Uganda and WHO to Test Vaccine Candidates to Combat Country’s Ebola Outbreak 04/11/2022 Stefan Anderson Health workers at the Madudu Health Center meet with Mohamed Fall, UNICEF Regional Director for Eastern & Southern Africa. On Friday, the Ebola taskforce of Kassanda district in Uganda delivered the remains of four people that succumbed to the the virus for burial to their home village of Kitongo. Three of the bodies belong to family members who died from exposure to the virus after they exhumed a loved one they had lost to Ebola the week before so they could rebury the body based on local religious traditions. Authorities insist the outbreak is under control. But despite its relatively limited spread, the deadly Sudan strain of Ebola continues to take a tragic toll on villages and families around the country – because there is currently no authorized vaccine against that particular Ebola virus strain. However, the World Health Organization (WHO), Uganda and a number of other international partners have announced plans to launch clinical trials of several promising vaccine candidates, in an effort to halt the deadly outbreak. The trials will be conducted with the support of Uganda´s Makarere University, as well as with Coalition for Epidemic Preparedness Innovation (CEPI) and the Vaccine Alliance (GAVI), the partners said in a joint statement. Embedding research into outbreak response ¨By embedding research at heart of the outbreak response, we can achieve two goals: to evaluate potentially efficacious candidate vaccines, and to potentially contribute to end this outbreak, and protect populations at risk in the future,¨ the statement said. ¨The Ministry of Health has designated the Makerere University Lung Institute to conduct vaccine and therapeutics clinical trials. A Principal investigator from Makerere University Lung Institute will lead the vaccine trial.¨ WHO, CEPI and Gavi are providing support to ensure that sufficient doses of candidate vaccines are available for the trial and beyond, the statemend added. ¨The aim of the vaccine trial would be to establish how effective the candidate vaccines are in diverse populations.¨ The vaccine candidates are being made available through the University of Oxford and the Serum Institute of India, the Sabin Vaccine Institute and the US government institutions Biomedical Advanced Research and Development Authority (BARDA) and National Institutes of Health (NIH), as well as International AIDS Vaccine Initiative (IAVI) and MSD, the statement added. Outbreak has spread to the capital Following the declaration of the outbreak in the country on 20 September, the virus has spread to seven districts, including the Ugandan capital of Kampala, thereby increasing the risks of further spread within the country and across borders. The Ministry of Health has confirmed 131 cases, 56 recoveries, and 48 deaths to date. There is currently no known vaccine for the Sudan strain of Ebola – and thus the outbreak represents a window of opportunity to bridge that gap. A similar strategy was tested in the deadly outbreaks of the Zaire strain of Ebola that ripped through West Africa in 2014-2016, followed by an outbreak in the Democratic Republic of Congo in 2018-2020. In both cases, the deployment of vaccine candidates, which ultimately were approved by regulatory agencies, eventually helped squash the outbreaks. “We are doing what we can with experimental options, and there are vaccines in clinical trials that we hope to deploy soon,” Dr Henry Kyobe Bosa, national incident manager for Ebola for Uganda’s Ministry of Health wrote in the New York Times on Thursday. “This outbreak is a test of how much faster we can secure vaccine access this time around [compared to the early days of COVID-19], and groups like CEPI and the WHO are helping us get that early access.” Goals of intervention: immediate impact with an eye on the future Ugandan Health Minister Dr. Jane Ruth Aceng visits a proposed site to construct an isolation facility in Kassanda District. Ebola has a fatality rate of up to 90%, making immediate support in areas like contact tracing key to limiting the damage caused by the virus. WHO has already helped the Ministry of Health train and deploy over 300 contact tracers, who have contributed to a rise in the success rate of contact tracing from 25% at the start of the outbreak, to nearly 94% in recent days, WHO said. “Today there is an outbreak in Uganda. Tomorrow it could be somewhere else,” Bosa said. “After the last major Ebola outbreak in West Africa, the world began to undertake changes to ensure it wouldn’t happen again, but then moved on. We need to finish the job this time.” Image Credits: UNICEF, Uganda Ministry of Health . Study Finds Potential for Larger, Deadlier Monkeypox Outbreaks 04/11/2022 Stefan Anderson Researchers have published data showing an increase in transmissibility of the deadly Clade-1 variant of monkeypox. A report presented at the Annual Meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) on Thursday found the potential for larger, deadlier outbreaks of monkeypox outbreaks in Central Africa and internationally – as the more dangerous Clade 1 of the virus become more transmissible. “Many people in the US CDC (Centers for Disease Control), the World Health Organization and in health ministries and research institutions across sub-Saharan Africa were calling attention to the rising danger of monkeypox long before we started seeing infections outside of Africa,” said ASTMH President Daniel Bausch. “This study provides important new insights that point to the urgent need to provide additional resources that can help Africans fight this disease.” There are two “clades” of monkeypox virus. The one that has long been endemic in the Democratic Republic of Congo (DRC) – known as Clade 1 – has a fatality rate of up to 10%, and can include severe complications such as blindness. Clade 2, the source of recent outbreaks outside of the west and central African countries where it is endemic, is fatal less than 3% of the time. The concern now, the report relates, is that Clade 1 is evolving to become more transmissible, at an increasing rate. The deadlier variant has increased its rate of transmission Tshuapa Province (noted in red), where the study took place, is situated in the remote reaches of the country’s north-west. Data from DRC´s Tshuapa province collected between 2013 and 2017 showed an increase in the transmissibility of the Clade 1 variant. The effective reproduction rate – a closely watched metric for any infectious disease denoting its capacity to infect new hosts – has increased to 0.81 from a baseline of 0.3 to 0.5 seen throughout the 1980s. When the reproduction rate reaches or exceeds 1, that is a tipping point where the number of new cases increases even faster than the numbers of people recovered or dying, creating the potential for transmission across much larger areas and populations. “Our data show that monkeypox transmission in the area we studied was notably higher than previous estimates and was getting close to the point where it can cause large and sustained local outbreaks,” said Dr Kelly Charniga, a Prevention Effectiveness Fellow at the CDC and first author of the study. “This research puts the global health community on alert that there may be the opportunity for larger outbreaks in DRC on the horizon.” The disease’s increased transmissibility has already led to longer outbreaks, increasing the opportunities for the virus to evolve to be able to sustain more person to person spread. Researchers also found evidence of more regular “spillovers” of monkeypox infections from rodents – thought to be the virus’s natural reservoir – to people. “With today’s interconnected world, outbreaks don’t necessarily stay at their source,” Charniga said. “The best way to prevent monkeypox from causing more outbreaks in DRC and from becoming a bigger global problem is to devote more attention to areas where it is clearly causing the most suffering today.” Monkeypox burden increasing in endemic countries Tshuapa River, Democratic Republic of the Congo Monkeypox cases in endemic African countries have been increasing for several years. The fall in cross-reactive immunity from the smallpox vaccination campaign ended after victory over the smallpox virus in 1982 led to the cessation of smallpox vaccination, which is protective against monkeypox too. That, in turn, has contributed to a rise in infections of both clades across Africa. The current global outbreak of Clade 2 Monkeypox virus began in the United Kingom in May, after a traveler returning to the UK from Nigeria was reported to have been infected. Since then, some 78,000 monkeypox cases have been reported globally, with the areas of most intensive transmission in Europe and the Americas. Although the number of new cases reported has declined sharply in the past two months, transmission remains a concern in many countries. Improving surveillance in endemic rural areas is the key to stemming the evolution of the disease, but is easier said than done. The regions of the DRC where the strongest monkeypox reservoirs can be found – like Tshuapa province where the study was carried out – are hard to access, researchers noted. This complicates the distribution of vaccines and antivirals already in limited supply, and many clinics still rely on paper forms to report suspected cases. Despite these difficulties, Charniga emphasized that pro-active health system measures will lead to the most favorable outcomes for everyone. “The best way to prevent monkeypox from causing more outbreaks in DRC and from becoming a bigger global problem is to devote more attention to areas where it is clearly causing the most suffering today,” she said. Image Credits: WikiCommons, United Nations. Gavi Undertakes to Change Vaccine Procurement to Support New African Manufacturers 03/11/2022 Kerry Cullinan Africa only produces 1% of the vaccines it uses. Gavi, the global vaccine alliance, has undertaken to adapt its approach to procuring vaccines in order to support African vaccine manufacturing. In a plan released on Thursday, Gavi has committed to placing “a higher value on the benefits of diversification to supply security, with a focus on Africa”. The 10-point plan, developed in consultation with the African Union and other key partners, also allocates responsibilities to other key players – G7 Development Ministers, African countries, international partners including development financial institutions, and the private sector – to support sustainable African manufacturing capacity. However, Gavi will drive and coordinate the plan, given its enormous clout as the world’s biggest buyer of vaccines. “For 22 years, as the largest buyer of vaccines in the world, Gavi has worked closely with African countries and manufacturers to favourably shape the market for essential routine and outbreak vaccines,” said Gavi CEO Dr Seth Berkley. “Gavi is committed to contributing to the AU’s vision. The plan published today provides a pathway to ensuring vaccine supply security for Africa during pandemics and expanding access to other life-saving vaccines at sustainable, affordable prices.” The COVID-19 pandemic exposed Africa’s vulnerability when the entire continent was unable to get vaccines for months as wealthy countries had bought up all the doses made by Pfizer and Moderna and India stopped the export of generic vaccines made by the Serum Institute of India destined for the continent. Stung by the COVID-19 experience, the AU has set a target to produce and supply more than 60% of its vaccine doses on the continent by 2040 – it currently supplies 1%. Although Africa consumes vaccines valued at over $1 billion every year, the cost of much of this is carried by Gavi, UNICEF and donors. At present, Gavi chooses vaccine suppliers on price, and “does not systematically permit the accommodation of higher prices in the name of geographical diversity and supply security”, it acknowledged. “New accommodations in the way Gavi assesses products against supply security as a new market health objective, could have a substantial impact,” it acknowledges. The risk of supporting more expensive African-made vaccines could be mitigated by countries committing upfront to vaccines which would enable “predictable pooled procurement volumes”. African countries themselves also need to “send clear demand signals to the market on willingness to select and procure from African suppliers”. “In the last 18 months alone, more than 30 new African manufacturing projects have been announced and estimates indicate that the African vaccine market across all existing and projected novel products could range between US$ 2.8 billion and US$ 5.6 billion by 2040, demonstrating the potential for a thriving regional industry to emerge,” according to Gavi. However, the report also acknowledges that “a disorderly expansion risks unhealthy competition, potentially undermining the impact of market-shaping initiatives that have delivered low vaccine prices to lower-income nations, while also failing to realise Africa’s manufacturing aspirations”. It calls for a “business model” that “actively shapes markets in support of the AU’s vision: meeting the mutually reinforcing objectives of continued global market health, and a sustainable regional manufacturing sector”. Nonetheless, the price of setting up new manufacturing facilities in Africa may mean that their products are way too expensive to be viable. “Modelling indicates that price differentials for new entrants may be in excess of levels that could be accommodated during standard Gavi/UNICEF competitive tenders, without impact on programme coverage,” Gavi warns. “Ways must be found to support new entrants, whilst at the same time, avoiding a situation in which incumbent manufacturers increase their prices for vaccines due to lost volumes. This carries a potential risk of increasing the costs of immunisation worldwide.” To address the high cost for new entrants, the plan proposes “a time-limited financial instrument that can help mitigate the high cost of vaccine production at market entry”. It also advocates that this financial instrument supports African manufacturers to make the most commercially viable antigen-based vaccines – starting with cholera and Ebola. For their part, African countries are tasked with accelerating investment in the enabling environment, including “strong regulatory authorities, robust supply chains, skilled human capital, reduced trade barriers and empowered regional coordination”. Image Credits: Gavi/Karel Prinsloo 2017. As Demand for Chicken Rises, Tanzanian Researchers Warn of Excessive Antibiotic Use at Farms 03/11/2022 Kizito Makoye Roast chicken vendors prepare their meals in Dar es Salaam DAR ES SALAAM, Tanzania—At a smoky kitchen in the port city of Dar es Salaam, none of the customers jostling to place their orders knows that the irresistibly tasty roast chicken may be harbouring bacteria that could make them sick. “I don’t think poultry farmers would do anything likely to cause harm,” said 34-year-old Lilian Kiswale a regular customer at this popular fast-food joint. However, what is not clear to Kiswale, is that strains of bacteria that are resistant to antibiotics have repeatedly been found in chickens at farms where city’s street kitchens source their poultry products. “None of our customers has ever complained about the smell of antibiotics in the food we have prepared,” said Kelvin Massawe who works as a chef at the chicken restaurant that is a culinary delight in the neighbourhood. But it’s not about antibiotics ruining the taste of roast chicken. The antibiotic-laced food that poultry farmers in Tanzania give to their birds, ostensibly to increase muscle weight quickly and keep infections at bay, poses a threat to humans as well. According to a recent study by Tanzania’s Muhimbili University of Health and Allied Sciences (MUHAS), excessive amounts of antibiotic residue had been found in broiler chicken tissues – a perfect condition for antimicrobial resistance (AMR). Using the liver samples of 84 commercial broiler chickens, the researchers found that 100% had the antibiotic tetracycline – and 90% at levels that exceeded acceptable daily limits. In addition, 21.4% of the samples also had sulphonamide, although this was within the maximum limit, according to the study, which was published in the journal, Antibiotics. Worse still, researchers say that poultry farmers have unrestricted access to prescription-only antibiotics including tetracycline, sulphonamides, penicillin, aminoglycosides and macrolides. Shop owner Jesca Anthony confirms that she sells antibiotics to farmers without prescription This was confirmed by shop owner Jesca Anthony, who said that she sells antibiotics, without prescriptions to farmers. “Random use of antibiotics in animal feeds heighten the risk of drug resistance not just to animals but in humans as well,” Professor Mecky Matee, head of microbiology at MUHAS and the study’s lead author, told Health Policy Watch. “The use of antibiotics as growth promoters for chicken should be banned,” Matee stressed. Antibiotics are losing their power When an antibiotic is used, it wipes out susceptible bacteria, leaving behind resistant ones. These resistant bacteria can grow and become dominant, and pass from chicken products to humans who eat or handle the meat. Once inside a person, these resistant bacteria can take over the colon, which is then unable to fight infections. Antibiotics are increasingly losing their efficacy due to indiscriminate use in humans and for stimulating animal and birds’ growth. The rise in drug-resistant bacteria has the potential to inflict a devastating human and economic toll globally, according to the United Nations. According to the most comprehensive estimate of the global impact of antimicrobial resistance (AMR), published in The Lancet in January 2022, an estimated 1.2 million people died in 2019 from antibiotic-resistant bacterial infections – more deaths than those from HIV/AIDS or malaria. “Many types of common antibiotics are no longer effective enough to treat bacteria, in many cases patients need hospitalisation,” said Hellen Sabuka, a senior epidemiologist at Shree Hindul Mandal Hospital in Dar es Salaam. Sabuka urged Tanzania’s health authorities to adopt strict regulations and control on the use of antibiotics in animal production. A customer at the Tegeta slaughter house Although Tanzania has policies and guidelines for the use of antibiotics in animal feed, such policies are poorly enforced due to weak systems for food and agricultural productions. In Dar es Salaam, one of Africa’s fastest-growing cities and home to 5.8 million inhabitants, poultry farmers routinely mix an array of human antibiotics into chicken feed to try to ensure they grow faster and don’t get sick. It is a humid Sunday evening at Kibamba, a suburb in the western part of Dar es Salaam, and Salma Libuhi is busy mixing a concoction of medicines into rice husks to feed her caged chickens. Amid smouldering heat, she methodically mixes in a cocktail of three antibiotics— oxytetracycline, doxycycline and enrofloxacin – and sets the food in cans. “When they eat this food, they grow faster,” she told Health Policy Watch. For the 38-year-old mother of four, poultry farming is her livelihood. In 2017, quit her job as a teacher and ventured into entrepreneurship. “Raising chicken is very profitable,” she said. To educate herself about animal husbandry, Libuhi joined a whatsapp groups where she gets all the information about diseases and antibiotics. “I never consulted a vet. The information I get from the group is enough,” she said. At Libuhi’s farm, broiler chickens usually take six weeks to reach market weight. Once they’ve reached the proper size and weight she catches each chicken by hand and transfers them to holding cages ready to be sold. Unlike wild chickens that traverse a range of habitats as they forage for seeds, insects and fresh leaves, broiler chicken are often kept in overcrowded, poorly ventilated and unhygienic shacks. Lack of controls in Africa Across Africa, antibiotics are heavily in the farming of cows, pigs and chickens to fight infections and promote growth. With the indiscriminate use of antibiotics, particularly in agriculture for stimulating animal and birds’ growth, these essential medicines are losing their efficacy. “Many types of common antibiotics are no longer effective enough to treat bacteria, in many cases patients need hospitalisation,” said Hellen Sabuka, a senior epidemiologist at Shree Hindul Mandal Hospital in Dar es Salaam. Sabuka urged Tanzania’s health authorities to adopt strict regulations and control on the use of antibiotics in animal production. While over-use of antibiotics as growth promoters is not a new phenomenon, global experts think preventing drug-resistant bacteria that kill millions of people every year, requires a coordinated approach. Mohan P. Joshi, technical lead for antimicrobial resistance and global health security at the non-profit, Management Sciences for Health, said the overuse of antimicrobials in animals, especially as growth-promoters in food-producing animals, is common in many countries. “In some countries, the proportion [of antibiotics] used in the animal sector is as high as 80% of the total antimicrobials consumed. Alternatives such as good animal husbandry, vaccinations, and biosecurity measures including hygienic practices are critical farming approaches that can help reduce antimicrobial use in animals raised for food,” he said. While 144 countries have national plans to combat AMR, according to a 2021 World Health Organization (WHO) report, Joshi says sectors differ in the amount of progress they’ve made, with the human health sector generally making the most progress and the animal sector lagging. “We need collaborative, multisectoral coordination to address public health threats at the intersection of humans, animals, and the environment. A One Health-focused approach is the only way to effectively address this widespread issue,” Joshi said. According to him, the fight against AMR needs coordinating bodies with adequate funding, political support and authority to act. “Countries need to establish functional multi-sectoral task forces to contain AMR that include high-level government officials and stakeholders from both human and animal health, along with the agricultural, environmental and food sectors, and ensure that such bodies are effectively facilitating One Health coordination, helping build capacities of local stakeholders, and mobilising diversified funding,” he said In 2019, five million human infections were associated with bacterial antimicrobial resistance worldwide, including more than 1.2 million human deaths attributable to bacterial AMR. The burden was highest in sub-Saharan Africa and South Asia, with children below five years of age the most affected. Pushed by the rising demand for cheap poultry products, the broiler value chain in Tanzania, is a big user of antibiotics. Most poultry farmers in Tanzania treat chicken with a concoction of antibiotics often without consulting veterinary doctors. Despite the growing adversity, global experts are cautiously optimistic about prescription-only system where veterinarians will have the upper hand in dispensing drugs used in animal production. Chicken dealers waiting for customers at Tegeta slaughter house. Thomas Van Boeckel, from the public research university, Zurich ETH, said the best way to curb antibiotic use in animals is to move to a prescription only –system where only trained veterinarian would be authorized to sell the antibiotics rather than retail shop owners. “However, even in Switzerland where such a system is in place, this does not resolve all problems because vets may still have a financial conflict of interest in prescribing for profit,” Boeckel said. He says that a better solution would be to “remove the profit margin from vets on drug prescription,” as is the case in Sweden. Meanwhile, Emma Berntman, senior engagement specialist at FAIRR initiative, said low and middle-income countries, including Tanzania have the largest share of global antimicrobial consumption in animals and agriculture, due to the routine use of antimicrobials in farming for growth promotion and prophylaxis. She blamed the countries’ lack of checks and balances and low awareness on overuse of antibiotics. “Tanzania is no exception to this. The country lacks regulation that is sufficient to adequately address the issue of excessive antimicrobial use and antibiotic are cheap and widely available,” said Berntman. FAIRR is an investor-run initiative to address threats to the global food supply. According to her, even when regulation exists in the emerging market, it can be hard to enforce when there is a lack of access to veterinarians and poor awareness of the impacts of overusing antibiotics. “On-the-ground initiatives are needed to help support farmers to reduce their dependence on these drugs,” she stressed. Growing appeal of organic products Although Switzerland launched an AMR strategy in 2015, FAIRR experts say the highest priority critically important antibiotics (HPCIAs) including fluoroquinolones, are still excessively used in farms, notably in broiler production, with authorities warning of high levels of resistance. “These antibiotics are deemed ‘the last line of defence’ in human medicine and are the only antibiotics available to treat certain bacterial infection. If they become ineffective, it poses a significant threat to human health,” Berntman said. “Resistant bacteria developed in broilers can spread to humans through direct contact with the birds, eating chicken or via the environment. There is also a risk to flock health due to the reduced efficacy of antimicrobials used to treat them.” Despite the growing threat, experts see glimmer of hope in reducing the use of antibiotics in broiler farms and other antibiotics used in human medicines. “The government can support reductions by further restricting the use of antibiotics in animals in line with the latest EU regulations, so that antibiotics can only be used to treat infections and routine use is prevented,” Berntman said. Moreover, Berntman said the government can facilitate antibiotic stewardship activities to support the adoption of alternatives to antimicrobials including vaccination programmes and improved nutrition. According to Berntman the rising awareness of the risk of AMR in Europe and North America has triggered a surge in demand for products associated with or lower antibiotic use. “Many consumers are willing to pay a price premium to purchase organic chicken or chicken raised without antibiotics,” she said. Approximately 60% of broilers in the US are now raised without antibiotics, according to Berntman. Moreover, the number of broiler chicks receiving antibiotics in the hatchery has dropped by 90% to nearly zero. “It is important that poultry producers improve animal welfare, vaccinate their flocks, and implement routine health monitoring programmes to meet consumer demand for broilers raised with less or no antibiotics while simultaneously creating environments where healthy flocks can be raised no antimicrobials required without impacting animal welfare,” Berntman said. But for chicken lovers in Dar es Salaam, antibiotic-free roast chicken meat is probably a distant dream. Image Credits: Peter Mgongo. Phase Out Fossil Fuels, Urges Tedros on Eve of COP27 02/11/2022 Megha Kaveri Severe air pollution in Anyang, China in January 2022. Ahead of the global climate talks in Egypt, the World Health Organization (WHO) has urged governments to expedite fossil fuel phase out and transition into clean energy. “Climate change is already impacting health in many ways, through more frequent and extreme weather events, more disease outbreaks, and more mental health issues,” Dr Tedros Adhanom Ghebreysus, the director-general of WHO said in a press briefing on Wednesday. Flagging the impact of climate change on various aspects of human life, including diseases and malnutrition, Dr Tedros called for governments “to lead a just, equitable and fast phase-out of fossil fuels and transition to a clean energy future”. The 27th United Nations Climate Change Conference (COP27) will take place in Sharm el-Sheikh, Egypt from 6 to 18 November. At the conference, world leaders are expected to assess the progress in limiting global warming to 1.5 º Celsius above the pre-industrial levels. “Meeting that target will have massive benefits for human health. Failing to meet it comes with massive risks,” Dr Tedros warned. Impact of climate change on food security Martin Griffiths, the UN Office for the Coordination of Humanitarian Affairs (OCHA), told the briefing that the world is in the grip of hunger crisis and that the pandemic and vast inequality are partly to blame. Listing the different crises happening across the world – the drought in the Horn of Africa, Somalia and Kenya, the floods in Pakistan, the civil war in Tigray, Ethiopia – the OCHA chief called for immediate action to control global warming. “This is the world at 1.2º Celsius [above pre-industrial levels]. But we’re on track to double that. And unless we act now, we’re heading for a future full of droughts, diseases and climate disasters across the whole world,” he added. In 2009 at the Copenhagen Summit, G20 countries pledged that they will channel $100 billion a year to less wealthy countries to mitigate the effects of climate change. Referring to this promise, Griffiths pointed out that the wealthy countries have not kept their word. “We need to come out of COP27 with clarity [about the missing money] and ability [to ensure the promise is kept].” He also referred to the UN Secretary General Antonio Guterres´ proposal to impose a windfall tax on the profits earned by fossil fuel and gas companies, saying that 18 days’ worth of such profits can cover the entire sum of UN’s humanitarian appeal for the year. “COP27 is going to be a major test for all of us to see if those commitments made so boldly in years gone past finally made land for the people who are staring climate [change impact] in the face,” Griffiths said. Adopt WHO 2021 air quality guidelines In line with the theme in the coming weeks, spotlight was also put on the role air pollution plays in public health and climate change. Around 1.1 million people in Africa died from diseases related to air-pollution in 2019. The WHO estimates that seven million people across the world stand to lose their lives to air pollution in a year. But Rosamund Kissi-Debrah, founder and trustee of the Ella Roberta Family Foundation, says that need not be the case. “Cleaning up the air will save lives and it will also reduce health healthcare costs to increase productivity, and it will save trillions of dollars from governments,” she said. Kissi-Debrah called for all the countries participating in COP27 to immediately adopt WHO’s air quality guidelines 2021, describing them as “achievable” and life-saving. She further said that governments must invest in solutions to tackle air pollution and raise public awareness about the adverse effects of rising air pollution on health. Pointing to the example of global cooperation to develop and deliver COVID-19 vaccines, Kissi-Debrah called for a similar level of cooperation to tackle air pollution. “We definitely believe seven to 9 million people every year are definitely worth saving. I urge everybody who goes into COP27 to not forget about public health.” Image Credits: Chris LeBoutillier, V.T. Polywoda. WHO Leadership Shake-up Takes Shape 02/11/2022 Editorial team WHO Assistant Director-General Dr Ren Minghui Two of the World Health Organisation’s top leadership team in Geneva – Dr Soumya Swaminathan and Dr Ren Minghui – are on the brink of leaving as Director-General Dr Tedros Adhanom Ghebreyesus’s long-anticipated leadership shake-up starts to take shape. Swaminathan is WHO’s Chief Scientist, while Ren serves as assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases. Meanwhile, Stéphanie Seydoux has been appointed as the WHO Director-General’s Envoy for Multilateral Affairs, replacing Dr Agnès Buzyn, who was appointed executive director of the WHO Academy in Lyon recently and remains on the leadership team in her new role. Thrilled to begin my new role today as Envoy for Multilateral Affairs, in the Office of @DrTedros, ahead of #G20BaliSummit. Ready to serve the #globalhealth #SDGs objectives of equitable access to health for all and #healthsecurity promoted by @WHO and international partners. pic.twitter.com/x8PU25VsLy — Stéphanie Seydoux (@S_Seydoux) November 2, 2022 Seydoux is the former French Global Health Ambassador. France has been a firm supporter of WHO and is the major investor in the new academy, which is expected to open in 2024, which will offer health workers around the world access to “the latest evidence-based health guidance, state-of-the-art learning technologies and advancements in the science of adult learning”, according to WHO. WHO Deputy Director Dr Zsuzsanna Jakab is also expected to leave soon. The 71-year-old Hungarian is well over the WHO mandatory retirement age of 65 – which can usually only be extended by three years. As Health Policy Watch previously reported, 63-year-old Swaminathan is still two years short of WHO’s mandatory age of retirement, but there have been hints that her style was too independent for the director-general. However, a source close to Swaminathan said that she was leaving voluntarily after five years in senior WHO leadership to reunite with her husband and elderly parents who remained in her hometown of Chennai, India, while she served in Geneva. Prior to WHO, Ren was director-general for international cooperation at the National Health and Family Planning Commission of China. Conversely, Dr Mike Ryan, executive director of WHO’s Health Emergencies Programme, who had earlier been expected to leave the organization, appears set to remain, several WHO insiders with knowledge of the pending reshuffle confirmed. Having Won the Right to Abortion, Colombian Activists Are Pressing Health Facilities to Deliver 01/11/2022 Juanita Rico Causa Justa activists outside Colombia’s Constitutional Court In February, Colombia introduced one of the most liberal abortion laws in the world after activists took to the courts – but now their challenge lies in ensuring the health system is in a position to offer terminations Not long ago, abortion in Colombia was a taboo topic that could not be mentioned during dinners or family gatherings, according to Florence Thomas, one of Colombia’s feminism most influential voices. “It was considered such a difficult subject that people would stand up and leave my lectures when I touched upon it,” Thomas told Health Policy Watch. Some 16 years ago, in 2006, Colombian lawyer Mónica Roa challenged the country’s complete ban on abortion in the Constitutional Court and achieved the decriminalization of abortion on three grounds: when the pregnancy was the result of rape or incest; when there was a severe malformation of the fetus; and when the pregnancy constituted a risk to the woman’s health. “That ruling changed the course of history,” Thomas explains because it made it evident that the legal way to fight for safe abortions was not the Congress, but the Constitutional Court, the highest court in Colombia. Since then, feminist movements and pro-choice lawyers like Roa have fought to extend the decriminalization of abortion in Colombia. Lawsuit against barriers In 2020, Causa Justa (“Just Cause”), a movement made up of over 100 organisations and 140 activists united to legalise abortion, filed a lawsuit against the criminalization of the early termination of pregnancy. Instead of proposing a whole new scheme of laws that would have to go through Congress, they sought a regulate abortion within the rules that were already in place and thus would not rely on politicians. Causa Justa showed that, despite the 2006 reforms, abortion remained a crime in the Penal Code, putting it out of reach for most women. Causa Justa’s lawsuit, supported by more than 100 national and international experts, also showed that almost 400 women were convicted every year for having or seeking an abortion, with sentences ranging from 16 to 54 months in prison. Between 2006 and 2019, more than 5,700 women were charged for abortion. Causa Justa’s lawyers also showed the judges that criminalization forced women to seek unsanitary and dangerous underground abortion clinics. According to Colombia’s Public Health and Epidemiology Observatory, one of the main causes of the deaths of over 400 women from haemorrhaging in 2020 was unsafe, illegal abortions. Between 59% and 70% of the complaints laid against the women seeking abortions had come from health workers, explains Mariana Ardila, a lawyer with Women’s Link, one of the organizations that are part of Causa Justa. Abortion providers could also face charges, which made most health professionals refuse to perform abortions. Nail-bitingly close judgement That sad reality changed with the new ruling in February this year, which established that abortion will only be an offence after the 24th week of pregnancy. “Women won,” said the plaintiffs after learning of the decision, surrounded by chants claiming: “It is a law! It is a law! It is a law.” The ruling is historic because successive Colombian governments have never legislated on an issue that they consider neither a priority nor find beneficial because of the controversy it generates in the street. Colombia is a secular but deeply religious country. A 2017 survey revealed that 97% of citizens believe in God and the different churches, predominantly Catholic and Evangelical, have enormous power over believers, pushing them into an all-out fight against abortion. In its final stage, the Constitutional Court judges voted on the lawsuit, and the vote was nail-bitingly close: five judges were in favor, and four against. With this final say, the court proved that Colombia is changing. Today, only 20% of the population approves that women go to jail if they get an abortion. Health services not prepared The Court also ruled that the government would have to implement a comprehensive public policy regarding access to safe and legal abortions in the “shortest possible time.” However, to date, such a policy hasn’t been fully defined and executed. Colombia’s Ministry of Health recognizes that barriers to abortion persist and are mainly associated with the denial of services – mainly due to ignorance of the changed legal framework and improper exercise of conscientious objection by medical personnel. On 28 September, it issued a document with instructions about how to strengthen sexual and reproductive health care, including abortion, that was addressed to all entities that are part of the health system. Colombia is part of a “green wave” of countries in the region that have decided to expand their abortion freedoms, but it allows abortion much later than its regional counterparts. Con @causajustaco Colombia🇨🇴 entró en la tendencia mundial de 75 países que protegen de manera amplia y brindan garantías para los derechos reproductivos de mujeres, niñas y adolescentes. Hoy allí el aborto es legal hasta la semana 24 de gestación👉https://t.co/FTOS0sRU5j pic.twitter.com/iWqdhXp6Uy — Centro de Derechos Reproductivos (@ReproRightsLAC) October 31, 2022 Mexico’s Supreme Court ruled late last year that was unconstitutional to criminalize abortion. However, each state has to regulate the decision of the Supreme Court. In Argentina, Congress approved abortion’s legality up to 14 weeks, and, as in Colombia, lifted the restrictions that only allowed for abortion in cases of rape or where the mother’s health is at risk. On the other hand, Ecuador’s National Assembly approved a bill that allows abortions if they result from rape up to the 12th week, but President Guillermo Lasso vetoed it, saying that he respects “life from conception.” Colombia’s ruling, however, is a historic victory for the Colombian women’s movement that has fought for decades for their rights to be recognized in a traditional and ultra-catholic country. The next step is for the public policy to be fully deployed across the country and to serve as a model for the region. Mesa por la Vida y la Salud de las Mujeres, a feminist collective that defends women’s sexual and reproductive rights, stated that during the first few months of 2022, they helped more than 90 women to overcome barriers while seeking an abortion within the new law’s parameters. Alejandra* (not her real name) is one example. She asked for an abortion in her sixth week of pregnancy but only finally got one in her 11th week. She states that the procedure was slow and painful and that the doctors did not provide clear information about the process. The numbers show that the path is still long for women in Colombia and that the famous feminist march slogan, “we want sex education to decide, contraceptives to avoid abortion, and legal abortion not to die,” will still echo in the streets, the mountains, the buildings, and law-making entities until Colombian women can feel free to decide, unchallenged, about their bodies. The Rosa Luxemburg Foundation provided support for this article. Image Credits: Causa Justa. New Initiative to Tackle Alcohol Harms Will Focus on Taxation 01/11/2022 Kerry Cullinan Alcohol is related to more than 60 different conditions, including cancers, heart and liver disease. A $15 million initiative to address the harms of alcohol consumption through policy change was launched Tuesday, roughly doubling the total global spending on mitigating the effects of alcohol. Alcohol is one of the top-ten drivers of death, illness and injury, with wide-ranging social and economic harms, many disproportionately affecting young adults, according to Vital Strategies, which heads the RESET Alcohol consortium. “RESET Alcohol is an initiative that brings together national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies from the World Health Organization’s WHO) SAFER technical package,” according to Vital Strategies. The initiative will focus on Latin America, Africa and Asia, with partners Movendi International; the University of Illinois Chicago; the Global Alcohol Policy Alliance (GAPA); the Non-Communicable Disease (NCD) Alliance; and the WHO, with GiveWell as the donor. RESET’s primary policy focus will be on increasing alcohol taxation and other pricing policies which it describes as being “among the most effective interventions for reducing consumption”. It also aims to regulate the availability of alcohol, and restrict its marketing. Over three years, the initiative will support 15 or more countries to develop policies including raising the price of alcohol via taxation, regulating availability, and restricting alcohol marketing. Policies to protect kids “Every year, alcohol use cuts millions of lives short and causes even more widespread suffering,” said Adam Karpati, senior vice president at Vital Strategies. “The onus can’t be on individuals. We must reset from an environment where the alcohol industry is empowered to push alcohol into nearly every aspect of our lives, including schools, sports, and media. We need policies that protect kids, make healthy choices, the easy choices, and check the industry’s influence. RESET Alcohol will do just that through strong partnerships with government and civil society leaders who are committed to action.” Alcohol consumption has increased in nearly all regions of the world consistently since 2005, and accelerated during the COVID-19 pandemic. It is related to more than 60 different conditions, including cancers, heart disease, liver disease, tuberculosis and HIV/AIDS; injuries and trauma including suicide, homicide, assault, falls, intimate partner violence, and vehicle crashes. Alcohol consumption is also associated with adverse economic impacts, from medical care costs to lost productivity. RESET Alcohol’s approach builds on its partners’ successes in similar consortiums that have addressed tobacco and other harmful commodities, including contributing to 18.5% reduction in tobacco use in Bangladesh between 2009 and 2017 and a 17% reduction in India between 2010 and 2017. “Failure to act has led to millions of preventable deaths and suffering from alcohol,” said Jacqui Drope, the new director of RESET Alcohol. “It’s time governments treat it like the public health crisis that it is. When governments take up policies proven to reduce alcohol-related harms, population health and economies will benefit.” RESET Alcohol will provide technical support to governments, improve national research and data collection, resource advocacy for policy change, and mount communications campaigns. “For governments, tax increases on alcohol are a win-win, especially given the sluggish global economy,” said Jeffrey Drope, Research Professor at UIC. “Effective alcohol taxation reduces affordability, consumption and alcohol-related disease and premature death. This means lower healthcare costs and increased productivity from a healthier population. Taxes also create revenue for governments to fund health programs or other social priorities. Image Credits: U.S. Air Force/Samuel King Jr. . WHO Launches Climate Portal and Malaria Guide for Cities 31/10/2022 Editorial team The World Health Organization (WHO) and World Meteorological Organization (WMO) launched the first global knowledge platform dedicated to climate and health on Monday called climahealth.info. The global open-access platform is envisaged as being the “go-to technical reference point for users of interdisciplinary health, environmental, and climate science”, according to the WHO in a media release. “The use of tailored climate and environmental science and tools for public health, such as disease forecasting and heat health early warning systems, have enormous life-saving potential. These tools and resources can enhance our understanding of the connections between climate and health, help us reach at-risk populations, and anticipate and reduce impacts,” according to the media release. “Climate change is killing people right now,” said Diarmid Campbell-Lendrum, coordinator of WHO’s climate change and health programme. “It is affecting the basics we need to survive – clean air, safe water, food and shelter – with the worst impacts being felt by the most vulnerable. Unmitigated climate change has the potential to undermine decades of progress in global health. Reducing its impacts requires evidence-based policy backed by the best available science and tools.” Joy Shumake-Guillemot, who leads the WMO-WHO Climate and Health Joint Office, said that public health practitioners who are concerned about the environmental impacts on health “lack access to training and tailored climate information needed to address these growing issues” while “climate experts (are) sitting on troves of research and resources that could be applied to support public health goals, but just aren’t reaching the right people”. The initiative is supported by the Wellcome Trust. “Collaboration between climate, health and technical specialists is crucial for helping us understand and tackle the health effects of climate change,” said Madeleine Thomson, Head of Climate Impacts and Adaptation for the Wellcome Trust. “But right now, experts can’t always partner and share information as effectively as we know they’d like to. We hope this portal will help fulfill the potential of different disciplines to work together on research and gain new insights into how climate change is affecting health around the world.” Cities’ Malaria Framework launched On the occasion of World Cities Day 2022 on Monday, the WHO and UN Habitat launched the Global framework for the response to malaria in urban areas, which provides guidance to city government officials, health professionals and urban planners on how to develop a comprehensive malaria response specifically in urban areas, “where the dynamics of transmission and burden of vector-borne diseases can be different from that of rural areas”. By 2050, nearly 70% of people globally will live in cities and other urban settings and the WHO predicts that unplanned urbanization is likely to result in a malaria disease burden that is “disproportionately high among the urban poor”. Speakers at the launch also anticipated that climate change will see malaria in places that were previously too cold for the disease that is carried by mosquitos. The framework provides guidance for city leaders, health programmes and urban planners to respond to the challenges of rapid urbanization in a targeted way that helps to build resilience against the threat of malaria and other vector-borne diseases. Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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Study Finds Potential for Larger, Deadlier Monkeypox Outbreaks 04/11/2022 Stefan Anderson Researchers have published data showing an increase in transmissibility of the deadly Clade-1 variant of monkeypox. A report presented at the Annual Meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) on Thursday found the potential for larger, deadlier outbreaks of monkeypox outbreaks in Central Africa and internationally – as the more dangerous Clade 1 of the virus become more transmissible. “Many people in the US CDC (Centers for Disease Control), the World Health Organization and in health ministries and research institutions across sub-Saharan Africa were calling attention to the rising danger of monkeypox long before we started seeing infections outside of Africa,” said ASTMH President Daniel Bausch. “This study provides important new insights that point to the urgent need to provide additional resources that can help Africans fight this disease.” There are two “clades” of monkeypox virus. The one that has long been endemic in the Democratic Republic of Congo (DRC) – known as Clade 1 – has a fatality rate of up to 10%, and can include severe complications such as blindness. Clade 2, the source of recent outbreaks outside of the west and central African countries where it is endemic, is fatal less than 3% of the time. The concern now, the report relates, is that Clade 1 is evolving to become more transmissible, at an increasing rate. The deadlier variant has increased its rate of transmission Tshuapa Province (noted in red), where the study took place, is situated in the remote reaches of the country’s north-west. Data from DRC´s Tshuapa province collected between 2013 and 2017 showed an increase in the transmissibility of the Clade 1 variant. The effective reproduction rate – a closely watched metric for any infectious disease denoting its capacity to infect new hosts – has increased to 0.81 from a baseline of 0.3 to 0.5 seen throughout the 1980s. When the reproduction rate reaches or exceeds 1, that is a tipping point where the number of new cases increases even faster than the numbers of people recovered or dying, creating the potential for transmission across much larger areas and populations. “Our data show that monkeypox transmission in the area we studied was notably higher than previous estimates and was getting close to the point where it can cause large and sustained local outbreaks,” said Dr Kelly Charniga, a Prevention Effectiveness Fellow at the CDC and first author of the study. “This research puts the global health community on alert that there may be the opportunity for larger outbreaks in DRC on the horizon.” The disease’s increased transmissibility has already led to longer outbreaks, increasing the opportunities for the virus to evolve to be able to sustain more person to person spread. Researchers also found evidence of more regular “spillovers” of monkeypox infections from rodents – thought to be the virus’s natural reservoir – to people. “With today’s interconnected world, outbreaks don’t necessarily stay at their source,” Charniga said. “The best way to prevent monkeypox from causing more outbreaks in DRC and from becoming a bigger global problem is to devote more attention to areas where it is clearly causing the most suffering today.” Monkeypox burden increasing in endemic countries Tshuapa River, Democratic Republic of the Congo Monkeypox cases in endemic African countries have been increasing for several years. The fall in cross-reactive immunity from the smallpox vaccination campaign ended after victory over the smallpox virus in 1982 led to the cessation of smallpox vaccination, which is protective against monkeypox too. That, in turn, has contributed to a rise in infections of both clades across Africa. The current global outbreak of Clade 2 Monkeypox virus began in the United Kingom in May, after a traveler returning to the UK from Nigeria was reported to have been infected. Since then, some 78,000 monkeypox cases have been reported globally, with the areas of most intensive transmission in Europe and the Americas. Although the number of new cases reported has declined sharply in the past two months, transmission remains a concern in many countries. Improving surveillance in endemic rural areas is the key to stemming the evolution of the disease, but is easier said than done. The regions of the DRC where the strongest monkeypox reservoirs can be found – like Tshuapa province where the study was carried out – are hard to access, researchers noted. This complicates the distribution of vaccines and antivirals already in limited supply, and many clinics still rely on paper forms to report suspected cases. Despite these difficulties, Charniga emphasized that pro-active health system measures will lead to the most favorable outcomes for everyone. “The best way to prevent monkeypox from causing more outbreaks in DRC and from becoming a bigger global problem is to devote more attention to areas where it is clearly causing the most suffering today,” she said. Image Credits: WikiCommons, United Nations. Gavi Undertakes to Change Vaccine Procurement to Support New African Manufacturers 03/11/2022 Kerry Cullinan Africa only produces 1% of the vaccines it uses. Gavi, the global vaccine alliance, has undertaken to adapt its approach to procuring vaccines in order to support African vaccine manufacturing. In a plan released on Thursday, Gavi has committed to placing “a higher value on the benefits of diversification to supply security, with a focus on Africa”. The 10-point plan, developed in consultation with the African Union and other key partners, also allocates responsibilities to other key players – G7 Development Ministers, African countries, international partners including development financial institutions, and the private sector – to support sustainable African manufacturing capacity. However, Gavi will drive and coordinate the plan, given its enormous clout as the world’s biggest buyer of vaccines. “For 22 years, as the largest buyer of vaccines in the world, Gavi has worked closely with African countries and manufacturers to favourably shape the market for essential routine and outbreak vaccines,” said Gavi CEO Dr Seth Berkley. “Gavi is committed to contributing to the AU’s vision. The plan published today provides a pathway to ensuring vaccine supply security for Africa during pandemics and expanding access to other life-saving vaccines at sustainable, affordable prices.” The COVID-19 pandemic exposed Africa’s vulnerability when the entire continent was unable to get vaccines for months as wealthy countries had bought up all the doses made by Pfizer and Moderna and India stopped the export of generic vaccines made by the Serum Institute of India destined for the continent. Stung by the COVID-19 experience, the AU has set a target to produce and supply more than 60% of its vaccine doses on the continent by 2040 – it currently supplies 1%. Although Africa consumes vaccines valued at over $1 billion every year, the cost of much of this is carried by Gavi, UNICEF and donors. At present, Gavi chooses vaccine suppliers on price, and “does not systematically permit the accommodation of higher prices in the name of geographical diversity and supply security”, it acknowledged. “New accommodations in the way Gavi assesses products against supply security as a new market health objective, could have a substantial impact,” it acknowledges. The risk of supporting more expensive African-made vaccines could be mitigated by countries committing upfront to vaccines which would enable “predictable pooled procurement volumes”. African countries themselves also need to “send clear demand signals to the market on willingness to select and procure from African suppliers”. “In the last 18 months alone, more than 30 new African manufacturing projects have been announced and estimates indicate that the African vaccine market across all existing and projected novel products could range between US$ 2.8 billion and US$ 5.6 billion by 2040, demonstrating the potential for a thriving regional industry to emerge,” according to Gavi. However, the report also acknowledges that “a disorderly expansion risks unhealthy competition, potentially undermining the impact of market-shaping initiatives that have delivered low vaccine prices to lower-income nations, while also failing to realise Africa’s manufacturing aspirations”. It calls for a “business model” that “actively shapes markets in support of the AU’s vision: meeting the mutually reinforcing objectives of continued global market health, and a sustainable regional manufacturing sector”. Nonetheless, the price of setting up new manufacturing facilities in Africa may mean that their products are way too expensive to be viable. “Modelling indicates that price differentials for new entrants may be in excess of levels that could be accommodated during standard Gavi/UNICEF competitive tenders, without impact on programme coverage,” Gavi warns. “Ways must be found to support new entrants, whilst at the same time, avoiding a situation in which incumbent manufacturers increase their prices for vaccines due to lost volumes. This carries a potential risk of increasing the costs of immunisation worldwide.” To address the high cost for new entrants, the plan proposes “a time-limited financial instrument that can help mitigate the high cost of vaccine production at market entry”. It also advocates that this financial instrument supports African manufacturers to make the most commercially viable antigen-based vaccines – starting with cholera and Ebola. For their part, African countries are tasked with accelerating investment in the enabling environment, including “strong regulatory authorities, robust supply chains, skilled human capital, reduced trade barriers and empowered regional coordination”. Image Credits: Gavi/Karel Prinsloo 2017. As Demand for Chicken Rises, Tanzanian Researchers Warn of Excessive Antibiotic Use at Farms 03/11/2022 Kizito Makoye Roast chicken vendors prepare their meals in Dar es Salaam DAR ES SALAAM, Tanzania—At a smoky kitchen in the port city of Dar es Salaam, none of the customers jostling to place their orders knows that the irresistibly tasty roast chicken may be harbouring bacteria that could make them sick. “I don’t think poultry farmers would do anything likely to cause harm,” said 34-year-old Lilian Kiswale a regular customer at this popular fast-food joint. However, what is not clear to Kiswale, is that strains of bacteria that are resistant to antibiotics have repeatedly been found in chickens at farms where city’s street kitchens source their poultry products. “None of our customers has ever complained about the smell of antibiotics in the food we have prepared,” said Kelvin Massawe who works as a chef at the chicken restaurant that is a culinary delight in the neighbourhood. But it’s not about antibiotics ruining the taste of roast chicken. The antibiotic-laced food that poultry farmers in Tanzania give to their birds, ostensibly to increase muscle weight quickly and keep infections at bay, poses a threat to humans as well. According to a recent study by Tanzania’s Muhimbili University of Health and Allied Sciences (MUHAS), excessive amounts of antibiotic residue had been found in broiler chicken tissues – a perfect condition for antimicrobial resistance (AMR). Using the liver samples of 84 commercial broiler chickens, the researchers found that 100% had the antibiotic tetracycline – and 90% at levels that exceeded acceptable daily limits. In addition, 21.4% of the samples also had sulphonamide, although this was within the maximum limit, according to the study, which was published in the journal, Antibiotics. Worse still, researchers say that poultry farmers have unrestricted access to prescription-only antibiotics including tetracycline, sulphonamides, penicillin, aminoglycosides and macrolides. Shop owner Jesca Anthony confirms that she sells antibiotics to farmers without prescription This was confirmed by shop owner Jesca Anthony, who said that she sells antibiotics, without prescriptions to farmers. “Random use of antibiotics in animal feeds heighten the risk of drug resistance not just to animals but in humans as well,” Professor Mecky Matee, head of microbiology at MUHAS and the study’s lead author, told Health Policy Watch. “The use of antibiotics as growth promoters for chicken should be banned,” Matee stressed. Antibiotics are losing their power When an antibiotic is used, it wipes out susceptible bacteria, leaving behind resistant ones. These resistant bacteria can grow and become dominant, and pass from chicken products to humans who eat or handle the meat. Once inside a person, these resistant bacteria can take over the colon, which is then unable to fight infections. Antibiotics are increasingly losing their efficacy due to indiscriminate use in humans and for stimulating animal and birds’ growth. The rise in drug-resistant bacteria has the potential to inflict a devastating human and economic toll globally, according to the United Nations. According to the most comprehensive estimate of the global impact of antimicrobial resistance (AMR), published in The Lancet in January 2022, an estimated 1.2 million people died in 2019 from antibiotic-resistant bacterial infections – more deaths than those from HIV/AIDS or malaria. “Many types of common antibiotics are no longer effective enough to treat bacteria, in many cases patients need hospitalisation,” said Hellen Sabuka, a senior epidemiologist at Shree Hindul Mandal Hospital in Dar es Salaam. Sabuka urged Tanzania’s health authorities to adopt strict regulations and control on the use of antibiotics in animal production. A customer at the Tegeta slaughter house Although Tanzania has policies and guidelines for the use of antibiotics in animal feed, such policies are poorly enforced due to weak systems for food and agricultural productions. In Dar es Salaam, one of Africa’s fastest-growing cities and home to 5.8 million inhabitants, poultry farmers routinely mix an array of human antibiotics into chicken feed to try to ensure they grow faster and don’t get sick. It is a humid Sunday evening at Kibamba, a suburb in the western part of Dar es Salaam, and Salma Libuhi is busy mixing a concoction of medicines into rice husks to feed her caged chickens. Amid smouldering heat, she methodically mixes in a cocktail of three antibiotics— oxytetracycline, doxycycline and enrofloxacin – and sets the food in cans. “When they eat this food, they grow faster,” she told Health Policy Watch. For the 38-year-old mother of four, poultry farming is her livelihood. In 2017, quit her job as a teacher and ventured into entrepreneurship. “Raising chicken is very profitable,” she said. To educate herself about animal husbandry, Libuhi joined a whatsapp groups where she gets all the information about diseases and antibiotics. “I never consulted a vet. The information I get from the group is enough,” she said. At Libuhi’s farm, broiler chickens usually take six weeks to reach market weight. Once they’ve reached the proper size and weight she catches each chicken by hand and transfers them to holding cages ready to be sold. Unlike wild chickens that traverse a range of habitats as they forage for seeds, insects and fresh leaves, broiler chicken are often kept in overcrowded, poorly ventilated and unhygienic shacks. Lack of controls in Africa Across Africa, antibiotics are heavily in the farming of cows, pigs and chickens to fight infections and promote growth. With the indiscriminate use of antibiotics, particularly in agriculture for stimulating animal and birds’ growth, these essential medicines are losing their efficacy. “Many types of common antibiotics are no longer effective enough to treat bacteria, in many cases patients need hospitalisation,” said Hellen Sabuka, a senior epidemiologist at Shree Hindul Mandal Hospital in Dar es Salaam. Sabuka urged Tanzania’s health authorities to adopt strict regulations and control on the use of antibiotics in animal production. While over-use of antibiotics as growth promoters is not a new phenomenon, global experts think preventing drug-resistant bacteria that kill millions of people every year, requires a coordinated approach. Mohan P. Joshi, technical lead for antimicrobial resistance and global health security at the non-profit, Management Sciences for Health, said the overuse of antimicrobials in animals, especially as growth-promoters in food-producing animals, is common in many countries. “In some countries, the proportion [of antibiotics] used in the animal sector is as high as 80% of the total antimicrobials consumed. Alternatives such as good animal husbandry, vaccinations, and biosecurity measures including hygienic practices are critical farming approaches that can help reduce antimicrobial use in animals raised for food,” he said. While 144 countries have national plans to combat AMR, according to a 2021 World Health Organization (WHO) report, Joshi says sectors differ in the amount of progress they’ve made, with the human health sector generally making the most progress and the animal sector lagging. “We need collaborative, multisectoral coordination to address public health threats at the intersection of humans, animals, and the environment. A One Health-focused approach is the only way to effectively address this widespread issue,” Joshi said. According to him, the fight against AMR needs coordinating bodies with adequate funding, political support and authority to act. “Countries need to establish functional multi-sectoral task forces to contain AMR that include high-level government officials and stakeholders from both human and animal health, along with the agricultural, environmental and food sectors, and ensure that such bodies are effectively facilitating One Health coordination, helping build capacities of local stakeholders, and mobilising diversified funding,” he said In 2019, five million human infections were associated with bacterial antimicrobial resistance worldwide, including more than 1.2 million human deaths attributable to bacterial AMR. The burden was highest in sub-Saharan Africa and South Asia, with children below five years of age the most affected. Pushed by the rising demand for cheap poultry products, the broiler value chain in Tanzania, is a big user of antibiotics. Most poultry farmers in Tanzania treat chicken with a concoction of antibiotics often without consulting veterinary doctors. Despite the growing adversity, global experts are cautiously optimistic about prescription-only system where veterinarians will have the upper hand in dispensing drugs used in animal production. Chicken dealers waiting for customers at Tegeta slaughter house. Thomas Van Boeckel, from the public research university, Zurich ETH, said the best way to curb antibiotic use in animals is to move to a prescription only –system where only trained veterinarian would be authorized to sell the antibiotics rather than retail shop owners. “However, even in Switzerland where such a system is in place, this does not resolve all problems because vets may still have a financial conflict of interest in prescribing for profit,” Boeckel said. He says that a better solution would be to “remove the profit margin from vets on drug prescription,” as is the case in Sweden. Meanwhile, Emma Berntman, senior engagement specialist at FAIRR initiative, said low and middle-income countries, including Tanzania have the largest share of global antimicrobial consumption in animals and agriculture, due to the routine use of antimicrobials in farming for growth promotion and prophylaxis. She blamed the countries’ lack of checks and balances and low awareness on overuse of antibiotics. “Tanzania is no exception to this. The country lacks regulation that is sufficient to adequately address the issue of excessive antimicrobial use and antibiotic are cheap and widely available,” said Berntman. FAIRR is an investor-run initiative to address threats to the global food supply. According to her, even when regulation exists in the emerging market, it can be hard to enforce when there is a lack of access to veterinarians and poor awareness of the impacts of overusing antibiotics. “On-the-ground initiatives are needed to help support farmers to reduce their dependence on these drugs,” she stressed. Growing appeal of organic products Although Switzerland launched an AMR strategy in 2015, FAIRR experts say the highest priority critically important antibiotics (HPCIAs) including fluoroquinolones, are still excessively used in farms, notably in broiler production, with authorities warning of high levels of resistance. “These antibiotics are deemed ‘the last line of defence’ in human medicine and are the only antibiotics available to treat certain bacterial infection. If they become ineffective, it poses a significant threat to human health,” Berntman said. “Resistant bacteria developed in broilers can spread to humans through direct contact with the birds, eating chicken or via the environment. There is also a risk to flock health due to the reduced efficacy of antimicrobials used to treat them.” Despite the growing threat, experts see glimmer of hope in reducing the use of antibiotics in broiler farms and other antibiotics used in human medicines. “The government can support reductions by further restricting the use of antibiotics in animals in line with the latest EU regulations, so that antibiotics can only be used to treat infections and routine use is prevented,” Berntman said. Moreover, Berntman said the government can facilitate antibiotic stewardship activities to support the adoption of alternatives to antimicrobials including vaccination programmes and improved nutrition. According to Berntman the rising awareness of the risk of AMR in Europe and North America has triggered a surge in demand for products associated with or lower antibiotic use. “Many consumers are willing to pay a price premium to purchase organic chicken or chicken raised without antibiotics,” she said. Approximately 60% of broilers in the US are now raised without antibiotics, according to Berntman. Moreover, the number of broiler chicks receiving antibiotics in the hatchery has dropped by 90% to nearly zero. “It is important that poultry producers improve animal welfare, vaccinate their flocks, and implement routine health monitoring programmes to meet consumer demand for broilers raised with less or no antibiotics while simultaneously creating environments where healthy flocks can be raised no antimicrobials required without impacting animal welfare,” Berntman said. But for chicken lovers in Dar es Salaam, antibiotic-free roast chicken meat is probably a distant dream. Image Credits: Peter Mgongo. Phase Out Fossil Fuels, Urges Tedros on Eve of COP27 02/11/2022 Megha Kaveri Severe air pollution in Anyang, China in January 2022. Ahead of the global climate talks in Egypt, the World Health Organization (WHO) has urged governments to expedite fossil fuel phase out and transition into clean energy. “Climate change is already impacting health in many ways, through more frequent and extreme weather events, more disease outbreaks, and more mental health issues,” Dr Tedros Adhanom Ghebreysus, the director-general of WHO said in a press briefing on Wednesday. Flagging the impact of climate change on various aspects of human life, including diseases and malnutrition, Dr Tedros called for governments “to lead a just, equitable and fast phase-out of fossil fuels and transition to a clean energy future”. The 27th United Nations Climate Change Conference (COP27) will take place in Sharm el-Sheikh, Egypt from 6 to 18 November. At the conference, world leaders are expected to assess the progress in limiting global warming to 1.5 º Celsius above the pre-industrial levels. “Meeting that target will have massive benefits for human health. Failing to meet it comes with massive risks,” Dr Tedros warned. Impact of climate change on food security Martin Griffiths, the UN Office for the Coordination of Humanitarian Affairs (OCHA), told the briefing that the world is in the grip of hunger crisis and that the pandemic and vast inequality are partly to blame. Listing the different crises happening across the world – the drought in the Horn of Africa, Somalia and Kenya, the floods in Pakistan, the civil war in Tigray, Ethiopia – the OCHA chief called for immediate action to control global warming. “This is the world at 1.2º Celsius [above pre-industrial levels]. But we’re on track to double that. And unless we act now, we’re heading for a future full of droughts, diseases and climate disasters across the whole world,” he added. In 2009 at the Copenhagen Summit, G20 countries pledged that they will channel $100 billion a year to less wealthy countries to mitigate the effects of climate change. Referring to this promise, Griffiths pointed out that the wealthy countries have not kept their word. “We need to come out of COP27 with clarity [about the missing money] and ability [to ensure the promise is kept].” He also referred to the UN Secretary General Antonio Guterres´ proposal to impose a windfall tax on the profits earned by fossil fuel and gas companies, saying that 18 days’ worth of such profits can cover the entire sum of UN’s humanitarian appeal for the year. “COP27 is going to be a major test for all of us to see if those commitments made so boldly in years gone past finally made land for the people who are staring climate [change impact] in the face,” Griffiths said. Adopt WHO 2021 air quality guidelines In line with the theme in the coming weeks, spotlight was also put on the role air pollution plays in public health and climate change. Around 1.1 million people in Africa died from diseases related to air-pollution in 2019. The WHO estimates that seven million people across the world stand to lose their lives to air pollution in a year. But Rosamund Kissi-Debrah, founder and trustee of the Ella Roberta Family Foundation, says that need not be the case. “Cleaning up the air will save lives and it will also reduce health healthcare costs to increase productivity, and it will save trillions of dollars from governments,” she said. Kissi-Debrah called for all the countries participating in COP27 to immediately adopt WHO’s air quality guidelines 2021, describing them as “achievable” and life-saving. She further said that governments must invest in solutions to tackle air pollution and raise public awareness about the adverse effects of rising air pollution on health. Pointing to the example of global cooperation to develop and deliver COVID-19 vaccines, Kissi-Debrah called for a similar level of cooperation to tackle air pollution. “We definitely believe seven to 9 million people every year are definitely worth saving. I urge everybody who goes into COP27 to not forget about public health.” Image Credits: Chris LeBoutillier, V.T. Polywoda. WHO Leadership Shake-up Takes Shape 02/11/2022 Editorial team WHO Assistant Director-General Dr Ren Minghui Two of the World Health Organisation’s top leadership team in Geneva – Dr Soumya Swaminathan and Dr Ren Minghui – are on the brink of leaving as Director-General Dr Tedros Adhanom Ghebreyesus’s long-anticipated leadership shake-up starts to take shape. Swaminathan is WHO’s Chief Scientist, while Ren serves as assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases. Meanwhile, Stéphanie Seydoux has been appointed as the WHO Director-General’s Envoy for Multilateral Affairs, replacing Dr Agnès Buzyn, who was appointed executive director of the WHO Academy in Lyon recently and remains on the leadership team in her new role. Thrilled to begin my new role today as Envoy for Multilateral Affairs, in the Office of @DrTedros, ahead of #G20BaliSummit. Ready to serve the #globalhealth #SDGs objectives of equitable access to health for all and #healthsecurity promoted by @WHO and international partners. pic.twitter.com/x8PU25VsLy — Stéphanie Seydoux (@S_Seydoux) November 2, 2022 Seydoux is the former French Global Health Ambassador. France has been a firm supporter of WHO and is the major investor in the new academy, which is expected to open in 2024, which will offer health workers around the world access to “the latest evidence-based health guidance, state-of-the-art learning technologies and advancements in the science of adult learning”, according to WHO. WHO Deputy Director Dr Zsuzsanna Jakab is also expected to leave soon. The 71-year-old Hungarian is well over the WHO mandatory retirement age of 65 – which can usually only be extended by three years. As Health Policy Watch previously reported, 63-year-old Swaminathan is still two years short of WHO’s mandatory age of retirement, but there have been hints that her style was too independent for the director-general. However, a source close to Swaminathan said that she was leaving voluntarily after five years in senior WHO leadership to reunite with her husband and elderly parents who remained in her hometown of Chennai, India, while she served in Geneva. Prior to WHO, Ren was director-general for international cooperation at the National Health and Family Planning Commission of China. Conversely, Dr Mike Ryan, executive director of WHO’s Health Emergencies Programme, who had earlier been expected to leave the organization, appears set to remain, several WHO insiders with knowledge of the pending reshuffle confirmed. Having Won the Right to Abortion, Colombian Activists Are Pressing Health Facilities to Deliver 01/11/2022 Juanita Rico Causa Justa activists outside Colombia’s Constitutional Court In February, Colombia introduced one of the most liberal abortion laws in the world after activists took to the courts – but now their challenge lies in ensuring the health system is in a position to offer terminations Not long ago, abortion in Colombia was a taboo topic that could not be mentioned during dinners or family gatherings, according to Florence Thomas, one of Colombia’s feminism most influential voices. “It was considered such a difficult subject that people would stand up and leave my lectures when I touched upon it,” Thomas told Health Policy Watch. Some 16 years ago, in 2006, Colombian lawyer Mónica Roa challenged the country’s complete ban on abortion in the Constitutional Court and achieved the decriminalization of abortion on three grounds: when the pregnancy was the result of rape or incest; when there was a severe malformation of the fetus; and when the pregnancy constituted a risk to the woman’s health. “That ruling changed the course of history,” Thomas explains because it made it evident that the legal way to fight for safe abortions was not the Congress, but the Constitutional Court, the highest court in Colombia. Since then, feminist movements and pro-choice lawyers like Roa have fought to extend the decriminalization of abortion in Colombia. Lawsuit against barriers In 2020, Causa Justa (“Just Cause”), a movement made up of over 100 organisations and 140 activists united to legalise abortion, filed a lawsuit against the criminalization of the early termination of pregnancy. Instead of proposing a whole new scheme of laws that would have to go through Congress, they sought a regulate abortion within the rules that were already in place and thus would not rely on politicians. Causa Justa showed that, despite the 2006 reforms, abortion remained a crime in the Penal Code, putting it out of reach for most women. Causa Justa’s lawsuit, supported by more than 100 national and international experts, also showed that almost 400 women were convicted every year for having or seeking an abortion, with sentences ranging from 16 to 54 months in prison. Between 2006 and 2019, more than 5,700 women were charged for abortion. Causa Justa’s lawyers also showed the judges that criminalization forced women to seek unsanitary and dangerous underground abortion clinics. According to Colombia’s Public Health and Epidemiology Observatory, one of the main causes of the deaths of over 400 women from haemorrhaging in 2020 was unsafe, illegal abortions. Between 59% and 70% of the complaints laid against the women seeking abortions had come from health workers, explains Mariana Ardila, a lawyer with Women’s Link, one of the organizations that are part of Causa Justa. Abortion providers could also face charges, which made most health professionals refuse to perform abortions. Nail-bitingly close judgement That sad reality changed with the new ruling in February this year, which established that abortion will only be an offence after the 24th week of pregnancy. “Women won,” said the plaintiffs after learning of the decision, surrounded by chants claiming: “It is a law! It is a law! It is a law.” The ruling is historic because successive Colombian governments have never legislated on an issue that they consider neither a priority nor find beneficial because of the controversy it generates in the street. Colombia is a secular but deeply religious country. A 2017 survey revealed that 97% of citizens believe in God and the different churches, predominantly Catholic and Evangelical, have enormous power over believers, pushing them into an all-out fight against abortion. In its final stage, the Constitutional Court judges voted on the lawsuit, and the vote was nail-bitingly close: five judges were in favor, and four against. With this final say, the court proved that Colombia is changing. Today, only 20% of the population approves that women go to jail if they get an abortion. Health services not prepared The Court also ruled that the government would have to implement a comprehensive public policy regarding access to safe and legal abortions in the “shortest possible time.” However, to date, such a policy hasn’t been fully defined and executed. Colombia’s Ministry of Health recognizes that barriers to abortion persist and are mainly associated with the denial of services – mainly due to ignorance of the changed legal framework and improper exercise of conscientious objection by medical personnel. On 28 September, it issued a document with instructions about how to strengthen sexual and reproductive health care, including abortion, that was addressed to all entities that are part of the health system. Colombia is part of a “green wave” of countries in the region that have decided to expand their abortion freedoms, but it allows abortion much later than its regional counterparts. Con @causajustaco Colombia🇨🇴 entró en la tendencia mundial de 75 países que protegen de manera amplia y brindan garantías para los derechos reproductivos de mujeres, niñas y adolescentes. Hoy allí el aborto es legal hasta la semana 24 de gestación👉https://t.co/FTOS0sRU5j pic.twitter.com/iWqdhXp6Uy — Centro de Derechos Reproductivos (@ReproRightsLAC) October 31, 2022 Mexico’s Supreme Court ruled late last year that was unconstitutional to criminalize abortion. However, each state has to regulate the decision of the Supreme Court. In Argentina, Congress approved abortion’s legality up to 14 weeks, and, as in Colombia, lifted the restrictions that only allowed for abortion in cases of rape or where the mother’s health is at risk. On the other hand, Ecuador’s National Assembly approved a bill that allows abortions if they result from rape up to the 12th week, but President Guillermo Lasso vetoed it, saying that he respects “life from conception.” Colombia’s ruling, however, is a historic victory for the Colombian women’s movement that has fought for decades for their rights to be recognized in a traditional and ultra-catholic country. The next step is for the public policy to be fully deployed across the country and to serve as a model for the region. Mesa por la Vida y la Salud de las Mujeres, a feminist collective that defends women’s sexual and reproductive rights, stated that during the first few months of 2022, they helped more than 90 women to overcome barriers while seeking an abortion within the new law’s parameters. Alejandra* (not her real name) is one example. She asked for an abortion in her sixth week of pregnancy but only finally got one in her 11th week. She states that the procedure was slow and painful and that the doctors did not provide clear information about the process. The numbers show that the path is still long for women in Colombia and that the famous feminist march slogan, “we want sex education to decide, contraceptives to avoid abortion, and legal abortion not to die,” will still echo in the streets, the mountains, the buildings, and law-making entities until Colombian women can feel free to decide, unchallenged, about their bodies. The Rosa Luxemburg Foundation provided support for this article. Image Credits: Causa Justa. New Initiative to Tackle Alcohol Harms Will Focus on Taxation 01/11/2022 Kerry Cullinan Alcohol is related to more than 60 different conditions, including cancers, heart and liver disease. A $15 million initiative to address the harms of alcohol consumption through policy change was launched Tuesday, roughly doubling the total global spending on mitigating the effects of alcohol. Alcohol is one of the top-ten drivers of death, illness and injury, with wide-ranging social and economic harms, many disproportionately affecting young adults, according to Vital Strategies, which heads the RESET Alcohol consortium. “RESET Alcohol is an initiative that brings together national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies from the World Health Organization’s WHO) SAFER technical package,” according to Vital Strategies. The initiative will focus on Latin America, Africa and Asia, with partners Movendi International; the University of Illinois Chicago; the Global Alcohol Policy Alliance (GAPA); the Non-Communicable Disease (NCD) Alliance; and the WHO, with GiveWell as the donor. RESET’s primary policy focus will be on increasing alcohol taxation and other pricing policies which it describes as being “among the most effective interventions for reducing consumption”. It also aims to regulate the availability of alcohol, and restrict its marketing. Over three years, the initiative will support 15 or more countries to develop policies including raising the price of alcohol via taxation, regulating availability, and restricting alcohol marketing. Policies to protect kids “Every year, alcohol use cuts millions of lives short and causes even more widespread suffering,” said Adam Karpati, senior vice president at Vital Strategies. “The onus can’t be on individuals. We must reset from an environment where the alcohol industry is empowered to push alcohol into nearly every aspect of our lives, including schools, sports, and media. We need policies that protect kids, make healthy choices, the easy choices, and check the industry’s influence. RESET Alcohol will do just that through strong partnerships with government and civil society leaders who are committed to action.” Alcohol consumption has increased in nearly all regions of the world consistently since 2005, and accelerated during the COVID-19 pandemic. It is related to more than 60 different conditions, including cancers, heart disease, liver disease, tuberculosis and HIV/AIDS; injuries and trauma including suicide, homicide, assault, falls, intimate partner violence, and vehicle crashes. Alcohol consumption is also associated with adverse economic impacts, from medical care costs to lost productivity. RESET Alcohol’s approach builds on its partners’ successes in similar consortiums that have addressed tobacco and other harmful commodities, including contributing to 18.5% reduction in tobacco use in Bangladesh between 2009 and 2017 and a 17% reduction in India between 2010 and 2017. “Failure to act has led to millions of preventable deaths and suffering from alcohol,” said Jacqui Drope, the new director of RESET Alcohol. “It’s time governments treat it like the public health crisis that it is. When governments take up policies proven to reduce alcohol-related harms, population health and economies will benefit.” RESET Alcohol will provide technical support to governments, improve national research and data collection, resource advocacy for policy change, and mount communications campaigns. “For governments, tax increases on alcohol are a win-win, especially given the sluggish global economy,” said Jeffrey Drope, Research Professor at UIC. “Effective alcohol taxation reduces affordability, consumption and alcohol-related disease and premature death. This means lower healthcare costs and increased productivity from a healthier population. Taxes also create revenue for governments to fund health programs or other social priorities. Image Credits: U.S. Air Force/Samuel King Jr. . WHO Launches Climate Portal and Malaria Guide for Cities 31/10/2022 Editorial team The World Health Organization (WHO) and World Meteorological Organization (WMO) launched the first global knowledge platform dedicated to climate and health on Monday called climahealth.info. The global open-access platform is envisaged as being the “go-to technical reference point for users of interdisciplinary health, environmental, and climate science”, according to the WHO in a media release. “The use of tailored climate and environmental science and tools for public health, such as disease forecasting and heat health early warning systems, have enormous life-saving potential. These tools and resources can enhance our understanding of the connections between climate and health, help us reach at-risk populations, and anticipate and reduce impacts,” according to the media release. “Climate change is killing people right now,” said Diarmid Campbell-Lendrum, coordinator of WHO’s climate change and health programme. “It is affecting the basics we need to survive – clean air, safe water, food and shelter – with the worst impacts being felt by the most vulnerable. Unmitigated climate change has the potential to undermine decades of progress in global health. Reducing its impacts requires evidence-based policy backed by the best available science and tools.” Joy Shumake-Guillemot, who leads the WMO-WHO Climate and Health Joint Office, said that public health practitioners who are concerned about the environmental impacts on health “lack access to training and tailored climate information needed to address these growing issues” while “climate experts (are) sitting on troves of research and resources that could be applied to support public health goals, but just aren’t reaching the right people”. The initiative is supported by the Wellcome Trust. “Collaboration between climate, health and technical specialists is crucial for helping us understand and tackle the health effects of climate change,” said Madeleine Thomson, Head of Climate Impacts and Adaptation for the Wellcome Trust. “But right now, experts can’t always partner and share information as effectively as we know they’d like to. We hope this portal will help fulfill the potential of different disciplines to work together on research and gain new insights into how climate change is affecting health around the world.” Cities’ Malaria Framework launched On the occasion of World Cities Day 2022 on Monday, the WHO and UN Habitat launched the Global framework for the response to malaria in urban areas, which provides guidance to city government officials, health professionals and urban planners on how to develop a comprehensive malaria response specifically in urban areas, “where the dynamics of transmission and burden of vector-borne diseases can be different from that of rural areas”. By 2050, nearly 70% of people globally will live in cities and other urban settings and the WHO predicts that unplanned urbanization is likely to result in a malaria disease burden that is “disproportionately high among the urban poor”. Speakers at the launch also anticipated that climate change will see malaria in places that were previously too cold for the disease that is carried by mosquitos. The framework provides guidance for city leaders, health programmes and urban planners to respond to the challenges of rapid urbanization in a targeted way that helps to build resilience against the threat of malaria and other vector-borne diseases. Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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Gavi Undertakes to Change Vaccine Procurement to Support New African Manufacturers 03/11/2022 Kerry Cullinan Africa only produces 1% of the vaccines it uses. Gavi, the global vaccine alliance, has undertaken to adapt its approach to procuring vaccines in order to support African vaccine manufacturing. In a plan released on Thursday, Gavi has committed to placing “a higher value on the benefits of diversification to supply security, with a focus on Africa”. The 10-point plan, developed in consultation with the African Union and other key partners, also allocates responsibilities to other key players – G7 Development Ministers, African countries, international partners including development financial institutions, and the private sector – to support sustainable African manufacturing capacity. However, Gavi will drive and coordinate the plan, given its enormous clout as the world’s biggest buyer of vaccines. “For 22 years, as the largest buyer of vaccines in the world, Gavi has worked closely with African countries and manufacturers to favourably shape the market for essential routine and outbreak vaccines,” said Gavi CEO Dr Seth Berkley. “Gavi is committed to contributing to the AU’s vision. The plan published today provides a pathway to ensuring vaccine supply security for Africa during pandemics and expanding access to other life-saving vaccines at sustainable, affordable prices.” The COVID-19 pandemic exposed Africa’s vulnerability when the entire continent was unable to get vaccines for months as wealthy countries had bought up all the doses made by Pfizer and Moderna and India stopped the export of generic vaccines made by the Serum Institute of India destined for the continent. Stung by the COVID-19 experience, the AU has set a target to produce and supply more than 60% of its vaccine doses on the continent by 2040 – it currently supplies 1%. Although Africa consumes vaccines valued at over $1 billion every year, the cost of much of this is carried by Gavi, UNICEF and donors. At present, Gavi chooses vaccine suppliers on price, and “does not systematically permit the accommodation of higher prices in the name of geographical diversity and supply security”, it acknowledged. “New accommodations in the way Gavi assesses products against supply security as a new market health objective, could have a substantial impact,” it acknowledges. The risk of supporting more expensive African-made vaccines could be mitigated by countries committing upfront to vaccines which would enable “predictable pooled procurement volumes”. African countries themselves also need to “send clear demand signals to the market on willingness to select and procure from African suppliers”. “In the last 18 months alone, more than 30 new African manufacturing projects have been announced and estimates indicate that the African vaccine market across all existing and projected novel products could range between US$ 2.8 billion and US$ 5.6 billion by 2040, demonstrating the potential for a thriving regional industry to emerge,” according to Gavi. However, the report also acknowledges that “a disorderly expansion risks unhealthy competition, potentially undermining the impact of market-shaping initiatives that have delivered low vaccine prices to lower-income nations, while also failing to realise Africa’s manufacturing aspirations”. It calls for a “business model” that “actively shapes markets in support of the AU’s vision: meeting the mutually reinforcing objectives of continued global market health, and a sustainable regional manufacturing sector”. Nonetheless, the price of setting up new manufacturing facilities in Africa may mean that their products are way too expensive to be viable. “Modelling indicates that price differentials for new entrants may be in excess of levels that could be accommodated during standard Gavi/UNICEF competitive tenders, without impact on programme coverage,” Gavi warns. “Ways must be found to support new entrants, whilst at the same time, avoiding a situation in which incumbent manufacturers increase their prices for vaccines due to lost volumes. This carries a potential risk of increasing the costs of immunisation worldwide.” To address the high cost for new entrants, the plan proposes “a time-limited financial instrument that can help mitigate the high cost of vaccine production at market entry”. It also advocates that this financial instrument supports African manufacturers to make the most commercially viable antigen-based vaccines – starting with cholera and Ebola. For their part, African countries are tasked with accelerating investment in the enabling environment, including “strong regulatory authorities, robust supply chains, skilled human capital, reduced trade barriers and empowered regional coordination”. Image Credits: Gavi/Karel Prinsloo 2017. As Demand for Chicken Rises, Tanzanian Researchers Warn of Excessive Antibiotic Use at Farms 03/11/2022 Kizito Makoye Roast chicken vendors prepare their meals in Dar es Salaam DAR ES SALAAM, Tanzania—At a smoky kitchen in the port city of Dar es Salaam, none of the customers jostling to place their orders knows that the irresistibly tasty roast chicken may be harbouring bacteria that could make them sick. “I don’t think poultry farmers would do anything likely to cause harm,” said 34-year-old Lilian Kiswale a regular customer at this popular fast-food joint. However, what is not clear to Kiswale, is that strains of bacteria that are resistant to antibiotics have repeatedly been found in chickens at farms where city’s street kitchens source their poultry products. “None of our customers has ever complained about the smell of antibiotics in the food we have prepared,” said Kelvin Massawe who works as a chef at the chicken restaurant that is a culinary delight in the neighbourhood. But it’s not about antibiotics ruining the taste of roast chicken. The antibiotic-laced food that poultry farmers in Tanzania give to their birds, ostensibly to increase muscle weight quickly and keep infections at bay, poses a threat to humans as well. According to a recent study by Tanzania’s Muhimbili University of Health and Allied Sciences (MUHAS), excessive amounts of antibiotic residue had been found in broiler chicken tissues – a perfect condition for antimicrobial resistance (AMR). Using the liver samples of 84 commercial broiler chickens, the researchers found that 100% had the antibiotic tetracycline – and 90% at levels that exceeded acceptable daily limits. In addition, 21.4% of the samples also had sulphonamide, although this was within the maximum limit, according to the study, which was published in the journal, Antibiotics. Worse still, researchers say that poultry farmers have unrestricted access to prescription-only antibiotics including tetracycline, sulphonamides, penicillin, aminoglycosides and macrolides. Shop owner Jesca Anthony confirms that she sells antibiotics to farmers without prescription This was confirmed by shop owner Jesca Anthony, who said that she sells antibiotics, without prescriptions to farmers. “Random use of antibiotics in animal feeds heighten the risk of drug resistance not just to animals but in humans as well,” Professor Mecky Matee, head of microbiology at MUHAS and the study’s lead author, told Health Policy Watch. “The use of antibiotics as growth promoters for chicken should be banned,” Matee stressed. Antibiotics are losing their power When an antibiotic is used, it wipes out susceptible bacteria, leaving behind resistant ones. These resistant bacteria can grow and become dominant, and pass from chicken products to humans who eat or handle the meat. Once inside a person, these resistant bacteria can take over the colon, which is then unable to fight infections. Antibiotics are increasingly losing their efficacy due to indiscriminate use in humans and for stimulating animal and birds’ growth. The rise in drug-resistant bacteria has the potential to inflict a devastating human and economic toll globally, according to the United Nations. According to the most comprehensive estimate of the global impact of antimicrobial resistance (AMR), published in The Lancet in January 2022, an estimated 1.2 million people died in 2019 from antibiotic-resistant bacterial infections – more deaths than those from HIV/AIDS or malaria. “Many types of common antibiotics are no longer effective enough to treat bacteria, in many cases patients need hospitalisation,” said Hellen Sabuka, a senior epidemiologist at Shree Hindul Mandal Hospital in Dar es Salaam. Sabuka urged Tanzania’s health authorities to adopt strict regulations and control on the use of antibiotics in animal production. A customer at the Tegeta slaughter house Although Tanzania has policies and guidelines for the use of antibiotics in animal feed, such policies are poorly enforced due to weak systems for food and agricultural productions. In Dar es Salaam, one of Africa’s fastest-growing cities and home to 5.8 million inhabitants, poultry farmers routinely mix an array of human antibiotics into chicken feed to try to ensure they grow faster and don’t get sick. It is a humid Sunday evening at Kibamba, a suburb in the western part of Dar es Salaam, and Salma Libuhi is busy mixing a concoction of medicines into rice husks to feed her caged chickens. Amid smouldering heat, she methodically mixes in a cocktail of three antibiotics— oxytetracycline, doxycycline and enrofloxacin – and sets the food in cans. “When they eat this food, they grow faster,” she told Health Policy Watch. For the 38-year-old mother of four, poultry farming is her livelihood. In 2017, quit her job as a teacher and ventured into entrepreneurship. “Raising chicken is very profitable,” she said. To educate herself about animal husbandry, Libuhi joined a whatsapp groups where she gets all the information about diseases and antibiotics. “I never consulted a vet. The information I get from the group is enough,” she said. At Libuhi’s farm, broiler chickens usually take six weeks to reach market weight. Once they’ve reached the proper size and weight she catches each chicken by hand and transfers them to holding cages ready to be sold. Unlike wild chickens that traverse a range of habitats as they forage for seeds, insects and fresh leaves, broiler chicken are often kept in overcrowded, poorly ventilated and unhygienic shacks. Lack of controls in Africa Across Africa, antibiotics are heavily in the farming of cows, pigs and chickens to fight infections and promote growth. With the indiscriminate use of antibiotics, particularly in agriculture for stimulating animal and birds’ growth, these essential medicines are losing their efficacy. “Many types of common antibiotics are no longer effective enough to treat bacteria, in many cases patients need hospitalisation,” said Hellen Sabuka, a senior epidemiologist at Shree Hindul Mandal Hospital in Dar es Salaam. Sabuka urged Tanzania’s health authorities to adopt strict regulations and control on the use of antibiotics in animal production. While over-use of antibiotics as growth promoters is not a new phenomenon, global experts think preventing drug-resistant bacteria that kill millions of people every year, requires a coordinated approach. Mohan P. Joshi, technical lead for antimicrobial resistance and global health security at the non-profit, Management Sciences for Health, said the overuse of antimicrobials in animals, especially as growth-promoters in food-producing animals, is common in many countries. “In some countries, the proportion [of antibiotics] used in the animal sector is as high as 80% of the total antimicrobials consumed. Alternatives such as good animal husbandry, vaccinations, and biosecurity measures including hygienic practices are critical farming approaches that can help reduce antimicrobial use in animals raised for food,” he said. While 144 countries have national plans to combat AMR, according to a 2021 World Health Organization (WHO) report, Joshi says sectors differ in the amount of progress they’ve made, with the human health sector generally making the most progress and the animal sector lagging. “We need collaborative, multisectoral coordination to address public health threats at the intersection of humans, animals, and the environment. A One Health-focused approach is the only way to effectively address this widespread issue,” Joshi said. According to him, the fight against AMR needs coordinating bodies with adequate funding, political support and authority to act. “Countries need to establish functional multi-sectoral task forces to contain AMR that include high-level government officials and stakeholders from both human and animal health, along with the agricultural, environmental and food sectors, and ensure that such bodies are effectively facilitating One Health coordination, helping build capacities of local stakeholders, and mobilising diversified funding,” he said In 2019, five million human infections were associated with bacterial antimicrobial resistance worldwide, including more than 1.2 million human deaths attributable to bacterial AMR. The burden was highest in sub-Saharan Africa and South Asia, with children below five years of age the most affected. Pushed by the rising demand for cheap poultry products, the broiler value chain in Tanzania, is a big user of antibiotics. Most poultry farmers in Tanzania treat chicken with a concoction of antibiotics often without consulting veterinary doctors. Despite the growing adversity, global experts are cautiously optimistic about prescription-only system where veterinarians will have the upper hand in dispensing drugs used in animal production. Chicken dealers waiting for customers at Tegeta slaughter house. Thomas Van Boeckel, from the public research university, Zurich ETH, said the best way to curb antibiotic use in animals is to move to a prescription only –system where only trained veterinarian would be authorized to sell the antibiotics rather than retail shop owners. “However, even in Switzerland where such a system is in place, this does not resolve all problems because vets may still have a financial conflict of interest in prescribing for profit,” Boeckel said. He says that a better solution would be to “remove the profit margin from vets on drug prescription,” as is the case in Sweden. Meanwhile, Emma Berntman, senior engagement specialist at FAIRR initiative, said low and middle-income countries, including Tanzania have the largest share of global antimicrobial consumption in animals and agriculture, due to the routine use of antimicrobials in farming for growth promotion and prophylaxis. She blamed the countries’ lack of checks and balances and low awareness on overuse of antibiotics. “Tanzania is no exception to this. The country lacks regulation that is sufficient to adequately address the issue of excessive antimicrobial use and antibiotic are cheap and widely available,” said Berntman. FAIRR is an investor-run initiative to address threats to the global food supply. According to her, even when regulation exists in the emerging market, it can be hard to enforce when there is a lack of access to veterinarians and poor awareness of the impacts of overusing antibiotics. “On-the-ground initiatives are needed to help support farmers to reduce their dependence on these drugs,” she stressed. Growing appeal of organic products Although Switzerland launched an AMR strategy in 2015, FAIRR experts say the highest priority critically important antibiotics (HPCIAs) including fluoroquinolones, are still excessively used in farms, notably in broiler production, with authorities warning of high levels of resistance. “These antibiotics are deemed ‘the last line of defence’ in human medicine and are the only antibiotics available to treat certain bacterial infection. If they become ineffective, it poses a significant threat to human health,” Berntman said. “Resistant bacteria developed in broilers can spread to humans through direct contact with the birds, eating chicken or via the environment. There is also a risk to flock health due to the reduced efficacy of antimicrobials used to treat them.” Despite the growing threat, experts see glimmer of hope in reducing the use of antibiotics in broiler farms and other antibiotics used in human medicines. “The government can support reductions by further restricting the use of antibiotics in animals in line with the latest EU regulations, so that antibiotics can only be used to treat infections and routine use is prevented,” Berntman said. Moreover, Berntman said the government can facilitate antibiotic stewardship activities to support the adoption of alternatives to antimicrobials including vaccination programmes and improved nutrition. According to Berntman the rising awareness of the risk of AMR in Europe and North America has triggered a surge in demand for products associated with or lower antibiotic use. “Many consumers are willing to pay a price premium to purchase organic chicken or chicken raised without antibiotics,” she said. Approximately 60% of broilers in the US are now raised without antibiotics, according to Berntman. Moreover, the number of broiler chicks receiving antibiotics in the hatchery has dropped by 90% to nearly zero. “It is important that poultry producers improve animal welfare, vaccinate their flocks, and implement routine health monitoring programmes to meet consumer demand for broilers raised with less or no antibiotics while simultaneously creating environments where healthy flocks can be raised no antimicrobials required without impacting animal welfare,” Berntman said. But for chicken lovers in Dar es Salaam, antibiotic-free roast chicken meat is probably a distant dream. Image Credits: Peter Mgongo. Phase Out Fossil Fuels, Urges Tedros on Eve of COP27 02/11/2022 Megha Kaveri Severe air pollution in Anyang, China in January 2022. Ahead of the global climate talks in Egypt, the World Health Organization (WHO) has urged governments to expedite fossil fuel phase out and transition into clean energy. “Climate change is already impacting health in many ways, through more frequent and extreme weather events, more disease outbreaks, and more mental health issues,” Dr Tedros Adhanom Ghebreysus, the director-general of WHO said in a press briefing on Wednesday. Flagging the impact of climate change on various aspects of human life, including diseases and malnutrition, Dr Tedros called for governments “to lead a just, equitable and fast phase-out of fossil fuels and transition to a clean energy future”. The 27th United Nations Climate Change Conference (COP27) will take place in Sharm el-Sheikh, Egypt from 6 to 18 November. At the conference, world leaders are expected to assess the progress in limiting global warming to 1.5 º Celsius above the pre-industrial levels. “Meeting that target will have massive benefits for human health. Failing to meet it comes with massive risks,” Dr Tedros warned. Impact of climate change on food security Martin Griffiths, the UN Office for the Coordination of Humanitarian Affairs (OCHA), told the briefing that the world is in the grip of hunger crisis and that the pandemic and vast inequality are partly to blame. Listing the different crises happening across the world – the drought in the Horn of Africa, Somalia and Kenya, the floods in Pakistan, the civil war in Tigray, Ethiopia – the OCHA chief called for immediate action to control global warming. “This is the world at 1.2º Celsius [above pre-industrial levels]. But we’re on track to double that. And unless we act now, we’re heading for a future full of droughts, diseases and climate disasters across the whole world,” he added. In 2009 at the Copenhagen Summit, G20 countries pledged that they will channel $100 billion a year to less wealthy countries to mitigate the effects of climate change. Referring to this promise, Griffiths pointed out that the wealthy countries have not kept their word. “We need to come out of COP27 with clarity [about the missing money] and ability [to ensure the promise is kept].” He also referred to the UN Secretary General Antonio Guterres´ proposal to impose a windfall tax on the profits earned by fossil fuel and gas companies, saying that 18 days’ worth of such profits can cover the entire sum of UN’s humanitarian appeal for the year. “COP27 is going to be a major test for all of us to see if those commitments made so boldly in years gone past finally made land for the people who are staring climate [change impact] in the face,” Griffiths said. Adopt WHO 2021 air quality guidelines In line with the theme in the coming weeks, spotlight was also put on the role air pollution plays in public health and climate change. Around 1.1 million people in Africa died from diseases related to air-pollution in 2019. The WHO estimates that seven million people across the world stand to lose their lives to air pollution in a year. But Rosamund Kissi-Debrah, founder and trustee of the Ella Roberta Family Foundation, says that need not be the case. “Cleaning up the air will save lives and it will also reduce health healthcare costs to increase productivity, and it will save trillions of dollars from governments,” she said. Kissi-Debrah called for all the countries participating in COP27 to immediately adopt WHO’s air quality guidelines 2021, describing them as “achievable” and life-saving. She further said that governments must invest in solutions to tackle air pollution and raise public awareness about the adverse effects of rising air pollution on health. Pointing to the example of global cooperation to develop and deliver COVID-19 vaccines, Kissi-Debrah called for a similar level of cooperation to tackle air pollution. “We definitely believe seven to 9 million people every year are definitely worth saving. I urge everybody who goes into COP27 to not forget about public health.” Image Credits: Chris LeBoutillier, V.T. Polywoda. WHO Leadership Shake-up Takes Shape 02/11/2022 Editorial team WHO Assistant Director-General Dr Ren Minghui Two of the World Health Organisation’s top leadership team in Geneva – Dr Soumya Swaminathan and Dr Ren Minghui – are on the brink of leaving as Director-General Dr Tedros Adhanom Ghebreyesus’s long-anticipated leadership shake-up starts to take shape. Swaminathan is WHO’s Chief Scientist, while Ren serves as assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases. Meanwhile, Stéphanie Seydoux has been appointed as the WHO Director-General’s Envoy for Multilateral Affairs, replacing Dr Agnès Buzyn, who was appointed executive director of the WHO Academy in Lyon recently and remains on the leadership team in her new role. Thrilled to begin my new role today as Envoy for Multilateral Affairs, in the Office of @DrTedros, ahead of #G20BaliSummit. Ready to serve the #globalhealth #SDGs objectives of equitable access to health for all and #healthsecurity promoted by @WHO and international partners. pic.twitter.com/x8PU25VsLy — Stéphanie Seydoux (@S_Seydoux) November 2, 2022 Seydoux is the former French Global Health Ambassador. France has been a firm supporter of WHO and is the major investor in the new academy, which is expected to open in 2024, which will offer health workers around the world access to “the latest evidence-based health guidance, state-of-the-art learning technologies and advancements in the science of adult learning”, according to WHO. WHO Deputy Director Dr Zsuzsanna Jakab is also expected to leave soon. The 71-year-old Hungarian is well over the WHO mandatory retirement age of 65 – which can usually only be extended by three years. As Health Policy Watch previously reported, 63-year-old Swaminathan is still two years short of WHO’s mandatory age of retirement, but there have been hints that her style was too independent for the director-general. However, a source close to Swaminathan said that she was leaving voluntarily after five years in senior WHO leadership to reunite with her husband and elderly parents who remained in her hometown of Chennai, India, while she served in Geneva. Prior to WHO, Ren was director-general for international cooperation at the National Health and Family Planning Commission of China. Conversely, Dr Mike Ryan, executive director of WHO’s Health Emergencies Programme, who had earlier been expected to leave the organization, appears set to remain, several WHO insiders with knowledge of the pending reshuffle confirmed. Having Won the Right to Abortion, Colombian Activists Are Pressing Health Facilities to Deliver 01/11/2022 Juanita Rico Causa Justa activists outside Colombia’s Constitutional Court In February, Colombia introduced one of the most liberal abortion laws in the world after activists took to the courts – but now their challenge lies in ensuring the health system is in a position to offer terminations Not long ago, abortion in Colombia was a taboo topic that could not be mentioned during dinners or family gatherings, according to Florence Thomas, one of Colombia’s feminism most influential voices. “It was considered such a difficult subject that people would stand up and leave my lectures when I touched upon it,” Thomas told Health Policy Watch. Some 16 years ago, in 2006, Colombian lawyer Mónica Roa challenged the country’s complete ban on abortion in the Constitutional Court and achieved the decriminalization of abortion on three grounds: when the pregnancy was the result of rape or incest; when there was a severe malformation of the fetus; and when the pregnancy constituted a risk to the woman’s health. “That ruling changed the course of history,” Thomas explains because it made it evident that the legal way to fight for safe abortions was not the Congress, but the Constitutional Court, the highest court in Colombia. Since then, feminist movements and pro-choice lawyers like Roa have fought to extend the decriminalization of abortion in Colombia. Lawsuit against barriers In 2020, Causa Justa (“Just Cause”), a movement made up of over 100 organisations and 140 activists united to legalise abortion, filed a lawsuit against the criminalization of the early termination of pregnancy. Instead of proposing a whole new scheme of laws that would have to go through Congress, they sought a regulate abortion within the rules that were already in place and thus would not rely on politicians. Causa Justa showed that, despite the 2006 reforms, abortion remained a crime in the Penal Code, putting it out of reach for most women. Causa Justa’s lawsuit, supported by more than 100 national and international experts, also showed that almost 400 women were convicted every year for having or seeking an abortion, with sentences ranging from 16 to 54 months in prison. Between 2006 and 2019, more than 5,700 women were charged for abortion. Causa Justa’s lawyers also showed the judges that criminalization forced women to seek unsanitary and dangerous underground abortion clinics. According to Colombia’s Public Health and Epidemiology Observatory, one of the main causes of the deaths of over 400 women from haemorrhaging in 2020 was unsafe, illegal abortions. Between 59% and 70% of the complaints laid against the women seeking abortions had come from health workers, explains Mariana Ardila, a lawyer with Women’s Link, one of the organizations that are part of Causa Justa. Abortion providers could also face charges, which made most health professionals refuse to perform abortions. Nail-bitingly close judgement That sad reality changed with the new ruling in February this year, which established that abortion will only be an offence after the 24th week of pregnancy. “Women won,” said the plaintiffs after learning of the decision, surrounded by chants claiming: “It is a law! It is a law! It is a law.” The ruling is historic because successive Colombian governments have never legislated on an issue that they consider neither a priority nor find beneficial because of the controversy it generates in the street. Colombia is a secular but deeply religious country. A 2017 survey revealed that 97% of citizens believe in God and the different churches, predominantly Catholic and Evangelical, have enormous power over believers, pushing them into an all-out fight against abortion. In its final stage, the Constitutional Court judges voted on the lawsuit, and the vote was nail-bitingly close: five judges were in favor, and four against. With this final say, the court proved that Colombia is changing. Today, only 20% of the population approves that women go to jail if they get an abortion. Health services not prepared The Court also ruled that the government would have to implement a comprehensive public policy regarding access to safe and legal abortions in the “shortest possible time.” However, to date, such a policy hasn’t been fully defined and executed. Colombia’s Ministry of Health recognizes that barriers to abortion persist and are mainly associated with the denial of services – mainly due to ignorance of the changed legal framework and improper exercise of conscientious objection by medical personnel. On 28 September, it issued a document with instructions about how to strengthen sexual and reproductive health care, including abortion, that was addressed to all entities that are part of the health system. Colombia is part of a “green wave” of countries in the region that have decided to expand their abortion freedoms, but it allows abortion much later than its regional counterparts. Con @causajustaco Colombia🇨🇴 entró en la tendencia mundial de 75 países que protegen de manera amplia y brindan garantías para los derechos reproductivos de mujeres, niñas y adolescentes. Hoy allí el aborto es legal hasta la semana 24 de gestación👉https://t.co/FTOS0sRU5j pic.twitter.com/iWqdhXp6Uy — Centro de Derechos Reproductivos (@ReproRightsLAC) October 31, 2022 Mexico’s Supreme Court ruled late last year that was unconstitutional to criminalize abortion. However, each state has to regulate the decision of the Supreme Court. In Argentina, Congress approved abortion’s legality up to 14 weeks, and, as in Colombia, lifted the restrictions that only allowed for abortion in cases of rape or where the mother’s health is at risk. On the other hand, Ecuador’s National Assembly approved a bill that allows abortions if they result from rape up to the 12th week, but President Guillermo Lasso vetoed it, saying that he respects “life from conception.” Colombia’s ruling, however, is a historic victory for the Colombian women’s movement that has fought for decades for their rights to be recognized in a traditional and ultra-catholic country. The next step is for the public policy to be fully deployed across the country and to serve as a model for the region. Mesa por la Vida y la Salud de las Mujeres, a feminist collective that defends women’s sexual and reproductive rights, stated that during the first few months of 2022, they helped more than 90 women to overcome barriers while seeking an abortion within the new law’s parameters. Alejandra* (not her real name) is one example. She asked for an abortion in her sixth week of pregnancy but only finally got one in her 11th week. She states that the procedure was slow and painful and that the doctors did not provide clear information about the process. The numbers show that the path is still long for women in Colombia and that the famous feminist march slogan, “we want sex education to decide, contraceptives to avoid abortion, and legal abortion not to die,” will still echo in the streets, the mountains, the buildings, and law-making entities until Colombian women can feel free to decide, unchallenged, about their bodies. The Rosa Luxemburg Foundation provided support for this article. Image Credits: Causa Justa. New Initiative to Tackle Alcohol Harms Will Focus on Taxation 01/11/2022 Kerry Cullinan Alcohol is related to more than 60 different conditions, including cancers, heart and liver disease. A $15 million initiative to address the harms of alcohol consumption through policy change was launched Tuesday, roughly doubling the total global spending on mitigating the effects of alcohol. Alcohol is one of the top-ten drivers of death, illness and injury, with wide-ranging social and economic harms, many disproportionately affecting young adults, according to Vital Strategies, which heads the RESET Alcohol consortium. “RESET Alcohol is an initiative that brings together national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies from the World Health Organization’s WHO) SAFER technical package,” according to Vital Strategies. The initiative will focus on Latin America, Africa and Asia, with partners Movendi International; the University of Illinois Chicago; the Global Alcohol Policy Alliance (GAPA); the Non-Communicable Disease (NCD) Alliance; and the WHO, with GiveWell as the donor. RESET’s primary policy focus will be on increasing alcohol taxation and other pricing policies which it describes as being “among the most effective interventions for reducing consumption”. It also aims to regulate the availability of alcohol, and restrict its marketing. Over three years, the initiative will support 15 or more countries to develop policies including raising the price of alcohol via taxation, regulating availability, and restricting alcohol marketing. Policies to protect kids “Every year, alcohol use cuts millions of lives short and causes even more widespread suffering,” said Adam Karpati, senior vice president at Vital Strategies. “The onus can’t be on individuals. We must reset from an environment where the alcohol industry is empowered to push alcohol into nearly every aspect of our lives, including schools, sports, and media. We need policies that protect kids, make healthy choices, the easy choices, and check the industry’s influence. RESET Alcohol will do just that through strong partnerships with government and civil society leaders who are committed to action.” Alcohol consumption has increased in nearly all regions of the world consistently since 2005, and accelerated during the COVID-19 pandemic. It is related to more than 60 different conditions, including cancers, heart disease, liver disease, tuberculosis and HIV/AIDS; injuries and trauma including suicide, homicide, assault, falls, intimate partner violence, and vehicle crashes. Alcohol consumption is also associated with adverse economic impacts, from medical care costs to lost productivity. RESET Alcohol’s approach builds on its partners’ successes in similar consortiums that have addressed tobacco and other harmful commodities, including contributing to 18.5% reduction in tobacco use in Bangladesh between 2009 and 2017 and a 17% reduction in India between 2010 and 2017. “Failure to act has led to millions of preventable deaths and suffering from alcohol,” said Jacqui Drope, the new director of RESET Alcohol. “It’s time governments treat it like the public health crisis that it is. When governments take up policies proven to reduce alcohol-related harms, population health and economies will benefit.” RESET Alcohol will provide technical support to governments, improve national research and data collection, resource advocacy for policy change, and mount communications campaigns. “For governments, tax increases on alcohol are a win-win, especially given the sluggish global economy,” said Jeffrey Drope, Research Professor at UIC. “Effective alcohol taxation reduces affordability, consumption and alcohol-related disease and premature death. This means lower healthcare costs and increased productivity from a healthier population. Taxes also create revenue for governments to fund health programs or other social priorities. Image Credits: U.S. Air Force/Samuel King Jr. . WHO Launches Climate Portal and Malaria Guide for Cities 31/10/2022 Editorial team The World Health Organization (WHO) and World Meteorological Organization (WMO) launched the first global knowledge platform dedicated to climate and health on Monday called climahealth.info. The global open-access platform is envisaged as being the “go-to technical reference point for users of interdisciplinary health, environmental, and climate science”, according to the WHO in a media release. “The use of tailored climate and environmental science and tools for public health, such as disease forecasting and heat health early warning systems, have enormous life-saving potential. These tools and resources can enhance our understanding of the connections between climate and health, help us reach at-risk populations, and anticipate and reduce impacts,” according to the media release. “Climate change is killing people right now,” said Diarmid Campbell-Lendrum, coordinator of WHO’s climate change and health programme. “It is affecting the basics we need to survive – clean air, safe water, food and shelter – with the worst impacts being felt by the most vulnerable. Unmitigated climate change has the potential to undermine decades of progress in global health. Reducing its impacts requires evidence-based policy backed by the best available science and tools.” Joy Shumake-Guillemot, who leads the WMO-WHO Climate and Health Joint Office, said that public health practitioners who are concerned about the environmental impacts on health “lack access to training and tailored climate information needed to address these growing issues” while “climate experts (are) sitting on troves of research and resources that could be applied to support public health goals, but just aren’t reaching the right people”. The initiative is supported by the Wellcome Trust. “Collaboration between climate, health and technical specialists is crucial for helping us understand and tackle the health effects of climate change,” said Madeleine Thomson, Head of Climate Impacts and Adaptation for the Wellcome Trust. “But right now, experts can’t always partner and share information as effectively as we know they’d like to. We hope this portal will help fulfill the potential of different disciplines to work together on research and gain new insights into how climate change is affecting health around the world.” Cities’ Malaria Framework launched On the occasion of World Cities Day 2022 on Monday, the WHO and UN Habitat launched the Global framework for the response to malaria in urban areas, which provides guidance to city government officials, health professionals and urban planners on how to develop a comprehensive malaria response specifically in urban areas, “where the dynamics of transmission and burden of vector-borne diseases can be different from that of rural areas”. By 2050, nearly 70% of people globally will live in cities and other urban settings and the WHO predicts that unplanned urbanization is likely to result in a malaria disease burden that is “disproportionately high among the urban poor”. Speakers at the launch also anticipated that climate change will see malaria in places that were previously too cold for the disease that is carried by mosquitos. The framework provides guidance for city leaders, health programmes and urban planners to respond to the challenges of rapid urbanization in a targeted way that helps to build resilience against the threat of malaria and other vector-borne diseases. Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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As Demand for Chicken Rises, Tanzanian Researchers Warn of Excessive Antibiotic Use at Farms 03/11/2022 Kizito Makoye Roast chicken vendors prepare their meals in Dar es Salaam DAR ES SALAAM, Tanzania—At a smoky kitchen in the port city of Dar es Salaam, none of the customers jostling to place their orders knows that the irresistibly tasty roast chicken may be harbouring bacteria that could make them sick. “I don’t think poultry farmers would do anything likely to cause harm,” said 34-year-old Lilian Kiswale a regular customer at this popular fast-food joint. However, what is not clear to Kiswale, is that strains of bacteria that are resistant to antibiotics have repeatedly been found in chickens at farms where city’s street kitchens source their poultry products. “None of our customers has ever complained about the smell of antibiotics in the food we have prepared,” said Kelvin Massawe who works as a chef at the chicken restaurant that is a culinary delight in the neighbourhood. But it’s not about antibiotics ruining the taste of roast chicken. The antibiotic-laced food that poultry farmers in Tanzania give to their birds, ostensibly to increase muscle weight quickly and keep infections at bay, poses a threat to humans as well. According to a recent study by Tanzania’s Muhimbili University of Health and Allied Sciences (MUHAS), excessive amounts of antibiotic residue had been found in broiler chicken tissues – a perfect condition for antimicrobial resistance (AMR). Using the liver samples of 84 commercial broiler chickens, the researchers found that 100% had the antibiotic tetracycline – and 90% at levels that exceeded acceptable daily limits. In addition, 21.4% of the samples also had sulphonamide, although this was within the maximum limit, according to the study, which was published in the journal, Antibiotics. Worse still, researchers say that poultry farmers have unrestricted access to prescription-only antibiotics including tetracycline, sulphonamides, penicillin, aminoglycosides and macrolides. Shop owner Jesca Anthony confirms that she sells antibiotics to farmers without prescription This was confirmed by shop owner Jesca Anthony, who said that she sells antibiotics, without prescriptions to farmers. “Random use of antibiotics in animal feeds heighten the risk of drug resistance not just to animals but in humans as well,” Professor Mecky Matee, head of microbiology at MUHAS and the study’s lead author, told Health Policy Watch. “The use of antibiotics as growth promoters for chicken should be banned,” Matee stressed. Antibiotics are losing their power When an antibiotic is used, it wipes out susceptible bacteria, leaving behind resistant ones. These resistant bacteria can grow and become dominant, and pass from chicken products to humans who eat or handle the meat. Once inside a person, these resistant bacteria can take over the colon, which is then unable to fight infections. Antibiotics are increasingly losing their efficacy due to indiscriminate use in humans and for stimulating animal and birds’ growth. The rise in drug-resistant bacteria has the potential to inflict a devastating human and economic toll globally, according to the United Nations. According to the most comprehensive estimate of the global impact of antimicrobial resistance (AMR), published in The Lancet in January 2022, an estimated 1.2 million people died in 2019 from antibiotic-resistant bacterial infections – more deaths than those from HIV/AIDS or malaria. “Many types of common antibiotics are no longer effective enough to treat bacteria, in many cases patients need hospitalisation,” said Hellen Sabuka, a senior epidemiologist at Shree Hindul Mandal Hospital in Dar es Salaam. Sabuka urged Tanzania’s health authorities to adopt strict regulations and control on the use of antibiotics in animal production. A customer at the Tegeta slaughter house Although Tanzania has policies and guidelines for the use of antibiotics in animal feed, such policies are poorly enforced due to weak systems for food and agricultural productions. In Dar es Salaam, one of Africa’s fastest-growing cities and home to 5.8 million inhabitants, poultry farmers routinely mix an array of human antibiotics into chicken feed to try to ensure they grow faster and don’t get sick. It is a humid Sunday evening at Kibamba, a suburb in the western part of Dar es Salaam, and Salma Libuhi is busy mixing a concoction of medicines into rice husks to feed her caged chickens. Amid smouldering heat, she methodically mixes in a cocktail of three antibiotics— oxytetracycline, doxycycline and enrofloxacin – and sets the food in cans. “When they eat this food, they grow faster,” she told Health Policy Watch. For the 38-year-old mother of four, poultry farming is her livelihood. In 2017, quit her job as a teacher and ventured into entrepreneurship. “Raising chicken is very profitable,” she said. To educate herself about animal husbandry, Libuhi joined a whatsapp groups where she gets all the information about diseases and antibiotics. “I never consulted a vet. The information I get from the group is enough,” she said. At Libuhi’s farm, broiler chickens usually take six weeks to reach market weight. Once they’ve reached the proper size and weight she catches each chicken by hand and transfers them to holding cages ready to be sold. Unlike wild chickens that traverse a range of habitats as they forage for seeds, insects and fresh leaves, broiler chicken are often kept in overcrowded, poorly ventilated and unhygienic shacks. Lack of controls in Africa Across Africa, antibiotics are heavily in the farming of cows, pigs and chickens to fight infections and promote growth. With the indiscriminate use of antibiotics, particularly in agriculture for stimulating animal and birds’ growth, these essential medicines are losing their efficacy. “Many types of common antibiotics are no longer effective enough to treat bacteria, in many cases patients need hospitalisation,” said Hellen Sabuka, a senior epidemiologist at Shree Hindul Mandal Hospital in Dar es Salaam. Sabuka urged Tanzania’s health authorities to adopt strict regulations and control on the use of antibiotics in animal production. While over-use of antibiotics as growth promoters is not a new phenomenon, global experts think preventing drug-resistant bacteria that kill millions of people every year, requires a coordinated approach. Mohan P. Joshi, technical lead for antimicrobial resistance and global health security at the non-profit, Management Sciences for Health, said the overuse of antimicrobials in animals, especially as growth-promoters in food-producing animals, is common in many countries. “In some countries, the proportion [of antibiotics] used in the animal sector is as high as 80% of the total antimicrobials consumed. Alternatives such as good animal husbandry, vaccinations, and biosecurity measures including hygienic practices are critical farming approaches that can help reduce antimicrobial use in animals raised for food,” he said. While 144 countries have national plans to combat AMR, according to a 2021 World Health Organization (WHO) report, Joshi says sectors differ in the amount of progress they’ve made, with the human health sector generally making the most progress and the animal sector lagging. “We need collaborative, multisectoral coordination to address public health threats at the intersection of humans, animals, and the environment. A One Health-focused approach is the only way to effectively address this widespread issue,” Joshi said. According to him, the fight against AMR needs coordinating bodies with adequate funding, political support and authority to act. “Countries need to establish functional multi-sectoral task forces to contain AMR that include high-level government officials and stakeholders from both human and animal health, along with the agricultural, environmental and food sectors, and ensure that such bodies are effectively facilitating One Health coordination, helping build capacities of local stakeholders, and mobilising diversified funding,” he said In 2019, five million human infections were associated with bacterial antimicrobial resistance worldwide, including more than 1.2 million human deaths attributable to bacterial AMR. The burden was highest in sub-Saharan Africa and South Asia, with children below five years of age the most affected. Pushed by the rising demand for cheap poultry products, the broiler value chain in Tanzania, is a big user of antibiotics. Most poultry farmers in Tanzania treat chicken with a concoction of antibiotics often without consulting veterinary doctors. Despite the growing adversity, global experts are cautiously optimistic about prescription-only system where veterinarians will have the upper hand in dispensing drugs used in animal production. Chicken dealers waiting for customers at Tegeta slaughter house. Thomas Van Boeckel, from the public research university, Zurich ETH, said the best way to curb antibiotic use in animals is to move to a prescription only –system where only trained veterinarian would be authorized to sell the antibiotics rather than retail shop owners. “However, even in Switzerland where such a system is in place, this does not resolve all problems because vets may still have a financial conflict of interest in prescribing for profit,” Boeckel said. He says that a better solution would be to “remove the profit margin from vets on drug prescription,” as is the case in Sweden. Meanwhile, Emma Berntman, senior engagement specialist at FAIRR initiative, said low and middle-income countries, including Tanzania have the largest share of global antimicrobial consumption in animals and agriculture, due to the routine use of antimicrobials in farming for growth promotion and prophylaxis. She blamed the countries’ lack of checks and balances and low awareness on overuse of antibiotics. “Tanzania is no exception to this. The country lacks regulation that is sufficient to adequately address the issue of excessive antimicrobial use and antibiotic are cheap and widely available,” said Berntman. FAIRR is an investor-run initiative to address threats to the global food supply. According to her, even when regulation exists in the emerging market, it can be hard to enforce when there is a lack of access to veterinarians and poor awareness of the impacts of overusing antibiotics. “On-the-ground initiatives are needed to help support farmers to reduce their dependence on these drugs,” she stressed. Growing appeal of organic products Although Switzerland launched an AMR strategy in 2015, FAIRR experts say the highest priority critically important antibiotics (HPCIAs) including fluoroquinolones, are still excessively used in farms, notably in broiler production, with authorities warning of high levels of resistance. “These antibiotics are deemed ‘the last line of defence’ in human medicine and are the only antibiotics available to treat certain bacterial infection. If they become ineffective, it poses a significant threat to human health,” Berntman said. “Resistant bacteria developed in broilers can spread to humans through direct contact with the birds, eating chicken or via the environment. There is also a risk to flock health due to the reduced efficacy of antimicrobials used to treat them.” Despite the growing threat, experts see glimmer of hope in reducing the use of antibiotics in broiler farms and other antibiotics used in human medicines. “The government can support reductions by further restricting the use of antibiotics in animals in line with the latest EU regulations, so that antibiotics can only be used to treat infections and routine use is prevented,” Berntman said. Moreover, Berntman said the government can facilitate antibiotic stewardship activities to support the adoption of alternatives to antimicrobials including vaccination programmes and improved nutrition. According to Berntman the rising awareness of the risk of AMR in Europe and North America has triggered a surge in demand for products associated with or lower antibiotic use. “Many consumers are willing to pay a price premium to purchase organic chicken or chicken raised without antibiotics,” she said. Approximately 60% of broilers in the US are now raised without antibiotics, according to Berntman. Moreover, the number of broiler chicks receiving antibiotics in the hatchery has dropped by 90% to nearly zero. “It is important that poultry producers improve animal welfare, vaccinate their flocks, and implement routine health monitoring programmes to meet consumer demand for broilers raised with less or no antibiotics while simultaneously creating environments where healthy flocks can be raised no antimicrobials required without impacting animal welfare,” Berntman said. But for chicken lovers in Dar es Salaam, antibiotic-free roast chicken meat is probably a distant dream. Image Credits: Peter Mgongo. Phase Out Fossil Fuels, Urges Tedros on Eve of COP27 02/11/2022 Megha Kaveri Severe air pollution in Anyang, China in January 2022. Ahead of the global climate talks in Egypt, the World Health Organization (WHO) has urged governments to expedite fossil fuel phase out and transition into clean energy. “Climate change is already impacting health in many ways, through more frequent and extreme weather events, more disease outbreaks, and more mental health issues,” Dr Tedros Adhanom Ghebreysus, the director-general of WHO said in a press briefing on Wednesday. Flagging the impact of climate change on various aspects of human life, including diseases and malnutrition, Dr Tedros called for governments “to lead a just, equitable and fast phase-out of fossil fuels and transition to a clean energy future”. The 27th United Nations Climate Change Conference (COP27) will take place in Sharm el-Sheikh, Egypt from 6 to 18 November. At the conference, world leaders are expected to assess the progress in limiting global warming to 1.5 º Celsius above the pre-industrial levels. “Meeting that target will have massive benefits for human health. Failing to meet it comes with massive risks,” Dr Tedros warned. Impact of climate change on food security Martin Griffiths, the UN Office for the Coordination of Humanitarian Affairs (OCHA), told the briefing that the world is in the grip of hunger crisis and that the pandemic and vast inequality are partly to blame. Listing the different crises happening across the world – the drought in the Horn of Africa, Somalia and Kenya, the floods in Pakistan, the civil war in Tigray, Ethiopia – the OCHA chief called for immediate action to control global warming. “This is the world at 1.2º Celsius [above pre-industrial levels]. But we’re on track to double that. And unless we act now, we’re heading for a future full of droughts, diseases and climate disasters across the whole world,” he added. In 2009 at the Copenhagen Summit, G20 countries pledged that they will channel $100 billion a year to less wealthy countries to mitigate the effects of climate change. Referring to this promise, Griffiths pointed out that the wealthy countries have not kept their word. “We need to come out of COP27 with clarity [about the missing money] and ability [to ensure the promise is kept].” He also referred to the UN Secretary General Antonio Guterres´ proposal to impose a windfall tax on the profits earned by fossil fuel and gas companies, saying that 18 days’ worth of such profits can cover the entire sum of UN’s humanitarian appeal for the year. “COP27 is going to be a major test for all of us to see if those commitments made so boldly in years gone past finally made land for the people who are staring climate [change impact] in the face,” Griffiths said. Adopt WHO 2021 air quality guidelines In line with the theme in the coming weeks, spotlight was also put on the role air pollution plays in public health and climate change. Around 1.1 million people in Africa died from diseases related to air-pollution in 2019. The WHO estimates that seven million people across the world stand to lose their lives to air pollution in a year. But Rosamund Kissi-Debrah, founder and trustee of the Ella Roberta Family Foundation, says that need not be the case. “Cleaning up the air will save lives and it will also reduce health healthcare costs to increase productivity, and it will save trillions of dollars from governments,” she said. Kissi-Debrah called for all the countries participating in COP27 to immediately adopt WHO’s air quality guidelines 2021, describing them as “achievable” and life-saving. She further said that governments must invest in solutions to tackle air pollution and raise public awareness about the adverse effects of rising air pollution on health. Pointing to the example of global cooperation to develop and deliver COVID-19 vaccines, Kissi-Debrah called for a similar level of cooperation to tackle air pollution. “We definitely believe seven to 9 million people every year are definitely worth saving. I urge everybody who goes into COP27 to not forget about public health.” Image Credits: Chris LeBoutillier, V.T. Polywoda. WHO Leadership Shake-up Takes Shape 02/11/2022 Editorial team WHO Assistant Director-General Dr Ren Minghui Two of the World Health Organisation’s top leadership team in Geneva – Dr Soumya Swaminathan and Dr Ren Minghui – are on the brink of leaving as Director-General Dr Tedros Adhanom Ghebreyesus’s long-anticipated leadership shake-up starts to take shape. Swaminathan is WHO’s Chief Scientist, while Ren serves as assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases. Meanwhile, Stéphanie Seydoux has been appointed as the WHO Director-General’s Envoy for Multilateral Affairs, replacing Dr Agnès Buzyn, who was appointed executive director of the WHO Academy in Lyon recently and remains on the leadership team in her new role. Thrilled to begin my new role today as Envoy for Multilateral Affairs, in the Office of @DrTedros, ahead of #G20BaliSummit. Ready to serve the #globalhealth #SDGs objectives of equitable access to health for all and #healthsecurity promoted by @WHO and international partners. pic.twitter.com/x8PU25VsLy — Stéphanie Seydoux (@S_Seydoux) November 2, 2022 Seydoux is the former French Global Health Ambassador. France has been a firm supporter of WHO and is the major investor in the new academy, which is expected to open in 2024, which will offer health workers around the world access to “the latest evidence-based health guidance, state-of-the-art learning technologies and advancements in the science of adult learning”, according to WHO. WHO Deputy Director Dr Zsuzsanna Jakab is also expected to leave soon. The 71-year-old Hungarian is well over the WHO mandatory retirement age of 65 – which can usually only be extended by three years. As Health Policy Watch previously reported, 63-year-old Swaminathan is still two years short of WHO’s mandatory age of retirement, but there have been hints that her style was too independent for the director-general. However, a source close to Swaminathan said that she was leaving voluntarily after five years in senior WHO leadership to reunite with her husband and elderly parents who remained in her hometown of Chennai, India, while she served in Geneva. Prior to WHO, Ren was director-general for international cooperation at the National Health and Family Planning Commission of China. Conversely, Dr Mike Ryan, executive director of WHO’s Health Emergencies Programme, who had earlier been expected to leave the organization, appears set to remain, several WHO insiders with knowledge of the pending reshuffle confirmed. Having Won the Right to Abortion, Colombian Activists Are Pressing Health Facilities to Deliver 01/11/2022 Juanita Rico Causa Justa activists outside Colombia’s Constitutional Court In February, Colombia introduced one of the most liberal abortion laws in the world after activists took to the courts – but now their challenge lies in ensuring the health system is in a position to offer terminations Not long ago, abortion in Colombia was a taboo topic that could not be mentioned during dinners or family gatherings, according to Florence Thomas, one of Colombia’s feminism most influential voices. “It was considered such a difficult subject that people would stand up and leave my lectures when I touched upon it,” Thomas told Health Policy Watch. Some 16 years ago, in 2006, Colombian lawyer Mónica Roa challenged the country’s complete ban on abortion in the Constitutional Court and achieved the decriminalization of abortion on three grounds: when the pregnancy was the result of rape or incest; when there was a severe malformation of the fetus; and when the pregnancy constituted a risk to the woman’s health. “That ruling changed the course of history,” Thomas explains because it made it evident that the legal way to fight for safe abortions was not the Congress, but the Constitutional Court, the highest court in Colombia. Since then, feminist movements and pro-choice lawyers like Roa have fought to extend the decriminalization of abortion in Colombia. Lawsuit against barriers In 2020, Causa Justa (“Just Cause”), a movement made up of over 100 organisations and 140 activists united to legalise abortion, filed a lawsuit against the criminalization of the early termination of pregnancy. Instead of proposing a whole new scheme of laws that would have to go through Congress, they sought a regulate abortion within the rules that were already in place and thus would not rely on politicians. Causa Justa showed that, despite the 2006 reforms, abortion remained a crime in the Penal Code, putting it out of reach for most women. Causa Justa’s lawsuit, supported by more than 100 national and international experts, also showed that almost 400 women were convicted every year for having or seeking an abortion, with sentences ranging from 16 to 54 months in prison. Between 2006 and 2019, more than 5,700 women were charged for abortion. Causa Justa’s lawyers also showed the judges that criminalization forced women to seek unsanitary and dangerous underground abortion clinics. According to Colombia’s Public Health and Epidemiology Observatory, one of the main causes of the deaths of over 400 women from haemorrhaging in 2020 was unsafe, illegal abortions. Between 59% and 70% of the complaints laid against the women seeking abortions had come from health workers, explains Mariana Ardila, a lawyer with Women’s Link, one of the organizations that are part of Causa Justa. Abortion providers could also face charges, which made most health professionals refuse to perform abortions. Nail-bitingly close judgement That sad reality changed with the new ruling in February this year, which established that abortion will only be an offence after the 24th week of pregnancy. “Women won,” said the plaintiffs after learning of the decision, surrounded by chants claiming: “It is a law! It is a law! It is a law.” The ruling is historic because successive Colombian governments have never legislated on an issue that they consider neither a priority nor find beneficial because of the controversy it generates in the street. Colombia is a secular but deeply religious country. A 2017 survey revealed that 97% of citizens believe in God and the different churches, predominantly Catholic and Evangelical, have enormous power over believers, pushing them into an all-out fight against abortion. In its final stage, the Constitutional Court judges voted on the lawsuit, and the vote was nail-bitingly close: five judges were in favor, and four against. With this final say, the court proved that Colombia is changing. Today, only 20% of the population approves that women go to jail if they get an abortion. Health services not prepared The Court also ruled that the government would have to implement a comprehensive public policy regarding access to safe and legal abortions in the “shortest possible time.” However, to date, such a policy hasn’t been fully defined and executed. Colombia’s Ministry of Health recognizes that barriers to abortion persist and are mainly associated with the denial of services – mainly due to ignorance of the changed legal framework and improper exercise of conscientious objection by medical personnel. On 28 September, it issued a document with instructions about how to strengthen sexual and reproductive health care, including abortion, that was addressed to all entities that are part of the health system. Colombia is part of a “green wave” of countries in the region that have decided to expand their abortion freedoms, but it allows abortion much later than its regional counterparts. Con @causajustaco Colombia🇨🇴 entró en la tendencia mundial de 75 países que protegen de manera amplia y brindan garantías para los derechos reproductivos de mujeres, niñas y adolescentes. Hoy allí el aborto es legal hasta la semana 24 de gestación👉https://t.co/FTOS0sRU5j pic.twitter.com/iWqdhXp6Uy — Centro de Derechos Reproductivos (@ReproRightsLAC) October 31, 2022 Mexico’s Supreme Court ruled late last year that was unconstitutional to criminalize abortion. However, each state has to regulate the decision of the Supreme Court. In Argentina, Congress approved abortion’s legality up to 14 weeks, and, as in Colombia, lifted the restrictions that only allowed for abortion in cases of rape or where the mother’s health is at risk. On the other hand, Ecuador’s National Assembly approved a bill that allows abortions if they result from rape up to the 12th week, but President Guillermo Lasso vetoed it, saying that he respects “life from conception.” Colombia’s ruling, however, is a historic victory for the Colombian women’s movement that has fought for decades for their rights to be recognized in a traditional and ultra-catholic country. The next step is for the public policy to be fully deployed across the country and to serve as a model for the region. Mesa por la Vida y la Salud de las Mujeres, a feminist collective that defends women’s sexual and reproductive rights, stated that during the first few months of 2022, they helped more than 90 women to overcome barriers while seeking an abortion within the new law’s parameters. Alejandra* (not her real name) is one example. She asked for an abortion in her sixth week of pregnancy but only finally got one in her 11th week. She states that the procedure was slow and painful and that the doctors did not provide clear information about the process. The numbers show that the path is still long for women in Colombia and that the famous feminist march slogan, “we want sex education to decide, contraceptives to avoid abortion, and legal abortion not to die,” will still echo in the streets, the mountains, the buildings, and law-making entities until Colombian women can feel free to decide, unchallenged, about their bodies. The Rosa Luxemburg Foundation provided support for this article. Image Credits: Causa Justa. New Initiative to Tackle Alcohol Harms Will Focus on Taxation 01/11/2022 Kerry Cullinan Alcohol is related to more than 60 different conditions, including cancers, heart and liver disease. A $15 million initiative to address the harms of alcohol consumption through policy change was launched Tuesday, roughly doubling the total global spending on mitigating the effects of alcohol. Alcohol is one of the top-ten drivers of death, illness and injury, with wide-ranging social and economic harms, many disproportionately affecting young adults, according to Vital Strategies, which heads the RESET Alcohol consortium. “RESET Alcohol is an initiative that brings together national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies from the World Health Organization’s WHO) SAFER technical package,” according to Vital Strategies. The initiative will focus on Latin America, Africa and Asia, with partners Movendi International; the University of Illinois Chicago; the Global Alcohol Policy Alliance (GAPA); the Non-Communicable Disease (NCD) Alliance; and the WHO, with GiveWell as the donor. RESET’s primary policy focus will be on increasing alcohol taxation and other pricing policies which it describes as being “among the most effective interventions for reducing consumption”. It also aims to regulate the availability of alcohol, and restrict its marketing. Over three years, the initiative will support 15 or more countries to develop policies including raising the price of alcohol via taxation, regulating availability, and restricting alcohol marketing. Policies to protect kids “Every year, alcohol use cuts millions of lives short and causes even more widespread suffering,” said Adam Karpati, senior vice president at Vital Strategies. “The onus can’t be on individuals. We must reset from an environment where the alcohol industry is empowered to push alcohol into nearly every aspect of our lives, including schools, sports, and media. We need policies that protect kids, make healthy choices, the easy choices, and check the industry’s influence. RESET Alcohol will do just that through strong partnerships with government and civil society leaders who are committed to action.” Alcohol consumption has increased in nearly all regions of the world consistently since 2005, and accelerated during the COVID-19 pandemic. It is related to more than 60 different conditions, including cancers, heart disease, liver disease, tuberculosis and HIV/AIDS; injuries and trauma including suicide, homicide, assault, falls, intimate partner violence, and vehicle crashes. Alcohol consumption is also associated with adverse economic impacts, from medical care costs to lost productivity. RESET Alcohol’s approach builds on its partners’ successes in similar consortiums that have addressed tobacco and other harmful commodities, including contributing to 18.5% reduction in tobacco use in Bangladesh between 2009 and 2017 and a 17% reduction in India between 2010 and 2017. “Failure to act has led to millions of preventable deaths and suffering from alcohol,” said Jacqui Drope, the new director of RESET Alcohol. “It’s time governments treat it like the public health crisis that it is. When governments take up policies proven to reduce alcohol-related harms, population health and economies will benefit.” RESET Alcohol will provide technical support to governments, improve national research and data collection, resource advocacy for policy change, and mount communications campaigns. “For governments, tax increases on alcohol are a win-win, especially given the sluggish global economy,” said Jeffrey Drope, Research Professor at UIC. “Effective alcohol taxation reduces affordability, consumption and alcohol-related disease and premature death. This means lower healthcare costs and increased productivity from a healthier population. Taxes also create revenue for governments to fund health programs or other social priorities. Image Credits: U.S. Air Force/Samuel King Jr. . WHO Launches Climate Portal and Malaria Guide for Cities 31/10/2022 Editorial team The World Health Organization (WHO) and World Meteorological Organization (WMO) launched the first global knowledge platform dedicated to climate and health on Monday called climahealth.info. The global open-access platform is envisaged as being the “go-to technical reference point for users of interdisciplinary health, environmental, and climate science”, according to the WHO in a media release. “The use of tailored climate and environmental science and tools for public health, such as disease forecasting and heat health early warning systems, have enormous life-saving potential. These tools and resources can enhance our understanding of the connections between climate and health, help us reach at-risk populations, and anticipate and reduce impacts,” according to the media release. “Climate change is killing people right now,” said Diarmid Campbell-Lendrum, coordinator of WHO’s climate change and health programme. “It is affecting the basics we need to survive – clean air, safe water, food and shelter – with the worst impacts being felt by the most vulnerable. Unmitigated climate change has the potential to undermine decades of progress in global health. Reducing its impacts requires evidence-based policy backed by the best available science and tools.” Joy Shumake-Guillemot, who leads the WMO-WHO Climate and Health Joint Office, said that public health practitioners who are concerned about the environmental impacts on health “lack access to training and tailored climate information needed to address these growing issues” while “climate experts (are) sitting on troves of research and resources that could be applied to support public health goals, but just aren’t reaching the right people”. The initiative is supported by the Wellcome Trust. “Collaboration between climate, health and technical specialists is crucial for helping us understand and tackle the health effects of climate change,” said Madeleine Thomson, Head of Climate Impacts and Adaptation for the Wellcome Trust. “But right now, experts can’t always partner and share information as effectively as we know they’d like to. We hope this portal will help fulfill the potential of different disciplines to work together on research and gain new insights into how climate change is affecting health around the world.” Cities’ Malaria Framework launched On the occasion of World Cities Day 2022 on Monday, the WHO and UN Habitat launched the Global framework for the response to malaria in urban areas, which provides guidance to city government officials, health professionals and urban planners on how to develop a comprehensive malaria response specifically in urban areas, “where the dynamics of transmission and burden of vector-borne diseases can be different from that of rural areas”. By 2050, nearly 70% of people globally will live in cities and other urban settings and the WHO predicts that unplanned urbanization is likely to result in a malaria disease burden that is “disproportionately high among the urban poor”. Speakers at the launch also anticipated that climate change will see malaria in places that were previously too cold for the disease that is carried by mosquitos. The framework provides guidance for city leaders, health programmes and urban planners to respond to the challenges of rapid urbanization in a targeted way that helps to build resilience against the threat of malaria and other vector-borne diseases. Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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Phase Out Fossil Fuels, Urges Tedros on Eve of COP27 02/11/2022 Megha Kaveri Severe air pollution in Anyang, China in January 2022. Ahead of the global climate talks in Egypt, the World Health Organization (WHO) has urged governments to expedite fossil fuel phase out and transition into clean energy. “Climate change is already impacting health in many ways, through more frequent and extreme weather events, more disease outbreaks, and more mental health issues,” Dr Tedros Adhanom Ghebreysus, the director-general of WHO said in a press briefing on Wednesday. Flagging the impact of climate change on various aspects of human life, including diseases and malnutrition, Dr Tedros called for governments “to lead a just, equitable and fast phase-out of fossil fuels and transition to a clean energy future”. The 27th United Nations Climate Change Conference (COP27) will take place in Sharm el-Sheikh, Egypt from 6 to 18 November. At the conference, world leaders are expected to assess the progress in limiting global warming to 1.5 º Celsius above the pre-industrial levels. “Meeting that target will have massive benefits for human health. Failing to meet it comes with massive risks,” Dr Tedros warned. Impact of climate change on food security Martin Griffiths, the UN Office for the Coordination of Humanitarian Affairs (OCHA), told the briefing that the world is in the grip of hunger crisis and that the pandemic and vast inequality are partly to blame. Listing the different crises happening across the world – the drought in the Horn of Africa, Somalia and Kenya, the floods in Pakistan, the civil war in Tigray, Ethiopia – the OCHA chief called for immediate action to control global warming. “This is the world at 1.2º Celsius [above pre-industrial levels]. But we’re on track to double that. And unless we act now, we’re heading for a future full of droughts, diseases and climate disasters across the whole world,” he added. In 2009 at the Copenhagen Summit, G20 countries pledged that they will channel $100 billion a year to less wealthy countries to mitigate the effects of climate change. Referring to this promise, Griffiths pointed out that the wealthy countries have not kept their word. “We need to come out of COP27 with clarity [about the missing money] and ability [to ensure the promise is kept].” He also referred to the UN Secretary General Antonio Guterres´ proposal to impose a windfall tax on the profits earned by fossil fuel and gas companies, saying that 18 days’ worth of such profits can cover the entire sum of UN’s humanitarian appeal for the year. “COP27 is going to be a major test for all of us to see if those commitments made so boldly in years gone past finally made land for the people who are staring climate [change impact] in the face,” Griffiths said. Adopt WHO 2021 air quality guidelines In line with the theme in the coming weeks, spotlight was also put on the role air pollution plays in public health and climate change. Around 1.1 million people in Africa died from diseases related to air-pollution in 2019. The WHO estimates that seven million people across the world stand to lose their lives to air pollution in a year. But Rosamund Kissi-Debrah, founder and trustee of the Ella Roberta Family Foundation, says that need not be the case. “Cleaning up the air will save lives and it will also reduce health healthcare costs to increase productivity, and it will save trillions of dollars from governments,” she said. Kissi-Debrah called for all the countries participating in COP27 to immediately adopt WHO’s air quality guidelines 2021, describing them as “achievable” and life-saving. She further said that governments must invest in solutions to tackle air pollution and raise public awareness about the adverse effects of rising air pollution on health. Pointing to the example of global cooperation to develop and deliver COVID-19 vaccines, Kissi-Debrah called for a similar level of cooperation to tackle air pollution. “We definitely believe seven to 9 million people every year are definitely worth saving. I urge everybody who goes into COP27 to not forget about public health.” Image Credits: Chris LeBoutillier, V.T. Polywoda. WHO Leadership Shake-up Takes Shape 02/11/2022 Editorial team WHO Assistant Director-General Dr Ren Minghui Two of the World Health Organisation’s top leadership team in Geneva – Dr Soumya Swaminathan and Dr Ren Minghui – are on the brink of leaving as Director-General Dr Tedros Adhanom Ghebreyesus’s long-anticipated leadership shake-up starts to take shape. Swaminathan is WHO’s Chief Scientist, while Ren serves as assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases. Meanwhile, Stéphanie Seydoux has been appointed as the WHO Director-General’s Envoy for Multilateral Affairs, replacing Dr Agnès Buzyn, who was appointed executive director of the WHO Academy in Lyon recently and remains on the leadership team in her new role. Thrilled to begin my new role today as Envoy for Multilateral Affairs, in the Office of @DrTedros, ahead of #G20BaliSummit. Ready to serve the #globalhealth #SDGs objectives of equitable access to health for all and #healthsecurity promoted by @WHO and international partners. pic.twitter.com/x8PU25VsLy — Stéphanie Seydoux (@S_Seydoux) November 2, 2022 Seydoux is the former French Global Health Ambassador. France has been a firm supporter of WHO and is the major investor in the new academy, which is expected to open in 2024, which will offer health workers around the world access to “the latest evidence-based health guidance, state-of-the-art learning technologies and advancements in the science of adult learning”, according to WHO. WHO Deputy Director Dr Zsuzsanna Jakab is also expected to leave soon. The 71-year-old Hungarian is well over the WHO mandatory retirement age of 65 – which can usually only be extended by three years. As Health Policy Watch previously reported, 63-year-old Swaminathan is still two years short of WHO’s mandatory age of retirement, but there have been hints that her style was too independent for the director-general. However, a source close to Swaminathan said that she was leaving voluntarily after five years in senior WHO leadership to reunite with her husband and elderly parents who remained in her hometown of Chennai, India, while she served in Geneva. Prior to WHO, Ren was director-general for international cooperation at the National Health and Family Planning Commission of China. Conversely, Dr Mike Ryan, executive director of WHO’s Health Emergencies Programme, who had earlier been expected to leave the organization, appears set to remain, several WHO insiders with knowledge of the pending reshuffle confirmed. Having Won the Right to Abortion, Colombian Activists Are Pressing Health Facilities to Deliver 01/11/2022 Juanita Rico Causa Justa activists outside Colombia’s Constitutional Court In February, Colombia introduced one of the most liberal abortion laws in the world after activists took to the courts – but now their challenge lies in ensuring the health system is in a position to offer terminations Not long ago, abortion in Colombia was a taboo topic that could not be mentioned during dinners or family gatherings, according to Florence Thomas, one of Colombia’s feminism most influential voices. “It was considered such a difficult subject that people would stand up and leave my lectures when I touched upon it,” Thomas told Health Policy Watch. Some 16 years ago, in 2006, Colombian lawyer Mónica Roa challenged the country’s complete ban on abortion in the Constitutional Court and achieved the decriminalization of abortion on three grounds: when the pregnancy was the result of rape or incest; when there was a severe malformation of the fetus; and when the pregnancy constituted a risk to the woman’s health. “That ruling changed the course of history,” Thomas explains because it made it evident that the legal way to fight for safe abortions was not the Congress, but the Constitutional Court, the highest court in Colombia. Since then, feminist movements and pro-choice lawyers like Roa have fought to extend the decriminalization of abortion in Colombia. Lawsuit against barriers In 2020, Causa Justa (“Just Cause”), a movement made up of over 100 organisations and 140 activists united to legalise abortion, filed a lawsuit against the criminalization of the early termination of pregnancy. Instead of proposing a whole new scheme of laws that would have to go through Congress, they sought a regulate abortion within the rules that were already in place and thus would not rely on politicians. Causa Justa showed that, despite the 2006 reforms, abortion remained a crime in the Penal Code, putting it out of reach for most women. Causa Justa’s lawsuit, supported by more than 100 national and international experts, also showed that almost 400 women were convicted every year for having or seeking an abortion, with sentences ranging from 16 to 54 months in prison. Between 2006 and 2019, more than 5,700 women were charged for abortion. Causa Justa’s lawyers also showed the judges that criminalization forced women to seek unsanitary and dangerous underground abortion clinics. According to Colombia’s Public Health and Epidemiology Observatory, one of the main causes of the deaths of over 400 women from haemorrhaging in 2020 was unsafe, illegal abortions. Between 59% and 70% of the complaints laid against the women seeking abortions had come from health workers, explains Mariana Ardila, a lawyer with Women’s Link, one of the organizations that are part of Causa Justa. Abortion providers could also face charges, which made most health professionals refuse to perform abortions. Nail-bitingly close judgement That sad reality changed with the new ruling in February this year, which established that abortion will only be an offence after the 24th week of pregnancy. “Women won,” said the plaintiffs after learning of the decision, surrounded by chants claiming: “It is a law! It is a law! It is a law.” The ruling is historic because successive Colombian governments have never legislated on an issue that they consider neither a priority nor find beneficial because of the controversy it generates in the street. Colombia is a secular but deeply religious country. A 2017 survey revealed that 97% of citizens believe in God and the different churches, predominantly Catholic and Evangelical, have enormous power over believers, pushing them into an all-out fight against abortion. In its final stage, the Constitutional Court judges voted on the lawsuit, and the vote was nail-bitingly close: five judges were in favor, and four against. With this final say, the court proved that Colombia is changing. Today, only 20% of the population approves that women go to jail if they get an abortion. Health services not prepared The Court also ruled that the government would have to implement a comprehensive public policy regarding access to safe and legal abortions in the “shortest possible time.” However, to date, such a policy hasn’t been fully defined and executed. Colombia’s Ministry of Health recognizes that barriers to abortion persist and are mainly associated with the denial of services – mainly due to ignorance of the changed legal framework and improper exercise of conscientious objection by medical personnel. On 28 September, it issued a document with instructions about how to strengthen sexual and reproductive health care, including abortion, that was addressed to all entities that are part of the health system. Colombia is part of a “green wave” of countries in the region that have decided to expand their abortion freedoms, but it allows abortion much later than its regional counterparts. Con @causajustaco Colombia🇨🇴 entró en la tendencia mundial de 75 países que protegen de manera amplia y brindan garantías para los derechos reproductivos de mujeres, niñas y adolescentes. Hoy allí el aborto es legal hasta la semana 24 de gestación👉https://t.co/FTOS0sRU5j pic.twitter.com/iWqdhXp6Uy — Centro de Derechos Reproductivos (@ReproRightsLAC) October 31, 2022 Mexico’s Supreme Court ruled late last year that was unconstitutional to criminalize abortion. However, each state has to regulate the decision of the Supreme Court. In Argentina, Congress approved abortion’s legality up to 14 weeks, and, as in Colombia, lifted the restrictions that only allowed for abortion in cases of rape or where the mother’s health is at risk. On the other hand, Ecuador’s National Assembly approved a bill that allows abortions if they result from rape up to the 12th week, but President Guillermo Lasso vetoed it, saying that he respects “life from conception.” Colombia’s ruling, however, is a historic victory for the Colombian women’s movement that has fought for decades for their rights to be recognized in a traditional and ultra-catholic country. The next step is for the public policy to be fully deployed across the country and to serve as a model for the region. Mesa por la Vida y la Salud de las Mujeres, a feminist collective that defends women’s sexual and reproductive rights, stated that during the first few months of 2022, they helped more than 90 women to overcome barriers while seeking an abortion within the new law’s parameters. Alejandra* (not her real name) is one example. She asked for an abortion in her sixth week of pregnancy but only finally got one in her 11th week. She states that the procedure was slow and painful and that the doctors did not provide clear information about the process. The numbers show that the path is still long for women in Colombia and that the famous feminist march slogan, “we want sex education to decide, contraceptives to avoid abortion, and legal abortion not to die,” will still echo in the streets, the mountains, the buildings, and law-making entities until Colombian women can feel free to decide, unchallenged, about their bodies. The Rosa Luxemburg Foundation provided support for this article. Image Credits: Causa Justa. New Initiative to Tackle Alcohol Harms Will Focus on Taxation 01/11/2022 Kerry Cullinan Alcohol is related to more than 60 different conditions, including cancers, heart and liver disease. A $15 million initiative to address the harms of alcohol consumption through policy change was launched Tuesday, roughly doubling the total global spending on mitigating the effects of alcohol. Alcohol is one of the top-ten drivers of death, illness and injury, with wide-ranging social and economic harms, many disproportionately affecting young adults, according to Vital Strategies, which heads the RESET Alcohol consortium. “RESET Alcohol is an initiative that brings together national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies from the World Health Organization’s WHO) SAFER technical package,” according to Vital Strategies. The initiative will focus on Latin America, Africa and Asia, with partners Movendi International; the University of Illinois Chicago; the Global Alcohol Policy Alliance (GAPA); the Non-Communicable Disease (NCD) Alliance; and the WHO, with GiveWell as the donor. RESET’s primary policy focus will be on increasing alcohol taxation and other pricing policies which it describes as being “among the most effective interventions for reducing consumption”. It also aims to regulate the availability of alcohol, and restrict its marketing. Over three years, the initiative will support 15 or more countries to develop policies including raising the price of alcohol via taxation, regulating availability, and restricting alcohol marketing. Policies to protect kids “Every year, alcohol use cuts millions of lives short and causes even more widespread suffering,” said Adam Karpati, senior vice president at Vital Strategies. “The onus can’t be on individuals. We must reset from an environment where the alcohol industry is empowered to push alcohol into nearly every aspect of our lives, including schools, sports, and media. We need policies that protect kids, make healthy choices, the easy choices, and check the industry’s influence. RESET Alcohol will do just that through strong partnerships with government and civil society leaders who are committed to action.” Alcohol consumption has increased in nearly all regions of the world consistently since 2005, and accelerated during the COVID-19 pandemic. It is related to more than 60 different conditions, including cancers, heart disease, liver disease, tuberculosis and HIV/AIDS; injuries and trauma including suicide, homicide, assault, falls, intimate partner violence, and vehicle crashes. Alcohol consumption is also associated with adverse economic impacts, from medical care costs to lost productivity. RESET Alcohol’s approach builds on its partners’ successes in similar consortiums that have addressed tobacco and other harmful commodities, including contributing to 18.5% reduction in tobacco use in Bangladesh between 2009 and 2017 and a 17% reduction in India between 2010 and 2017. “Failure to act has led to millions of preventable deaths and suffering from alcohol,” said Jacqui Drope, the new director of RESET Alcohol. “It’s time governments treat it like the public health crisis that it is. When governments take up policies proven to reduce alcohol-related harms, population health and economies will benefit.” RESET Alcohol will provide technical support to governments, improve national research and data collection, resource advocacy for policy change, and mount communications campaigns. “For governments, tax increases on alcohol are a win-win, especially given the sluggish global economy,” said Jeffrey Drope, Research Professor at UIC. “Effective alcohol taxation reduces affordability, consumption and alcohol-related disease and premature death. This means lower healthcare costs and increased productivity from a healthier population. Taxes also create revenue for governments to fund health programs or other social priorities. Image Credits: U.S. Air Force/Samuel King Jr. . WHO Launches Climate Portal and Malaria Guide for Cities 31/10/2022 Editorial team The World Health Organization (WHO) and World Meteorological Organization (WMO) launched the first global knowledge platform dedicated to climate and health on Monday called climahealth.info. The global open-access platform is envisaged as being the “go-to technical reference point for users of interdisciplinary health, environmental, and climate science”, according to the WHO in a media release. “The use of tailored climate and environmental science and tools for public health, such as disease forecasting and heat health early warning systems, have enormous life-saving potential. These tools and resources can enhance our understanding of the connections between climate and health, help us reach at-risk populations, and anticipate and reduce impacts,” according to the media release. “Climate change is killing people right now,” said Diarmid Campbell-Lendrum, coordinator of WHO’s climate change and health programme. “It is affecting the basics we need to survive – clean air, safe water, food and shelter – with the worst impacts being felt by the most vulnerable. Unmitigated climate change has the potential to undermine decades of progress in global health. Reducing its impacts requires evidence-based policy backed by the best available science and tools.” Joy Shumake-Guillemot, who leads the WMO-WHO Climate and Health Joint Office, said that public health practitioners who are concerned about the environmental impacts on health “lack access to training and tailored climate information needed to address these growing issues” while “climate experts (are) sitting on troves of research and resources that could be applied to support public health goals, but just aren’t reaching the right people”. The initiative is supported by the Wellcome Trust. “Collaboration between climate, health and technical specialists is crucial for helping us understand and tackle the health effects of climate change,” said Madeleine Thomson, Head of Climate Impacts and Adaptation for the Wellcome Trust. “But right now, experts can’t always partner and share information as effectively as we know they’d like to. We hope this portal will help fulfill the potential of different disciplines to work together on research and gain new insights into how climate change is affecting health around the world.” Cities’ Malaria Framework launched On the occasion of World Cities Day 2022 on Monday, the WHO and UN Habitat launched the Global framework for the response to malaria in urban areas, which provides guidance to city government officials, health professionals and urban planners on how to develop a comprehensive malaria response specifically in urban areas, “where the dynamics of transmission and burden of vector-borne diseases can be different from that of rural areas”. By 2050, nearly 70% of people globally will live in cities and other urban settings and the WHO predicts that unplanned urbanization is likely to result in a malaria disease burden that is “disproportionately high among the urban poor”. Speakers at the launch also anticipated that climate change will see malaria in places that were previously too cold for the disease that is carried by mosquitos. The framework provides guidance for city leaders, health programmes and urban planners to respond to the challenges of rapid urbanization in a targeted way that helps to build resilience against the threat of malaria and other vector-borne diseases. Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. 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 Leadership Shake-up Takes Shape 02/11/2022 Editorial team WHO Assistant Director-General Dr Ren Minghui Two of the World Health Organisation’s top leadership team in Geneva – Dr Soumya Swaminathan and Dr Ren Minghui – are on the brink of leaving as Director-General Dr Tedros Adhanom Ghebreyesus’s long-anticipated leadership shake-up starts to take shape. Swaminathan is WHO’s Chief Scientist, while Ren serves as assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases. Meanwhile, Stéphanie Seydoux has been appointed as the WHO Director-General’s Envoy for Multilateral Affairs, replacing Dr Agnès Buzyn, who was appointed executive director of the WHO Academy in Lyon recently and remains on the leadership team in her new role. Thrilled to begin my new role today as Envoy for Multilateral Affairs, in the Office of @DrTedros, ahead of #G20BaliSummit. Ready to serve the #globalhealth #SDGs objectives of equitable access to health for all and #healthsecurity promoted by @WHO and international partners. pic.twitter.com/x8PU25VsLy — Stéphanie Seydoux (@S_Seydoux) November 2, 2022 Seydoux is the former French Global Health Ambassador. France has been a firm supporter of WHO and is the major investor in the new academy, which is expected to open in 2024, which will offer health workers around the world access to “the latest evidence-based health guidance, state-of-the-art learning technologies and advancements in the science of adult learning”, according to WHO. WHO Deputy Director Dr Zsuzsanna Jakab is also expected to leave soon. The 71-year-old Hungarian is well over the WHO mandatory retirement age of 65 – which can usually only be extended by three years. As Health Policy Watch previously reported, 63-year-old Swaminathan is still two years short of WHO’s mandatory age of retirement, but there have been hints that her style was too independent for the director-general. However, a source close to Swaminathan said that she was leaving voluntarily after five years in senior WHO leadership to reunite with her husband and elderly parents who remained in her hometown of Chennai, India, while she served in Geneva. Prior to WHO, Ren was director-general for international cooperation at the National Health and Family Planning Commission of China. Conversely, Dr Mike Ryan, executive director of WHO’s Health Emergencies Programme, who had earlier been expected to leave the organization, appears set to remain, several WHO insiders with knowledge of the pending reshuffle confirmed. Having Won the Right to Abortion, Colombian Activists Are Pressing Health Facilities to Deliver 01/11/2022 Juanita Rico Causa Justa activists outside Colombia’s Constitutional Court In February, Colombia introduced one of the most liberal abortion laws in the world after activists took to the courts – but now their challenge lies in ensuring the health system is in a position to offer terminations Not long ago, abortion in Colombia was a taboo topic that could not be mentioned during dinners or family gatherings, according to Florence Thomas, one of Colombia’s feminism most influential voices. “It was considered such a difficult subject that people would stand up and leave my lectures when I touched upon it,” Thomas told Health Policy Watch. Some 16 years ago, in 2006, Colombian lawyer Mónica Roa challenged the country’s complete ban on abortion in the Constitutional Court and achieved the decriminalization of abortion on three grounds: when the pregnancy was the result of rape or incest; when there was a severe malformation of the fetus; and when the pregnancy constituted a risk to the woman’s health. “That ruling changed the course of history,” Thomas explains because it made it evident that the legal way to fight for safe abortions was not the Congress, but the Constitutional Court, the highest court in Colombia. Since then, feminist movements and pro-choice lawyers like Roa have fought to extend the decriminalization of abortion in Colombia. Lawsuit against barriers In 2020, Causa Justa (“Just Cause”), a movement made up of over 100 organisations and 140 activists united to legalise abortion, filed a lawsuit against the criminalization of the early termination of pregnancy. Instead of proposing a whole new scheme of laws that would have to go through Congress, they sought a regulate abortion within the rules that were already in place and thus would not rely on politicians. Causa Justa showed that, despite the 2006 reforms, abortion remained a crime in the Penal Code, putting it out of reach for most women. Causa Justa’s lawsuit, supported by more than 100 national and international experts, also showed that almost 400 women were convicted every year for having or seeking an abortion, with sentences ranging from 16 to 54 months in prison. Between 2006 and 2019, more than 5,700 women were charged for abortion. Causa Justa’s lawyers also showed the judges that criminalization forced women to seek unsanitary and dangerous underground abortion clinics. According to Colombia’s Public Health and Epidemiology Observatory, one of the main causes of the deaths of over 400 women from haemorrhaging in 2020 was unsafe, illegal abortions. Between 59% and 70% of the complaints laid against the women seeking abortions had come from health workers, explains Mariana Ardila, a lawyer with Women’s Link, one of the organizations that are part of Causa Justa. Abortion providers could also face charges, which made most health professionals refuse to perform abortions. Nail-bitingly close judgement That sad reality changed with the new ruling in February this year, which established that abortion will only be an offence after the 24th week of pregnancy. “Women won,” said the plaintiffs after learning of the decision, surrounded by chants claiming: “It is a law! It is a law! It is a law.” The ruling is historic because successive Colombian governments have never legislated on an issue that they consider neither a priority nor find beneficial because of the controversy it generates in the street. Colombia is a secular but deeply religious country. A 2017 survey revealed that 97% of citizens believe in God and the different churches, predominantly Catholic and Evangelical, have enormous power over believers, pushing them into an all-out fight against abortion. In its final stage, the Constitutional Court judges voted on the lawsuit, and the vote was nail-bitingly close: five judges were in favor, and four against. With this final say, the court proved that Colombia is changing. Today, only 20% of the population approves that women go to jail if they get an abortion. Health services not prepared The Court also ruled that the government would have to implement a comprehensive public policy regarding access to safe and legal abortions in the “shortest possible time.” However, to date, such a policy hasn’t been fully defined and executed. Colombia’s Ministry of Health recognizes that barriers to abortion persist and are mainly associated with the denial of services – mainly due to ignorance of the changed legal framework and improper exercise of conscientious objection by medical personnel. On 28 September, it issued a document with instructions about how to strengthen sexual and reproductive health care, including abortion, that was addressed to all entities that are part of the health system. Colombia is part of a “green wave” of countries in the region that have decided to expand their abortion freedoms, but it allows abortion much later than its regional counterparts. Con @causajustaco Colombia🇨🇴 entró en la tendencia mundial de 75 países que protegen de manera amplia y brindan garantías para los derechos reproductivos de mujeres, niñas y adolescentes. Hoy allí el aborto es legal hasta la semana 24 de gestación👉https://t.co/FTOS0sRU5j pic.twitter.com/iWqdhXp6Uy — Centro de Derechos Reproductivos (@ReproRightsLAC) October 31, 2022 Mexico’s Supreme Court ruled late last year that was unconstitutional to criminalize abortion. However, each state has to regulate the decision of the Supreme Court. In Argentina, Congress approved abortion’s legality up to 14 weeks, and, as in Colombia, lifted the restrictions that only allowed for abortion in cases of rape or where the mother’s health is at risk. On the other hand, Ecuador’s National Assembly approved a bill that allows abortions if they result from rape up to the 12th week, but President Guillermo Lasso vetoed it, saying that he respects “life from conception.” Colombia’s ruling, however, is a historic victory for the Colombian women’s movement that has fought for decades for their rights to be recognized in a traditional and ultra-catholic country. The next step is for the public policy to be fully deployed across the country and to serve as a model for the region. Mesa por la Vida y la Salud de las Mujeres, a feminist collective that defends women’s sexual and reproductive rights, stated that during the first few months of 2022, they helped more than 90 women to overcome barriers while seeking an abortion within the new law’s parameters. Alejandra* (not her real name) is one example. She asked for an abortion in her sixth week of pregnancy but only finally got one in her 11th week. She states that the procedure was slow and painful and that the doctors did not provide clear information about the process. The numbers show that the path is still long for women in Colombia and that the famous feminist march slogan, “we want sex education to decide, contraceptives to avoid abortion, and legal abortion not to die,” will still echo in the streets, the mountains, the buildings, and law-making entities until Colombian women can feel free to decide, unchallenged, about their bodies. The Rosa Luxemburg Foundation provided support for this article. Image Credits: Causa Justa. New Initiative to Tackle Alcohol Harms Will Focus on Taxation 01/11/2022 Kerry Cullinan Alcohol is related to more than 60 different conditions, including cancers, heart and liver disease. A $15 million initiative to address the harms of alcohol consumption through policy change was launched Tuesday, roughly doubling the total global spending on mitigating the effects of alcohol. Alcohol is one of the top-ten drivers of death, illness and injury, with wide-ranging social and economic harms, many disproportionately affecting young adults, according to Vital Strategies, which heads the RESET Alcohol consortium. “RESET Alcohol is an initiative that brings together national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies from the World Health Organization’s WHO) SAFER technical package,” according to Vital Strategies. The initiative will focus on Latin America, Africa and Asia, with partners Movendi International; the University of Illinois Chicago; the Global Alcohol Policy Alliance (GAPA); the Non-Communicable Disease (NCD) Alliance; and the WHO, with GiveWell as the donor. RESET’s primary policy focus will be on increasing alcohol taxation and other pricing policies which it describes as being “among the most effective interventions for reducing consumption”. It also aims to regulate the availability of alcohol, and restrict its marketing. Over three years, the initiative will support 15 or more countries to develop policies including raising the price of alcohol via taxation, regulating availability, and restricting alcohol marketing. Policies to protect kids “Every year, alcohol use cuts millions of lives short and causes even more widespread suffering,” said Adam Karpati, senior vice president at Vital Strategies. “The onus can’t be on individuals. We must reset from an environment where the alcohol industry is empowered to push alcohol into nearly every aspect of our lives, including schools, sports, and media. We need policies that protect kids, make healthy choices, the easy choices, and check the industry’s influence. RESET Alcohol will do just that through strong partnerships with government and civil society leaders who are committed to action.” Alcohol consumption has increased in nearly all regions of the world consistently since 2005, and accelerated during the COVID-19 pandemic. It is related to more than 60 different conditions, including cancers, heart disease, liver disease, tuberculosis and HIV/AIDS; injuries and trauma including suicide, homicide, assault, falls, intimate partner violence, and vehicle crashes. Alcohol consumption is also associated with adverse economic impacts, from medical care costs to lost productivity. RESET Alcohol’s approach builds on its partners’ successes in similar consortiums that have addressed tobacco and other harmful commodities, including contributing to 18.5% reduction in tobacco use in Bangladesh between 2009 and 2017 and a 17% reduction in India between 2010 and 2017. “Failure to act has led to millions of preventable deaths and suffering from alcohol,” said Jacqui Drope, the new director of RESET Alcohol. “It’s time governments treat it like the public health crisis that it is. When governments take up policies proven to reduce alcohol-related harms, population health and economies will benefit.” RESET Alcohol will provide technical support to governments, improve national research and data collection, resource advocacy for policy change, and mount communications campaigns. “For governments, tax increases on alcohol are a win-win, especially given the sluggish global economy,” said Jeffrey Drope, Research Professor at UIC. “Effective alcohol taxation reduces affordability, consumption and alcohol-related disease and premature death. This means lower healthcare costs and increased productivity from a healthier population. Taxes also create revenue for governments to fund health programs or other social priorities. Image Credits: U.S. Air Force/Samuel King Jr. . WHO Launches Climate Portal and Malaria Guide for Cities 31/10/2022 Editorial team The World Health Organization (WHO) and World Meteorological Organization (WMO) launched the first global knowledge platform dedicated to climate and health on Monday called climahealth.info. The global open-access platform is envisaged as being the “go-to technical reference point for users of interdisciplinary health, environmental, and climate science”, according to the WHO in a media release. “The use of tailored climate and environmental science and tools for public health, such as disease forecasting and heat health early warning systems, have enormous life-saving potential. These tools and resources can enhance our understanding of the connections between climate and health, help us reach at-risk populations, and anticipate and reduce impacts,” according to the media release. “Climate change is killing people right now,” said Diarmid Campbell-Lendrum, coordinator of WHO’s climate change and health programme. “It is affecting the basics we need to survive – clean air, safe water, food and shelter – with the worst impacts being felt by the most vulnerable. Unmitigated climate change has the potential to undermine decades of progress in global health. Reducing its impacts requires evidence-based policy backed by the best available science and tools.” Joy Shumake-Guillemot, who leads the WMO-WHO Climate and Health Joint Office, said that public health practitioners who are concerned about the environmental impacts on health “lack access to training and tailored climate information needed to address these growing issues” while “climate experts (are) sitting on troves of research and resources that could be applied to support public health goals, but just aren’t reaching the right people”. The initiative is supported by the Wellcome Trust. “Collaboration between climate, health and technical specialists is crucial for helping us understand and tackle the health effects of climate change,” said Madeleine Thomson, Head of Climate Impacts and Adaptation for the Wellcome Trust. “But right now, experts can’t always partner and share information as effectively as we know they’d like to. We hope this portal will help fulfill the potential of different disciplines to work together on research and gain new insights into how climate change is affecting health around the world.” Cities’ Malaria Framework launched On the occasion of World Cities Day 2022 on Monday, the WHO and UN Habitat launched the Global framework for the response to malaria in urban areas, which provides guidance to city government officials, health professionals and urban planners on how to develop a comprehensive malaria response specifically in urban areas, “where the dynamics of transmission and burden of vector-borne diseases can be different from that of rural areas”. By 2050, nearly 70% of people globally will live in cities and other urban settings and the WHO predicts that unplanned urbanization is likely to result in a malaria disease burden that is “disproportionately high among the urban poor”. Speakers at the launch also anticipated that climate change will see malaria in places that were previously too cold for the disease that is carried by mosquitos. The framework provides guidance for city leaders, health programmes and urban planners to respond to the challenges of rapid urbanization in a targeted way that helps to build resilience against the threat of malaria and other vector-borne diseases. Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. 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.
Having Won the Right to Abortion, Colombian Activists Are Pressing Health Facilities to Deliver 01/11/2022 Juanita Rico Causa Justa activists outside Colombia’s Constitutional Court In February, Colombia introduced one of the most liberal abortion laws in the world after activists took to the courts – but now their challenge lies in ensuring the health system is in a position to offer terminations Not long ago, abortion in Colombia was a taboo topic that could not be mentioned during dinners or family gatherings, according to Florence Thomas, one of Colombia’s feminism most influential voices. “It was considered such a difficult subject that people would stand up and leave my lectures when I touched upon it,” Thomas told Health Policy Watch. Some 16 years ago, in 2006, Colombian lawyer Mónica Roa challenged the country’s complete ban on abortion in the Constitutional Court and achieved the decriminalization of abortion on three grounds: when the pregnancy was the result of rape or incest; when there was a severe malformation of the fetus; and when the pregnancy constituted a risk to the woman’s health. “That ruling changed the course of history,” Thomas explains because it made it evident that the legal way to fight for safe abortions was not the Congress, but the Constitutional Court, the highest court in Colombia. Since then, feminist movements and pro-choice lawyers like Roa have fought to extend the decriminalization of abortion in Colombia. Lawsuit against barriers In 2020, Causa Justa (“Just Cause”), a movement made up of over 100 organisations and 140 activists united to legalise abortion, filed a lawsuit against the criminalization of the early termination of pregnancy. Instead of proposing a whole new scheme of laws that would have to go through Congress, they sought a regulate abortion within the rules that were already in place and thus would not rely on politicians. Causa Justa showed that, despite the 2006 reforms, abortion remained a crime in the Penal Code, putting it out of reach for most women. Causa Justa’s lawsuit, supported by more than 100 national and international experts, also showed that almost 400 women were convicted every year for having or seeking an abortion, with sentences ranging from 16 to 54 months in prison. Between 2006 and 2019, more than 5,700 women were charged for abortion. Causa Justa’s lawyers also showed the judges that criminalization forced women to seek unsanitary and dangerous underground abortion clinics. According to Colombia’s Public Health and Epidemiology Observatory, one of the main causes of the deaths of over 400 women from haemorrhaging in 2020 was unsafe, illegal abortions. Between 59% and 70% of the complaints laid against the women seeking abortions had come from health workers, explains Mariana Ardila, a lawyer with Women’s Link, one of the organizations that are part of Causa Justa. Abortion providers could also face charges, which made most health professionals refuse to perform abortions. Nail-bitingly close judgement That sad reality changed with the new ruling in February this year, which established that abortion will only be an offence after the 24th week of pregnancy. “Women won,” said the plaintiffs after learning of the decision, surrounded by chants claiming: “It is a law! It is a law! It is a law.” The ruling is historic because successive Colombian governments have never legislated on an issue that they consider neither a priority nor find beneficial because of the controversy it generates in the street. Colombia is a secular but deeply religious country. A 2017 survey revealed that 97% of citizens believe in God and the different churches, predominantly Catholic and Evangelical, have enormous power over believers, pushing them into an all-out fight against abortion. In its final stage, the Constitutional Court judges voted on the lawsuit, and the vote was nail-bitingly close: five judges were in favor, and four against. With this final say, the court proved that Colombia is changing. Today, only 20% of the population approves that women go to jail if they get an abortion. Health services not prepared The Court also ruled that the government would have to implement a comprehensive public policy regarding access to safe and legal abortions in the “shortest possible time.” However, to date, such a policy hasn’t been fully defined and executed. Colombia’s Ministry of Health recognizes that barriers to abortion persist and are mainly associated with the denial of services – mainly due to ignorance of the changed legal framework and improper exercise of conscientious objection by medical personnel. On 28 September, it issued a document with instructions about how to strengthen sexual and reproductive health care, including abortion, that was addressed to all entities that are part of the health system. Colombia is part of a “green wave” of countries in the region that have decided to expand their abortion freedoms, but it allows abortion much later than its regional counterparts. Con @causajustaco Colombia🇨🇴 entró en la tendencia mundial de 75 países que protegen de manera amplia y brindan garantías para los derechos reproductivos de mujeres, niñas y adolescentes. Hoy allí el aborto es legal hasta la semana 24 de gestación👉https://t.co/FTOS0sRU5j pic.twitter.com/iWqdhXp6Uy — Centro de Derechos Reproductivos (@ReproRightsLAC) October 31, 2022 Mexico’s Supreme Court ruled late last year that was unconstitutional to criminalize abortion. However, each state has to regulate the decision of the Supreme Court. In Argentina, Congress approved abortion’s legality up to 14 weeks, and, as in Colombia, lifted the restrictions that only allowed for abortion in cases of rape or where the mother’s health is at risk. On the other hand, Ecuador’s National Assembly approved a bill that allows abortions if they result from rape up to the 12th week, but President Guillermo Lasso vetoed it, saying that he respects “life from conception.” Colombia’s ruling, however, is a historic victory for the Colombian women’s movement that has fought for decades for their rights to be recognized in a traditional and ultra-catholic country. The next step is for the public policy to be fully deployed across the country and to serve as a model for the region. Mesa por la Vida y la Salud de las Mujeres, a feminist collective that defends women’s sexual and reproductive rights, stated that during the first few months of 2022, they helped more than 90 women to overcome barriers while seeking an abortion within the new law’s parameters. Alejandra* (not her real name) is one example. She asked for an abortion in her sixth week of pregnancy but only finally got one in her 11th week. She states that the procedure was slow and painful and that the doctors did not provide clear information about the process. The numbers show that the path is still long for women in Colombia and that the famous feminist march slogan, “we want sex education to decide, contraceptives to avoid abortion, and legal abortion not to die,” will still echo in the streets, the mountains, the buildings, and law-making entities until Colombian women can feel free to decide, unchallenged, about their bodies. The Rosa Luxemburg Foundation provided support for this article. Image Credits: Causa Justa. New Initiative to Tackle Alcohol Harms Will Focus on Taxation 01/11/2022 Kerry Cullinan Alcohol is related to more than 60 different conditions, including cancers, heart and liver disease. A $15 million initiative to address the harms of alcohol consumption through policy change was launched Tuesday, roughly doubling the total global spending on mitigating the effects of alcohol. Alcohol is one of the top-ten drivers of death, illness and injury, with wide-ranging social and economic harms, many disproportionately affecting young adults, according to Vital Strategies, which heads the RESET Alcohol consortium. “RESET Alcohol is an initiative that brings together national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies from the World Health Organization’s WHO) SAFER technical package,” according to Vital Strategies. The initiative will focus on Latin America, Africa and Asia, with partners Movendi International; the University of Illinois Chicago; the Global Alcohol Policy Alliance (GAPA); the Non-Communicable Disease (NCD) Alliance; and the WHO, with GiveWell as the donor. RESET’s primary policy focus will be on increasing alcohol taxation and other pricing policies which it describes as being “among the most effective interventions for reducing consumption”. It also aims to regulate the availability of alcohol, and restrict its marketing. Over three years, the initiative will support 15 or more countries to develop policies including raising the price of alcohol via taxation, regulating availability, and restricting alcohol marketing. Policies to protect kids “Every year, alcohol use cuts millions of lives short and causes even more widespread suffering,” said Adam Karpati, senior vice president at Vital Strategies. “The onus can’t be on individuals. We must reset from an environment where the alcohol industry is empowered to push alcohol into nearly every aspect of our lives, including schools, sports, and media. We need policies that protect kids, make healthy choices, the easy choices, and check the industry’s influence. RESET Alcohol will do just that through strong partnerships with government and civil society leaders who are committed to action.” Alcohol consumption has increased in nearly all regions of the world consistently since 2005, and accelerated during the COVID-19 pandemic. It is related to more than 60 different conditions, including cancers, heart disease, liver disease, tuberculosis and HIV/AIDS; injuries and trauma including suicide, homicide, assault, falls, intimate partner violence, and vehicle crashes. Alcohol consumption is also associated with adverse economic impacts, from medical care costs to lost productivity. RESET Alcohol’s approach builds on its partners’ successes in similar consortiums that have addressed tobacco and other harmful commodities, including contributing to 18.5% reduction in tobacco use in Bangladesh between 2009 and 2017 and a 17% reduction in India between 2010 and 2017. “Failure to act has led to millions of preventable deaths and suffering from alcohol,” said Jacqui Drope, the new director of RESET Alcohol. “It’s time governments treat it like the public health crisis that it is. When governments take up policies proven to reduce alcohol-related harms, population health and economies will benefit.” RESET Alcohol will provide technical support to governments, improve national research and data collection, resource advocacy for policy change, and mount communications campaigns. “For governments, tax increases on alcohol are a win-win, especially given the sluggish global economy,” said Jeffrey Drope, Research Professor at UIC. “Effective alcohol taxation reduces affordability, consumption and alcohol-related disease and premature death. This means lower healthcare costs and increased productivity from a healthier population. Taxes also create revenue for governments to fund health programs or other social priorities. Image Credits: U.S. Air Force/Samuel King Jr. . WHO Launches Climate Portal and Malaria Guide for Cities 31/10/2022 Editorial team The World Health Organization (WHO) and World Meteorological Organization (WMO) launched the first global knowledge platform dedicated to climate and health on Monday called climahealth.info. The global open-access platform is envisaged as being the “go-to technical reference point for users of interdisciplinary health, environmental, and climate science”, according to the WHO in a media release. “The use of tailored climate and environmental science and tools for public health, such as disease forecasting and heat health early warning systems, have enormous life-saving potential. These tools and resources can enhance our understanding of the connections between climate and health, help us reach at-risk populations, and anticipate and reduce impacts,” according to the media release. “Climate change is killing people right now,” said Diarmid Campbell-Lendrum, coordinator of WHO’s climate change and health programme. “It is affecting the basics we need to survive – clean air, safe water, food and shelter – with the worst impacts being felt by the most vulnerable. Unmitigated climate change has the potential to undermine decades of progress in global health. Reducing its impacts requires evidence-based policy backed by the best available science and tools.” Joy Shumake-Guillemot, who leads the WMO-WHO Climate and Health Joint Office, said that public health practitioners who are concerned about the environmental impacts on health “lack access to training and tailored climate information needed to address these growing issues” while “climate experts (are) sitting on troves of research and resources that could be applied to support public health goals, but just aren’t reaching the right people”. The initiative is supported by the Wellcome Trust. “Collaboration between climate, health and technical specialists is crucial for helping us understand and tackle the health effects of climate change,” said Madeleine Thomson, Head of Climate Impacts and Adaptation for the Wellcome Trust. “But right now, experts can’t always partner and share information as effectively as we know they’d like to. We hope this portal will help fulfill the potential of different disciplines to work together on research and gain new insights into how climate change is affecting health around the world.” Cities’ Malaria Framework launched On the occasion of World Cities Day 2022 on Monday, the WHO and UN Habitat launched the Global framework for the response to malaria in urban areas, which provides guidance to city government officials, health professionals and urban planners on how to develop a comprehensive malaria response specifically in urban areas, “where the dynamics of transmission and burden of vector-borne diseases can be different from that of rural areas”. By 2050, nearly 70% of people globally will live in cities and other urban settings and the WHO predicts that unplanned urbanization is likely to result in a malaria disease burden that is “disproportionately high among the urban poor”. Speakers at the launch also anticipated that climate change will see malaria in places that were previously too cold for the disease that is carried by mosquitos. The framework provides guidance for city leaders, health programmes and urban planners to respond to the challenges of rapid urbanization in a targeted way that helps to build resilience against the threat of malaria and other vector-borne diseases. Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. 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.
New Initiative to Tackle Alcohol Harms Will Focus on Taxation 01/11/2022 Kerry Cullinan Alcohol is related to more than 60 different conditions, including cancers, heart and liver disease. A $15 million initiative to address the harms of alcohol consumption through policy change was launched Tuesday, roughly doubling the total global spending on mitigating the effects of alcohol. Alcohol is one of the top-ten drivers of death, illness and injury, with wide-ranging social and economic harms, many disproportionately affecting young adults, according to Vital Strategies, which heads the RESET Alcohol consortium. “RESET Alcohol is an initiative that brings together national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies from the World Health Organization’s WHO) SAFER technical package,” according to Vital Strategies. The initiative will focus on Latin America, Africa and Asia, with partners Movendi International; the University of Illinois Chicago; the Global Alcohol Policy Alliance (GAPA); the Non-Communicable Disease (NCD) Alliance; and the WHO, with GiveWell as the donor. RESET’s primary policy focus will be on increasing alcohol taxation and other pricing policies which it describes as being “among the most effective interventions for reducing consumption”. It also aims to regulate the availability of alcohol, and restrict its marketing. Over three years, the initiative will support 15 or more countries to develop policies including raising the price of alcohol via taxation, regulating availability, and restricting alcohol marketing. Policies to protect kids “Every year, alcohol use cuts millions of lives short and causes even more widespread suffering,” said Adam Karpati, senior vice president at Vital Strategies. “The onus can’t be on individuals. We must reset from an environment where the alcohol industry is empowered to push alcohol into nearly every aspect of our lives, including schools, sports, and media. We need policies that protect kids, make healthy choices, the easy choices, and check the industry’s influence. RESET Alcohol will do just that through strong partnerships with government and civil society leaders who are committed to action.” Alcohol consumption has increased in nearly all regions of the world consistently since 2005, and accelerated during the COVID-19 pandemic. It is related to more than 60 different conditions, including cancers, heart disease, liver disease, tuberculosis and HIV/AIDS; injuries and trauma including suicide, homicide, assault, falls, intimate partner violence, and vehicle crashes. Alcohol consumption is also associated with adverse economic impacts, from medical care costs to lost productivity. RESET Alcohol’s approach builds on its partners’ successes in similar consortiums that have addressed tobacco and other harmful commodities, including contributing to 18.5% reduction in tobacco use in Bangladesh between 2009 and 2017 and a 17% reduction in India between 2010 and 2017. “Failure to act has led to millions of preventable deaths and suffering from alcohol,” said Jacqui Drope, the new director of RESET Alcohol. “It’s time governments treat it like the public health crisis that it is. When governments take up policies proven to reduce alcohol-related harms, population health and economies will benefit.” RESET Alcohol will provide technical support to governments, improve national research and data collection, resource advocacy for policy change, and mount communications campaigns. “For governments, tax increases on alcohol are a win-win, especially given the sluggish global economy,” said Jeffrey Drope, Research Professor at UIC. “Effective alcohol taxation reduces affordability, consumption and alcohol-related disease and premature death. This means lower healthcare costs and increased productivity from a healthier population. Taxes also create revenue for governments to fund health programs or other social priorities. Image Credits: U.S. Air Force/Samuel King Jr. . WHO Launches Climate Portal and Malaria Guide for Cities 31/10/2022 Editorial team The World Health Organization (WHO) and World Meteorological Organization (WMO) launched the first global knowledge platform dedicated to climate and health on Monday called climahealth.info. The global open-access platform is envisaged as being the “go-to technical reference point for users of interdisciplinary health, environmental, and climate science”, according to the WHO in a media release. “The use of tailored climate and environmental science and tools for public health, such as disease forecasting and heat health early warning systems, have enormous life-saving potential. These tools and resources can enhance our understanding of the connections between climate and health, help us reach at-risk populations, and anticipate and reduce impacts,” according to the media release. “Climate change is killing people right now,” said Diarmid Campbell-Lendrum, coordinator of WHO’s climate change and health programme. “It is affecting the basics we need to survive – clean air, safe water, food and shelter – with the worst impacts being felt by the most vulnerable. Unmitigated climate change has the potential to undermine decades of progress in global health. Reducing its impacts requires evidence-based policy backed by the best available science and tools.” Joy Shumake-Guillemot, who leads the WMO-WHO Climate and Health Joint Office, said that public health practitioners who are concerned about the environmental impacts on health “lack access to training and tailored climate information needed to address these growing issues” while “climate experts (are) sitting on troves of research and resources that could be applied to support public health goals, but just aren’t reaching the right people”. The initiative is supported by the Wellcome Trust. “Collaboration between climate, health and technical specialists is crucial for helping us understand and tackle the health effects of climate change,” said Madeleine Thomson, Head of Climate Impacts and Adaptation for the Wellcome Trust. “But right now, experts can’t always partner and share information as effectively as we know they’d like to. We hope this portal will help fulfill the potential of different disciplines to work together on research and gain new insights into how climate change is affecting health around the world.” Cities’ Malaria Framework launched On the occasion of World Cities Day 2022 on Monday, the WHO and UN Habitat launched the Global framework for the response to malaria in urban areas, which provides guidance to city government officials, health professionals and urban planners on how to develop a comprehensive malaria response specifically in urban areas, “where the dynamics of transmission and burden of vector-borne diseases can be different from that of rural areas”. By 2050, nearly 70% of people globally will live in cities and other urban settings and the WHO predicts that unplanned urbanization is likely to result in a malaria disease burden that is “disproportionately high among the urban poor”. Speakers at the launch also anticipated that climate change will see malaria in places that were previously too cold for the disease that is carried by mosquitos. The framework provides guidance for city leaders, health programmes and urban planners to respond to the challenges of rapid urbanization in a targeted way that helps to build resilience against the threat of malaria and other vector-borne diseases. Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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WHO Launches Climate Portal and Malaria Guide for Cities 31/10/2022 Editorial team The World Health Organization (WHO) and World Meteorological Organization (WMO) launched the first global knowledge platform dedicated to climate and health on Monday called climahealth.info. The global open-access platform is envisaged as being the “go-to technical reference point for users of interdisciplinary health, environmental, and climate science”, according to the WHO in a media release. “The use of tailored climate and environmental science and tools for public health, such as disease forecasting and heat health early warning systems, have enormous life-saving potential. These tools and resources can enhance our understanding of the connections between climate and health, help us reach at-risk populations, and anticipate and reduce impacts,” according to the media release. “Climate change is killing people right now,” said Diarmid Campbell-Lendrum, coordinator of WHO’s climate change and health programme. “It is affecting the basics we need to survive – clean air, safe water, food and shelter – with the worst impacts being felt by the most vulnerable. Unmitigated climate change has the potential to undermine decades of progress in global health. Reducing its impacts requires evidence-based policy backed by the best available science and tools.” Joy Shumake-Guillemot, who leads the WMO-WHO Climate and Health Joint Office, said that public health practitioners who are concerned about the environmental impacts on health “lack access to training and tailored climate information needed to address these growing issues” while “climate experts (are) sitting on troves of research and resources that could be applied to support public health goals, but just aren’t reaching the right people”. The initiative is supported by the Wellcome Trust. “Collaboration between climate, health and technical specialists is crucial for helping us understand and tackle the health effects of climate change,” said Madeleine Thomson, Head of Climate Impacts and Adaptation for the Wellcome Trust. “But right now, experts can’t always partner and share information as effectively as we know they’d like to. We hope this portal will help fulfill the potential of different disciplines to work together on research and gain new insights into how climate change is affecting health around the world.” Cities’ Malaria Framework launched On the occasion of World Cities Day 2022 on Monday, the WHO and UN Habitat launched the Global framework for the response to malaria in urban areas, which provides guidance to city government officials, health professionals and urban planners on how to develop a comprehensive malaria response specifically in urban areas, “where the dynamics of transmission and burden of vector-borne diseases can be different from that of rural areas”. By 2050, nearly 70% of people globally will live in cities and other urban settings and the WHO predicts that unplanned urbanization is likely to result in a malaria disease burden that is “disproportionately high among the urban poor”. Speakers at the launch also anticipated that climate change will see malaria in places that were previously too cold for the disease that is carried by mosquitos. The framework provides guidance for city leaders, health programmes and urban planners to respond to the challenges of rapid urbanization in a targeted way that helps to build resilience against the threat of malaria and other vector-borne diseases. Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. 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
Omicron Subvariants Race for Dominance 31/10/2022 Stefan Anderson Experts have described the array of subvariants as a “swarm”. The SARS-CoV2 virus just won’t give up. As the northern hemisphere heads into its third pandemic winter, experts say the continued evolution of Omicron’s sub-variants indicates a fresh wave is coming, but no one knows which variant will fuel it. Scientists have catalogued 390 Omicron lineages and 48 recombinants of the virus – which occur when at least two variants co-infect the same person, allowing them to ‘exchange notes’ and evolve. The sheer number of Omicron strains circulating makes predictions complicated. “We’re having trouble isolating which of the omicron sub-variants will have a growth advantage and will take over in dominating the spread,” WHO Senior Emergency Officer Dr Catherine Smallwood explained at a press conference last week. “Some variants like BQ.1 have been noted as potentially accelerated, but we’re not sure yet how this is going to pan out in the longer term.” The variety of offshoots also creates the possibility of a ‘double wave’ in some places if two successive variants with different immune-dodging characteristics succeed each other. “Looking at all the data, it seems a sizable new infection wave is certain to come,” Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven told Nature. Subvariant surges not causing hospitalization spikes – for now Ranking of the immune evasion for the new variants There is some good news: early signs show that though the BA.4, BA.5, BQ.1.1 and XBB subvariants are able to break through immune protections and resist certain treatments, they do not appear to be causing increases in hospitalizations. “An encouraging sign for one of – if not the most – immune evasive new variants XBB: it is dominant in India and Bangladesh without a rise in cases or deaths to date,” said Eric Topol, founder and director of Scripps Research. Despite the dominance of the highly infectious XBB variant, deaths and cases in India and Bengladesh have remained stable. Similar findings have come out of South Africa, where the Africa Health Research Institute in Durban conducted studies on the BA.4 and BA.5 sub-lineages. The team, led by virologist Alex Sigal, found that while these Omicron families possess strong enough immune-dodging mechanisms to lead to an infection wave, they are “not likely to cause much more severe disease than the previous waves, especially in vaccinated people.” The World Health Organization’s (WHO) Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE), which released a statement singling out BQ.1 and XBB as key variants of concern on Thursday, issued a similar analysis. “While we are looking at a vast genetic diversity of Omicron sublineages, they currently display similar clinical outcomes, but with differences in immune escape potential,” TAG-VE’s expert panel found. “So far there is no epidemiological evidence that these sublineages will be of substantially greater risk compared to other Omicron sublineages.” World trending in the right direction – but surprises could be around the corner WHO data as of the October 26 SARS-CoV2 weekly situation report. The question lingering on the mind of many experts is whether the varying properties of subvariants mean infection by one will provide immunity from others – a key determinant of whether double waves will hit. A team at Peking University in Beijing, led by Yunglong Richard Cao, has been studying the variants’ immune-evading capacities. “I have a feeling that if you’re infected with BQ.1, you might have some protection against XBB,” he told Nature. “We don’t have data yet.” Experts warn not to rule out more surprises from the virus. With Delta still circulating in the background, the deadlier variant could return to the fore. “The virus has surprised us more than once,” said Dr Hans Kluge, WHO Europe Regional Director. “We are much better prepared, and the fall surge has not led to previous ICU admission or severe disease levels, but forecasting remains tricky.” Russia’s invasion of Ukraine – denoted by the red line above – caused the country’s ability to report cases and deaths to fall. Reports emerged this week of yet another subvariant, BA.5.2.6 taking hold in Ukraine. The dire conditions occasioned by Russia’s invasion of the country have made it conducive ground for viral spread, and reporting since the start of the conflict has dropped off a cliff. Little is known about the true state of play on the ground – nor which subvariant will take over next. Image Credits: Nature, Stuart Turville. Posts navigation Older postsNewer posts