Climate Crisis and Poor Government Planning Are Blamed for Pakistan Floods 31/08/2022 Rahul Basharat Rajput & Mohammed Nadeem Chaudhry Floods have affected all four provinces of Pakistan. MAHANDRI, Pakistan – The village of Mahandri was once a scenic stopover for tourists visiting the valley of Kaghan in Pakistan’s northernmost province of Khyber Pakhtunkhwa but recent flash floods have destroyed most of its infrastructure. The monsoon floods have killed about 14 people, washed away five restaurants, all 30 shops in the local market and destroyed health infrastructure in the village, which located on the Kunhar River. The river starts in the glaciers of the Kaghan valley, and melting ice has added to the deluge. “The estimated cost of the commercial and domestic damage in the area is above $600,000,” said Babu Ashraf, a local councillor. The Pakistani government has announced a national emergency amidst reports by the National Disaster Management Authority that over 1191 people have died and 33 million people have been affected from Khyber Pakhtunkhwa in the far north to Baluchistan, Punjab, and Sindh province in the far south. One-third of the country is under water UNOSAT image of Pakistan flood damage from 1-29 August – from Kyber Pakhtunkhwa to Punjab and the worst-affected Balochistan and Sindh provinces. According to Pakistan’s Federal Minister for Climate Change, Senator Sherry Rehman, one-third of Pakistan is under water, with the rainfall in some parts of the country almost 400% more than average. Some 22 million people have been exposed to flood-related risks -about 10% of the country’s population, according to United Nations estimates. At a briefing on Wednesday, Rehman said that Pakistan was at “ground zero of this climate catastrophe created by the greenhouse gas emissions of richer countries”. While the country needed to improve its planning by “not building close to river beds, and better drainage”, that is not why the deluge took place, she stressed: “Make no mistake, climate change has caused this catastrophe.” “The rains in Sindh and Balochistan have surpassed 30-year averages and have taken more than 1191 lives, with well over 33 million severely affected. More than 5000 kms of roads and 243 bridges have been destroyed, and nearly a million homes have been fully or partially damaged,” Rehman said. “If we are to build back better, it will honestly require more than the $10 billion that is being talked about,” said Rehman, adding that temperatures in Sindh province had exceeded 53ºC which is “unlivable”. Pakistan floods – summary of damage to date. Glacier melt further exacerbates moonsoon floods Earlier, Rehman noted to the Associated Press that Pakistan had the largest number of glaciers outside the polar region, and as these are melting, as well, they are exacerbating the monsoon floods. Pakistan is home to over 7,200 glaciers. World Health Organisation (WHO) Director General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday that “damage to health infrastructure, shortages of health workers and limited health supplies are disrupting health services, leaving children and pregnant and lactating women at increased risk”. “Pakistan was already facing health threats including COVID-19, cholera, typhoid, measles, leishmaniasis, HIV and polio,” said Tedros. “Now the flooding has led to new outbreaks of dengue and skin infections, respiratory tract infections, malaria and more. In addition, the loss of crops and livestock will have a significant impact on the nutrition and health of many communities that depend on these resources. And more rain is expected.” Government planning failures Pakistan floods have destroyed bridges and other infrastructure along rivers. However, some also blame the Pakistan government for its failure to plan for climate crises and for allowing construction to alter the rivers’ natural pathways and human settlements on floodplains. Mohammed Hanif, District Community Officer in Kaghan, said that most of the damage done in his province of Khyber Pakthunkhwa was in areas where the course of the rivers Sindh, Kabul, Swat, and Kunhar have been encroached on by commercial activities. “People have encroached and made construction on the beds of rivers and natural streams for commercial benefits,” said Hanif. Back in 2002, a River Act was passed by the provincial assembly, followed by a 2014 amendment to stop the illegal construction, but this had not been implementation, he pointed out. Hanif added that Pakistan is on the list of the top ten countries vulnerable to climate change impacts and it needs a clear policy to deal with such natural disasters. “The country even does not have the required departments to deal with such natural calamities,” he said. Stronger climate adaptation efforts needed People who have been displaced as a result of flooding. Climate change activists believe that Pakistan should adopt a climate governance model to prevent such calamities. Aftab Alam Khan, CEO of Resilient Future International (RSI), a research and training social enterprise focused on climate change in Pakistan, said the country has to move towards the climate governance system because it cannot handle such calamities with ordinary governance. “Much more seriousness is required at federal, provincial, and down to district level governments towards climate adaptability,” he said. Khan said the government should learn from the 2010 floods, which affected 20 million people, and the 2005 earthquake, and improve the coordination amongst all the departments. Comparing the 2010 floods with current floods, he said this year’s floods were more devastating, affecting over 30 million people. The damage to livestock in 2010 were around $0.27 million whereas it was already around $0.7 million so far and likely to increase. Some 45 % of crops had been lost in some areas, including devastating damage to the cotton crop upon which much of Pakistan’s GDP depends, in comparison to 11% in 2010,. Khan said as Pakistan has been marked in the top ten countries being affected by climate change, the government has to take some emergency measures and develop a national adaptation plan. Health crises loom These floods can lead to infectious and waterborne diseases in stagnant pools of water across the country. “Floods have already started affecting the health of the people and a large number of people are facing issues of gastroenteritis, malaria, dengue, snake bites and typhoid in the flood-affected areas,’ said Khan. Health experts also believe that the damage will not stop here and floods will bring long-term health challenges for millions of affected people. “With the change in temperature, the whole environment is changing and even the diseases which were well under control are being unleashed again because of the temperate conditions,” warned Dr Zafar Mirza, a public health expert and Pakistan’s former health minister. He predicted that waterborne diseases including diarrhoea, cholera, malaria, and dengue will spread in the medium term because there will be stagnant pools of water on vast areas of land across Pakistan. Satellite images released on Wednesday show that overflow from the Indus River has turned part of Sindh Province into a 100 km-wide lake, according to CNN. “If this is not addressed, it will cause mortality there,” Mirza said, adding that, in the longer-term, lack of food and healthcare would make people more vulnerable to many secondary infections. Mirza said the government’s biggest challenge is putting all its relief and rescue departments in the coordination and raising funds to reach the public suffering from floods. “Financial resources are also needed and the United Nations (UN) has flashed an appeal to help Pakistan but the amount is very small. Much more would be required,” Mirza. WHO warning after damage to health facilities Millions displaced by floods have been left without access to health care. The WHO reported on Tuesday that around 888 health facilities had been damaged, of which 180 are completely destroyed, leaving millions of people without access to health care. WHO has diverted mobile medical camps, including teams responding to COVID-19, to affected districts, delivered over one million water purifying tablets and provided sample collection kits to ensure clinical testing of samples to ensure early detection of infectious diseases. “According to a preliminary assessment conducted by WHO and humanitarian partners, the current level of devastation is much more severe than that caused by floods in Pakistan in previous years, including those that devastated the country in 2010,” said Dr Ahmed Al-Mandhari, WHO’s Regional Director for the Eastern Mediterranean. Ongoing disease outbreaks in Pakistan, including acute watery diarrhoea, dengue fever, malaria, polio, and COVID-19 are being further aggravated, particularly in camps and where water and sanitation facilities have been damaged “WHO is working with health authorities to respond quickly and effectively on the ground. Our key priorities now are to ensure rapid access to essential health services to the flood-affected population strengthen and expand disease surveillance, outbreak prevention and control, and ensure robust health cluster coordination,” said Dr Palitha Mahipala, WHO Representative in Pakistan. The spokesperson for the Ministry of National Health Services and Regulations, Sajid Hussain Shah, said these floods are testing times for the country and the ministry is taking all efforts to control the disease spread in flood-affected areas. He said though health is a provincial matter in the country, but the federal ministry is coordinating with provinces to provide them with maximum facilities. Shah said over 600,000 medicated mosquito nets have been distributed in 22 districts of Sindh and above $2.5 million worth of medicine has been provided to people affected. “This is a huge calamity and the government cannot recover from it without international community help,” said Shah. Image Credits: Rahul Rajput, UNOSAT , UNHCR . Searching for ‘Pathogen X’ That Will Drive the Next Pandemic 30/08/2022 Kerry Cullinan A researcher explores samples from the wildlife trade. Drug-resistant bacteria, influenza, Crimean-Congo haemorrhagic fever – all have the potential to be the ‘pathogen X’ that could drive the next pandemic, according to scientists sharing notes at a two-day meeting convened by the World Health Organization (WHO) R&D Blueprint. Dr Ana Maria Restrepo, WHO head of research and development, said that while predicting the future was impossible, the body wanted to develop a common global priority list for pathogens as there was a “pandemic of lists”. Research has shown that although the number of viral species was increasing, the number of new viral families that are infecting humans is beginning to plateau, according to Dr Barney Graham, formerly with vaccine research at the US National Institutes of Health. “That suggests that this is a finite problem that we could prepare for in a more proactive way,” he added, pointing out that if viruses within the 27 viral families were grouped according to entry mechanisms, about 120 had the potential for increased human-to-human transmission. “It would be possible to develop vaccines for 30 prototype viruses in phase one and generate the reagents and data on all the other 90 viruses, at least through animal testing,” said Graham, now at the Morehouse School of Medicine in Atlanta. Dr Ana Maria Restrepo, WHO head of research and development Graham is most worried about influenza driving the next pandemic: “Even though we’ve been dealing with influenza for almost 90 years now, I don’t think we’re really ready for the next pandemic. We have vaccine technologies that require six to seven months to scale up,” said Graham, adding that new vaccine technology needed to be applied to influenza so that billions of doses could be made within three to four months. Drug-resistant bacteria are already killing millions “We are also very much or considering bacteria as an important potential cause of the next pandemic,” said Restrepo. “Antimicrobial resistance comes to mind, but there is also the evolution of bacteria.” Dr Loice Achieng from Nairobi University in Kenya, made a convincing case for a bacterium driving the next pandemic, highlighting that many bacteria have high case fatality rates and efficient human-to-human transmissibility. “Looking at the mortality around antimicrobial resistance for many years, we’ve had the projection that by 2050 there would be about 10 million deaths per year from antimicrobial resistance,” said Achieng, adding that some had seen this as an exaggeration. However, recent research published in The Lancet found that, in 2019, there were almost five million deaths associated with bacterial AMR, and about 1.3 million deaths directly attributable to bacterial AMR. “If you compare this to mortality from COVID-19 over the last two and a half years there have been 6.5 million deaths globally. If the estimates of AMR-related deaths are indeed true, then it means over that same period, there have been more than 10 million deaths,” said Achieng. “They’re slow. They’re undocumented, many times unrecognised and continue to kill many people.” She cited gram-negative bacteria like E.coli and Klebsiella pneumonia and gram-positive bacteria like methicillin-resistant staph aureus (SARS) and Streptococcus as being amongst the most deadly bacteria. Lessons from COVID and other outbreaks An effective surveillance network for both animals and humans is critical to preparing for the next pandemic, said Dr Kanta Subbarao, director of the WHO Collaborating Centre for Reference and Research on Influenza, based at the Doherty Institute in Melbourne, Australia. “Surveillance networks came to play a big part even in the response to COVID-19. And I would argue that at least in influenza, we have much more interaction with our animal health colleagues in the surveillance space,” said Subbarao. “When outbreaks begin, we really rely on astute clinicians to pick them up and identify a cluster of unusual illnesses that they then track and say what is going on. At that point, you need diagnostic assays to identify what the pathogen is, and that means the ability to isolate the virus.” Professor Madhu Pai Pathogen X is mostly like to emerge at level of primary health care where it will not get detected, as 50% of the world primarily in LMICs lack access to essential diagnostics, and primary care is the weakest in terms of access, according to Professor Madhukar Pai from McGill University in Canada. “Secondly, pathogen X will emerge in a world where high-income countries are repeatedly failing in terms of global solidarity, and repeatedly failing in terms of what not to do in a crisis,” said Pai. “We should assume rich nations will again hoard vaccinations, diagnostics and supplies for the next pandemic. And low and middle-income countries be left with nothing,” he added. Thus preparing for ‘pathogen X’ should focus on building low and middle-income countries’ manufacturing capacity, including of diagnostics, added Pai. “India and China produced their own COVID19 tests and did not have to wait for the trickle-down charity from high-income countries,” he said. Graham added that emerging viral diseases are almost always recognised first in high-income countries but they almost always emerge from LMICs. “This means that we all have we have mutual interest and should have a coordinated global effort towards addressing this problem because it’s not going to stop.” Wildlife dangers The most likely source of pathogen X is zoonotic diseases, said John Hopkins University epidemiologist Dr Pranab Chatterjee. While we have learned a lot about how a new pathogen behaves once it has become capable of infecting humans, there remains a lot of unanswered questions regarding pathogens spillovers from animals to humans, added Chatterjee. “The focus should remain on [identifying] a zoonotic source for an emerging pathogen X or a reemerging known pathogens, strengthening global governance mechanisms and supporting countries in designing and deploying One Health informed surveillance systems embedded within existing public health systems,” he added. The EcoHealth Alliance’s Dr Willian Karesh said that global investment in pandemics had focused on health security but there was little money going to prevention and recovery. Groups including the World Bank are starting to think about the drivers of emerging infectious diseases and pandemics, and there a tight correlation with land use change, deforestation, agricultural expansion and the wildlife trade, said Karesh. COVID-19 has highlighted the potential risks emanating from the wildlife trade,and there were a number of possibilities to address these, he added. While there are potentially millions of viruses in wildlife, there has been almost no research to implement and test interventions to address this risk, said Karesh, highlighting this as a “priority research area”. Karesh also highlighted the danger of “spill back” of pathogens from humans to animals, where they had the potential to mutate and reinfect humans at a later stage. SARS CoV2 spilt into mink and white-tailed deer, and there is “a large swath of the US where Delta variants are circulating in deer,” he said. Image Credits: Wildlife Conservation Society . Lack of Basic Hygiene Faulted in UN Report 30/08/2022 John Heilprin Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children, according to UNICEF. A new UN report showing that half of the world’s health care facilities fail to meet the basic standard for providing hygiene services like soap and water or an alcohol-based hand rub highlights the widespread global risk of disease spread and infections to patients and health care providers. About two-thirds of all health care facilities provide these services at the points of care or toilets but not at both, which is the basic standard. Only 51% meet that standard by providing both, says a new report Tuesday from the World Health Organization (WHO) and UNICEF. The report, “Progress on WASH in health care facilities 2000-2021: Special focus on WASH and infection prevention and control (IPC)“, focuses on data from 2000 to 2021 and finds that the lack of basic hygiene puts around 3.85 billion people who use these facilities at greater risk of infection. That includes 688 million whose facilities offer no basic hygiene services at all. Just 40 countries in the world kept their own national estimates for basic hygiene services last year Hygiene ‘non-negotiable’ Health officials say the situation likely will prolong the COVID-19 pandemic, monkeypox outbreak and other health crises. “Hygiene facilities and practices in health care settings are non-negotiable,” said Dr Maria Neira, director of WHO’s Department of Environment, Climate Change and Health. “Their improvement is essential to pandemic recovery, prevention and preparedness,” she said, urging nations to spend more for “basic measures, which include safe water, clean toilets, and safely managed health care waste.” That is in line with the 194-nation World Health Assembly’s commitment in 2019 to strengthen and monitor water, sanitation and hygiene services in health care facilities. WHO and UNICEF operate a Joint Monitoring Program that provides regional, national and global estimates of progress on drinking water, hygiene and sanitation. The latest report on hygiene covers 35% of the world’s population and 40 nations, up from 21 nations in 2020. Low-and-middle-income countries have made significantly less progress than high-income countries in implementing hand hygiene and infection prevention programmes that can stop deadly diseases, from diarrhoea to COVID-19, according to a recent WHO survey of 88 countries. “If health care providers don’t have access to a hygiene service, patients don’t have a health care facility,” said Kelly Ann Naylor, UNICEF’s director of Water, Sanitation and Hygiene (WASH) and Climate, Environment, Energy, and Disaster Risk Reduction (CEED). “Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children,” she said. “Every year, around 670,000 newborns lose their lives to sepsis. This is a travesty — even more so as their deaths are preventable.” Practical steps outlined by the joint WHO-UNICEF report to improving water, sanitation, and hygiene in health care facilities, and reduce risk to patients. In 2017, the World Health Assembly adopted a resolution to fight which is a life-threatening blood stream infection for which there is growing resistance. The Assembly, which is WHO’s governing body, acknowledged that antimicrobial resistance is a growing health concern and underlined the urgent need for new accessible and affordable antibiotics. The report finds the lack of basic hygiene is uneven across different regions and income groupings. Facilities in sub-Saharan Africa are lagging; 73% in the region have alcohol-based hand rub or water and soap at points of care, but only 37% have handwashing facilities with water and soap at toilets. Among hospitals, 87% have hand hygiene facilities at points of care. In the least developed countries, only 53% of health care facilities have access on-premises to a protected water source, the report says. That compares with 78% globally. Many health care facilities also lack basic environmental cleaning and safe segregation and disposal of health care waste, it says. Image Credits: WHO/UNICEF. Political Leaders Need to invest in Global Research & Development to Prepare for Next Pandemic 30/08/2022 CEPI & UNITE CEPI is helping to improve global laboratory capacity. Recently, the Coalition for Epidemic Preparedness (CEPI) launched a $3.5 billion plan of investment in ground-breaking R&D, linked to equitable access commitments, which aims to transform the world’s ability to respond to new epidemic and pandemic threats and catalyze cooperation across a coalition of public and private sector partners. As parliamentarians from across the European Union, we want to underscore the importance of governments’ role in actively supporting these kinds of global health preparedness plans at national level – with concrete investments and actions. The COVID-19 pandemic has demonstrated that multilateralism and solidarity are fundamental to address any global health threat and that governments must increase global solidarity and collaboration, ensuring fair and universal access to vaccines. The pandemic also has made us realize the impact that infectious diseases can have on our daily lives. And it is now more clear than ever that it is not possible to rebuild our societies unless we control the epidemiological risk and commit to a more robust and effective global epidemic and pandemic preparedness and response architecture. Investment in regional and international health security As each country discusses how to strengthen its own domestic preparedness and response, it is also crucial to be certain that those efforts feed into a stronger global ecosystem. Domestic plans will be of little worth if the infectious disease threats that loom now or rise up in the future continue to hover just across our borders. National contingency plans will only be effective if they also take into account and invest in the regional and international health security systems. As a globally recognised organising force for R&D collaboration and innovation, CEPI is uniquely placed to coordinate an international approach to the research and development of new vaccines and other tools that significantly reduce future epidemic and pandemic risks. CEPI offers a global focus and the agility to move quickly, extensive partnerships, and a proven track record with its rapid and effective action in response to the ongoing COVID-19 crisis. It is able to leverage its unique connecting role, being able to work with vaccine developers and manufacturers, national governments, philanthropies, civil society and global health organisations, with an extensive network to pool and deploy resources in ways that states often cannot. CEPI is continuing to respond to the COVID-19 pandemic – optimising current vaccines and developing the next-generation of COVID-19 vaccines to respond to variants of concern. Simultaneously, however, CEPI is also preparing for future infectious disease threats through initiating the development of a) broadly protective coronavirus vaccines, b) advancing vaccines for other known infectious disease threats and c) producing a library of prototype vaccines and other biological interventions against representative pathogens from critical viral families. Building global capacity CEPI is also working to establish global networks for lab capacity, assays, and preclinical models that are critical for rapid vaccine development, and to support the efforts of low- and middle-income countries to take full ownership of their national health security. Taken together, these tools will support CEPI’s ambitious aim to compress vaccine development timelines to 100 days from genetic sequence to vaccine availability. The plan is developed, but it now needs funding. National contingency plans are only effective if they also pay attention to, and invest in, the international health security system. Investing in research and development for pandemic preparedness, both from domestic and foreign aid budgets, in an all-of-government strategy, is an efficient way to protect our future, as emerging infectious diseases require a similar kind of investment attention as other major threats, such as climate change or wars. Therefore, we need to establish a coordinated global R&D system where national and regional initiatives can complement each other, in order to avoid economic turmoil and save lives. One of the main priorities of UNITE Members, Members of Parliament and policymakers around the world is to protect the people they represent and they are therefore fundamental in this process. We can hold governments accountable and advocate for more investment in R&D for pandemic preparedness. We can also give political support for a strengthened future ecosystem through the work on a global accord, that secures appropriate funding for pandemic preparedness and makes sure that we put equitable access at the heart of the response. We have the technology. Now, we need the political leadership. UNITE Global Parliamentarians Network to End Infectious Diseases: Petra Bayr, Member of Parliament, Austria Jean François Mbaye, Former Member of Parliament, France Jean-Luc Romero Michel – Deputy-Mayor of Paris and President of Local Elected Representatives against AIDS Jean Spiri, Former Member of the Regional Council of Île-de-France Sara Cerdas, Member of the European Parliament, Portugal Juan Ignacio Echániz Salgado, Member of Parliament, Spain Lisa Cameron, Member of Parliament, UK Lia Quartapelle, Member of Parliament, Italy Sirpa Pietikäinen, Member of the European Parliament, Finland Andrew Ullmann, Member of Parliament, Germany Image Credits: Novavax, Sanofi. WHO Urges Universal Monkeypox Fight 30/08/2022 John Heilprin The World Health Organization’s top official in Europe says the monkeypox outbreak appears to be slowing in the region, and could be eliminated through universal effort. “There are encouraging early signs, as evidenced in France, Germany, Portugal, Spain, the U.K., and other countries, that the outbreak may be slowing,” WHO’s Regional Director for Europe Dr Hans Kluge told an online press briefing. “To move towards elimination in our region,” he said, “we need to urgently step up our efforts.” Kluge reported more than 22,000 confirmed cases of monkeypox across 43 countries and areas, representing more than a third of the global tally. His office is advising all governments and policymakers to join in efforts at controlling and eliminating monkeypox. “All countries — whether they currently have cases or not — need to implement a set of combined interventions towards this end,” Kluge said. “Yet we believe we can eliminate sustained human-to-human transmission of monkeypox in the region if we commit to doing so and put the needed resources towards that end,” he said. Monkeypox trends point to importance of earlier detection, isolation The global number of weekly new cases of monkeypox reported to WHO declined by 21% last week — the first such decline since the infection endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots. But there has been a global shortage of monkeypox vaccines. The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said last week. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned. The rollout of MVA-BN vaccine, made by Danish company Bavarian Nordic, has been hampered by limited supplies. In response, WHO is examining proposals to split scarce monkeypox vaccines doses to stretch supplies. The United States adopted that strategy earlier this month. The slowdown in monkeypox outbreak may be due to better detection and earlier isolation among some communities, said WHO Europe’s incident manager, Dr Catherine Smallwood. “We do have some pretty good anecdotal evidence that people — particularly men who have sex with men, who are in particular risk groups — are much more informed about the disease,” Smallwood said. Holistic monkeypox approach working well “Which really leads us to believe that a major change, at least for the moment, is contributing very significantly to them,” she said. “We need to build on that … and we firmly believe that if we continue to do that, we will be able to sustain this decline.” In Europe there are “early signs” that “this is going in the right direction, but it’s not enough,” Kluge said of the monkeypox outbreak. Kluge pointed to the example of Portugal, where the government’s community outreach and partnership efforts raised awareness, prompting people “to take precautions and modify their behavior, resulting in better health outcomes and helping curb the outbreak.” Monkeypox, which was long isolated in a few countries in Africa, broke out in Europe in early May but WHO waited until 10 weeks later to declare a public health emergency. Much like with AIDS, initially the most affected group has been gay and bisexual men. The cause of the early neglect towards monkeypox is rooted in homophobia, says Michael Weinstein, president of AIDS Healthcare Foundation (AHF), the largest global nonprofit AIDS organization. Kluge said the current outbreak in Europe emerged among men who have sex with men, often through sex with anonymous or multiple partners, and “that’s where the outbreak remains centered.” “And that’s where we must concentrate our prevention and response efforts — with the active collaboration and participation of the community itself, fostering an environment free of stigma and discrimination against this long-marginalized population,” he said. Swiss Approve 1st Booster for Variants 29/08/2022 John Heilprin Gavi, The Vaccine Alliance, will receive 500 million doses of the Moderna vaccine Swiss drugs regulator Swissmedic announced it has temporarily authorized the first bivalent Covid-19 booster vaccine in the country. That clears the way for an eagerly anticipated second round of booster vaccinations that should better target Omicron sub-variants. Moderna’s COVID-19 mRNA-1273.214 vaccine, Spikevax, is the first COVID-19 vaccine that contains messenger ribonucleic acid (mRNA) against two coronavirus variants known as BA.1 and BA.4/5, Swissmedic said Monday. It is authorized for anyone 18 years or older. “In trials, a booster dose with this bivalent vaccine demonstrated higher antibody concentrations against the Omicron variants than a booster with Spikevax, the original COVID-19 vaccine from Moderna, with comparable side effects,” the agency said. Federal vaccination and public health officials will now draw up plans to offer the vaccine to the Swiss public. It is administered as a single dose of 0.5 ml (50 micrograms). Side effects like fever, headaches and muscle pains are “similar to that seen following administration of the second dose (100 micrograms) or the booster (50 micrograms) of the original vaccine,” according to the Swiss regulator. COVID booster vaccines have gained traction in several countries – US, Israel, Germany, UK, and others, but low- and middle-income countries lag significantly behind in shots. Booster Meets Safety Standards The original Moderna vaccine worked against early COVID-19 strains such as Alpha and Delta, but it provided little immunity against Omicron or its sub-variants, which are now causing all of the coronavirus infections that are being detected in Switzerland. Swissmedic said its review shows the booster vaccine meets the safety, efficacy and quality requirements. It contains 25 micrograms of mRNA-1273 (original Spikevax) and 25 micrograms of mRNA that targets the Omicron variant BA.1. “Compared to the original vaccine, trials have shown that this produces a stronger immune response against the Omicron variants BA.1 and BA.4/5,” Swissmedic said. “The protective effect of the bivalent vaccine against the original SARS-CoV-2 virus (Wuhan type) measured in the antibody concentration is equivalent to the effect of the original vaccine (Spikevax),” it said. The original vaccines were designed to train the body to fight the virus in the form in which it first emerged from Wuhan, China, at the end of 2019. But the virus continues to mutate. Switzerland during COVID-19 pandemic. Swiss Booster Approval Follows U.K. Moderna and Pfizer and BioNTech have submitted applications to the US Food and Drug Administration for emergency use authorization of their updated Covid-19 vaccine boosters. Both are bivalent vaccines that combine the original vaccines with ones that target Omicron sub-variants BA.4 and BA.5, which are prevalent in the United States. BioNTech said earlier this month it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. Two weeks ago, the UK became the first country to approve a bivalent COVID-19 booster vaccine that works against both the original COVID-19 virus and the newer Omicron variant. An expert panel of advisers to the World Health Organization (WHO) recommended that countries consider a second COVID-19 booster dose for older, at-risk and immunocompromised people, echoing guidance from European and U.S. regulators. WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization released its updated recommendations for a second vaccine booster dose for all elderly people using age-specific cutoffs to be defined by each country. It also recommended a second booster for adults with comorbidities that put them at higher risk of severe disease, including pregnant women and health care workers. Image Credits: Gavi , Marco Verch/Flickr, Transformer18/Flickr. WHO Lists Entities That Can Engage with Pandemic Treaty Negotiating Body 29/08/2022 Kerry Cullinan WHO member states at the INB meeting taking place 18-22 July 2022 in Geneva A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument. The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness. “The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik. The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities. Environmental actors In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel. Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB. “In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview. “We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. “Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts. They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.” In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: “Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. Reactive not proactive list However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty. Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. Additional reporting by Elaine Fletcher. How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. 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.
Searching for ‘Pathogen X’ That Will Drive the Next Pandemic 30/08/2022 Kerry Cullinan A researcher explores samples from the wildlife trade. Drug-resistant bacteria, influenza, Crimean-Congo haemorrhagic fever – all have the potential to be the ‘pathogen X’ that could drive the next pandemic, according to scientists sharing notes at a two-day meeting convened by the World Health Organization (WHO) R&D Blueprint. Dr Ana Maria Restrepo, WHO head of research and development, said that while predicting the future was impossible, the body wanted to develop a common global priority list for pathogens as there was a “pandemic of lists”. Research has shown that although the number of viral species was increasing, the number of new viral families that are infecting humans is beginning to plateau, according to Dr Barney Graham, formerly with vaccine research at the US National Institutes of Health. “That suggests that this is a finite problem that we could prepare for in a more proactive way,” he added, pointing out that if viruses within the 27 viral families were grouped according to entry mechanisms, about 120 had the potential for increased human-to-human transmission. “It would be possible to develop vaccines for 30 prototype viruses in phase one and generate the reagents and data on all the other 90 viruses, at least through animal testing,” said Graham, now at the Morehouse School of Medicine in Atlanta. Dr Ana Maria Restrepo, WHO head of research and development Graham is most worried about influenza driving the next pandemic: “Even though we’ve been dealing with influenza for almost 90 years now, I don’t think we’re really ready for the next pandemic. We have vaccine technologies that require six to seven months to scale up,” said Graham, adding that new vaccine technology needed to be applied to influenza so that billions of doses could be made within three to four months. Drug-resistant bacteria are already killing millions “We are also very much or considering bacteria as an important potential cause of the next pandemic,” said Restrepo. “Antimicrobial resistance comes to mind, but there is also the evolution of bacteria.” Dr Loice Achieng from Nairobi University in Kenya, made a convincing case for a bacterium driving the next pandemic, highlighting that many bacteria have high case fatality rates and efficient human-to-human transmissibility. “Looking at the mortality around antimicrobial resistance for many years, we’ve had the projection that by 2050 there would be about 10 million deaths per year from antimicrobial resistance,” said Achieng, adding that some had seen this as an exaggeration. However, recent research published in The Lancet found that, in 2019, there were almost five million deaths associated with bacterial AMR, and about 1.3 million deaths directly attributable to bacterial AMR. “If you compare this to mortality from COVID-19 over the last two and a half years there have been 6.5 million deaths globally. If the estimates of AMR-related deaths are indeed true, then it means over that same period, there have been more than 10 million deaths,” said Achieng. “They’re slow. They’re undocumented, many times unrecognised and continue to kill many people.” She cited gram-negative bacteria like E.coli and Klebsiella pneumonia and gram-positive bacteria like methicillin-resistant staph aureus (SARS) and Streptococcus as being amongst the most deadly bacteria. Lessons from COVID and other outbreaks An effective surveillance network for both animals and humans is critical to preparing for the next pandemic, said Dr Kanta Subbarao, director of the WHO Collaborating Centre for Reference and Research on Influenza, based at the Doherty Institute in Melbourne, Australia. “Surveillance networks came to play a big part even in the response to COVID-19. And I would argue that at least in influenza, we have much more interaction with our animal health colleagues in the surveillance space,” said Subbarao. “When outbreaks begin, we really rely on astute clinicians to pick them up and identify a cluster of unusual illnesses that they then track and say what is going on. At that point, you need diagnostic assays to identify what the pathogen is, and that means the ability to isolate the virus.” Professor Madhu Pai Pathogen X is mostly like to emerge at level of primary health care where it will not get detected, as 50% of the world primarily in LMICs lack access to essential diagnostics, and primary care is the weakest in terms of access, according to Professor Madhukar Pai from McGill University in Canada. “Secondly, pathogen X will emerge in a world where high-income countries are repeatedly failing in terms of global solidarity, and repeatedly failing in terms of what not to do in a crisis,” said Pai. “We should assume rich nations will again hoard vaccinations, diagnostics and supplies for the next pandemic. And low and middle-income countries be left with nothing,” he added. Thus preparing for ‘pathogen X’ should focus on building low and middle-income countries’ manufacturing capacity, including of diagnostics, added Pai. “India and China produced their own COVID19 tests and did not have to wait for the trickle-down charity from high-income countries,” he said. Graham added that emerging viral diseases are almost always recognised first in high-income countries but they almost always emerge from LMICs. “This means that we all have we have mutual interest and should have a coordinated global effort towards addressing this problem because it’s not going to stop.” Wildlife dangers The most likely source of pathogen X is zoonotic diseases, said John Hopkins University epidemiologist Dr Pranab Chatterjee. While we have learned a lot about how a new pathogen behaves once it has become capable of infecting humans, there remains a lot of unanswered questions regarding pathogens spillovers from animals to humans, added Chatterjee. “The focus should remain on [identifying] a zoonotic source for an emerging pathogen X or a reemerging known pathogens, strengthening global governance mechanisms and supporting countries in designing and deploying One Health informed surveillance systems embedded within existing public health systems,” he added. The EcoHealth Alliance’s Dr Willian Karesh said that global investment in pandemics had focused on health security but there was little money going to prevention and recovery. Groups including the World Bank are starting to think about the drivers of emerging infectious diseases and pandemics, and there a tight correlation with land use change, deforestation, agricultural expansion and the wildlife trade, said Karesh. COVID-19 has highlighted the potential risks emanating from the wildlife trade,and there were a number of possibilities to address these, he added. While there are potentially millions of viruses in wildlife, there has been almost no research to implement and test interventions to address this risk, said Karesh, highlighting this as a “priority research area”. Karesh also highlighted the danger of “spill back” of pathogens from humans to animals, where they had the potential to mutate and reinfect humans at a later stage. SARS CoV2 spilt into mink and white-tailed deer, and there is “a large swath of the US where Delta variants are circulating in deer,” he said. Image Credits: Wildlife Conservation Society . Lack of Basic Hygiene Faulted in UN Report 30/08/2022 John Heilprin Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children, according to UNICEF. A new UN report showing that half of the world’s health care facilities fail to meet the basic standard for providing hygiene services like soap and water or an alcohol-based hand rub highlights the widespread global risk of disease spread and infections to patients and health care providers. About two-thirds of all health care facilities provide these services at the points of care or toilets but not at both, which is the basic standard. Only 51% meet that standard by providing both, says a new report Tuesday from the World Health Organization (WHO) and UNICEF. The report, “Progress on WASH in health care facilities 2000-2021: Special focus on WASH and infection prevention and control (IPC)“, focuses on data from 2000 to 2021 and finds that the lack of basic hygiene puts around 3.85 billion people who use these facilities at greater risk of infection. That includes 688 million whose facilities offer no basic hygiene services at all. Just 40 countries in the world kept their own national estimates for basic hygiene services last year Hygiene ‘non-negotiable’ Health officials say the situation likely will prolong the COVID-19 pandemic, monkeypox outbreak and other health crises. “Hygiene facilities and practices in health care settings are non-negotiable,” said Dr Maria Neira, director of WHO’s Department of Environment, Climate Change and Health. “Their improvement is essential to pandemic recovery, prevention and preparedness,” she said, urging nations to spend more for “basic measures, which include safe water, clean toilets, and safely managed health care waste.” That is in line with the 194-nation World Health Assembly’s commitment in 2019 to strengthen and monitor water, sanitation and hygiene services in health care facilities. WHO and UNICEF operate a Joint Monitoring Program that provides regional, national and global estimates of progress on drinking water, hygiene and sanitation. The latest report on hygiene covers 35% of the world’s population and 40 nations, up from 21 nations in 2020. Low-and-middle-income countries have made significantly less progress than high-income countries in implementing hand hygiene and infection prevention programmes that can stop deadly diseases, from diarrhoea to COVID-19, according to a recent WHO survey of 88 countries. “If health care providers don’t have access to a hygiene service, patients don’t have a health care facility,” said Kelly Ann Naylor, UNICEF’s director of Water, Sanitation and Hygiene (WASH) and Climate, Environment, Energy, and Disaster Risk Reduction (CEED). “Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children,” she said. “Every year, around 670,000 newborns lose their lives to sepsis. This is a travesty — even more so as their deaths are preventable.” Practical steps outlined by the joint WHO-UNICEF report to improving water, sanitation, and hygiene in health care facilities, and reduce risk to patients. In 2017, the World Health Assembly adopted a resolution to fight which is a life-threatening blood stream infection for which there is growing resistance. The Assembly, which is WHO’s governing body, acknowledged that antimicrobial resistance is a growing health concern and underlined the urgent need for new accessible and affordable antibiotics. The report finds the lack of basic hygiene is uneven across different regions and income groupings. Facilities in sub-Saharan Africa are lagging; 73% in the region have alcohol-based hand rub or water and soap at points of care, but only 37% have handwashing facilities with water and soap at toilets. Among hospitals, 87% have hand hygiene facilities at points of care. In the least developed countries, only 53% of health care facilities have access on-premises to a protected water source, the report says. That compares with 78% globally. Many health care facilities also lack basic environmental cleaning and safe segregation and disposal of health care waste, it says. Image Credits: WHO/UNICEF. Political Leaders Need to invest in Global Research & Development to Prepare for Next Pandemic 30/08/2022 CEPI & UNITE CEPI is helping to improve global laboratory capacity. Recently, the Coalition for Epidemic Preparedness (CEPI) launched a $3.5 billion plan of investment in ground-breaking R&D, linked to equitable access commitments, which aims to transform the world’s ability to respond to new epidemic and pandemic threats and catalyze cooperation across a coalition of public and private sector partners. As parliamentarians from across the European Union, we want to underscore the importance of governments’ role in actively supporting these kinds of global health preparedness plans at national level – with concrete investments and actions. The COVID-19 pandemic has demonstrated that multilateralism and solidarity are fundamental to address any global health threat and that governments must increase global solidarity and collaboration, ensuring fair and universal access to vaccines. The pandemic also has made us realize the impact that infectious diseases can have on our daily lives. And it is now more clear than ever that it is not possible to rebuild our societies unless we control the epidemiological risk and commit to a more robust and effective global epidemic and pandemic preparedness and response architecture. Investment in regional and international health security As each country discusses how to strengthen its own domestic preparedness and response, it is also crucial to be certain that those efforts feed into a stronger global ecosystem. Domestic plans will be of little worth if the infectious disease threats that loom now or rise up in the future continue to hover just across our borders. National contingency plans will only be effective if they also take into account and invest in the regional and international health security systems. As a globally recognised organising force for R&D collaboration and innovation, CEPI is uniquely placed to coordinate an international approach to the research and development of new vaccines and other tools that significantly reduce future epidemic and pandemic risks. CEPI offers a global focus and the agility to move quickly, extensive partnerships, and a proven track record with its rapid and effective action in response to the ongoing COVID-19 crisis. It is able to leverage its unique connecting role, being able to work with vaccine developers and manufacturers, national governments, philanthropies, civil society and global health organisations, with an extensive network to pool and deploy resources in ways that states often cannot. CEPI is continuing to respond to the COVID-19 pandemic – optimising current vaccines and developing the next-generation of COVID-19 vaccines to respond to variants of concern. Simultaneously, however, CEPI is also preparing for future infectious disease threats through initiating the development of a) broadly protective coronavirus vaccines, b) advancing vaccines for other known infectious disease threats and c) producing a library of prototype vaccines and other biological interventions against representative pathogens from critical viral families. Building global capacity CEPI is also working to establish global networks for lab capacity, assays, and preclinical models that are critical for rapid vaccine development, and to support the efforts of low- and middle-income countries to take full ownership of their national health security. Taken together, these tools will support CEPI’s ambitious aim to compress vaccine development timelines to 100 days from genetic sequence to vaccine availability. The plan is developed, but it now needs funding. National contingency plans are only effective if they also pay attention to, and invest in, the international health security system. Investing in research and development for pandemic preparedness, both from domestic and foreign aid budgets, in an all-of-government strategy, is an efficient way to protect our future, as emerging infectious diseases require a similar kind of investment attention as other major threats, such as climate change or wars. Therefore, we need to establish a coordinated global R&D system where national and regional initiatives can complement each other, in order to avoid economic turmoil and save lives. One of the main priorities of UNITE Members, Members of Parliament and policymakers around the world is to protect the people they represent and they are therefore fundamental in this process. We can hold governments accountable and advocate for more investment in R&D for pandemic preparedness. We can also give political support for a strengthened future ecosystem through the work on a global accord, that secures appropriate funding for pandemic preparedness and makes sure that we put equitable access at the heart of the response. We have the technology. Now, we need the political leadership. UNITE Global Parliamentarians Network to End Infectious Diseases: Petra Bayr, Member of Parliament, Austria Jean François Mbaye, Former Member of Parliament, France Jean-Luc Romero Michel – Deputy-Mayor of Paris and President of Local Elected Representatives against AIDS Jean Spiri, Former Member of the Regional Council of Île-de-France Sara Cerdas, Member of the European Parliament, Portugal Juan Ignacio Echániz Salgado, Member of Parliament, Spain Lisa Cameron, Member of Parliament, UK Lia Quartapelle, Member of Parliament, Italy Sirpa Pietikäinen, Member of the European Parliament, Finland Andrew Ullmann, Member of Parliament, Germany Image Credits: Novavax, Sanofi. WHO Urges Universal Monkeypox Fight 30/08/2022 John Heilprin The World Health Organization’s top official in Europe says the monkeypox outbreak appears to be slowing in the region, and could be eliminated through universal effort. “There are encouraging early signs, as evidenced in France, Germany, Portugal, Spain, the U.K., and other countries, that the outbreak may be slowing,” WHO’s Regional Director for Europe Dr Hans Kluge told an online press briefing. “To move towards elimination in our region,” he said, “we need to urgently step up our efforts.” Kluge reported more than 22,000 confirmed cases of monkeypox across 43 countries and areas, representing more than a third of the global tally. His office is advising all governments and policymakers to join in efforts at controlling and eliminating monkeypox. “All countries — whether they currently have cases or not — need to implement a set of combined interventions towards this end,” Kluge said. “Yet we believe we can eliminate sustained human-to-human transmission of monkeypox in the region if we commit to doing so and put the needed resources towards that end,” he said. Monkeypox trends point to importance of earlier detection, isolation The global number of weekly new cases of monkeypox reported to WHO declined by 21% last week — the first such decline since the infection endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots. But there has been a global shortage of monkeypox vaccines. The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said last week. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned. The rollout of MVA-BN vaccine, made by Danish company Bavarian Nordic, has been hampered by limited supplies. In response, WHO is examining proposals to split scarce monkeypox vaccines doses to stretch supplies. The United States adopted that strategy earlier this month. The slowdown in monkeypox outbreak may be due to better detection and earlier isolation among some communities, said WHO Europe’s incident manager, Dr Catherine Smallwood. “We do have some pretty good anecdotal evidence that people — particularly men who have sex with men, who are in particular risk groups — are much more informed about the disease,” Smallwood said. Holistic monkeypox approach working well “Which really leads us to believe that a major change, at least for the moment, is contributing very significantly to them,” she said. “We need to build on that … and we firmly believe that if we continue to do that, we will be able to sustain this decline.” In Europe there are “early signs” that “this is going in the right direction, but it’s not enough,” Kluge said of the monkeypox outbreak. Kluge pointed to the example of Portugal, where the government’s community outreach and partnership efforts raised awareness, prompting people “to take precautions and modify their behavior, resulting in better health outcomes and helping curb the outbreak.” Monkeypox, which was long isolated in a few countries in Africa, broke out in Europe in early May but WHO waited until 10 weeks later to declare a public health emergency. Much like with AIDS, initially the most affected group has been gay and bisexual men. The cause of the early neglect towards monkeypox is rooted in homophobia, says Michael Weinstein, president of AIDS Healthcare Foundation (AHF), the largest global nonprofit AIDS organization. Kluge said the current outbreak in Europe emerged among men who have sex with men, often through sex with anonymous or multiple partners, and “that’s where the outbreak remains centered.” “And that’s where we must concentrate our prevention and response efforts — with the active collaboration and participation of the community itself, fostering an environment free of stigma and discrimination against this long-marginalized population,” he said. Swiss Approve 1st Booster for Variants 29/08/2022 John Heilprin Gavi, The Vaccine Alliance, will receive 500 million doses of the Moderna vaccine Swiss drugs regulator Swissmedic announced it has temporarily authorized the first bivalent Covid-19 booster vaccine in the country. That clears the way for an eagerly anticipated second round of booster vaccinations that should better target Omicron sub-variants. Moderna’s COVID-19 mRNA-1273.214 vaccine, Spikevax, is the first COVID-19 vaccine that contains messenger ribonucleic acid (mRNA) against two coronavirus variants known as BA.1 and BA.4/5, Swissmedic said Monday. It is authorized for anyone 18 years or older. “In trials, a booster dose with this bivalent vaccine demonstrated higher antibody concentrations against the Omicron variants than a booster with Spikevax, the original COVID-19 vaccine from Moderna, with comparable side effects,” the agency said. Federal vaccination and public health officials will now draw up plans to offer the vaccine to the Swiss public. It is administered as a single dose of 0.5 ml (50 micrograms). Side effects like fever, headaches and muscle pains are “similar to that seen following administration of the second dose (100 micrograms) or the booster (50 micrograms) of the original vaccine,” according to the Swiss regulator. COVID booster vaccines have gained traction in several countries – US, Israel, Germany, UK, and others, but low- and middle-income countries lag significantly behind in shots. Booster Meets Safety Standards The original Moderna vaccine worked against early COVID-19 strains such as Alpha and Delta, but it provided little immunity against Omicron or its sub-variants, which are now causing all of the coronavirus infections that are being detected in Switzerland. Swissmedic said its review shows the booster vaccine meets the safety, efficacy and quality requirements. It contains 25 micrograms of mRNA-1273 (original Spikevax) and 25 micrograms of mRNA that targets the Omicron variant BA.1. “Compared to the original vaccine, trials have shown that this produces a stronger immune response against the Omicron variants BA.1 and BA.4/5,” Swissmedic said. “The protective effect of the bivalent vaccine against the original SARS-CoV-2 virus (Wuhan type) measured in the antibody concentration is equivalent to the effect of the original vaccine (Spikevax),” it said. The original vaccines were designed to train the body to fight the virus in the form in which it first emerged from Wuhan, China, at the end of 2019. But the virus continues to mutate. Switzerland during COVID-19 pandemic. Swiss Booster Approval Follows U.K. Moderna and Pfizer and BioNTech have submitted applications to the US Food and Drug Administration for emergency use authorization of their updated Covid-19 vaccine boosters. Both are bivalent vaccines that combine the original vaccines with ones that target Omicron sub-variants BA.4 and BA.5, which are prevalent in the United States. BioNTech said earlier this month it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. Two weeks ago, the UK became the first country to approve a bivalent COVID-19 booster vaccine that works against both the original COVID-19 virus and the newer Omicron variant. An expert panel of advisers to the World Health Organization (WHO) recommended that countries consider a second COVID-19 booster dose for older, at-risk and immunocompromised people, echoing guidance from European and U.S. regulators. WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization released its updated recommendations for a second vaccine booster dose for all elderly people using age-specific cutoffs to be defined by each country. It also recommended a second booster for adults with comorbidities that put them at higher risk of severe disease, including pregnant women and health care workers. Image Credits: Gavi , Marco Verch/Flickr, Transformer18/Flickr. WHO Lists Entities That Can Engage with Pandemic Treaty Negotiating Body 29/08/2022 Kerry Cullinan WHO member states at the INB meeting taking place 18-22 July 2022 in Geneva A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument. The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness. “The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik. The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities. Environmental actors In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel. Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB. “In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview. “We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. “Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts. They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.” In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: “Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. Reactive not proactive list However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty. Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. Additional reporting by Elaine Fletcher. How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. 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.
Lack of Basic Hygiene Faulted in UN Report 30/08/2022 John Heilprin Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children, according to UNICEF. A new UN report showing that half of the world’s health care facilities fail to meet the basic standard for providing hygiene services like soap and water or an alcohol-based hand rub highlights the widespread global risk of disease spread and infections to patients and health care providers. About two-thirds of all health care facilities provide these services at the points of care or toilets but not at both, which is the basic standard. Only 51% meet that standard by providing both, says a new report Tuesday from the World Health Organization (WHO) and UNICEF. The report, “Progress on WASH in health care facilities 2000-2021: Special focus on WASH and infection prevention and control (IPC)“, focuses on data from 2000 to 2021 and finds that the lack of basic hygiene puts around 3.85 billion people who use these facilities at greater risk of infection. That includes 688 million whose facilities offer no basic hygiene services at all. Just 40 countries in the world kept their own national estimates for basic hygiene services last year Hygiene ‘non-negotiable’ Health officials say the situation likely will prolong the COVID-19 pandemic, monkeypox outbreak and other health crises. “Hygiene facilities and practices in health care settings are non-negotiable,” said Dr Maria Neira, director of WHO’s Department of Environment, Climate Change and Health. “Their improvement is essential to pandemic recovery, prevention and preparedness,” she said, urging nations to spend more for “basic measures, which include safe water, clean toilets, and safely managed health care waste.” That is in line with the 194-nation World Health Assembly’s commitment in 2019 to strengthen and monitor water, sanitation and hygiene services in health care facilities. WHO and UNICEF operate a Joint Monitoring Program that provides regional, national and global estimates of progress on drinking water, hygiene and sanitation. The latest report on hygiene covers 35% of the world’s population and 40 nations, up from 21 nations in 2020. Low-and-middle-income countries have made significantly less progress than high-income countries in implementing hand hygiene and infection prevention programmes that can stop deadly diseases, from diarrhoea to COVID-19, according to a recent WHO survey of 88 countries. “If health care providers don’t have access to a hygiene service, patients don’t have a health care facility,” said Kelly Ann Naylor, UNICEF’s director of Water, Sanitation and Hygiene (WASH) and Climate, Environment, Energy, and Disaster Risk Reduction (CEED). “Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children,” she said. “Every year, around 670,000 newborns lose their lives to sepsis. This is a travesty — even more so as their deaths are preventable.” Practical steps outlined by the joint WHO-UNICEF report to improving water, sanitation, and hygiene in health care facilities, and reduce risk to patients. In 2017, the World Health Assembly adopted a resolution to fight which is a life-threatening blood stream infection for which there is growing resistance. The Assembly, which is WHO’s governing body, acknowledged that antimicrobial resistance is a growing health concern and underlined the urgent need for new accessible and affordable antibiotics. The report finds the lack of basic hygiene is uneven across different regions and income groupings. Facilities in sub-Saharan Africa are lagging; 73% in the region have alcohol-based hand rub or water and soap at points of care, but only 37% have handwashing facilities with water and soap at toilets. Among hospitals, 87% have hand hygiene facilities at points of care. In the least developed countries, only 53% of health care facilities have access on-premises to a protected water source, the report says. That compares with 78% globally. Many health care facilities also lack basic environmental cleaning and safe segregation and disposal of health care waste, it says. Image Credits: WHO/UNICEF. Political Leaders Need to invest in Global Research & Development to Prepare for Next Pandemic 30/08/2022 CEPI & UNITE CEPI is helping to improve global laboratory capacity. Recently, the Coalition for Epidemic Preparedness (CEPI) launched a $3.5 billion plan of investment in ground-breaking R&D, linked to equitable access commitments, which aims to transform the world’s ability to respond to new epidemic and pandemic threats and catalyze cooperation across a coalition of public and private sector partners. As parliamentarians from across the European Union, we want to underscore the importance of governments’ role in actively supporting these kinds of global health preparedness plans at national level – with concrete investments and actions. The COVID-19 pandemic has demonstrated that multilateralism and solidarity are fundamental to address any global health threat and that governments must increase global solidarity and collaboration, ensuring fair and universal access to vaccines. The pandemic also has made us realize the impact that infectious diseases can have on our daily lives. And it is now more clear than ever that it is not possible to rebuild our societies unless we control the epidemiological risk and commit to a more robust and effective global epidemic and pandemic preparedness and response architecture. Investment in regional and international health security As each country discusses how to strengthen its own domestic preparedness and response, it is also crucial to be certain that those efforts feed into a stronger global ecosystem. Domestic plans will be of little worth if the infectious disease threats that loom now or rise up in the future continue to hover just across our borders. National contingency plans will only be effective if they also take into account and invest in the regional and international health security systems. As a globally recognised organising force for R&D collaboration and innovation, CEPI is uniquely placed to coordinate an international approach to the research and development of new vaccines and other tools that significantly reduce future epidemic and pandemic risks. CEPI offers a global focus and the agility to move quickly, extensive partnerships, and a proven track record with its rapid and effective action in response to the ongoing COVID-19 crisis. It is able to leverage its unique connecting role, being able to work with vaccine developers and manufacturers, national governments, philanthropies, civil society and global health organisations, with an extensive network to pool and deploy resources in ways that states often cannot. CEPI is continuing to respond to the COVID-19 pandemic – optimising current vaccines and developing the next-generation of COVID-19 vaccines to respond to variants of concern. Simultaneously, however, CEPI is also preparing for future infectious disease threats through initiating the development of a) broadly protective coronavirus vaccines, b) advancing vaccines for other known infectious disease threats and c) producing a library of prototype vaccines and other biological interventions against representative pathogens from critical viral families. Building global capacity CEPI is also working to establish global networks for lab capacity, assays, and preclinical models that are critical for rapid vaccine development, and to support the efforts of low- and middle-income countries to take full ownership of their national health security. Taken together, these tools will support CEPI’s ambitious aim to compress vaccine development timelines to 100 days from genetic sequence to vaccine availability. The plan is developed, but it now needs funding. National contingency plans are only effective if they also pay attention to, and invest in, the international health security system. Investing in research and development for pandemic preparedness, both from domestic and foreign aid budgets, in an all-of-government strategy, is an efficient way to protect our future, as emerging infectious diseases require a similar kind of investment attention as other major threats, such as climate change or wars. Therefore, we need to establish a coordinated global R&D system where national and regional initiatives can complement each other, in order to avoid economic turmoil and save lives. One of the main priorities of UNITE Members, Members of Parliament and policymakers around the world is to protect the people they represent and they are therefore fundamental in this process. We can hold governments accountable and advocate for more investment in R&D for pandemic preparedness. We can also give political support for a strengthened future ecosystem through the work on a global accord, that secures appropriate funding for pandemic preparedness and makes sure that we put equitable access at the heart of the response. We have the technology. Now, we need the political leadership. UNITE Global Parliamentarians Network to End Infectious Diseases: Petra Bayr, Member of Parliament, Austria Jean François Mbaye, Former Member of Parliament, France Jean-Luc Romero Michel – Deputy-Mayor of Paris and President of Local Elected Representatives against AIDS Jean Spiri, Former Member of the Regional Council of Île-de-France Sara Cerdas, Member of the European Parliament, Portugal Juan Ignacio Echániz Salgado, Member of Parliament, Spain Lisa Cameron, Member of Parliament, UK Lia Quartapelle, Member of Parliament, Italy Sirpa Pietikäinen, Member of the European Parliament, Finland Andrew Ullmann, Member of Parliament, Germany Image Credits: Novavax, Sanofi. WHO Urges Universal Monkeypox Fight 30/08/2022 John Heilprin The World Health Organization’s top official in Europe says the monkeypox outbreak appears to be slowing in the region, and could be eliminated through universal effort. “There are encouraging early signs, as evidenced in France, Germany, Portugal, Spain, the U.K., and other countries, that the outbreak may be slowing,” WHO’s Regional Director for Europe Dr Hans Kluge told an online press briefing. “To move towards elimination in our region,” he said, “we need to urgently step up our efforts.” Kluge reported more than 22,000 confirmed cases of monkeypox across 43 countries and areas, representing more than a third of the global tally. His office is advising all governments and policymakers to join in efforts at controlling and eliminating monkeypox. “All countries — whether they currently have cases or not — need to implement a set of combined interventions towards this end,” Kluge said. “Yet we believe we can eliminate sustained human-to-human transmission of monkeypox in the region if we commit to doing so and put the needed resources towards that end,” he said. Monkeypox trends point to importance of earlier detection, isolation The global number of weekly new cases of monkeypox reported to WHO declined by 21% last week — the first such decline since the infection endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots. But there has been a global shortage of monkeypox vaccines. The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said last week. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned. The rollout of MVA-BN vaccine, made by Danish company Bavarian Nordic, has been hampered by limited supplies. In response, WHO is examining proposals to split scarce monkeypox vaccines doses to stretch supplies. The United States adopted that strategy earlier this month. The slowdown in monkeypox outbreak may be due to better detection and earlier isolation among some communities, said WHO Europe’s incident manager, Dr Catherine Smallwood. “We do have some pretty good anecdotal evidence that people — particularly men who have sex with men, who are in particular risk groups — are much more informed about the disease,” Smallwood said. Holistic monkeypox approach working well “Which really leads us to believe that a major change, at least for the moment, is contributing very significantly to them,” she said. “We need to build on that … and we firmly believe that if we continue to do that, we will be able to sustain this decline.” In Europe there are “early signs” that “this is going in the right direction, but it’s not enough,” Kluge said of the monkeypox outbreak. Kluge pointed to the example of Portugal, where the government’s community outreach and partnership efforts raised awareness, prompting people “to take precautions and modify their behavior, resulting in better health outcomes and helping curb the outbreak.” Monkeypox, which was long isolated in a few countries in Africa, broke out in Europe in early May but WHO waited until 10 weeks later to declare a public health emergency. Much like with AIDS, initially the most affected group has been gay and bisexual men. The cause of the early neglect towards monkeypox is rooted in homophobia, says Michael Weinstein, president of AIDS Healthcare Foundation (AHF), the largest global nonprofit AIDS organization. Kluge said the current outbreak in Europe emerged among men who have sex with men, often through sex with anonymous or multiple partners, and “that’s where the outbreak remains centered.” “And that’s where we must concentrate our prevention and response efforts — with the active collaboration and participation of the community itself, fostering an environment free of stigma and discrimination against this long-marginalized population,” he said. Swiss Approve 1st Booster for Variants 29/08/2022 John Heilprin Gavi, The Vaccine Alliance, will receive 500 million doses of the Moderna vaccine Swiss drugs regulator Swissmedic announced it has temporarily authorized the first bivalent Covid-19 booster vaccine in the country. That clears the way for an eagerly anticipated second round of booster vaccinations that should better target Omicron sub-variants. Moderna’s COVID-19 mRNA-1273.214 vaccine, Spikevax, is the first COVID-19 vaccine that contains messenger ribonucleic acid (mRNA) against two coronavirus variants known as BA.1 and BA.4/5, Swissmedic said Monday. It is authorized for anyone 18 years or older. “In trials, a booster dose with this bivalent vaccine demonstrated higher antibody concentrations against the Omicron variants than a booster with Spikevax, the original COVID-19 vaccine from Moderna, with comparable side effects,” the agency said. Federal vaccination and public health officials will now draw up plans to offer the vaccine to the Swiss public. It is administered as a single dose of 0.5 ml (50 micrograms). Side effects like fever, headaches and muscle pains are “similar to that seen following administration of the second dose (100 micrograms) or the booster (50 micrograms) of the original vaccine,” according to the Swiss regulator. COVID booster vaccines have gained traction in several countries – US, Israel, Germany, UK, and others, but low- and middle-income countries lag significantly behind in shots. Booster Meets Safety Standards The original Moderna vaccine worked against early COVID-19 strains such as Alpha and Delta, but it provided little immunity against Omicron or its sub-variants, which are now causing all of the coronavirus infections that are being detected in Switzerland. Swissmedic said its review shows the booster vaccine meets the safety, efficacy and quality requirements. It contains 25 micrograms of mRNA-1273 (original Spikevax) and 25 micrograms of mRNA that targets the Omicron variant BA.1. “Compared to the original vaccine, trials have shown that this produces a stronger immune response against the Omicron variants BA.1 and BA.4/5,” Swissmedic said. “The protective effect of the bivalent vaccine against the original SARS-CoV-2 virus (Wuhan type) measured in the antibody concentration is equivalent to the effect of the original vaccine (Spikevax),” it said. The original vaccines were designed to train the body to fight the virus in the form in which it first emerged from Wuhan, China, at the end of 2019. But the virus continues to mutate. Switzerland during COVID-19 pandemic. Swiss Booster Approval Follows U.K. Moderna and Pfizer and BioNTech have submitted applications to the US Food and Drug Administration for emergency use authorization of their updated Covid-19 vaccine boosters. Both are bivalent vaccines that combine the original vaccines with ones that target Omicron sub-variants BA.4 and BA.5, which are prevalent in the United States. BioNTech said earlier this month it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. Two weeks ago, the UK became the first country to approve a bivalent COVID-19 booster vaccine that works against both the original COVID-19 virus and the newer Omicron variant. An expert panel of advisers to the World Health Organization (WHO) recommended that countries consider a second COVID-19 booster dose for older, at-risk and immunocompromised people, echoing guidance from European and U.S. regulators. WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization released its updated recommendations for a second vaccine booster dose for all elderly people using age-specific cutoffs to be defined by each country. It also recommended a second booster for adults with comorbidities that put them at higher risk of severe disease, including pregnant women and health care workers. Image Credits: Gavi , Marco Verch/Flickr, Transformer18/Flickr. WHO Lists Entities That Can Engage with Pandemic Treaty Negotiating Body 29/08/2022 Kerry Cullinan WHO member states at the INB meeting taking place 18-22 July 2022 in Geneva A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument. The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness. “The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik. The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities. Environmental actors In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel. Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB. “In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview. “We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. “Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts. They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.” In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: “Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. Reactive not proactive list However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty. Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. Additional reporting by Elaine Fletcher. How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. 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.
Political Leaders Need to invest in Global Research & Development to Prepare for Next Pandemic 30/08/2022 CEPI & UNITE CEPI is helping to improve global laboratory capacity. Recently, the Coalition for Epidemic Preparedness (CEPI) launched a $3.5 billion plan of investment in ground-breaking R&D, linked to equitable access commitments, which aims to transform the world’s ability to respond to new epidemic and pandemic threats and catalyze cooperation across a coalition of public and private sector partners. As parliamentarians from across the European Union, we want to underscore the importance of governments’ role in actively supporting these kinds of global health preparedness plans at national level – with concrete investments and actions. The COVID-19 pandemic has demonstrated that multilateralism and solidarity are fundamental to address any global health threat and that governments must increase global solidarity and collaboration, ensuring fair and universal access to vaccines. The pandemic also has made us realize the impact that infectious diseases can have on our daily lives. And it is now more clear than ever that it is not possible to rebuild our societies unless we control the epidemiological risk and commit to a more robust and effective global epidemic and pandemic preparedness and response architecture. Investment in regional and international health security As each country discusses how to strengthen its own domestic preparedness and response, it is also crucial to be certain that those efforts feed into a stronger global ecosystem. Domestic plans will be of little worth if the infectious disease threats that loom now or rise up in the future continue to hover just across our borders. National contingency plans will only be effective if they also take into account and invest in the regional and international health security systems. As a globally recognised organising force for R&D collaboration and innovation, CEPI is uniquely placed to coordinate an international approach to the research and development of new vaccines and other tools that significantly reduce future epidemic and pandemic risks. CEPI offers a global focus and the agility to move quickly, extensive partnerships, and a proven track record with its rapid and effective action in response to the ongoing COVID-19 crisis. It is able to leverage its unique connecting role, being able to work with vaccine developers and manufacturers, national governments, philanthropies, civil society and global health organisations, with an extensive network to pool and deploy resources in ways that states often cannot. CEPI is continuing to respond to the COVID-19 pandemic – optimising current vaccines and developing the next-generation of COVID-19 vaccines to respond to variants of concern. Simultaneously, however, CEPI is also preparing for future infectious disease threats through initiating the development of a) broadly protective coronavirus vaccines, b) advancing vaccines for other known infectious disease threats and c) producing a library of prototype vaccines and other biological interventions against representative pathogens from critical viral families. Building global capacity CEPI is also working to establish global networks for lab capacity, assays, and preclinical models that are critical for rapid vaccine development, and to support the efforts of low- and middle-income countries to take full ownership of their national health security. Taken together, these tools will support CEPI’s ambitious aim to compress vaccine development timelines to 100 days from genetic sequence to vaccine availability. The plan is developed, but it now needs funding. National contingency plans are only effective if they also pay attention to, and invest in, the international health security system. Investing in research and development for pandemic preparedness, both from domestic and foreign aid budgets, in an all-of-government strategy, is an efficient way to protect our future, as emerging infectious diseases require a similar kind of investment attention as other major threats, such as climate change or wars. Therefore, we need to establish a coordinated global R&D system where national and regional initiatives can complement each other, in order to avoid economic turmoil and save lives. One of the main priorities of UNITE Members, Members of Parliament and policymakers around the world is to protect the people they represent and they are therefore fundamental in this process. We can hold governments accountable and advocate for more investment in R&D for pandemic preparedness. We can also give political support for a strengthened future ecosystem through the work on a global accord, that secures appropriate funding for pandemic preparedness and makes sure that we put equitable access at the heart of the response. We have the technology. Now, we need the political leadership. UNITE Global Parliamentarians Network to End Infectious Diseases: Petra Bayr, Member of Parliament, Austria Jean François Mbaye, Former Member of Parliament, France Jean-Luc Romero Michel – Deputy-Mayor of Paris and President of Local Elected Representatives against AIDS Jean Spiri, Former Member of the Regional Council of Île-de-France Sara Cerdas, Member of the European Parliament, Portugal Juan Ignacio Echániz Salgado, Member of Parliament, Spain Lisa Cameron, Member of Parliament, UK Lia Quartapelle, Member of Parliament, Italy Sirpa Pietikäinen, Member of the European Parliament, Finland Andrew Ullmann, Member of Parliament, Germany Image Credits: Novavax, Sanofi. WHO Urges Universal Monkeypox Fight 30/08/2022 John Heilprin The World Health Organization’s top official in Europe says the monkeypox outbreak appears to be slowing in the region, and could be eliminated through universal effort. “There are encouraging early signs, as evidenced in France, Germany, Portugal, Spain, the U.K., and other countries, that the outbreak may be slowing,” WHO’s Regional Director for Europe Dr Hans Kluge told an online press briefing. “To move towards elimination in our region,” he said, “we need to urgently step up our efforts.” Kluge reported more than 22,000 confirmed cases of monkeypox across 43 countries and areas, representing more than a third of the global tally. His office is advising all governments and policymakers to join in efforts at controlling and eliminating monkeypox. “All countries — whether they currently have cases or not — need to implement a set of combined interventions towards this end,” Kluge said. “Yet we believe we can eliminate sustained human-to-human transmission of monkeypox in the region if we commit to doing so and put the needed resources towards that end,” he said. Monkeypox trends point to importance of earlier detection, isolation The global number of weekly new cases of monkeypox reported to WHO declined by 21% last week — the first such decline since the infection endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots. But there has been a global shortage of monkeypox vaccines. The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said last week. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned. The rollout of MVA-BN vaccine, made by Danish company Bavarian Nordic, has been hampered by limited supplies. In response, WHO is examining proposals to split scarce monkeypox vaccines doses to stretch supplies. The United States adopted that strategy earlier this month. The slowdown in monkeypox outbreak may be due to better detection and earlier isolation among some communities, said WHO Europe’s incident manager, Dr Catherine Smallwood. “We do have some pretty good anecdotal evidence that people — particularly men who have sex with men, who are in particular risk groups — are much more informed about the disease,” Smallwood said. Holistic monkeypox approach working well “Which really leads us to believe that a major change, at least for the moment, is contributing very significantly to them,” she said. “We need to build on that … and we firmly believe that if we continue to do that, we will be able to sustain this decline.” In Europe there are “early signs” that “this is going in the right direction, but it’s not enough,” Kluge said of the monkeypox outbreak. Kluge pointed to the example of Portugal, where the government’s community outreach and partnership efforts raised awareness, prompting people “to take precautions and modify their behavior, resulting in better health outcomes and helping curb the outbreak.” Monkeypox, which was long isolated in a few countries in Africa, broke out in Europe in early May but WHO waited until 10 weeks later to declare a public health emergency. Much like with AIDS, initially the most affected group has been gay and bisexual men. The cause of the early neglect towards monkeypox is rooted in homophobia, says Michael Weinstein, president of AIDS Healthcare Foundation (AHF), the largest global nonprofit AIDS organization. Kluge said the current outbreak in Europe emerged among men who have sex with men, often through sex with anonymous or multiple partners, and “that’s where the outbreak remains centered.” “And that’s where we must concentrate our prevention and response efforts — with the active collaboration and participation of the community itself, fostering an environment free of stigma and discrimination against this long-marginalized population,” he said. Swiss Approve 1st Booster for Variants 29/08/2022 John Heilprin Gavi, The Vaccine Alliance, will receive 500 million doses of the Moderna vaccine Swiss drugs regulator Swissmedic announced it has temporarily authorized the first bivalent Covid-19 booster vaccine in the country. That clears the way for an eagerly anticipated second round of booster vaccinations that should better target Omicron sub-variants. Moderna’s COVID-19 mRNA-1273.214 vaccine, Spikevax, is the first COVID-19 vaccine that contains messenger ribonucleic acid (mRNA) against two coronavirus variants known as BA.1 and BA.4/5, Swissmedic said Monday. It is authorized for anyone 18 years or older. “In trials, a booster dose with this bivalent vaccine demonstrated higher antibody concentrations against the Omicron variants than a booster with Spikevax, the original COVID-19 vaccine from Moderna, with comparable side effects,” the agency said. Federal vaccination and public health officials will now draw up plans to offer the vaccine to the Swiss public. It is administered as a single dose of 0.5 ml (50 micrograms). Side effects like fever, headaches and muscle pains are “similar to that seen following administration of the second dose (100 micrograms) or the booster (50 micrograms) of the original vaccine,” according to the Swiss regulator. COVID booster vaccines have gained traction in several countries – US, Israel, Germany, UK, and others, but low- and middle-income countries lag significantly behind in shots. Booster Meets Safety Standards The original Moderna vaccine worked against early COVID-19 strains such as Alpha and Delta, but it provided little immunity against Omicron or its sub-variants, which are now causing all of the coronavirus infections that are being detected in Switzerland. Swissmedic said its review shows the booster vaccine meets the safety, efficacy and quality requirements. It contains 25 micrograms of mRNA-1273 (original Spikevax) and 25 micrograms of mRNA that targets the Omicron variant BA.1. “Compared to the original vaccine, trials have shown that this produces a stronger immune response against the Omicron variants BA.1 and BA.4/5,” Swissmedic said. “The protective effect of the bivalent vaccine against the original SARS-CoV-2 virus (Wuhan type) measured in the antibody concentration is equivalent to the effect of the original vaccine (Spikevax),” it said. The original vaccines were designed to train the body to fight the virus in the form in which it first emerged from Wuhan, China, at the end of 2019. But the virus continues to mutate. Switzerland during COVID-19 pandemic. Swiss Booster Approval Follows U.K. Moderna and Pfizer and BioNTech have submitted applications to the US Food and Drug Administration for emergency use authorization of their updated Covid-19 vaccine boosters. Both are bivalent vaccines that combine the original vaccines with ones that target Omicron sub-variants BA.4 and BA.5, which are prevalent in the United States. BioNTech said earlier this month it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. Two weeks ago, the UK became the first country to approve a bivalent COVID-19 booster vaccine that works against both the original COVID-19 virus and the newer Omicron variant. An expert panel of advisers to the World Health Organization (WHO) recommended that countries consider a second COVID-19 booster dose for older, at-risk and immunocompromised people, echoing guidance from European and U.S. regulators. WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization released its updated recommendations for a second vaccine booster dose for all elderly people using age-specific cutoffs to be defined by each country. It also recommended a second booster for adults with comorbidities that put them at higher risk of severe disease, including pregnant women and health care workers. Image Credits: Gavi , Marco Verch/Flickr, Transformer18/Flickr. WHO Lists Entities That Can Engage with Pandemic Treaty Negotiating Body 29/08/2022 Kerry Cullinan WHO member states at the INB meeting taking place 18-22 July 2022 in Geneva A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument. The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness. “The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik. The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities. Environmental actors In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel. Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB. “In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview. “We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. “Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts. They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.” In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: “Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. Reactive not proactive list However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty. Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. Additional reporting by Elaine Fletcher. How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. 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 Urges Universal Monkeypox Fight 30/08/2022 John Heilprin The World Health Organization’s top official in Europe says the monkeypox outbreak appears to be slowing in the region, and could be eliminated through universal effort. “There are encouraging early signs, as evidenced in France, Germany, Portugal, Spain, the U.K., and other countries, that the outbreak may be slowing,” WHO’s Regional Director for Europe Dr Hans Kluge told an online press briefing. “To move towards elimination in our region,” he said, “we need to urgently step up our efforts.” Kluge reported more than 22,000 confirmed cases of monkeypox across 43 countries and areas, representing more than a third of the global tally. His office is advising all governments and policymakers to join in efforts at controlling and eliminating monkeypox. “All countries — whether they currently have cases or not — need to implement a set of combined interventions towards this end,” Kluge said. “Yet we believe we can eliminate sustained human-to-human transmission of monkeypox in the region if we commit to doing so and put the needed resources towards that end,” he said. Monkeypox trends point to importance of earlier detection, isolation The global number of weekly new cases of monkeypox reported to WHO declined by 21% last week — the first such decline since the infection endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots. But there has been a global shortage of monkeypox vaccines. The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said last week. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned. The rollout of MVA-BN vaccine, made by Danish company Bavarian Nordic, has been hampered by limited supplies. In response, WHO is examining proposals to split scarce monkeypox vaccines doses to stretch supplies. The United States adopted that strategy earlier this month. The slowdown in monkeypox outbreak may be due to better detection and earlier isolation among some communities, said WHO Europe’s incident manager, Dr Catherine Smallwood. “We do have some pretty good anecdotal evidence that people — particularly men who have sex with men, who are in particular risk groups — are much more informed about the disease,” Smallwood said. Holistic monkeypox approach working well “Which really leads us to believe that a major change, at least for the moment, is contributing very significantly to them,” she said. “We need to build on that … and we firmly believe that if we continue to do that, we will be able to sustain this decline.” In Europe there are “early signs” that “this is going in the right direction, but it’s not enough,” Kluge said of the monkeypox outbreak. Kluge pointed to the example of Portugal, where the government’s community outreach and partnership efforts raised awareness, prompting people “to take precautions and modify their behavior, resulting in better health outcomes and helping curb the outbreak.” Monkeypox, which was long isolated in a few countries in Africa, broke out in Europe in early May but WHO waited until 10 weeks later to declare a public health emergency. Much like with AIDS, initially the most affected group has been gay and bisexual men. The cause of the early neglect towards monkeypox is rooted in homophobia, says Michael Weinstein, president of AIDS Healthcare Foundation (AHF), the largest global nonprofit AIDS organization. Kluge said the current outbreak in Europe emerged among men who have sex with men, often through sex with anonymous or multiple partners, and “that’s where the outbreak remains centered.” “And that’s where we must concentrate our prevention and response efforts — with the active collaboration and participation of the community itself, fostering an environment free of stigma and discrimination against this long-marginalized population,” he said. Swiss Approve 1st Booster for Variants 29/08/2022 John Heilprin Gavi, The Vaccine Alliance, will receive 500 million doses of the Moderna vaccine Swiss drugs regulator Swissmedic announced it has temporarily authorized the first bivalent Covid-19 booster vaccine in the country. That clears the way for an eagerly anticipated second round of booster vaccinations that should better target Omicron sub-variants. Moderna’s COVID-19 mRNA-1273.214 vaccine, Spikevax, is the first COVID-19 vaccine that contains messenger ribonucleic acid (mRNA) against two coronavirus variants known as BA.1 and BA.4/5, Swissmedic said Monday. It is authorized for anyone 18 years or older. “In trials, a booster dose with this bivalent vaccine demonstrated higher antibody concentrations against the Omicron variants than a booster with Spikevax, the original COVID-19 vaccine from Moderna, with comparable side effects,” the agency said. Federal vaccination and public health officials will now draw up plans to offer the vaccine to the Swiss public. It is administered as a single dose of 0.5 ml (50 micrograms). Side effects like fever, headaches and muscle pains are “similar to that seen following administration of the second dose (100 micrograms) or the booster (50 micrograms) of the original vaccine,” according to the Swiss regulator. COVID booster vaccines have gained traction in several countries – US, Israel, Germany, UK, and others, but low- and middle-income countries lag significantly behind in shots. Booster Meets Safety Standards The original Moderna vaccine worked against early COVID-19 strains such as Alpha and Delta, but it provided little immunity against Omicron or its sub-variants, which are now causing all of the coronavirus infections that are being detected in Switzerland. Swissmedic said its review shows the booster vaccine meets the safety, efficacy and quality requirements. It contains 25 micrograms of mRNA-1273 (original Spikevax) and 25 micrograms of mRNA that targets the Omicron variant BA.1. “Compared to the original vaccine, trials have shown that this produces a stronger immune response against the Omicron variants BA.1 and BA.4/5,” Swissmedic said. “The protective effect of the bivalent vaccine against the original SARS-CoV-2 virus (Wuhan type) measured in the antibody concentration is equivalent to the effect of the original vaccine (Spikevax),” it said. The original vaccines were designed to train the body to fight the virus in the form in which it first emerged from Wuhan, China, at the end of 2019. But the virus continues to mutate. Switzerland during COVID-19 pandemic. Swiss Booster Approval Follows U.K. Moderna and Pfizer and BioNTech have submitted applications to the US Food and Drug Administration for emergency use authorization of their updated Covid-19 vaccine boosters. Both are bivalent vaccines that combine the original vaccines with ones that target Omicron sub-variants BA.4 and BA.5, which are prevalent in the United States. BioNTech said earlier this month it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. Two weeks ago, the UK became the first country to approve a bivalent COVID-19 booster vaccine that works against both the original COVID-19 virus and the newer Omicron variant. An expert panel of advisers to the World Health Organization (WHO) recommended that countries consider a second COVID-19 booster dose for older, at-risk and immunocompromised people, echoing guidance from European and U.S. regulators. WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization released its updated recommendations for a second vaccine booster dose for all elderly people using age-specific cutoffs to be defined by each country. It also recommended a second booster for adults with comorbidities that put them at higher risk of severe disease, including pregnant women and health care workers. Image Credits: Gavi , Marco Verch/Flickr, Transformer18/Flickr. WHO Lists Entities That Can Engage with Pandemic Treaty Negotiating Body 29/08/2022 Kerry Cullinan WHO member states at the INB meeting taking place 18-22 July 2022 in Geneva A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument. The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness. “The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik. The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities. Environmental actors In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel. Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB. “In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview. “We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. “Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts. They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.” In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: “Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. Reactive not proactive list However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty. Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. Additional reporting by Elaine Fletcher. How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. 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.
Swiss Approve 1st Booster for Variants 29/08/2022 John Heilprin Gavi, The Vaccine Alliance, will receive 500 million doses of the Moderna vaccine Swiss drugs regulator Swissmedic announced it has temporarily authorized the first bivalent Covid-19 booster vaccine in the country. That clears the way for an eagerly anticipated second round of booster vaccinations that should better target Omicron sub-variants. Moderna’s COVID-19 mRNA-1273.214 vaccine, Spikevax, is the first COVID-19 vaccine that contains messenger ribonucleic acid (mRNA) against two coronavirus variants known as BA.1 and BA.4/5, Swissmedic said Monday. It is authorized for anyone 18 years or older. “In trials, a booster dose with this bivalent vaccine demonstrated higher antibody concentrations against the Omicron variants than a booster with Spikevax, the original COVID-19 vaccine from Moderna, with comparable side effects,” the agency said. Federal vaccination and public health officials will now draw up plans to offer the vaccine to the Swiss public. It is administered as a single dose of 0.5 ml (50 micrograms). Side effects like fever, headaches and muscle pains are “similar to that seen following administration of the second dose (100 micrograms) or the booster (50 micrograms) of the original vaccine,” according to the Swiss regulator. COVID booster vaccines have gained traction in several countries – US, Israel, Germany, UK, and others, but low- and middle-income countries lag significantly behind in shots. Booster Meets Safety Standards The original Moderna vaccine worked against early COVID-19 strains such as Alpha and Delta, but it provided little immunity against Omicron or its sub-variants, which are now causing all of the coronavirus infections that are being detected in Switzerland. Swissmedic said its review shows the booster vaccine meets the safety, efficacy and quality requirements. It contains 25 micrograms of mRNA-1273 (original Spikevax) and 25 micrograms of mRNA that targets the Omicron variant BA.1. “Compared to the original vaccine, trials have shown that this produces a stronger immune response against the Omicron variants BA.1 and BA.4/5,” Swissmedic said. “The protective effect of the bivalent vaccine against the original SARS-CoV-2 virus (Wuhan type) measured in the antibody concentration is equivalent to the effect of the original vaccine (Spikevax),” it said. The original vaccines were designed to train the body to fight the virus in the form in which it first emerged from Wuhan, China, at the end of 2019. But the virus continues to mutate. Switzerland during COVID-19 pandemic. Swiss Booster Approval Follows U.K. Moderna and Pfizer and BioNTech have submitted applications to the US Food and Drug Administration for emergency use authorization of their updated Covid-19 vaccine boosters. Both are bivalent vaccines that combine the original vaccines with ones that target Omicron sub-variants BA.4 and BA.5, which are prevalent in the United States. BioNTech said earlier this month it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. Two weeks ago, the UK became the first country to approve a bivalent COVID-19 booster vaccine that works against both the original COVID-19 virus and the newer Omicron variant. An expert panel of advisers to the World Health Organization (WHO) recommended that countries consider a second COVID-19 booster dose for older, at-risk and immunocompromised people, echoing guidance from European and U.S. regulators. WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization released its updated recommendations for a second vaccine booster dose for all elderly people using age-specific cutoffs to be defined by each country. It also recommended a second booster for adults with comorbidities that put them at higher risk of severe disease, including pregnant women and health care workers. Image Credits: Gavi , Marco Verch/Flickr, Transformer18/Flickr. WHO Lists Entities That Can Engage with Pandemic Treaty Negotiating Body 29/08/2022 Kerry Cullinan WHO member states at the INB meeting taking place 18-22 July 2022 in Geneva A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument. The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness. “The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik. The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities. Environmental actors In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel. Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB. “In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview. “We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. “Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts. They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.” In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: “Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. Reactive not proactive list However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty. Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. Additional reporting by Elaine Fletcher. How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. 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 Lists Entities That Can Engage with Pandemic Treaty Negotiating Body 29/08/2022 Kerry Cullinan WHO member states at the INB meeting taking place 18-22 July 2022 in Geneva A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument. The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness. “The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik. The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities. Environmental actors In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel. Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB. “In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview. “We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. “Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts. They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.” In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: “Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. Reactive not proactive list However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty. Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. Additional reporting by Elaine Fletcher. How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. 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.
How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. 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.
Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. 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
Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. Posts navigation Older postsNewer posts