudforchange #WorldCancerDay #AlcoholHarms #CancerAwareness pic.twitter.com/jhaS9jJYdW — Movendi International (@Movendi_Int) February 4, 2023 Since 1988, alcohol – like tobacco and asbestos – has been scientifically proven to be a group one carcinogen. When humans consume ethanol in beer, wine, and liquor, the byproduct attacks the DNA. But the media found it difficult to report properly on the real effects of alcohol and instead helped the alcohol industry to keep people in the dark. After tobacco, alcohol is the second biggest cause of cancer – before other risk factors such as infections, physical inactivity, or sunlight. Globally, 740,000 people get cancer due to alcohol, each year. The alcohol industry wants to keep people in the dark about the fact that their products are as carcinogenic as cigarettes and asbestos. Research has shown that awareness of the link between alcohol and cancer is very low internationally. Alcohol companies are afraid of people becoming aware of the fact that ethanol in beer, wine, and liquor causes at least seven types of cancer. And so they fight tooth and nail against scientific studies, warning labels on alcohol products, and other alcohol policy solutions contained in the recently updated list of NCD best buys. The wide support of the WHO Executive Board and growing momentum for addressing cancer risk factors, such as alcohol, mean something significant: The world is experiencing a shift in awareness about alcohol harm, driven by growing awareness that alcohol causes cancer. And the world is experiencing a shift in perception of alcohol policy solutions. The alcohol policy best buys – raising alcohol taxes, banning alcohol advertising, limiting alcohol availability – help prevent diseases such as cancer and heart disease; they help strengthen health systems; and they boost economic growth. Alcohol taxes and warning labels This means, our governments can do a lot to bring about change. They can develop alcohol taxation systems that effectively protect people from alcohol harm, including cancer. For example, reducing total alcohol consumption by 10% would lead to a 9% reduction in alcohol-related cancer deaths. That means ca. 57.000 fewer deaths. Our governments can also put warning labels on alcoholic products informing about cancer, heart disease, and other alcohol harms. They can fund mass media campaigns to increase public recognition of the real harm due to alcohol. They can ban alcohol advertising, sponsorship, and promotion. And our governments can put in place common sense limits on the presence of alcohol in our communities. Our governments have proven solutions at their disposal. There has never been a better time for an ambitious approach to protect our societies from cancer caused by alcohol. Such an initiative will protect and improve the health and well-being of people and communities, it will strengthen our health systems as alcohol harms, such as cancer cases and deaths, decline, and will unlock fresh resources for investment in health promotion and disease prevention. Kristina Sperkova is International President of Movendi International Pubudu Sumanasekara is International Vice President of Movendi International Image Credits: Taylor Brandon/ Unsplash. Ukraine War Sparks Global Health Crisis 10/02/2023 Editorial team Over eight million Ukrainians have fled the country. Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues. “The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute. “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. “Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said. ‘Defend Europe’ Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”. “A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare. At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging. International food security Ukraine food crisis The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa. “Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt. The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added. While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found. “We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked. The role of international actors In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. Looking forward, international cooperation is also going to be crucial after the war ends. “[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.” First priority Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January. “Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” “We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged. Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted. “I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” “The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed. Mental health emergency People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges. “One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face. Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.” The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues. Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers. “It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. “Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.” “There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.” Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter . Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Ukraine War Sparks Global Health Crisis 10/02/2023 Editorial team Over eight million Ukrainians have fled the country. Russia’s war in Ukraine has sparked a global health crisis – from the death, suffering and displacement of people in the country to the global food and fuel insecurity, and diminished donor funds to support other health issues. “The UN High Commission for Refugees estimated that about 17.6 million Ukrainians, which is about 43% of Ukraine’s population of 41 million, will need humanitarian assistance in the year 2023,” Ulana Suprun, a former Ukrainian health minister, told a webinar organized by the Global Health Center at the Geneva Graduate Institute. “Some 45% of those are women, 23% are children and 15% are people with disabilities,” she said. While the latest official civilian death toll as recorded by the Office of the UN High Commission on Human Rights, stands at 7,155, the real number could be as high as 100,000, Suprun pointed out. “Nearly eight million people have been displaced going into neighbouring countries, and 5.3 million people are internally displaced,” she said. ‘Defend Europe’ Suprun was part of a panel looking at the global health impact of the war In Ukraine, which took place on Wednesday, shortly after Ukraine’s President Voldymyr Zelensky addressed the European Parliament, and appealed for his country to be admitted to the European Union and for more weapons to “defend Europe”. “A number of the governments that have traditionally been the largest donors to global health initiatives, such as in Europe and the United States, have sent millions of dollars in aid to Ukraine, and this has raised difficult questions in many capitals, about whether they can continue at the same level of funding to other global health initiatives,” said moderator Suerie Moon, co-director of Global Health Centre. In spite of the difficulties, including the deliberate targeting of health facilities by the Russian army, with 171 health facilities completely destroyed and at least 1,200 damaged anywhere between 10 and 90%, Suprum said the health system is functioning surprisingly well. This is also thanks to a process of healthcare reforms that the country has been conducting for the past six years to begin implementing universal healthcare. At the same time, she highlighted how international help has been crucial while the logistics of supplying Ukraine with necessary items such as medicines, electric generators and food remains very challenging. International food security Ukraine food crisis The war has disrupted food supply chains well beyond Ukraine, said Ahmad Mukhtar, a senior economist at the Food and Agricultural Organization (FAO) for Near East and North Africa. “Ukraine and the Russian Federation are some of the largest producers of the Black Sea region and a lot of the world depends on the Black Sea for seedlings exports,” said Mukhtar, who is based in Egypt. The world already had a food security problem on the eve of the COVID-19 pandemic, but until 2019, the absolute number of people suffering from hunger had been declining, he added. The pandemic, followed by the war, had caused an increase in numbers. The WHO has been trying to persuade countries to promote healthy and nutritious diets, but many nations are grappling with food security and consider such diets to be luxuries that only rich countries can afford, despite the detrimental long-term effects of unbalanced diets, he added. While the Black Sea Grain Initiative brokered by the UN last July, has allowed significant volumes of grain to be exported from three key Ukrainian ports in the Black Sea – Odesa, Chornomorsk, Yuzhny – Mukhtar called for a “new and more general approach” to food security to be found. “We are going to have a global food systems reset, let us recognize, internalize and manage it so that it will be a win-win for everyone, including citizens, governments and the global community,” he said. Working on countries’ self-sufficiency in food production can be one of the tools, but at the same time it is necessary to help over 100 nations for which this is not an attainable goal with trade mechanisms “more from a food security and humanitarian perspective, rather than the transactional perspective, that is the state of affairs for now,” he remarked. The role of international actors In light of the crisis in Ukraine, the international actors must continue to guarantee their financial support to Kyiv, otherwise “Ukraine and its healthcare system will not continue to function and people will not receive their salaries,” said Michel Kazatchkine, Special Advisor to WHO Europe, and a Senior Fellow and Course Director at the Global Health Centre. Kazatchkine suggested that the international community should also prioritize persuading Russia to give international humanitarian organizations access to the occupied territories to assess their health needs. Looking forward, international cooperation is also going to be crucial after the war ends. “[Ukraine] is working on reforming its systems and looking towards reconstruction,” Kazatchkine said. “And of course, here the international donors will have a key role in terms of budgetary support, but also in terms of helping Ukraine to reconstruct hospitals and other health care facilities not as they were before, but as facilities responding to the best modern standards of care.” First priority Jakob Ström, a senior health diplomat at the Swedish Ministry for Foreign Affairs, said Stockholm considers supporting Ukraine one of the highest priorities of its presidency of the EU Council, which began on 1 January. “Our government has been very clear that Ukraine is the number one priority for our development cooperation during the EU presidency,” he said. “The second priority for the Swedish EU presidency in this field is global health, and the third is corruption.” “We can and we will combine the engagement with Ukraine with global solidarity on issues such as food security, climate change and global health,” he pledged. Both Kazatchkine and Ström agreed that, despite the war, international negotiations in the health field had not been disrupted. “I don’t think that multilateral negotiations are immune from geopolitics,” said Ström. However, I disagree that the Russian aggression against Ukraine has disrupted negotiations in Geneva on health because we’ve been witnessing an increased interest in matters related to global health.” “The Russian Federation keeps sending strong messages that it wants to be part of WHO,” Kazatchkine echoed. Mental health emergency People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. As Ukraine is working around the clock to provide for the health needs of its people, one of the major emergencies is assisting Ukrainians with mental health challenges. “One in every four Ukrainians – about 10 million people – are at risk of having mental health issues as time goes on,” said Suprun. “That’s something that we need to face. Ukrainian First Lady Olena Zelenska is coordinating an initiative partnering with national and international organizations to handle the emergency.” The efforts involve offering further training to mental health specialists, setting up specialized hotlines and creating a program for primary health physicians to recognize and provide at least first aid in mental health issues. Suprun highlighted that one of the current mental health emergencies is helping victims of sexual violence perpetrated by Russian soldiers. “It is currently very difficult to establish the exact number of victims of sexual violence by the Russian occupiers,” she said. “Although people don’t want to remember it and relive the horror, documenting it is very important, and we need the information as well as to identify those people so that we can provide help for them.” “There is one country here that is at fault,” Suprun concluded. “It is very nice to say that health care is not political or global health doesn’t get involved in politics. But we can see today that global health is being impacted by the war that Russia started in Ukraine.” Image Credits: Sam Mednick/TNH, People in Need, Joseph C. Okechukwu/Twitter . Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
Malawi Battles Worst Cholera Outbreak Ever Amid Ongoing Global Vaccine Shortage 09/02/2023 Kerry Cullinan Cholera flourishes in dirty water. As Malawi struggles with its biggest-ever cholera outbreak, its response is being hampered by the global shortage of vaccines, warned Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response at a media briefing on Thursday. By Wednesday, Malawi had recorded 40,284 cases and 1,316 deaths, with a case fatality rate of 3.3%, Dr Charles Mwansambo, Malawi’s Secretary for Health, told the WHO Africa media briefing. Confirming that his country had run out of vaccines last month, Mwansambo said that while the vaccines were important in preventing transmission, cholera could only be stopped by addressing “water, sanitation and hygiene”. “What is a bit unusual is that this cholera outbreak started during the dry season,” added Mwansambo. “Last year, we had tropical cyclones and floods that destroyed most of the water and sanitation facilities in the southern region, and this was the start of the current problem of cholera. “We then had cases in the fishing community in the north, which is a very mobile population, and it has gone out of control. So there are a number of issues, starting with climate and the weather.” Dr Charles Mwansambo, Malawi’s Secretary for Health, Horn of Africa drought Ten countries in the African region have reported cholera cases, with the DRC recording over 3,000 cases, mostly in the north of the country which has been destabilised by M23 insurgents. Many people displaced by the conflict between M23 and government forces are living in close quarters in camps with inadequate water and sanitation – a breeding ground for the rapidly spreading cholera bacteria that breed in dirty water, contaminated food and sewage. #Africa 🌍 is witnessing an exponential rise in cholera cases amid a global surge. Cases recorded on the continent in January 2023 alone have already risen by more than 30% of the total caseload reached in the whole of 2022 👉🏿 https://t.co/HdzcBwMEPm pic.twitter.com/hPgszmmYSo — WHO African Region (@WHOAFRO) February 9, 2023 DRC health official Dr Placide Welo Okitayemba said that most people in the camps got their water from water tankers, and many of the children in the camps are malnourished “and cholera progresses faster in children who are malnourished”. “Some of the camps are in mountainous areas and it is hard to get water to them, so we may have to move some of the camps,” added Okitayemba, who directs the DRC’s cholera control programme. The drought in the Horn of Africa is driving cholera cases in Kenya, Somalia and Ethiopia. Case statistics for January alone accounted for 30% of the total cases in 2022, added Ramadan. “We are concerned that, if this trend continues, we will far exceed the number of cases that we’ve seen in 2022 and it will put significant strain on the health systems in the countries that are affected, but also significant demand on the medical countermeasures that we need to respond to this,” he added. Acute shortage of vaccines With 18 countries globally reporting vaccines, there is an “acute shortage of oral cholera vaccines, routinely used to stop transmission in areas where access to safe water cannot be rapidly scaled up”, said Ramadan. To alleviate this shortage, the WHO recommended using a single dose of the two-dose vaccine last October, while at a global level, the WHO has been engaging with manufacturers. As previously reported by Health Policy Watch, only two global suppliers make cholera vaccines available for mass vaccinations. Shanchol is produced by Shanta Biotechnics, a Sanofi subsidiary in India, and Euvichol-Plus, made by EuBiologics in South Korea. Both companies supply the international cholera vaccine stockpile managed by the International Coordinating Group (ICG), a mechanism that coordinates the provision of emergency vaccines and antibiotics to countries during major outbreaks. All countries that need cholera vaccines apply to the ICG, and those that qualify for Gavi financing get free vaccines while the others need to reimburse the stockpile. But Shanta Biotechnics announced a while back that it will stop making Shanchol this year, while production at EuBiologics is currently constrained as the company is expanding its facilities. The expansion will ultimately enable it to produce 50 million vaccines a year. Countries are also short of pre-packed cholera kits containing IV fluids and other measures to address infections, said Ramadan. Dr Patrick Otim Ramadan, World Health Organization (WHO) Africa’s Incident Manager for Regional Cholera Response Lessons from COVID-19 Dr Theirno Baldé, WHO Africa’s incident manager for COVID-19, said all countries were better prepared to address pandemics, including cholera, since the start of the COVID-19 pandemic. “It’s very important to mention that a lot of effort has been done by countries supported by WHO and also the partners to scaling up response capacities in the region, both for detecting new pathogens but also for trying to respond to them,” said Baldé. ‘But we are not there yet. We need to triple our response mechanisms.” Mwansambo concurred, saying that Malawi is using the same structures that were put in place for COVID-19 to respond to cholera, with the Presidential Task Force coordinating the response and also a budget for pandemic preparedness and response. However, Ramadan stressed that, in the context of cholera, all countries also needed to urgently improve their water, sanitation and hygiene (WASH) plans. Image Credits: L Pezzoli/ WHO. Posts navigation Older postsNewer posts