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. Trick or Treat? Artificial Sweeteners Impact Gut Bacteria, Could Alter Glucose Tolerance – Study 26/08/2022 Maayan Hoffman Sugar is more deadly than gunpowder Non-nutritive artificial sweeteners duplicate the taste of sugar but have fewer calories. As such, sugar alternatives like saccharin, sucralose, aspartame and stevia are often consumed in large quantities by people looking to watch their weight or shed a few pounds. But a team of researchers from Israel’s Weizmann Institute of Science said these alternative sugars should no longer be assumed safe because they can cause harm. In some people, they alter their microbiome (gut bacteria) and change blood sugar levels. “Our trial has shown that non-nutritive sweeteners may impair glucose responses by altering our microbiome, and they do so in a highly personalized manner, that is, by affecting each person in a unique way,” said Prof. Eran Elinav of Weizmann’s Systems Immunology Department, who led the study. Altering the Composition and Function of the Biome with Artificial Sweeteners Building off an animal trial conducted in 2014 that showed that some artificial sweeteners might contribute to changes in the sugar metabolism they are meant to prevent, a new team of researchers worked with 120 people who avoided artificially sweetened foods or drinks. The volunteers were divided into six groups: two controls and four who received one of four artificial sweeteners – saccharin, sucralose, aspartame or stevia – at lower than acceptable daily intake levels. In just two weeks, the researchers found consuming any of the sweeteners altered the composition and function of the microbiome and the small molecules that the gut microbes secrete into people’s blood. Moreover, saccharin and sucralose were found to alter glucose metabolism – the way a person disposes of glucose – which could contribute to metabolic disease, they said. No changes in either the microbiome or glucose tolerance were found in the two control groups that did not consume any alternative sugars. The findings were published on August 19 in the peer-reviewed journal Cell. “These findings reinforce the view of the microbiome as a hub that integrates the signals coming from the human body’s own systems and from external factors such as the food we eat, the medications we take, our lifestyle and physical surroundings,” Elinav said. Changes in the composition and function of gut microbes were observed in all four groups of trial participants who consumed non-nutritive sweeteners. Each group consumed one of the following: saccharine, sucralose, stevia or aspartame. The diagram shows increases in glucose levels in the saccharin and sucralose groups (two graphs on the left), compared to the stevia and aspartame groups (middle) and to the two control groups (right) Still Unproven That Sugar Is Healthier To help validate their findings and confirm that changes in the microbiome were responsible for impaired glucose tolerance, the researchers next implanted feces from more than 40 of the trial participants into healthy mice who were bred to have no gut bacteria of their own and who had never consumed artificial sweeteners. Those who received microbes from participants with the most pronounced alterations in glucose tolerance had more alterations in glucose tolerance themselves. This was compared to those mice that received microbes from people who had the least changes in glucose tolerance, and also had less changes. “The health implications of the changes that non-nutritive sweeteners may elicit in humans remain to be determined, and they merit new, long-term studies,” Elinav said. Previous studies have shown the detriments of eating artificial sweeteners, including weight gain, brain tumors and cancer. A BMJ study by French researchers in 2019 reinforced the link between consumption of sugar-laced sodas & fruit juices and cancer incidence, in particular breast cancer. Nonetheless, Elinav cautioned, the findings of this latest study do not imply that sugar is healthier than alternative sugars. Image Credits: Marco Verch. First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been 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, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. NEJM Study: Pfizer’s Paxlovid Reduces COVID-19 Death by 81% in Older Adults, Not Effective in Younger Patients 24/08/2022 Maayan Hoffman Pfizer’s Paxlovid, an oral antiviral, has been found to reduce the mortality rate in older adults. Pfizer’s COVID-19 oral antiviral Paxlovid was found to reduce the mortality rate among people over the age of 65 by 81% in a new Israeli study published Wednesday in the New England Journal of Medicine. However, the study also found no significant benefit of the drug in patients aged 64 and younger. It is the first peer-reviewed study on the effectiveness of the drug in real-world conditions, one of its lead researchers told Health Policy Watch. The study also differs from the Pfizer clinical trials on the drug that were conducted during the Delta wave, and on patients who were unvaccinated. The Israeli study took place during the Omicron wave, and the majority of patients had been fully vaccinated with three jabs of the Pfizer Covid-19 vaccine. The study is peer-reviewed and a fuller version of data first published in June on the Research Gate Platform. The researchers also found a 73% reduction in hospitalization rate compared to the control group. Hospitalization and Mortality Rates Paxlovid To arrive at their results, the team of researchers analyzed Clalit electronic health records of high-risk patients over the age of 40 with advanced statistical methods between 9 January and 10 March of this year. During this period, 3,902 COVID-19 patients received Paxlovid via Clalit. The researchers compared the hospitalization and mortality rates among Covid patients who took the medicine and COVID patients who did not take the medicine (the control group). The Pfizer clinical trial found that Paxlovid was 89% effective in patients at risk of serious illness, the company reported at the end of 2021. As noted, the Clalit rate of effectiveness was much lower. However, Dr Ronen Arbel, Health Outcomes Researcher at Clalit Health Services and Sapir College, told Health Policy Watch that “if you want to compare apples to apples, you have to look at the minority of patients in our study who were unvaccinated and over the age of 65. If you look at them, the effectiveness is much more similar [to the Pfizer study]. “It is when you look at the majority of the patients, while the effect is significant, it is much smaller,” he said. Clalit has distributed more Paxlovid than any other health fund in Israel, according to Dr Doron Netzer, Chief Medical Officer of Clalit’s Community Health Division. In total, some 30,000 Israelis have received the drug. In March, a Medicines Patent Pool (MPP) announced it had signed agreements with 35 companies to manufacture generic versions of Paxlovid for distribution in 95 low- and middle-income countries. But that came under fire almost immediately from medicines access groups as too little, too late. Reported Significant Reduction in Risk of Hospitalization and Death In Israel, the drug is prescribed to COVID-19 patients aged 12 and older with mild to moderate symptoms who are at high risk for complications of Covid-19. The treatment is given for five days, as close as possible to the date that a positive COVID-19 test is received. “The results if the study show unequivocally that treatment with Paxlovid significantly reduces the risk of hospitalization and death from Covid-19 in those over the age of 65,” Netzer said. “The decision of the Health Ministry to allow this treatment saved many lives.” Earlier this month, the US Food and Drug Administration called on Pfizer to test another course of Paxlovid for those who have rebounded and tested positive after an initial dose. It also requested that Pfizer hold a clinical trial to evaluate different durations of treatment in immunocompromised patients with mild-to-moderate disease, Health Policy Watch reported. Pfizer told Bloomberg News that the trial protocol is expected to be finalized this month. Arbel said that the Clalit study did not examine these questions due to limitations in its data. Image Credits: Pfizer , Bobbi-Jean MacKinnon. Health System “Shaken” by Ukraine War 24/08/2022 John Heilprin COVID-19 patient in severe state in Chernivtsi, southwestern Ukraine. As the SARS-CoV2 pandemic wanes, health services must deal with a health emergency – created solely by human forces. Six months into the Ukraine war, the World Health Organization warns that the nation’s battered but “still-resilient” health system is facing “severe challenges and shortages in many areas” that must be dealt with as the nation prepares for a challenging winter. WHO officials marked the half-year point in the war, which coincided with Ukraine’s Independence Day, with a somber reflection on the state of the nation’s life-saving health system. The UN healthy agency says Ukraine has a “badly affected but still-resilient health system” even as attacks on it continue. Since the war began with Russia’s invasion on February 24, WHO says it has verified 473 attacks carried out on health systems, including facilities and personnel, resulting in at least 98 deaths and 134 injuries. In May, the World Health Assembly approved a resolution condemning the Ukraine war by 88 votes to 12. But the 53 abstentions reflected the discomfort of many member states with a debate that polarised the global health body. Most African nations abstained, as did many Middle Eastern nations, India and Pakistan. Most of Europe, the United States, Oceania and many Latin American countries supported the Ukrainian-backed resolution, which condemns “in the strongest terms, Russian Federation’s military aggression against Ukraine, including attacks on health care facilities.” Empty hospital beds line the hallways of the Kyiv Regional Perinatal Centre, Ukraine, on 7 March 2022. As hospitals are disrupted or destroyed, online healthcare services can mitigate gaps. Health System “Shaken” by Ukraine War, But Not “Collapsed” WHO says it is supporting Ukraine’s Ministry of Health in the Ukraine war by helping to restore disrupted services, displaced health workers and destroyed infrastructure. It also helped the ministry and partners deliver more than 1300 metric tonnes of medical supplies, WHO says, including power generators, ambulances and oxygen supplies for medical facilities. The UN health agency says those deliveries also include supplies for trauma and emergency surgeries and medicines to help treat noncommunicable diseases (NCDs). “Six months of war have had a devastating impact on the health and lives of Ukraine’s people, but despite many challenges the health system has managed to survive and deliver care where and when it is needed most,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Though shaken, the health system has not collapsed,” he said. “But no system can deliver optimum health to its people under the stress of war, which is why we continue to call on the Russian Federation to end this war.” After six months of war, #Ukraine’s badly affected but still-resilient health system is taking stock of lessons learnt in providing lifesaving care as it prepares for a challenging winter ahead.@WHO and partners are ready to provide continued support.https://t.co/Ezsrc5qgGe pic.twitter.com/caTNNgXkUk — WHO Ukraine (@WHOUkraine) August 24, 2022 Ukraine War’s “Horror” Demands Mental Health Response Dr Hans Henri Kluge, WHO Regional Director for Europe, said attacks on health care violate international humanitarian law and are “unconscionable” because they kill and maim civilians and health-care providers, and severely hinder or prevent the delivery of health care services to those who needed it most. “Amid the horror of war,” he said, “we continue to witness the heroic efforts of health providers – including the many I’ve been privileged to meet in person myself – who are such a credit to their profession despite their own personal suffering.” WHO also has helped train more than 9000 health care workers. Areas of focus include trauma surgery, mass casualties, chemical exposure, epidemiology and laboratory diagnostics. But mental health, including stress management for health care workers and the public, is a priority in the Ukraine war. “WHO is stepping up its efforts with the Ministry of Health to ensure that the health workforce is prepared with the necessary skills to respond to mounting needs as winter approaches,” said Dr Jarno Habicht, WHO Representative in Ukraine. “We’re already seeing severe challenges and shortages in many areas, with rising inequalities in access to health and other essentials, impacting, as always, the most vulnerable – women, children and the elderly,” said Habicht. “Even as we look to a time when peace is restored,” he said, “we must focus on the here and now – the next six months could test Ukraine’s health system as never before.” A destroyed tank is abandoned on the road to Bucha, Ukraine. Image Credits: Mstyslav Chernov/ Wikimedia Commons, UNICEF/Oleksandr Ratushniak, Marco Frattini/ World Food Program. Pfizer Submits Reguest to US FDA for Approval of Omicron-targeted COVID Booster Shot 23/08/2022 Zachary Brennan, via Endpoints News Albert Bourla, CEO of Pfizer, at a World Economic Forum meeting in 2018. The Omicron-targeted boosters are coming. Almost 250 days since Omicron became the dominant variant in the US, Pfizer and BioNTech on Monday officially announced that they’ve requested an Emergency Use Authorization (EUA) from the US Food and Drug Administration for their booster dose of an Omicron BA.4/BA.5-adapted bivalent vaccine for those 12 and older. The application’s submission comes as BioNTech said earlier this month that it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. The FDA’s vaccine advisory committee in late June gave the thumbs up — by a vote of 19-2 — to requiring an Omicron-related component in this season’s booster dose; both Pfizer/BioNTech and Moderna have been working on such boosters over the past few months. The EUA for Pfizer/BioNTech’s booster would be based on preclinical data showing that it generated a strong neutralizing antibody response against the BA.4/BA.5 variants, as well as safety, tolerability and immunogenicity data from a Phase II/III trial of a 30-µg booster dose of the companies’ other, Omicron BA.1-adapted bivalent vaccine candidate. A clinical study investigating the safety, tolerability and immunogenicity of the Omicron BA.4/BA.5-adapted bivalent vaccine in individuals 12 years of age and older is expected to start this month, Pfizer and BioNTech said. FDA to Pfizer: Test another course of Paxlovid for those rebounding In other COVID-related drug developments, the FDA earlier this month quietly called on Pfizer to test another course of its Covid-19 antiviral Paxlovid for those who have rebounded and tested positive after an initial dose. On Aug. 5, the FDA reissued its EUA letter for Paxlovid to include additional post-authorization requirements, including calling on Pfizer “to conduct a clinical trial in patients with ‘COVID-19 rebound’ and a clinical trial evaluating different durations of treatment in immunocompromised patients with mild-to-moderate Covid-19.” Pfizer told Bloomberg News that it is “working with the FDA to finalize a protocol to study patients who may be in need of retreatment,” and the trial protocol is expected to be finalized this month. FDA expands Novavax EUA for teenagers Additionally, US teenagers looking for an option outside of the mRNA Covid-19 vaccines will now be able to turn to Novavax’s Covid-19 vaccine which won an expanded EUA on Friday from the FDA. Those aged 12 through 17 will gain access to the Novavax vaccine after the company submitted data from an ongoing pediatric expansion of its Phase III trial of 2,247 adolescents within that same age range across 75 sites in the US. The company said that in this population the vaccine achieved its primary efficacy endpoint, with clinical efficacy of about 78% (95% CI: 37.55%, 92.45%) overall, at a time when the Delta variant was the predominant circulating variant. The efficacy analysis was supported by assessment of antibody titers that were shown to be higher in adolescents than in young adults, Novavax added. Canada buys 12M doses of Moderna’s Omicron-targeted booster Meanwhile, mRNA powerhouse Moderna said Monday that Canada’s government has exercised its option to purchase an additional 4.5 million doses of an Omicron-containing bivalent vaccine booster candidate, in addition to moving forward the scheduled delivery of 1.5 million doses of the bivalent vaccine candidate from 2023 to 2022. Moderna and Canada also agreed to shift six million doses of the current vaccine to the Omicron-containing vaccine, subject to regulatory approval, with doses scheduled for delivery this year. The vaccine is expected to be ready for deployment in the US in October. ______________________________________________________ This article was first published by Endpoints News. Image Credits: Flickr – World Economic Forum. WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Trick or Treat? Artificial Sweeteners Impact Gut Bacteria, Could Alter Glucose Tolerance – Study 26/08/2022 Maayan Hoffman Sugar is more deadly than gunpowder Non-nutritive artificial sweeteners duplicate the taste of sugar but have fewer calories. As such, sugar alternatives like saccharin, sucralose, aspartame and stevia are often consumed in large quantities by people looking to watch their weight or shed a few pounds. But a team of researchers from Israel’s Weizmann Institute of Science said these alternative sugars should no longer be assumed safe because they can cause harm. In some people, they alter their microbiome (gut bacteria) and change blood sugar levels. “Our trial has shown that non-nutritive sweeteners may impair glucose responses by altering our microbiome, and they do so in a highly personalized manner, that is, by affecting each person in a unique way,” said Prof. Eran Elinav of Weizmann’s Systems Immunology Department, who led the study. Altering the Composition and Function of the Biome with Artificial Sweeteners Building off an animal trial conducted in 2014 that showed that some artificial sweeteners might contribute to changes in the sugar metabolism they are meant to prevent, a new team of researchers worked with 120 people who avoided artificially sweetened foods or drinks. The volunteers were divided into six groups: two controls and four who received one of four artificial sweeteners – saccharin, sucralose, aspartame or stevia – at lower than acceptable daily intake levels. In just two weeks, the researchers found consuming any of the sweeteners altered the composition and function of the microbiome and the small molecules that the gut microbes secrete into people’s blood. Moreover, saccharin and sucralose were found to alter glucose metabolism – the way a person disposes of glucose – which could contribute to metabolic disease, they said. No changes in either the microbiome or glucose tolerance were found in the two control groups that did not consume any alternative sugars. The findings were published on August 19 in the peer-reviewed journal Cell. “These findings reinforce the view of the microbiome as a hub that integrates the signals coming from the human body’s own systems and from external factors such as the food we eat, the medications we take, our lifestyle and physical surroundings,” Elinav said. Changes in the composition and function of gut microbes were observed in all four groups of trial participants who consumed non-nutritive sweeteners. Each group consumed one of the following: saccharine, sucralose, stevia or aspartame. The diagram shows increases in glucose levels in the saccharin and sucralose groups (two graphs on the left), compared to the stevia and aspartame groups (middle) and to the two control groups (right) Still Unproven That Sugar Is Healthier To help validate their findings and confirm that changes in the microbiome were responsible for impaired glucose tolerance, the researchers next implanted feces from more than 40 of the trial participants into healthy mice who were bred to have no gut bacteria of their own and who had never consumed artificial sweeteners. Those who received microbes from participants with the most pronounced alterations in glucose tolerance had more alterations in glucose tolerance themselves. This was compared to those mice that received microbes from people who had the least changes in glucose tolerance, and also had less changes. “The health implications of the changes that non-nutritive sweeteners may elicit in humans remain to be determined, and they merit new, long-term studies,” Elinav said. Previous studies have shown the detriments of eating artificial sweeteners, including weight gain, brain tumors and cancer. A BMJ study by French researchers in 2019 reinforced the link between consumption of sugar-laced sodas & fruit juices and cancer incidence, in particular breast cancer. Nonetheless, Elinav cautioned, the findings of this latest study do not imply that sugar is healthier than alternative sugars. Image Credits: Marco Verch. First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been 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, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. NEJM Study: Pfizer’s Paxlovid Reduces COVID-19 Death by 81% in Older Adults, Not Effective in Younger Patients 24/08/2022 Maayan Hoffman Pfizer’s Paxlovid, an oral antiviral, has been found to reduce the mortality rate in older adults. Pfizer’s COVID-19 oral antiviral Paxlovid was found to reduce the mortality rate among people over the age of 65 by 81% in a new Israeli study published Wednesday in the New England Journal of Medicine. However, the study also found no significant benefit of the drug in patients aged 64 and younger. It is the first peer-reviewed study on the effectiveness of the drug in real-world conditions, one of its lead researchers told Health Policy Watch. The study also differs from the Pfizer clinical trials on the drug that were conducted during the Delta wave, and on patients who were unvaccinated. The Israeli study took place during the Omicron wave, and the majority of patients had been fully vaccinated with three jabs of the Pfizer Covid-19 vaccine. The study is peer-reviewed and a fuller version of data first published in June on the Research Gate Platform. The researchers also found a 73% reduction in hospitalization rate compared to the control group. Hospitalization and Mortality Rates Paxlovid To arrive at their results, the team of researchers analyzed Clalit electronic health records of high-risk patients over the age of 40 with advanced statistical methods between 9 January and 10 March of this year. During this period, 3,902 COVID-19 patients received Paxlovid via Clalit. The researchers compared the hospitalization and mortality rates among Covid patients who took the medicine and COVID patients who did not take the medicine (the control group). The Pfizer clinical trial found that Paxlovid was 89% effective in patients at risk of serious illness, the company reported at the end of 2021. As noted, the Clalit rate of effectiveness was much lower. However, Dr Ronen Arbel, Health Outcomes Researcher at Clalit Health Services and Sapir College, told Health Policy Watch that “if you want to compare apples to apples, you have to look at the minority of patients in our study who were unvaccinated and over the age of 65. If you look at them, the effectiveness is much more similar [to the Pfizer study]. “It is when you look at the majority of the patients, while the effect is significant, it is much smaller,” he said. Clalit has distributed more Paxlovid than any other health fund in Israel, according to Dr Doron Netzer, Chief Medical Officer of Clalit’s Community Health Division. In total, some 30,000 Israelis have received the drug. In March, a Medicines Patent Pool (MPP) announced it had signed agreements with 35 companies to manufacture generic versions of Paxlovid for distribution in 95 low- and middle-income countries. But that came under fire almost immediately from medicines access groups as too little, too late. Reported Significant Reduction in Risk of Hospitalization and Death In Israel, the drug is prescribed to COVID-19 patients aged 12 and older with mild to moderate symptoms who are at high risk for complications of Covid-19. The treatment is given for five days, as close as possible to the date that a positive COVID-19 test is received. “The results if the study show unequivocally that treatment with Paxlovid significantly reduces the risk of hospitalization and death from Covid-19 in those over the age of 65,” Netzer said. “The decision of the Health Ministry to allow this treatment saved many lives.” Earlier this month, the US Food and Drug Administration called on Pfizer to test another course of Paxlovid for those who have rebounded and tested positive after an initial dose. It also requested that Pfizer hold a clinical trial to evaluate different durations of treatment in immunocompromised patients with mild-to-moderate disease, Health Policy Watch reported. Pfizer told Bloomberg News that the trial protocol is expected to be finalized this month. Arbel said that the Clalit study did not examine these questions due to limitations in its data. Image Credits: Pfizer , Bobbi-Jean MacKinnon. Health System “Shaken” by Ukraine War 24/08/2022 John Heilprin COVID-19 patient in severe state in Chernivtsi, southwestern Ukraine. As the SARS-CoV2 pandemic wanes, health services must deal with a health emergency – created solely by human forces. Six months into the Ukraine war, the World Health Organization warns that the nation’s battered but “still-resilient” health system is facing “severe challenges and shortages in many areas” that must be dealt with as the nation prepares for a challenging winter. WHO officials marked the half-year point in the war, which coincided with Ukraine’s Independence Day, with a somber reflection on the state of the nation’s life-saving health system. The UN healthy agency says Ukraine has a “badly affected but still-resilient health system” even as attacks on it continue. Since the war began with Russia’s invasion on February 24, WHO says it has verified 473 attacks carried out on health systems, including facilities and personnel, resulting in at least 98 deaths and 134 injuries. In May, the World Health Assembly approved a resolution condemning the Ukraine war by 88 votes to 12. But the 53 abstentions reflected the discomfort of many member states with a debate that polarised the global health body. Most African nations abstained, as did many Middle Eastern nations, India and Pakistan. Most of Europe, the United States, Oceania and many Latin American countries supported the Ukrainian-backed resolution, which condemns “in the strongest terms, Russian Federation’s military aggression against Ukraine, including attacks on health care facilities.” Empty hospital beds line the hallways of the Kyiv Regional Perinatal Centre, Ukraine, on 7 March 2022. As hospitals are disrupted or destroyed, online healthcare services can mitigate gaps. Health System “Shaken” by Ukraine War, But Not “Collapsed” WHO says it is supporting Ukraine’s Ministry of Health in the Ukraine war by helping to restore disrupted services, displaced health workers and destroyed infrastructure. It also helped the ministry and partners deliver more than 1300 metric tonnes of medical supplies, WHO says, including power generators, ambulances and oxygen supplies for medical facilities. The UN health agency says those deliveries also include supplies for trauma and emergency surgeries and medicines to help treat noncommunicable diseases (NCDs). “Six months of war have had a devastating impact on the health and lives of Ukraine’s people, but despite many challenges the health system has managed to survive and deliver care where and when it is needed most,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Though shaken, the health system has not collapsed,” he said. “But no system can deliver optimum health to its people under the stress of war, which is why we continue to call on the Russian Federation to end this war.” After six months of war, #Ukraine’s badly affected but still-resilient health system is taking stock of lessons learnt in providing lifesaving care as it prepares for a challenging winter ahead.@WHO and partners are ready to provide continued support.https://t.co/Ezsrc5qgGe pic.twitter.com/caTNNgXkUk — WHO Ukraine (@WHOUkraine) August 24, 2022 Ukraine War’s “Horror” Demands Mental Health Response Dr Hans Henri Kluge, WHO Regional Director for Europe, said attacks on health care violate international humanitarian law and are “unconscionable” because they kill and maim civilians and health-care providers, and severely hinder or prevent the delivery of health care services to those who needed it most. “Amid the horror of war,” he said, “we continue to witness the heroic efforts of health providers – including the many I’ve been privileged to meet in person myself – who are such a credit to their profession despite their own personal suffering.” WHO also has helped train more than 9000 health care workers. Areas of focus include trauma surgery, mass casualties, chemical exposure, epidemiology and laboratory diagnostics. But mental health, including stress management for health care workers and the public, is a priority in the Ukraine war. “WHO is stepping up its efforts with the Ministry of Health to ensure that the health workforce is prepared with the necessary skills to respond to mounting needs as winter approaches,” said Dr Jarno Habicht, WHO Representative in Ukraine. “We’re already seeing severe challenges and shortages in many areas, with rising inequalities in access to health and other essentials, impacting, as always, the most vulnerable – women, children and the elderly,” said Habicht. “Even as we look to a time when peace is restored,” he said, “we must focus on the here and now – the next six months could test Ukraine’s health system as never before.” A destroyed tank is abandoned on the road to Bucha, Ukraine. Image Credits: Mstyslav Chernov/ Wikimedia Commons, UNICEF/Oleksandr Ratushniak, Marco Frattini/ World Food Program. Pfizer Submits Reguest to US FDA for Approval of Omicron-targeted COVID Booster Shot 23/08/2022 Zachary Brennan, via Endpoints News Albert Bourla, CEO of Pfizer, at a World Economic Forum meeting in 2018. The Omicron-targeted boosters are coming. Almost 250 days since Omicron became the dominant variant in the US, Pfizer and BioNTech on Monday officially announced that they’ve requested an Emergency Use Authorization (EUA) from the US Food and Drug Administration for their booster dose of an Omicron BA.4/BA.5-adapted bivalent vaccine for those 12 and older. The application’s submission comes as BioNTech said earlier this month that it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. The FDA’s vaccine advisory committee in late June gave the thumbs up — by a vote of 19-2 — to requiring an Omicron-related component in this season’s booster dose; both Pfizer/BioNTech and Moderna have been working on such boosters over the past few months. The EUA for Pfizer/BioNTech’s booster would be based on preclinical data showing that it generated a strong neutralizing antibody response against the BA.4/BA.5 variants, as well as safety, tolerability and immunogenicity data from a Phase II/III trial of a 30-µg booster dose of the companies’ other, Omicron BA.1-adapted bivalent vaccine candidate. A clinical study investigating the safety, tolerability and immunogenicity of the Omicron BA.4/BA.5-adapted bivalent vaccine in individuals 12 years of age and older is expected to start this month, Pfizer and BioNTech said. FDA to Pfizer: Test another course of Paxlovid for those rebounding In other COVID-related drug developments, the FDA earlier this month quietly called on Pfizer to test another course of its Covid-19 antiviral Paxlovid for those who have rebounded and tested positive after an initial dose. On Aug. 5, the FDA reissued its EUA letter for Paxlovid to include additional post-authorization requirements, including calling on Pfizer “to conduct a clinical trial in patients with ‘COVID-19 rebound’ and a clinical trial evaluating different durations of treatment in immunocompromised patients with mild-to-moderate Covid-19.” Pfizer told Bloomberg News that it is “working with the FDA to finalize a protocol to study patients who may be in need of retreatment,” and the trial protocol is expected to be finalized this month. FDA expands Novavax EUA for teenagers Additionally, US teenagers looking for an option outside of the mRNA Covid-19 vaccines will now be able to turn to Novavax’s Covid-19 vaccine which won an expanded EUA on Friday from the FDA. Those aged 12 through 17 will gain access to the Novavax vaccine after the company submitted data from an ongoing pediatric expansion of its Phase III trial of 2,247 adolescents within that same age range across 75 sites in the US. The company said that in this population the vaccine achieved its primary efficacy endpoint, with clinical efficacy of about 78% (95% CI: 37.55%, 92.45%) overall, at a time when the Delta variant was the predominant circulating variant. The efficacy analysis was supported by assessment of antibody titers that were shown to be higher in adolescents than in young adults, Novavax added. Canada buys 12M doses of Moderna’s Omicron-targeted booster Meanwhile, mRNA powerhouse Moderna said Monday that Canada’s government has exercised its option to purchase an additional 4.5 million doses of an Omicron-containing bivalent vaccine booster candidate, in addition to moving forward the scheduled delivery of 1.5 million doses of the bivalent vaccine candidate from 2023 to 2022. Moderna and Canada also agreed to shift six million doses of the current vaccine to the Omicron-containing vaccine, subject to regulatory approval, with doses scheduled for delivery this year. The vaccine is expected to be ready for deployment in the US in October. ______________________________________________________ This article was first published by Endpoints News. Image Credits: Flickr – World Economic Forum. WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been 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, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. NEJM Study: Pfizer’s Paxlovid Reduces COVID-19 Death by 81% in Older Adults, Not Effective in Younger Patients 24/08/2022 Maayan Hoffman Pfizer’s Paxlovid, an oral antiviral, has been found to reduce the mortality rate in older adults. Pfizer’s COVID-19 oral antiviral Paxlovid was found to reduce the mortality rate among people over the age of 65 by 81% in a new Israeli study published Wednesday in the New England Journal of Medicine. However, the study also found no significant benefit of the drug in patients aged 64 and younger. It is the first peer-reviewed study on the effectiveness of the drug in real-world conditions, one of its lead researchers told Health Policy Watch. The study also differs from the Pfizer clinical trials on the drug that were conducted during the Delta wave, and on patients who were unvaccinated. The Israeli study took place during the Omicron wave, and the majority of patients had been fully vaccinated with three jabs of the Pfizer Covid-19 vaccine. The study is peer-reviewed and a fuller version of data first published in June on the Research Gate Platform. The researchers also found a 73% reduction in hospitalization rate compared to the control group. Hospitalization and Mortality Rates Paxlovid To arrive at their results, the team of researchers analyzed Clalit electronic health records of high-risk patients over the age of 40 with advanced statistical methods between 9 January and 10 March of this year. During this period, 3,902 COVID-19 patients received Paxlovid via Clalit. The researchers compared the hospitalization and mortality rates among Covid patients who took the medicine and COVID patients who did not take the medicine (the control group). The Pfizer clinical trial found that Paxlovid was 89% effective in patients at risk of serious illness, the company reported at the end of 2021. As noted, the Clalit rate of effectiveness was much lower. However, Dr Ronen Arbel, Health Outcomes Researcher at Clalit Health Services and Sapir College, told Health Policy Watch that “if you want to compare apples to apples, you have to look at the minority of patients in our study who were unvaccinated and over the age of 65. If you look at them, the effectiveness is much more similar [to the Pfizer study]. “It is when you look at the majority of the patients, while the effect is significant, it is much smaller,” he said. Clalit has distributed more Paxlovid than any other health fund in Israel, according to Dr Doron Netzer, Chief Medical Officer of Clalit’s Community Health Division. In total, some 30,000 Israelis have received the drug. In March, a Medicines Patent Pool (MPP) announced it had signed agreements with 35 companies to manufacture generic versions of Paxlovid for distribution in 95 low- and middle-income countries. But that came under fire almost immediately from medicines access groups as too little, too late. Reported Significant Reduction in Risk of Hospitalization and Death In Israel, the drug is prescribed to COVID-19 patients aged 12 and older with mild to moderate symptoms who are at high risk for complications of Covid-19. The treatment is given for five days, as close as possible to the date that a positive COVID-19 test is received. “The results if the study show unequivocally that treatment with Paxlovid significantly reduces the risk of hospitalization and death from Covid-19 in those over the age of 65,” Netzer said. “The decision of the Health Ministry to allow this treatment saved many lives.” Earlier this month, the US Food and Drug Administration called on Pfizer to test another course of Paxlovid for those who have rebounded and tested positive after an initial dose. It also requested that Pfizer hold a clinical trial to evaluate different durations of treatment in immunocompromised patients with mild-to-moderate disease, Health Policy Watch reported. Pfizer told Bloomberg News that the trial protocol is expected to be finalized this month. Arbel said that the Clalit study did not examine these questions due to limitations in its data. Image Credits: Pfizer , Bobbi-Jean MacKinnon. Health System “Shaken” by Ukraine War 24/08/2022 John Heilprin COVID-19 patient in severe state in Chernivtsi, southwestern Ukraine. As the SARS-CoV2 pandemic wanes, health services must deal with a health emergency – created solely by human forces. Six months into the Ukraine war, the World Health Organization warns that the nation’s battered but “still-resilient” health system is facing “severe challenges and shortages in many areas” that must be dealt with as the nation prepares for a challenging winter. WHO officials marked the half-year point in the war, which coincided with Ukraine’s Independence Day, with a somber reflection on the state of the nation’s life-saving health system. The UN healthy agency says Ukraine has a “badly affected but still-resilient health system” even as attacks on it continue. Since the war began with Russia’s invasion on February 24, WHO says it has verified 473 attacks carried out on health systems, including facilities and personnel, resulting in at least 98 deaths and 134 injuries. In May, the World Health Assembly approved a resolution condemning the Ukraine war by 88 votes to 12. But the 53 abstentions reflected the discomfort of many member states with a debate that polarised the global health body. Most African nations abstained, as did many Middle Eastern nations, India and Pakistan. Most of Europe, the United States, Oceania and many Latin American countries supported the Ukrainian-backed resolution, which condemns “in the strongest terms, Russian Federation’s military aggression against Ukraine, including attacks on health care facilities.” Empty hospital beds line the hallways of the Kyiv Regional Perinatal Centre, Ukraine, on 7 March 2022. As hospitals are disrupted or destroyed, online healthcare services can mitigate gaps. Health System “Shaken” by Ukraine War, But Not “Collapsed” WHO says it is supporting Ukraine’s Ministry of Health in the Ukraine war by helping to restore disrupted services, displaced health workers and destroyed infrastructure. It also helped the ministry and partners deliver more than 1300 metric tonnes of medical supplies, WHO says, including power generators, ambulances and oxygen supplies for medical facilities. The UN health agency says those deliveries also include supplies for trauma and emergency surgeries and medicines to help treat noncommunicable diseases (NCDs). “Six months of war have had a devastating impact on the health and lives of Ukraine’s people, but despite many challenges the health system has managed to survive and deliver care where and when it is needed most,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Though shaken, the health system has not collapsed,” he said. “But no system can deliver optimum health to its people under the stress of war, which is why we continue to call on the Russian Federation to end this war.” After six months of war, #Ukraine’s badly affected but still-resilient health system is taking stock of lessons learnt in providing lifesaving care as it prepares for a challenging winter ahead.@WHO and partners are ready to provide continued support.https://t.co/Ezsrc5qgGe pic.twitter.com/caTNNgXkUk — WHO Ukraine (@WHOUkraine) August 24, 2022 Ukraine War’s “Horror” Demands Mental Health Response Dr Hans Henri Kluge, WHO Regional Director for Europe, said attacks on health care violate international humanitarian law and are “unconscionable” because they kill and maim civilians and health-care providers, and severely hinder or prevent the delivery of health care services to those who needed it most. “Amid the horror of war,” he said, “we continue to witness the heroic efforts of health providers – including the many I’ve been privileged to meet in person myself – who are such a credit to their profession despite their own personal suffering.” WHO also has helped train more than 9000 health care workers. Areas of focus include trauma surgery, mass casualties, chemical exposure, epidemiology and laboratory diagnostics. But mental health, including stress management for health care workers and the public, is a priority in the Ukraine war. “WHO is stepping up its efforts with the Ministry of Health to ensure that the health workforce is prepared with the necessary skills to respond to mounting needs as winter approaches,” said Dr Jarno Habicht, WHO Representative in Ukraine. “We’re already seeing severe challenges and shortages in many areas, with rising inequalities in access to health and other essentials, impacting, as always, the most vulnerable – women, children and the elderly,” said Habicht. “Even as we look to a time when peace is restored,” he said, “we must focus on the here and now – the next six months could test Ukraine’s health system as never before.” A destroyed tank is abandoned on the road to Bucha, Ukraine. Image Credits: Mstyslav Chernov/ Wikimedia Commons, UNICEF/Oleksandr Ratushniak, Marco Frattini/ World Food Program. Pfizer Submits Reguest to US FDA for Approval of Omicron-targeted COVID Booster Shot 23/08/2022 Zachary Brennan, via Endpoints News Albert Bourla, CEO of Pfizer, at a World Economic Forum meeting in 2018. The Omicron-targeted boosters are coming. Almost 250 days since Omicron became the dominant variant in the US, Pfizer and BioNTech on Monday officially announced that they’ve requested an Emergency Use Authorization (EUA) from the US Food and Drug Administration for their booster dose of an Omicron BA.4/BA.5-adapted bivalent vaccine for those 12 and older. The application’s submission comes as BioNTech said earlier this month that it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. The FDA’s vaccine advisory committee in late June gave the thumbs up — by a vote of 19-2 — to requiring an Omicron-related component in this season’s booster dose; both Pfizer/BioNTech and Moderna have been working on such boosters over the past few months. The EUA for Pfizer/BioNTech’s booster would be based on preclinical data showing that it generated a strong neutralizing antibody response against the BA.4/BA.5 variants, as well as safety, tolerability and immunogenicity data from a Phase II/III trial of a 30-µg booster dose of the companies’ other, Omicron BA.1-adapted bivalent vaccine candidate. A clinical study investigating the safety, tolerability and immunogenicity of the Omicron BA.4/BA.5-adapted bivalent vaccine in individuals 12 years of age and older is expected to start this month, Pfizer and BioNTech said. FDA to Pfizer: Test another course of Paxlovid for those rebounding In other COVID-related drug developments, the FDA earlier this month quietly called on Pfizer to test another course of its Covid-19 antiviral Paxlovid for those who have rebounded and tested positive after an initial dose. On Aug. 5, the FDA reissued its EUA letter for Paxlovid to include additional post-authorization requirements, including calling on Pfizer “to conduct a clinical trial in patients with ‘COVID-19 rebound’ and a clinical trial evaluating different durations of treatment in immunocompromised patients with mild-to-moderate Covid-19.” Pfizer told Bloomberg News that it is “working with the FDA to finalize a protocol to study patients who may be in need of retreatment,” and the trial protocol is expected to be finalized this month. FDA expands Novavax EUA for teenagers Additionally, US teenagers looking for an option outside of the mRNA Covid-19 vaccines will now be able to turn to Novavax’s Covid-19 vaccine which won an expanded EUA on Friday from the FDA. Those aged 12 through 17 will gain access to the Novavax vaccine after the company submitted data from an ongoing pediatric expansion of its Phase III trial of 2,247 adolescents within that same age range across 75 sites in the US. The company said that in this population the vaccine achieved its primary efficacy endpoint, with clinical efficacy of about 78% (95% CI: 37.55%, 92.45%) overall, at a time when the Delta variant was the predominant circulating variant. The efficacy analysis was supported by assessment of antibody titers that were shown to be higher in adolescents than in young adults, Novavax added. Canada buys 12M doses of Moderna’s Omicron-targeted booster Meanwhile, mRNA powerhouse Moderna said Monday that Canada’s government has exercised its option to purchase an additional 4.5 million doses of an Omicron-containing bivalent vaccine booster candidate, in addition to moving forward the scheduled delivery of 1.5 million doses of the bivalent vaccine candidate from 2023 to 2022. Moderna and Canada also agreed to shift six million doses of the current vaccine to the Omicron-containing vaccine, subject to regulatory approval, with doses scheduled for delivery this year. The vaccine is expected to be ready for deployment in the US in October. ______________________________________________________ This article was first published by Endpoints News. Image Credits: Flickr – World Economic Forum. WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been 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, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. NEJM Study: Pfizer’s Paxlovid Reduces COVID-19 Death by 81% in Older Adults, Not Effective in Younger Patients 24/08/2022 Maayan Hoffman Pfizer’s Paxlovid, an oral antiviral, has been found to reduce the mortality rate in older adults. Pfizer’s COVID-19 oral antiviral Paxlovid was found to reduce the mortality rate among people over the age of 65 by 81% in a new Israeli study published Wednesday in the New England Journal of Medicine. However, the study also found no significant benefit of the drug in patients aged 64 and younger. It is the first peer-reviewed study on the effectiveness of the drug in real-world conditions, one of its lead researchers told Health Policy Watch. The study also differs from the Pfizer clinical trials on the drug that were conducted during the Delta wave, and on patients who were unvaccinated. The Israeli study took place during the Omicron wave, and the majority of patients had been fully vaccinated with three jabs of the Pfizer Covid-19 vaccine. The study is peer-reviewed and a fuller version of data first published in June on the Research Gate Platform. The researchers also found a 73% reduction in hospitalization rate compared to the control group. Hospitalization and Mortality Rates Paxlovid To arrive at their results, the team of researchers analyzed Clalit electronic health records of high-risk patients over the age of 40 with advanced statistical methods between 9 January and 10 March of this year. During this period, 3,902 COVID-19 patients received Paxlovid via Clalit. The researchers compared the hospitalization and mortality rates among Covid patients who took the medicine and COVID patients who did not take the medicine (the control group). The Pfizer clinical trial found that Paxlovid was 89% effective in patients at risk of serious illness, the company reported at the end of 2021. As noted, the Clalit rate of effectiveness was much lower. However, Dr Ronen Arbel, Health Outcomes Researcher at Clalit Health Services and Sapir College, told Health Policy Watch that “if you want to compare apples to apples, you have to look at the minority of patients in our study who were unvaccinated and over the age of 65. If you look at them, the effectiveness is much more similar [to the Pfizer study]. “It is when you look at the majority of the patients, while the effect is significant, it is much smaller,” he said. Clalit has distributed more Paxlovid than any other health fund in Israel, according to Dr Doron Netzer, Chief Medical Officer of Clalit’s Community Health Division. In total, some 30,000 Israelis have received the drug. In March, a Medicines Patent Pool (MPP) announced it had signed agreements with 35 companies to manufacture generic versions of Paxlovid for distribution in 95 low- and middle-income countries. But that came under fire almost immediately from medicines access groups as too little, too late. Reported Significant Reduction in Risk of Hospitalization and Death In Israel, the drug is prescribed to COVID-19 patients aged 12 and older with mild to moderate symptoms who are at high risk for complications of Covid-19. The treatment is given for five days, as close as possible to the date that a positive COVID-19 test is received. “The results if the study show unequivocally that treatment with Paxlovid significantly reduces the risk of hospitalization and death from Covid-19 in those over the age of 65,” Netzer said. “The decision of the Health Ministry to allow this treatment saved many lives.” Earlier this month, the US Food and Drug Administration called on Pfizer to test another course of Paxlovid for those who have rebounded and tested positive after an initial dose. It also requested that Pfizer hold a clinical trial to evaluate different durations of treatment in immunocompromised patients with mild-to-moderate disease, Health Policy Watch reported. Pfizer told Bloomberg News that the trial protocol is expected to be finalized this month. Arbel said that the Clalit study did not examine these questions due to limitations in its data. Image Credits: Pfizer , Bobbi-Jean MacKinnon. Health System “Shaken” by Ukraine War 24/08/2022 John Heilprin COVID-19 patient in severe state in Chernivtsi, southwestern Ukraine. As the SARS-CoV2 pandemic wanes, health services must deal with a health emergency – created solely by human forces. Six months into the Ukraine war, the World Health Organization warns that the nation’s battered but “still-resilient” health system is facing “severe challenges and shortages in many areas” that must be dealt with as the nation prepares for a challenging winter. WHO officials marked the half-year point in the war, which coincided with Ukraine’s Independence Day, with a somber reflection on the state of the nation’s life-saving health system. The UN healthy agency says Ukraine has a “badly affected but still-resilient health system” even as attacks on it continue. Since the war began with Russia’s invasion on February 24, WHO says it has verified 473 attacks carried out on health systems, including facilities and personnel, resulting in at least 98 deaths and 134 injuries. In May, the World Health Assembly approved a resolution condemning the Ukraine war by 88 votes to 12. But the 53 abstentions reflected the discomfort of many member states with a debate that polarised the global health body. Most African nations abstained, as did many Middle Eastern nations, India and Pakistan. Most of Europe, the United States, Oceania and many Latin American countries supported the Ukrainian-backed resolution, which condemns “in the strongest terms, Russian Federation’s military aggression against Ukraine, including attacks on health care facilities.” Empty hospital beds line the hallways of the Kyiv Regional Perinatal Centre, Ukraine, on 7 March 2022. As hospitals are disrupted or destroyed, online healthcare services can mitigate gaps. Health System “Shaken” by Ukraine War, But Not “Collapsed” WHO says it is supporting Ukraine’s Ministry of Health in the Ukraine war by helping to restore disrupted services, displaced health workers and destroyed infrastructure. It also helped the ministry and partners deliver more than 1300 metric tonnes of medical supplies, WHO says, including power generators, ambulances and oxygen supplies for medical facilities. The UN health agency says those deliveries also include supplies for trauma and emergency surgeries and medicines to help treat noncommunicable diseases (NCDs). “Six months of war have had a devastating impact on the health and lives of Ukraine’s people, but despite many challenges the health system has managed to survive and deliver care where and when it is needed most,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Though shaken, the health system has not collapsed,” he said. “But no system can deliver optimum health to its people under the stress of war, which is why we continue to call on the Russian Federation to end this war.” After six months of war, #Ukraine’s badly affected but still-resilient health system is taking stock of lessons learnt in providing lifesaving care as it prepares for a challenging winter ahead.@WHO and partners are ready to provide continued support.https://t.co/Ezsrc5qgGe pic.twitter.com/caTNNgXkUk — WHO Ukraine (@WHOUkraine) August 24, 2022 Ukraine War’s “Horror” Demands Mental Health Response Dr Hans Henri Kluge, WHO Regional Director for Europe, said attacks on health care violate international humanitarian law and are “unconscionable” because they kill and maim civilians and health-care providers, and severely hinder or prevent the delivery of health care services to those who needed it most. “Amid the horror of war,” he said, “we continue to witness the heroic efforts of health providers – including the many I’ve been privileged to meet in person myself – who are such a credit to their profession despite their own personal suffering.” WHO also has helped train more than 9000 health care workers. Areas of focus include trauma surgery, mass casualties, chemical exposure, epidemiology and laboratory diagnostics. But mental health, including stress management for health care workers and the public, is a priority in the Ukraine war. “WHO is stepping up its efforts with the Ministry of Health to ensure that the health workforce is prepared with the necessary skills to respond to mounting needs as winter approaches,” said Dr Jarno Habicht, WHO Representative in Ukraine. “We’re already seeing severe challenges and shortages in many areas, with rising inequalities in access to health and other essentials, impacting, as always, the most vulnerable – women, children and the elderly,” said Habicht. “Even as we look to a time when peace is restored,” he said, “we must focus on the here and now – the next six months could test Ukraine’s health system as never before.” A destroyed tank is abandoned on the road to Bucha, Ukraine. Image Credits: Mstyslav Chernov/ Wikimedia Commons, UNICEF/Oleksandr Ratushniak, Marco Frattini/ World Food Program. Pfizer Submits Reguest to US FDA for Approval of Omicron-targeted COVID Booster Shot 23/08/2022 Zachary Brennan, via Endpoints News Albert Bourla, CEO of Pfizer, at a World Economic Forum meeting in 2018. The Omicron-targeted boosters are coming. Almost 250 days since Omicron became the dominant variant in the US, Pfizer and BioNTech on Monday officially announced that they’ve requested an Emergency Use Authorization (EUA) from the US Food and Drug Administration for their booster dose of an Omicron BA.4/BA.5-adapted bivalent vaccine for those 12 and older. The application’s submission comes as BioNTech said earlier this month that it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. The FDA’s vaccine advisory committee in late June gave the thumbs up — by a vote of 19-2 — to requiring an Omicron-related component in this season’s booster dose; both Pfizer/BioNTech and Moderna have been working on such boosters over the past few months. The EUA for Pfizer/BioNTech’s booster would be based on preclinical data showing that it generated a strong neutralizing antibody response against the BA.4/BA.5 variants, as well as safety, tolerability and immunogenicity data from a Phase II/III trial of a 30-µg booster dose of the companies’ other, Omicron BA.1-adapted bivalent vaccine candidate. A clinical study investigating the safety, tolerability and immunogenicity of the Omicron BA.4/BA.5-adapted bivalent vaccine in individuals 12 years of age and older is expected to start this month, Pfizer and BioNTech said. FDA to Pfizer: Test another course of Paxlovid for those rebounding In other COVID-related drug developments, the FDA earlier this month quietly called on Pfizer to test another course of its Covid-19 antiviral Paxlovid for those who have rebounded and tested positive after an initial dose. On Aug. 5, the FDA reissued its EUA letter for Paxlovid to include additional post-authorization requirements, including calling on Pfizer “to conduct a clinical trial in patients with ‘COVID-19 rebound’ and a clinical trial evaluating different durations of treatment in immunocompromised patients with mild-to-moderate Covid-19.” Pfizer told Bloomberg News that it is “working with the FDA to finalize a protocol to study patients who may be in need of retreatment,” and the trial protocol is expected to be finalized this month. FDA expands Novavax EUA for teenagers Additionally, US teenagers looking for an option outside of the mRNA Covid-19 vaccines will now be able to turn to Novavax’s Covid-19 vaccine which won an expanded EUA on Friday from the FDA. Those aged 12 through 17 will gain access to the Novavax vaccine after the company submitted data from an ongoing pediatric expansion of its Phase III trial of 2,247 adolescents within that same age range across 75 sites in the US. The company said that in this population the vaccine achieved its primary efficacy endpoint, with clinical efficacy of about 78% (95% CI: 37.55%, 92.45%) overall, at a time when the Delta variant was the predominant circulating variant. The efficacy analysis was supported by assessment of antibody titers that were shown to be higher in adolescents than in young adults, Novavax added. Canada buys 12M doses of Moderna’s Omicron-targeted booster Meanwhile, mRNA powerhouse Moderna said Monday that Canada’s government has exercised its option to purchase an additional 4.5 million doses of an Omicron-containing bivalent vaccine booster candidate, in addition to moving forward the scheduled delivery of 1.5 million doses of the bivalent vaccine candidate from 2023 to 2022. Moderna and Canada also agreed to shift six million doses of the current vaccine to the Omicron-containing vaccine, subject to regulatory approval, with doses scheduled for delivery this year. The vaccine is expected to be ready for deployment in the US in October. ______________________________________________________ This article was first published by Endpoints News. Image Credits: Flickr – World Economic Forum. WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been 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, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. NEJM Study: Pfizer’s Paxlovid Reduces COVID-19 Death by 81% in Older Adults, Not Effective in Younger Patients 24/08/2022 Maayan Hoffman Pfizer’s Paxlovid, an oral antiviral, has been found to reduce the mortality rate in older adults. Pfizer’s COVID-19 oral antiviral Paxlovid was found to reduce the mortality rate among people over the age of 65 by 81% in a new Israeli study published Wednesday in the New England Journal of Medicine. However, the study also found no significant benefit of the drug in patients aged 64 and younger. It is the first peer-reviewed study on the effectiveness of the drug in real-world conditions, one of its lead researchers told Health Policy Watch. The study also differs from the Pfizer clinical trials on the drug that were conducted during the Delta wave, and on patients who were unvaccinated. The Israeli study took place during the Omicron wave, and the majority of patients had been fully vaccinated with three jabs of the Pfizer Covid-19 vaccine. The study is peer-reviewed and a fuller version of data first published in June on the Research Gate Platform. The researchers also found a 73% reduction in hospitalization rate compared to the control group. Hospitalization and Mortality Rates Paxlovid To arrive at their results, the team of researchers analyzed Clalit electronic health records of high-risk patients over the age of 40 with advanced statistical methods between 9 January and 10 March of this year. During this period, 3,902 COVID-19 patients received Paxlovid via Clalit. The researchers compared the hospitalization and mortality rates among Covid patients who took the medicine and COVID patients who did not take the medicine (the control group). The Pfizer clinical trial found that Paxlovid was 89% effective in patients at risk of serious illness, the company reported at the end of 2021. As noted, the Clalit rate of effectiveness was much lower. However, Dr Ronen Arbel, Health Outcomes Researcher at Clalit Health Services and Sapir College, told Health Policy Watch that “if you want to compare apples to apples, you have to look at the minority of patients in our study who were unvaccinated and over the age of 65. If you look at them, the effectiveness is much more similar [to the Pfizer study]. “It is when you look at the majority of the patients, while the effect is significant, it is much smaller,” he said. Clalit has distributed more Paxlovid than any other health fund in Israel, according to Dr Doron Netzer, Chief Medical Officer of Clalit’s Community Health Division. In total, some 30,000 Israelis have received the drug. In March, a Medicines Patent Pool (MPP) announced it had signed agreements with 35 companies to manufacture generic versions of Paxlovid for distribution in 95 low- and middle-income countries. But that came under fire almost immediately from medicines access groups as too little, too late. Reported Significant Reduction in Risk of Hospitalization and Death In Israel, the drug is prescribed to COVID-19 patients aged 12 and older with mild to moderate symptoms who are at high risk for complications of Covid-19. The treatment is given for five days, as close as possible to the date that a positive COVID-19 test is received. “The results if the study show unequivocally that treatment with Paxlovid significantly reduces the risk of hospitalization and death from Covid-19 in those over the age of 65,” Netzer said. “The decision of the Health Ministry to allow this treatment saved many lives.” Earlier this month, the US Food and Drug Administration called on Pfizer to test another course of Paxlovid for those who have rebounded and tested positive after an initial dose. It also requested that Pfizer hold a clinical trial to evaluate different durations of treatment in immunocompromised patients with mild-to-moderate disease, Health Policy Watch reported. Pfizer told Bloomberg News that the trial protocol is expected to be finalized this month. Arbel said that the Clalit study did not examine these questions due to limitations in its data. Image Credits: Pfizer , Bobbi-Jean MacKinnon. Health System “Shaken” by Ukraine War 24/08/2022 John Heilprin COVID-19 patient in severe state in Chernivtsi, southwestern Ukraine. As the SARS-CoV2 pandemic wanes, health services must deal with a health emergency – created solely by human forces. Six months into the Ukraine war, the World Health Organization warns that the nation’s battered but “still-resilient” health system is facing “severe challenges and shortages in many areas” that must be dealt with as the nation prepares for a challenging winter. WHO officials marked the half-year point in the war, which coincided with Ukraine’s Independence Day, with a somber reflection on the state of the nation’s life-saving health system. The UN healthy agency says Ukraine has a “badly affected but still-resilient health system” even as attacks on it continue. Since the war began with Russia’s invasion on February 24, WHO says it has verified 473 attacks carried out on health systems, including facilities and personnel, resulting in at least 98 deaths and 134 injuries. In May, the World Health Assembly approved a resolution condemning the Ukraine war by 88 votes to 12. But the 53 abstentions reflected the discomfort of many member states with a debate that polarised the global health body. Most African nations abstained, as did many Middle Eastern nations, India and Pakistan. Most of Europe, the United States, Oceania and many Latin American countries supported the Ukrainian-backed resolution, which condemns “in the strongest terms, Russian Federation’s military aggression against Ukraine, including attacks on health care facilities.” Empty hospital beds line the hallways of the Kyiv Regional Perinatal Centre, Ukraine, on 7 March 2022. As hospitals are disrupted or destroyed, online healthcare services can mitigate gaps. Health System “Shaken” by Ukraine War, But Not “Collapsed” WHO says it is supporting Ukraine’s Ministry of Health in the Ukraine war by helping to restore disrupted services, displaced health workers and destroyed infrastructure. It also helped the ministry and partners deliver more than 1300 metric tonnes of medical supplies, WHO says, including power generators, ambulances and oxygen supplies for medical facilities. The UN health agency says those deliveries also include supplies for trauma and emergency surgeries and medicines to help treat noncommunicable diseases (NCDs). “Six months of war have had a devastating impact on the health and lives of Ukraine’s people, but despite many challenges the health system has managed to survive and deliver care where and when it is needed most,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Though shaken, the health system has not collapsed,” he said. “But no system can deliver optimum health to its people under the stress of war, which is why we continue to call on the Russian Federation to end this war.” After six months of war, #Ukraine’s badly affected but still-resilient health system is taking stock of lessons learnt in providing lifesaving care as it prepares for a challenging winter ahead.@WHO and partners are ready to provide continued support.https://t.co/Ezsrc5qgGe pic.twitter.com/caTNNgXkUk — WHO Ukraine (@WHOUkraine) August 24, 2022 Ukraine War’s “Horror” Demands Mental Health Response Dr Hans Henri Kluge, WHO Regional Director for Europe, said attacks on health care violate international humanitarian law and are “unconscionable” because they kill and maim civilians and health-care providers, and severely hinder or prevent the delivery of health care services to those who needed it most. “Amid the horror of war,” he said, “we continue to witness the heroic efforts of health providers – including the many I’ve been privileged to meet in person myself – who are such a credit to their profession despite their own personal suffering.” WHO also has helped train more than 9000 health care workers. Areas of focus include trauma surgery, mass casualties, chemical exposure, epidemiology and laboratory diagnostics. But mental health, including stress management for health care workers and the public, is a priority in the Ukraine war. “WHO is stepping up its efforts with the Ministry of Health to ensure that the health workforce is prepared with the necessary skills to respond to mounting needs as winter approaches,” said Dr Jarno Habicht, WHO Representative in Ukraine. “We’re already seeing severe challenges and shortages in many areas, with rising inequalities in access to health and other essentials, impacting, as always, the most vulnerable – women, children and the elderly,” said Habicht. “Even as we look to a time when peace is restored,” he said, “we must focus on the here and now – the next six months could test Ukraine’s health system as never before.” A destroyed tank is abandoned on the road to Bucha, Ukraine. Image Credits: Mstyslav Chernov/ Wikimedia Commons, UNICEF/Oleksandr Ratushniak, Marco Frattini/ World Food Program. Pfizer Submits Reguest to US FDA for Approval of Omicron-targeted COVID Booster Shot 23/08/2022 Zachary Brennan, via Endpoints News Albert Bourla, CEO of Pfizer, at a World Economic Forum meeting in 2018. The Omicron-targeted boosters are coming. Almost 250 days since Omicron became the dominant variant in the US, Pfizer and BioNTech on Monday officially announced that they’ve requested an Emergency Use Authorization (EUA) from the US Food and Drug Administration for their booster dose of an Omicron BA.4/BA.5-adapted bivalent vaccine for those 12 and older. The application’s submission comes as BioNTech said earlier this month that it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. The FDA’s vaccine advisory committee in late June gave the thumbs up — by a vote of 19-2 — to requiring an Omicron-related component in this season’s booster dose; both Pfizer/BioNTech and Moderna have been working on such boosters over the past few months. The EUA for Pfizer/BioNTech’s booster would be based on preclinical data showing that it generated a strong neutralizing antibody response against the BA.4/BA.5 variants, as well as safety, tolerability and immunogenicity data from a Phase II/III trial of a 30-µg booster dose of the companies’ other, Omicron BA.1-adapted bivalent vaccine candidate. A clinical study investigating the safety, tolerability and immunogenicity of the Omicron BA.4/BA.5-adapted bivalent vaccine in individuals 12 years of age and older is expected to start this month, Pfizer and BioNTech said. FDA to Pfizer: Test another course of Paxlovid for those rebounding In other COVID-related drug developments, the FDA earlier this month quietly called on Pfizer to test another course of its Covid-19 antiviral Paxlovid for those who have rebounded and tested positive after an initial dose. On Aug. 5, the FDA reissued its EUA letter for Paxlovid to include additional post-authorization requirements, including calling on Pfizer “to conduct a clinical trial in patients with ‘COVID-19 rebound’ and a clinical trial evaluating different durations of treatment in immunocompromised patients with mild-to-moderate Covid-19.” Pfizer told Bloomberg News that it is “working with the FDA to finalize a protocol to study patients who may be in need of retreatment,” and the trial protocol is expected to be finalized this month. FDA expands Novavax EUA for teenagers Additionally, US teenagers looking for an option outside of the mRNA Covid-19 vaccines will now be able to turn to Novavax’s Covid-19 vaccine which won an expanded EUA on Friday from the FDA. Those aged 12 through 17 will gain access to the Novavax vaccine after the company submitted data from an ongoing pediatric expansion of its Phase III trial of 2,247 adolescents within that same age range across 75 sites in the US. The company said that in this population the vaccine achieved its primary efficacy endpoint, with clinical efficacy of about 78% (95% CI: 37.55%, 92.45%) overall, at a time when the Delta variant was the predominant circulating variant. The efficacy analysis was supported by assessment of antibody titers that were shown to be higher in adolescents than in young adults, Novavax added. Canada buys 12M doses of Moderna’s Omicron-targeted booster Meanwhile, mRNA powerhouse Moderna said Monday that Canada’s government has exercised its option to purchase an additional 4.5 million doses of an Omicron-containing bivalent vaccine booster candidate, in addition to moving forward the scheduled delivery of 1.5 million doses of the bivalent vaccine candidate from 2023 to 2022. Moderna and Canada also agreed to shift six million doses of the current vaccine to the Omicron-containing vaccine, subject to regulatory approval, with doses scheduled for delivery this year. The vaccine is expected to be ready for deployment in the US in October. ______________________________________________________ This article was first published by Endpoints News. Image Credits: Flickr – World Economic Forum. WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. NEJM Study: Pfizer’s Paxlovid Reduces COVID-19 Death by 81% in Older Adults, Not Effective in Younger Patients 24/08/2022 Maayan Hoffman Pfizer’s Paxlovid, an oral antiviral, has been found to reduce the mortality rate in older adults. Pfizer’s COVID-19 oral antiviral Paxlovid was found to reduce the mortality rate among people over the age of 65 by 81% in a new Israeli study published Wednesday in the New England Journal of Medicine. However, the study also found no significant benefit of the drug in patients aged 64 and younger. It is the first peer-reviewed study on the effectiveness of the drug in real-world conditions, one of its lead researchers told Health Policy Watch. The study also differs from the Pfizer clinical trials on the drug that were conducted during the Delta wave, and on patients who were unvaccinated. The Israeli study took place during the Omicron wave, and the majority of patients had been fully vaccinated with three jabs of the Pfizer Covid-19 vaccine. The study is peer-reviewed and a fuller version of data first published in June on the Research Gate Platform. The researchers also found a 73% reduction in hospitalization rate compared to the control group. Hospitalization and Mortality Rates Paxlovid To arrive at their results, the team of researchers analyzed Clalit electronic health records of high-risk patients over the age of 40 with advanced statistical methods between 9 January and 10 March of this year. During this period, 3,902 COVID-19 patients received Paxlovid via Clalit. The researchers compared the hospitalization and mortality rates among Covid patients who took the medicine and COVID patients who did not take the medicine (the control group). The Pfizer clinical trial found that Paxlovid was 89% effective in patients at risk of serious illness, the company reported at the end of 2021. As noted, the Clalit rate of effectiveness was much lower. However, Dr Ronen Arbel, Health Outcomes Researcher at Clalit Health Services and Sapir College, told Health Policy Watch that “if you want to compare apples to apples, you have to look at the minority of patients in our study who were unvaccinated and over the age of 65. If you look at them, the effectiveness is much more similar [to the Pfizer study]. “It is when you look at the majority of the patients, while the effect is significant, it is much smaller,” he said. Clalit has distributed more Paxlovid than any other health fund in Israel, according to Dr Doron Netzer, Chief Medical Officer of Clalit’s Community Health Division. In total, some 30,000 Israelis have received the drug. In March, a Medicines Patent Pool (MPP) announced it had signed agreements with 35 companies to manufacture generic versions of Paxlovid for distribution in 95 low- and middle-income countries. But that came under fire almost immediately from medicines access groups as too little, too late. Reported Significant Reduction in Risk of Hospitalization and Death In Israel, the drug is prescribed to COVID-19 patients aged 12 and older with mild to moderate symptoms who are at high risk for complications of Covid-19. The treatment is given for five days, as close as possible to the date that a positive COVID-19 test is received. “The results if the study show unequivocally that treatment with Paxlovid significantly reduces the risk of hospitalization and death from Covid-19 in those over the age of 65,” Netzer said. “The decision of the Health Ministry to allow this treatment saved many lives.” Earlier this month, the US Food and Drug Administration called on Pfizer to test another course of Paxlovid for those who have rebounded and tested positive after an initial dose. It also requested that Pfizer hold a clinical trial to evaluate different durations of treatment in immunocompromised patients with mild-to-moderate disease, Health Policy Watch reported. Pfizer told Bloomberg News that the trial protocol is expected to be finalized this month. Arbel said that the Clalit study did not examine these questions due to limitations in its data. Image Credits: Pfizer , Bobbi-Jean MacKinnon. Health System “Shaken” by Ukraine War 24/08/2022 John Heilprin COVID-19 patient in severe state in Chernivtsi, southwestern Ukraine. As the SARS-CoV2 pandemic wanes, health services must deal with a health emergency – created solely by human forces. Six months into the Ukraine war, the World Health Organization warns that the nation’s battered but “still-resilient” health system is facing “severe challenges and shortages in many areas” that must be dealt with as the nation prepares for a challenging winter. WHO officials marked the half-year point in the war, which coincided with Ukraine’s Independence Day, with a somber reflection on the state of the nation’s life-saving health system. The UN healthy agency says Ukraine has a “badly affected but still-resilient health system” even as attacks on it continue. Since the war began with Russia’s invasion on February 24, WHO says it has verified 473 attacks carried out on health systems, including facilities and personnel, resulting in at least 98 deaths and 134 injuries. In May, the World Health Assembly approved a resolution condemning the Ukraine war by 88 votes to 12. But the 53 abstentions reflected the discomfort of many member states with a debate that polarised the global health body. Most African nations abstained, as did many Middle Eastern nations, India and Pakistan. Most of Europe, the United States, Oceania and many Latin American countries supported the Ukrainian-backed resolution, which condemns “in the strongest terms, Russian Federation’s military aggression against Ukraine, including attacks on health care facilities.” Empty hospital beds line the hallways of the Kyiv Regional Perinatal Centre, Ukraine, on 7 March 2022. As hospitals are disrupted or destroyed, online healthcare services can mitigate gaps. Health System “Shaken” by Ukraine War, But Not “Collapsed” WHO says it is supporting Ukraine’s Ministry of Health in the Ukraine war by helping to restore disrupted services, displaced health workers and destroyed infrastructure. It also helped the ministry and partners deliver more than 1300 metric tonnes of medical supplies, WHO says, including power generators, ambulances and oxygen supplies for medical facilities. The UN health agency says those deliveries also include supplies for trauma and emergency surgeries and medicines to help treat noncommunicable diseases (NCDs). “Six months of war have had a devastating impact on the health and lives of Ukraine’s people, but despite many challenges the health system has managed to survive and deliver care where and when it is needed most,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Though shaken, the health system has not collapsed,” he said. “But no system can deliver optimum health to its people under the stress of war, which is why we continue to call on the Russian Federation to end this war.” After six months of war, #Ukraine’s badly affected but still-resilient health system is taking stock of lessons learnt in providing lifesaving care as it prepares for a challenging winter ahead.@WHO and partners are ready to provide continued support.https://t.co/Ezsrc5qgGe pic.twitter.com/caTNNgXkUk — WHO Ukraine (@WHOUkraine) August 24, 2022 Ukraine War’s “Horror” Demands Mental Health Response Dr Hans Henri Kluge, WHO Regional Director for Europe, said attacks on health care violate international humanitarian law and are “unconscionable” because they kill and maim civilians and health-care providers, and severely hinder or prevent the delivery of health care services to those who needed it most. “Amid the horror of war,” he said, “we continue to witness the heroic efforts of health providers – including the many I’ve been privileged to meet in person myself – who are such a credit to their profession despite their own personal suffering.” WHO also has helped train more than 9000 health care workers. Areas of focus include trauma surgery, mass casualties, chemical exposure, epidemiology and laboratory diagnostics. But mental health, including stress management for health care workers and the public, is a priority in the Ukraine war. “WHO is stepping up its efforts with the Ministry of Health to ensure that the health workforce is prepared with the necessary skills to respond to mounting needs as winter approaches,” said Dr Jarno Habicht, WHO Representative in Ukraine. “We’re already seeing severe challenges and shortages in many areas, with rising inequalities in access to health and other essentials, impacting, as always, the most vulnerable – women, children and the elderly,” said Habicht. “Even as we look to a time when peace is restored,” he said, “we must focus on the here and now – the next six months could test Ukraine’s health system as never before.” A destroyed tank is abandoned on the road to Bucha, Ukraine. Image Credits: Mstyslav Chernov/ Wikimedia Commons, UNICEF/Oleksandr Ratushniak, Marco Frattini/ World Food Program. Pfizer Submits Reguest to US FDA for Approval of Omicron-targeted COVID Booster Shot 23/08/2022 Zachary Brennan, via Endpoints News Albert Bourla, CEO of Pfizer, at a World Economic Forum meeting in 2018. The Omicron-targeted boosters are coming. Almost 250 days since Omicron became the dominant variant in the US, Pfizer and BioNTech on Monday officially announced that they’ve requested an Emergency Use Authorization (EUA) from the US Food and Drug Administration for their booster dose of an Omicron BA.4/BA.5-adapted bivalent vaccine for those 12 and older. The application’s submission comes as BioNTech said earlier this month that it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. The FDA’s vaccine advisory committee in late June gave the thumbs up — by a vote of 19-2 — to requiring an Omicron-related component in this season’s booster dose; both Pfizer/BioNTech and Moderna have been working on such boosters over the past few months. The EUA for Pfizer/BioNTech’s booster would be based on preclinical data showing that it generated a strong neutralizing antibody response against the BA.4/BA.5 variants, as well as safety, tolerability and immunogenicity data from a Phase II/III trial of a 30-µg booster dose of the companies’ other, Omicron BA.1-adapted bivalent vaccine candidate. A clinical study investigating the safety, tolerability and immunogenicity of the Omicron BA.4/BA.5-adapted bivalent vaccine in individuals 12 years of age and older is expected to start this month, Pfizer and BioNTech said. FDA to Pfizer: Test another course of Paxlovid for those rebounding In other COVID-related drug developments, the FDA earlier this month quietly called on Pfizer to test another course of its Covid-19 antiviral Paxlovid for those who have rebounded and tested positive after an initial dose. On Aug. 5, the FDA reissued its EUA letter for Paxlovid to include additional post-authorization requirements, including calling on Pfizer “to conduct a clinical trial in patients with ‘COVID-19 rebound’ and a clinical trial evaluating different durations of treatment in immunocompromised patients with mild-to-moderate Covid-19.” Pfizer told Bloomberg News that it is “working with the FDA to finalize a protocol to study patients who may be in need of retreatment,” and the trial protocol is expected to be finalized this month. FDA expands Novavax EUA for teenagers Additionally, US teenagers looking for an option outside of the mRNA Covid-19 vaccines will now be able to turn to Novavax’s Covid-19 vaccine which won an expanded EUA on Friday from the FDA. Those aged 12 through 17 will gain access to the Novavax vaccine after the company submitted data from an ongoing pediatric expansion of its Phase III trial of 2,247 adolescents within that same age range across 75 sites in the US. The company said that in this population the vaccine achieved its primary efficacy endpoint, with clinical efficacy of about 78% (95% CI: 37.55%, 92.45%) overall, at a time when the Delta variant was the predominant circulating variant. The efficacy analysis was supported by assessment of antibody titers that were shown to be higher in adolescents than in young adults, Novavax added. Canada buys 12M doses of Moderna’s Omicron-targeted booster Meanwhile, mRNA powerhouse Moderna said Monday that Canada’s government has exercised its option to purchase an additional 4.5 million doses of an Omicron-containing bivalent vaccine booster candidate, in addition to moving forward the scheduled delivery of 1.5 million doses of the bivalent vaccine candidate from 2023 to 2022. Moderna and Canada also agreed to shift six million doses of the current vaccine to the Omicron-containing vaccine, subject to regulatory approval, with doses scheduled for delivery this year. The vaccine is expected to be ready for deployment in the US in October. ______________________________________________________ This article was first published by Endpoints News. Image Credits: Flickr – World Economic Forum. WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
NEJM Study: Pfizer’s Paxlovid Reduces COVID-19 Death by 81% in Older Adults, Not Effective in Younger Patients 24/08/2022 Maayan Hoffman Pfizer’s Paxlovid, an oral antiviral, has been found to reduce the mortality rate in older adults. Pfizer’s COVID-19 oral antiviral Paxlovid was found to reduce the mortality rate among people over the age of 65 by 81% in a new Israeli study published Wednesday in the New England Journal of Medicine. However, the study also found no significant benefit of the drug in patients aged 64 and younger. It is the first peer-reviewed study on the effectiveness of the drug in real-world conditions, one of its lead researchers told Health Policy Watch. The study also differs from the Pfizer clinical trials on the drug that were conducted during the Delta wave, and on patients who were unvaccinated. The Israeli study took place during the Omicron wave, and the majority of patients had been fully vaccinated with three jabs of the Pfizer Covid-19 vaccine. The study is peer-reviewed and a fuller version of data first published in June on the Research Gate Platform. The researchers also found a 73% reduction in hospitalization rate compared to the control group. Hospitalization and Mortality Rates Paxlovid To arrive at their results, the team of researchers analyzed Clalit electronic health records of high-risk patients over the age of 40 with advanced statistical methods between 9 January and 10 March of this year. During this period, 3,902 COVID-19 patients received Paxlovid via Clalit. The researchers compared the hospitalization and mortality rates among Covid patients who took the medicine and COVID patients who did not take the medicine (the control group). The Pfizer clinical trial found that Paxlovid was 89% effective in patients at risk of serious illness, the company reported at the end of 2021. As noted, the Clalit rate of effectiveness was much lower. However, Dr Ronen Arbel, Health Outcomes Researcher at Clalit Health Services and Sapir College, told Health Policy Watch that “if you want to compare apples to apples, you have to look at the minority of patients in our study who were unvaccinated and over the age of 65. If you look at them, the effectiveness is much more similar [to the Pfizer study]. “It is when you look at the majority of the patients, while the effect is significant, it is much smaller,” he said. Clalit has distributed more Paxlovid than any other health fund in Israel, according to Dr Doron Netzer, Chief Medical Officer of Clalit’s Community Health Division. In total, some 30,000 Israelis have received the drug. In March, a Medicines Patent Pool (MPP) announced it had signed agreements with 35 companies to manufacture generic versions of Paxlovid for distribution in 95 low- and middle-income countries. But that came under fire almost immediately from medicines access groups as too little, too late. Reported Significant Reduction in Risk of Hospitalization and Death In Israel, the drug is prescribed to COVID-19 patients aged 12 and older with mild to moderate symptoms who are at high risk for complications of Covid-19. The treatment is given for five days, as close as possible to the date that a positive COVID-19 test is received. “The results if the study show unequivocally that treatment with Paxlovid significantly reduces the risk of hospitalization and death from Covid-19 in those over the age of 65,” Netzer said. “The decision of the Health Ministry to allow this treatment saved many lives.” Earlier this month, the US Food and Drug Administration called on Pfizer to test another course of Paxlovid for those who have rebounded and tested positive after an initial dose. It also requested that Pfizer hold a clinical trial to evaluate different durations of treatment in immunocompromised patients with mild-to-moderate disease, Health Policy Watch reported. Pfizer told Bloomberg News that the trial protocol is expected to be finalized this month. Arbel said that the Clalit study did not examine these questions due to limitations in its data. Image Credits: Pfizer , Bobbi-Jean MacKinnon. Health System “Shaken” by Ukraine War 24/08/2022 John Heilprin COVID-19 patient in severe state in Chernivtsi, southwestern Ukraine. As the SARS-CoV2 pandemic wanes, health services must deal with a health emergency – created solely by human forces. Six months into the Ukraine war, the World Health Organization warns that the nation’s battered but “still-resilient” health system is facing “severe challenges and shortages in many areas” that must be dealt with as the nation prepares for a challenging winter. WHO officials marked the half-year point in the war, which coincided with Ukraine’s Independence Day, with a somber reflection on the state of the nation’s life-saving health system. The UN healthy agency says Ukraine has a “badly affected but still-resilient health system” even as attacks on it continue. Since the war began with Russia’s invasion on February 24, WHO says it has verified 473 attacks carried out on health systems, including facilities and personnel, resulting in at least 98 deaths and 134 injuries. In May, the World Health Assembly approved a resolution condemning the Ukraine war by 88 votes to 12. But the 53 abstentions reflected the discomfort of many member states with a debate that polarised the global health body. Most African nations abstained, as did many Middle Eastern nations, India and Pakistan. Most of Europe, the United States, Oceania and many Latin American countries supported the Ukrainian-backed resolution, which condemns “in the strongest terms, Russian Federation’s military aggression against Ukraine, including attacks on health care facilities.” Empty hospital beds line the hallways of the Kyiv Regional Perinatal Centre, Ukraine, on 7 March 2022. As hospitals are disrupted or destroyed, online healthcare services can mitigate gaps. Health System “Shaken” by Ukraine War, But Not “Collapsed” WHO says it is supporting Ukraine’s Ministry of Health in the Ukraine war by helping to restore disrupted services, displaced health workers and destroyed infrastructure. It also helped the ministry and partners deliver more than 1300 metric tonnes of medical supplies, WHO says, including power generators, ambulances and oxygen supplies for medical facilities. The UN health agency says those deliveries also include supplies for trauma and emergency surgeries and medicines to help treat noncommunicable diseases (NCDs). “Six months of war have had a devastating impact on the health and lives of Ukraine’s people, but despite many challenges the health system has managed to survive and deliver care where and when it is needed most,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Though shaken, the health system has not collapsed,” he said. “But no system can deliver optimum health to its people under the stress of war, which is why we continue to call on the Russian Federation to end this war.” After six months of war, #Ukraine’s badly affected but still-resilient health system is taking stock of lessons learnt in providing lifesaving care as it prepares for a challenging winter ahead.@WHO and partners are ready to provide continued support.https://t.co/Ezsrc5qgGe pic.twitter.com/caTNNgXkUk — WHO Ukraine (@WHOUkraine) August 24, 2022 Ukraine War’s “Horror” Demands Mental Health Response Dr Hans Henri Kluge, WHO Regional Director for Europe, said attacks on health care violate international humanitarian law and are “unconscionable” because they kill and maim civilians and health-care providers, and severely hinder or prevent the delivery of health care services to those who needed it most. “Amid the horror of war,” he said, “we continue to witness the heroic efforts of health providers – including the many I’ve been privileged to meet in person myself – who are such a credit to their profession despite their own personal suffering.” WHO also has helped train more than 9000 health care workers. Areas of focus include trauma surgery, mass casualties, chemical exposure, epidemiology and laboratory diagnostics. But mental health, including stress management for health care workers and the public, is a priority in the Ukraine war. “WHO is stepping up its efforts with the Ministry of Health to ensure that the health workforce is prepared with the necessary skills to respond to mounting needs as winter approaches,” said Dr Jarno Habicht, WHO Representative in Ukraine. “We’re already seeing severe challenges and shortages in many areas, with rising inequalities in access to health and other essentials, impacting, as always, the most vulnerable – women, children and the elderly,” said Habicht. “Even as we look to a time when peace is restored,” he said, “we must focus on the here and now – the next six months could test Ukraine’s health system as never before.” A destroyed tank is abandoned on the road to Bucha, Ukraine. Image Credits: Mstyslav Chernov/ Wikimedia Commons, UNICEF/Oleksandr Ratushniak, Marco Frattini/ World Food Program. Pfizer Submits Reguest to US FDA for Approval of Omicron-targeted COVID Booster Shot 23/08/2022 Zachary Brennan, via Endpoints News Albert Bourla, CEO of Pfizer, at a World Economic Forum meeting in 2018. The Omicron-targeted boosters are coming. Almost 250 days since Omicron became the dominant variant in the US, Pfizer and BioNTech on Monday officially announced that they’ve requested an Emergency Use Authorization (EUA) from the US Food and Drug Administration for their booster dose of an Omicron BA.4/BA.5-adapted bivalent vaccine for those 12 and older. The application’s submission comes as BioNTech said earlier this month that it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. The FDA’s vaccine advisory committee in late June gave the thumbs up — by a vote of 19-2 — to requiring an Omicron-related component in this season’s booster dose; both Pfizer/BioNTech and Moderna have been working on such boosters over the past few months. The EUA for Pfizer/BioNTech’s booster would be based on preclinical data showing that it generated a strong neutralizing antibody response against the BA.4/BA.5 variants, as well as safety, tolerability and immunogenicity data from a Phase II/III trial of a 30-µg booster dose of the companies’ other, Omicron BA.1-adapted bivalent vaccine candidate. A clinical study investigating the safety, tolerability and immunogenicity of the Omicron BA.4/BA.5-adapted bivalent vaccine in individuals 12 years of age and older is expected to start this month, Pfizer and BioNTech said. FDA to Pfizer: Test another course of Paxlovid for those rebounding In other COVID-related drug developments, the FDA earlier this month quietly called on Pfizer to test another course of its Covid-19 antiviral Paxlovid for those who have rebounded and tested positive after an initial dose. On Aug. 5, the FDA reissued its EUA letter for Paxlovid to include additional post-authorization requirements, including calling on Pfizer “to conduct a clinical trial in patients with ‘COVID-19 rebound’ and a clinical trial evaluating different durations of treatment in immunocompromised patients with mild-to-moderate Covid-19.” Pfizer told Bloomberg News that it is “working with the FDA to finalize a protocol to study patients who may be in need of retreatment,” and the trial protocol is expected to be finalized this month. FDA expands Novavax EUA for teenagers Additionally, US teenagers looking for an option outside of the mRNA Covid-19 vaccines will now be able to turn to Novavax’s Covid-19 vaccine which won an expanded EUA on Friday from the FDA. Those aged 12 through 17 will gain access to the Novavax vaccine after the company submitted data from an ongoing pediatric expansion of its Phase III trial of 2,247 adolescents within that same age range across 75 sites in the US. The company said that in this population the vaccine achieved its primary efficacy endpoint, with clinical efficacy of about 78% (95% CI: 37.55%, 92.45%) overall, at a time when the Delta variant was the predominant circulating variant. The efficacy analysis was supported by assessment of antibody titers that were shown to be higher in adolescents than in young adults, Novavax added. Canada buys 12M doses of Moderna’s Omicron-targeted booster Meanwhile, mRNA powerhouse Moderna said Monday that Canada’s government has exercised its option to purchase an additional 4.5 million doses of an Omicron-containing bivalent vaccine booster candidate, in addition to moving forward the scheduled delivery of 1.5 million doses of the bivalent vaccine candidate from 2023 to 2022. Moderna and Canada also agreed to shift six million doses of the current vaccine to the Omicron-containing vaccine, subject to regulatory approval, with doses scheduled for delivery this year. The vaccine is expected to be ready for deployment in the US in October. ______________________________________________________ This article was first published by Endpoints News. Image Credits: Flickr – World Economic Forum. WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Health System “Shaken” by Ukraine War 24/08/2022 John Heilprin COVID-19 patient in severe state in Chernivtsi, southwestern Ukraine. As the SARS-CoV2 pandemic wanes, health services must deal with a health emergency – created solely by human forces. Six months into the Ukraine war, the World Health Organization warns that the nation’s battered but “still-resilient” health system is facing “severe challenges and shortages in many areas” that must be dealt with as the nation prepares for a challenging winter. WHO officials marked the half-year point in the war, which coincided with Ukraine’s Independence Day, with a somber reflection on the state of the nation’s life-saving health system. The UN healthy agency says Ukraine has a “badly affected but still-resilient health system” even as attacks on it continue. Since the war began with Russia’s invasion on February 24, WHO says it has verified 473 attacks carried out on health systems, including facilities and personnel, resulting in at least 98 deaths and 134 injuries. In May, the World Health Assembly approved a resolution condemning the Ukraine war by 88 votes to 12. But the 53 abstentions reflected the discomfort of many member states with a debate that polarised the global health body. Most African nations abstained, as did many Middle Eastern nations, India and Pakistan. Most of Europe, the United States, Oceania and many Latin American countries supported the Ukrainian-backed resolution, which condemns “in the strongest terms, Russian Federation’s military aggression against Ukraine, including attacks on health care facilities.” Empty hospital beds line the hallways of the Kyiv Regional Perinatal Centre, Ukraine, on 7 March 2022. As hospitals are disrupted or destroyed, online healthcare services can mitigate gaps. Health System “Shaken” by Ukraine War, But Not “Collapsed” WHO says it is supporting Ukraine’s Ministry of Health in the Ukraine war by helping to restore disrupted services, displaced health workers and destroyed infrastructure. It also helped the ministry and partners deliver more than 1300 metric tonnes of medical supplies, WHO says, including power generators, ambulances and oxygen supplies for medical facilities. The UN health agency says those deliveries also include supplies for trauma and emergency surgeries and medicines to help treat noncommunicable diseases (NCDs). “Six months of war have had a devastating impact on the health and lives of Ukraine’s people, but despite many challenges the health system has managed to survive and deliver care where and when it is needed most,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Though shaken, the health system has not collapsed,” he said. “But no system can deliver optimum health to its people under the stress of war, which is why we continue to call on the Russian Federation to end this war.” After six months of war, #Ukraine’s badly affected but still-resilient health system is taking stock of lessons learnt in providing lifesaving care as it prepares for a challenging winter ahead.@WHO and partners are ready to provide continued support.https://t.co/Ezsrc5qgGe pic.twitter.com/caTNNgXkUk — WHO Ukraine (@WHOUkraine) August 24, 2022 Ukraine War’s “Horror” Demands Mental Health Response Dr Hans Henri Kluge, WHO Regional Director for Europe, said attacks on health care violate international humanitarian law and are “unconscionable” because they kill and maim civilians and health-care providers, and severely hinder or prevent the delivery of health care services to those who needed it most. “Amid the horror of war,” he said, “we continue to witness the heroic efforts of health providers – including the many I’ve been privileged to meet in person myself – who are such a credit to their profession despite their own personal suffering.” WHO also has helped train more than 9000 health care workers. Areas of focus include trauma surgery, mass casualties, chemical exposure, epidemiology and laboratory diagnostics. But mental health, including stress management for health care workers and the public, is a priority in the Ukraine war. “WHO is stepping up its efforts with the Ministry of Health to ensure that the health workforce is prepared with the necessary skills to respond to mounting needs as winter approaches,” said Dr Jarno Habicht, WHO Representative in Ukraine. “We’re already seeing severe challenges and shortages in many areas, with rising inequalities in access to health and other essentials, impacting, as always, the most vulnerable – women, children and the elderly,” said Habicht. “Even as we look to a time when peace is restored,” he said, “we must focus on the here and now – the next six months could test Ukraine’s health system as never before.” A destroyed tank is abandoned on the road to Bucha, Ukraine. Image Credits: Mstyslav Chernov/ Wikimedia Commons, UNICEF/Oleksandr Ratushniak, Marco Frattini/ World Food Program. Pfizer Submits Reguest to US FDA for Approval of Omicron-targeted COVID Booster Shot 23/08/2022 Zachary Brennan, via Endpoints News Albert Bourla, CEO of Pfizer, at a World Economic Forum meeting in 2018. The Omicron-targeted boosters are coming. Almost 250 days since Omicron became the dominant variant in the US, Pfizer and BioNTech on Monday officially announced that they’ve requested an Emergency Use Authorization (EUA) from the US Food and Drug Administration for their booster dose of an Omicron BA.4/BA.5-adapted bivalent vaccine for those 12 and older. The application’s submission comes as BioNTech said earlier this month that it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. The FDA’s vaccine advisory committee in late June gave the thumbs up — by a vote of 19-2 — to requiring an Omicron-related component in this season’s booster dose; both Pfizer/BioNTech and Moderna have been working on such boosters over the past few months. The EUA for Pfizer/BioNTech’s booster would be based on preclinical data showing that it generated a strong neutralizing antibody response against the BA.4/BA.5 variants, as well as safety, tolerability and immunogenicity data from a Phase II/III trial of a 30-µg booster dose of the companies’ other, Omicron BA.1-adapted bivalent vaccine candidate. A clinical study investigating the safety, tolerability and immunogenicity of the Omicron BA.4/BA.5-adapted bivalent vaccine in individuals 12 years of age and older is expected to start this month, Pfizer and BioNTech said. FDA to Pfizer: Test another course of Paxlovid for those rebounding In other COVID-related drug developments, the FDA earlier this month quietly called on Pfizer to test another course of its Covid-19 antiviral Paxlovid for those who have rebounded and tested positive after an initial dose. On Aug. 5, the FDA reissued its EUA letter for Paxlovid to include additional post-authorization requirements, including calling on Pfizer “to conduct a clinical trial in patients with ‘COVID-19 rebound’ and a clinical trial evaluating different durations of treatment in immunocompromised patients with mild-to-moderate Covid-19.” Pfizer told Bloomberg News that it is “working with the FDA to finalize a protocol to study patients who may be in need of retreatment,” and the trial protocol is expected to be finalized this month. FDA expands Novavax EUA for teenagers Additionally, US teenagers looking for an option outside of the mRNA Covid-19 vaccines will now be able to turn to Novavax’s Covid-19 vaccine which won an expanded EUA on Friday from the FDA. Those aged 12 through 17 will gain access to the Novavax vaccine after the company submitted data from an ongoing pediatric expansion of its Phase III trial of 2,247 adolescents within that same age range across 75 sites in the US. The company said that in this population the vaccine achieved its primary efficacy endpoint, with clinical efficacy of about 78% (95% CI: 37.55%, 92.45%) overall, at a time when the Delta variant was the predominant circulating variant. The efficacy analysis was supported by assessment of antibody titers that were shown to be higher in adolescents than in young adults, Novavax added. Canada buys 12M doses of Moderna’s Omicron-targeted booster Meanwhile, mRNA powerhouse Moderna said Monday that Canada’s government has exercised its option to purchase an additional 4.5 million doses of an Omicron-containing bivalent vaccine booster candidate, in addition to moving forward the scheduled delivery of 1.5 million doses of the bivalent vaccine candidate from 2023 to 2022. Moderna and Canada also agreed to shift six million doses of the current vaccine to the Omicron-containing vaccine, subject to regulatory approval, with doses scheduled for delivery this year. The vaccine is expected to be ready for deployment in the US in October. ______________________________________________________ This article was first published by Endpoints News. Image Credits: Flickr – World Economic Forum. WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Pfizer Submits Reguest to US FDA for Approval of Omicron-targeted COVID Booster Shot 23/08/2022 Zachary Brennan, via Endpoints News Albert Bourla, CEO of Pfizer, at a World Economic Forum meeting in 2018. The Omicron-targeted boosters are coming. Almost 250 days since Omicron became the dominant variant in the US, Pfizer and BioNTech on Monday officially announced that they’ve requested an Emergency Use Authorization (EUA) from the US Food and Drug Administration for their booster dose of an Omicron BA.4/BA.5-adapted bivalent vaccine for those 12 and older. The application’s submission comes as BioNTech said earlier this month that it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. The FDA’s vaccine advisory committee in late June gave the thumbs up — by a vote of 19-2 — to requiring an Omicron-related component in this season’s booster dose; both Pfizer/BioNTech and Moderna have been working on such boosters over the past few months. The EUA for Pfizer/BioNTech’s booster would be based on preclinical data showing that it generated a strong neutralizing antibody response against the BA.4/BA.5 variants, as well as safety, tolerability and immunogenicity data from a Phase II/III trial of a 30-µg booster dose of the companies’ other, Omicron BA.1-adapted bivalent vaccine candidate. A clinical study investigating the safety, tolerability and immunogenicity of the Omicron BA.4/BA.5-adapted bivalent vaccine in individuals 12 years of age and older is expected to start this month, Pfizer and BioNTech said. FDA to Pfizer: Test another course of Paxlovid for those rebounding In other COVID-related drug developments, the FDA earlier this month quietly called on Pfizer to test another course of its Covid-19 antiviral Paxlovid for those who have rebounded and tested positive after an initial dose. On Aug. 5, the FDA reissued its EUA letter for Paxlovid to include additional post-authorization requirements, including calling on Pfizer “to conduct a clinical trial in patients with ‘COVID-19 rebound’ and a clinical trial evaluating different durations of treatment in immunocompromised patients with mild-to-moderate Covid-19.” Pfizer told Bloomberg News that it is “working with the FDA to finalize a protocol to study patients who may be in need of retreatment,” and the trial protocol is expected to be finalized this month. FDA expands Novavax EUA for teenagers Additionally, US teenagers looking for an option outside of the mRNA Covid-19 vaccines will now be able to turn to Novavax’s Covid-19 vaccine which won an expanded EUA on Friday from the FDA. Those aged 12 through 17 will gain access to the Novavax vaccine after the company submitted data from an ongoing pediatric expansion of its Phase III trial of 2,247 adolescents within that same age range across 75 sites in the US. The company said that in this population the vaccine achieved its primary efficacy endpoint, with clinical efficacy of about 78% (95% CI: 37.55%, 92.45%) overall, at a time when the Delta variant was the predominant circulating variant. The efficacy analysis was supported by assessment of antibody titers that were shown to be higher in adolescents than in young adults, Novavax added. Canada buys 12M doses of Moderna’s Omicron-targeted booster Meanwhile, mRNA powerhouse Moderna said Monday that Canada’s government has exercised its option to purchase an additional 4.5 million doses of an Omicron-containing bivalent vaccine booster candidate, in addition to moving forward the scheduled delivery of 1.5 million doses of the bivalent vaccine candidate from 2023 to 2022. Moderna and Canada also agreed to shift six million doses of the current vaccine to the Omicron-containing vaccine, subject to regulatory approval, with doses scheduled for delivery this year. The vaccine is expected to be ready for deployment in the US in October. ______________________________________________________ This article was first published by Endpoints News. Image Credits: Flickr – World Economic Forum. WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
WHO Warns of New Ebola Threat in DRC 23/08/2022 John Heilprin A health worker in Democratic Republic of the Congo’s eastern province of North Kivu. A new case of Ebola has been confirmed in the Democratic Republic of the Congo’s eastern province of North Kivu, prompting health authorities to declare a resurgence of the deadly virus, World Health Organization (WHO) officials said on Tuesday. WHO announced that health authorities confirmed a 46-year-old woman died of the disease on 15 August in Beni, a town located in North Kivu. She initially received care for other ailments at the Beni Referral Hospital, who said, but the began exhibiting symptoms consistent with Ebola. A statement from WHO said both the Beni and Goma branches of the DRC’s National Institute of Biomedical Research (INRB) confirmed Ebola virus in samples taken from the patient. Further analysis showed her death was genetically linked to the 2018-2020 outbreak in North Kivu and Ituri provinces that was the country’s longest and largest. Last week, WHO issued its first guidelines ever for Ebola treatment. It advised using two monoclonal antibodies — mAb114 (Ansuvimab®, also known as Ebanga®) and REGN-EB3 (Inmazeb®) — that were first approved by the US Food and Drug Administration for use against the Zaire ebolavirus species in 2020. WHO says its “strong recommendations” for the two monoclonal antibody treatments that were released on Friday are based on a systematic review and meta-analysis of randomized clinical trials examining potential therapeutics for the deadly disease. The two therapies demonstrated “clear benefits and therefore can be used for all patients confirmed positive for Ebola virus disease,” WHO says. That includes older people, pregnant and breastfeeding women, children and newborns born to mothers with confirmed Ebola within the first seven days after birth. Dr Matshidiso Moeti, WHO Africa Executive Director. Battling ‘Greater Frequency’ of Resurgent Ebola Cases This latest resurgence comes just four months after the Ebola outbreak that erupted on 23 April in DRC was declared to be over by DRC and WHO authorities, with fewer cases and deaths than previous episodes due to a swift response including vaccinations. The last time the disease flared up in Beni it was brought under control in about two months and ended in mid-December 2021, after causing six deaths among eight confirmed and three probable cases. “Ebola resurgences are occurring with greater frequency in the Democratic Republic of the Congo which is concerning,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, health authorities in North Kivu have successfully stopped several Ebola flareups and, building on this expertise, will no doubt bring this one under control quickly,” Moeti said. Some 160 people have been identified as contacts and their health is being closely monitored by WHO staff and DRC health authorities, WHO said, and it has not yet been determined whether the woman who died was vaccinated. The nation has 1,000 doses of the rVSV-ZEBOV Ebola vaccine in its stockpile, including 200 that are being shipped to Beni this week. Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, produces early symptoms of fever and muscle aches like malaria. WHO’s “ring vaccination” strategy — vaccinating people who came into contact with patients — is expected to begin shortly after having shown some effectiveness at preventing new cases and limiting the spread of the disease in the DRC. WHO has been supporting DRC’s government to scale up testing, contact tracing and public health measures. Stockpiles of Ebola vaccines from the cities of Goma and Kinshasa were transported to Mbandaka earlier this year so vaccinations could start. A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts was underway in Mbandaka, a city in DR Congo’s north-western Equateur Province. Image Credits: WHO. Posts navigation Older postsNewer posts