WHO Issues Urgent Call to Develop New Vaccines to Tackle Drug-Resistant Bacteria 12/07/2022 Dann Okoth A USAID-led session in Bangkok trains laboratory workers to identify drug resistant pathogens in food samples. NAIROBI — With antimicrobial resistance (AMR) on the rise globally, the World Health Organization (WHO) Tuesday issued an urgent call to step up investment and research into vaccine candidates that can tackle the problem of drug-resistant bacteria in a new report that looks at key research gaps and opportunities. Antimicrobial resistance, which refers to bacteria, viruses and parasites that are resistant to drug treatment, results from factors such as the overuse and misuse of antibiotics and other antimicrobials in human and animal health. But along with new drugs, the development of new vaccines can also help counter the problem, experts say. WHO consultant Isabel Frost “Vaccines are highly vital tools in fighting AMR,” Isabel Frost, lead author of the analysis, told a virtual press briefing on Monday. “This analysis was needed to understand where opportunities for development were, and where there might be some vaccines available in the near future to fight some pathogens.” Infections from drug resistant pathogens are the third leading cause of death after cardiovascular diseases. Some 1.27 million deaths were attributable to AMR in 2019, while nearly 5 million deaths were somehow associated with drug-resistant infections, according to a major study published in January 2022 in The Lancet. That is more people than the number of deaths from either HIV or malaria. The death rate was highest in western Sub-Saharan Africa, where there were 27.3 deaths per 100,000 people. It was lowest in Australia, where there were 6.5 deaths per 100,000 people, according to the Lancet study of January 2022, published by the Global Burden of Disease Collaborative Network, led by the Seattle-based Institute of Health Metrics and Evaluation (IHME). The World Bank estimates that by 2050, infections associated with AMR will cause 28 million more people to fall into poverty, as a result of catastrophic illness, as well as adding US$1 trillion in healthcare costs. WHO Press Technical Briefing 11 July 2022 AMR pathogens are a silent pandemic that threaten global public health The report is the first to provide a detailed analysis of vaccines in development that have the potential to address drug resistance from priority pathogens. It also draws attention to a need to accelerate trials in AMR vaccines, and makes a case for increased investment that can lead to more global health equity. For instance, vaccines with varying degrees of efficacy already exist for dealing with four priority pathogens: Streptococcus pneumoniae, Haemophilus influenza type B, Salmonella Typhi, and microbacterium tuberculosis. (In the case of the latter, there are advanced trials underway of new TB candidate ‘subunit’ vaccines which could also be given in combination with the old BCG vaccine). But their uptake and access vary globally, in yet another example of the enormous inequities found in global public health. On the other side of the spectrum, there are no vaccine candidates in clinical development against six bacterial infections on WHO’s list of priority list of drug resistant pathogens, including ones that commonly cause severe and chronic gastro-intestinal illness or blood, urinary track and lung infections: C. Jejuni, H. pylori, E. faecium, Enterobacter spp, A. baumanii and P. aerungi. WHO Press Technical Briefing 11 July 2022 Having identified AMR as a silent pandemic, and in response to this major public health threat, WHO developed a global action plan in 2015 to combat AMR. The plan, adopted by the World Health Assembly (WHA) in May 2015, identifies five key strategic areas: 1) increasing awareness, surveillance and monitoring; 2) combating infection through control measures; 3) reducing inappropriate use of antimicrobials; 4) making an economic case for more investment in diagnostics, antimicrobials and new treatments; and 5) the need for vaccines to combat AMR. WHO priority pathogen list for research and development of new vaccine candidates In 2017, WHO developed the first list of bacteria for which new antibiotics are urgently needed. The intent was to curb AMR and develop an analysis to inform R&D, investment decisions and policy actions globally. Those considered to be “priority pathogens” are ones that pose the greatest global health threat because of their widespread resistance to common drugs, according to Frost, who also works as a WHO consultant for the Department of Immunization, Vaccines and Biologicals. “We have identified 61 vaccine candidates in active clinical development against these pathogens,” she told Health Policy Watch, but noted some pathogens in this list are challenging targets for vaccine development. WHO Press Technical Briefing 11 July 2022 Vaccine equity still hampered by poor distribution, access and uptake in most vulnerable regions Streptococcus pneumoniae remains the leading cause of death from resistant bacteria; it caused 122,000 deaths in 2019. “These deaths are concentrated in countries that have the lowest levels of access not only to vaccines but to antibiotics and other health services,” Frost said. “The good news is there are several vaccine candidates in late stage clinical development that have the potential to impact AMR. These include TB, e-coli and gonorrhea,” she added. But vaccine development is expensive, and failure rates are high, Frost noted, so even getting some of the vaccines into advanced stages of development doesn’t mean all of them will reach the market. Clinical trials also typically need large populations and take years to complete before vaccines reach the licensing and manufacturing stages. And she laments the fact that there are still no vaccine candidates in clinical development against six key bacterial pathogens on WHO’s list of priority list.: C. Jejuni, H. pylori, E. faecium, Enterobacter spp, A. baumanii and P. aerungi. Dr. Dr. Mateusz Hasso Agopdowicz, a WHO technical officer, noted many challenges remain to increase coverage of existing vaccines, especially for vulnerable populations in low- and middle-income countries where they are needed most. “To introduce new vaccines and increase coverage of existing vaccines,” he said, “we need sufficient funding for vaccination campaigns [and to] look for cheaper methods of developing vaccines, alternative ways of vaccine administration, and delivery as well as addressing vaccine hesitancy.” Dr. Mateusz Hasso Agopdowicz. WHO Investment in research and development vital to keep priority pathogens in check More resources are needed to continue R&D for vaccines in clinical development. And for pathogens with new vaccines in late-stage clinical trials, like microbacterium tuberculosis, funds are needed to accelerate these trials so tthey’re finished and the vaccines made available for use. And last month WHO raised the red flag over the lack of new antibacterial treatments being developed to address the mounting threat of antimicrobial resistance (AMR). Agopdowicz emphasised the need for further analysis to establish demand trends for vaccines so researchers can determine the number of doses needed when vaccines are ready to be used. “For the next 10 years, we need to use alternative approaches to contain resistant pathogens and use disruptive ways of vaccine manufacturing like mRNA,” he said. Even with promising vaccine candidates in the pipeline, questions remain around IP rights and trade issues that could hinder global vaccine equity. “No one benefits unless vaccines are created and then delivered to everyone who needs them,” said Boston University law professor Kevin Outterson, who is executive director at Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X). “This is exactly why every CARB-X-supported product is backed by a contractual promise to avoid the issues with access to COVID vaccines.” Image Credits: Richard Nyberg, USAID. UN Human Rights Council’s Resolution on Access to Medicines and Vaccines Welcomed by Civil Society 11/07/2022 Elaine Ruth Fletcher COVID vaccine shipments to Africa began in February 2021, but subsequent shortfalls laid bare the acute access problems faced in many low-income countries. Citizens and NGOs welcomed the United Nations Human Rights Council’s adoption of a much-debated draft resolution that calls on nations to ensure everyone has access to medicines and vaccines. The resolution was adopted by consensus Friday shortly before the close of the HRC’s 50th session, sending what proponents called a “clear message” that access to medicines and diagnostics, including COVID-19 vaccines, tests, and treatments, is a human right. Opponents such as the European Union, United Kingdom and United States, all home to major pharmaceutical companies, said the World Health Organization should be managing access. “It is yet another rebuke to the rich countries and pharmaceutical companies that have chosen to uphold monopolies on life-saving medicines despite the human cost, which on one estimate is a preventable COVID-19 death every minute. That is a violation of human rights,” said a joint statement from Amnesty International, Human Rights Watch, Knowledge Ecology International, and the People’s Vaccine Alliance. The UN Human Rights Council meeting last week in its 50th session. Though the resolution is non-binding and may have little practical impact, it could influence similar debate at the World Trade Organization over a proposal by India, South Africa and some low- to middle-income countries to relax intellectual property rules for manufacturing COVID treatments and tests. At its meeting of trade ministers in June, the WTO approved a resolution on a “limited” waiver of IP rules around COVID vaccine production. The current surfeit of vaccines, however, means the resolution would have little practical impact. But the WTO is supposed to decide within the next six months whether to extend the waiver to COVID tests and treatments that are costlier or in short supply in many countries. Those talks have already begun in the WTO’s Council on Trade-related Aspects of Intellectual Property Rights (TRIPS), WTO’s Director General Ngozi Okonjo-Iweala said after an informal meeting with WTO heads of delegations in Geneva on Thursday. HRC resolution touches on wide range of topics The final draft of the Human Rights Council resolution, co-sponsored by Argentina, Brazil, China, Egypt, India, Indonesia and 10 other nations, includes ambitious calls to countries to ensure access to immunization as a “global public good.” It calls for the “de-linkage” of the costs of new research and development from medicines and vaccines prices to ensure their wider availability, in keeping with the wishes of citizens and NGOs. Countries are asked to promote research, build capacity, and take “all measures necesary to strengthen regional and local production.”\ Developing nations that sought the resolution and rich nations that opposed it engaged in heated, mostly backroom debates over the precedents it could set even from a rhetorical standpoint. After the United Kingdom said “securing” immunization as a “global public good” is not necessarily up to government, the final text was changed to refer to “access to immunization as a global public good.” And wealthy countries insisted on adding a caveat to the final text that says all transfers of technology and know-how to developing countries must be “on mutually agreed terms” rather than compulsory. ‘Commitment, where possible, to voluntary licensing’ The 47-nation Human Rights Council’s language linking the promotion of research and innovation to a “commitment, where possible, to voluntary licensing in all agreements in which public funding has been invested in research and development” is significant because of the way COVID vaccines and treatments were marketed under exclusive patents after being financed with public funds. But language calling for “a strong spirit of international solidarity” was changed to merely “a strong spirit of solidarity,” reportedly at the behest of the EU and the UK, according to an analysis by Knowledge Ecology International (KEI). “There were deliberate attempts from some states to water down the language of this resolution, and the United Kingdom and the European Union initially pushed back on the principle of international solidarity,” the analysis said. “Yet the final resolution clearly states that health is a human right and that international cooperation must be the world’s guiding principle for this pandemic and any future health crisis.” The analysis said governments must live up to their human rights obligations in several international human rights treaties, and that means “addressing the disproportionate impact of global health crises on marginalized groups, as well as fostering knowledge and technology transfer, and making full use of flexibilities in global intellectual property rules to adequately respond to and prepare for public health needs.” Image Credits: Bicanski on Pixnio, GovernmentZA/Flickr, European Union . Some 1.1 Billion COVID-19 Vaccine Doses Likely Wasted Since Rollout Began 11/07/2022 Editorial team Wasted COVID-19 vaccine doses since beginning of immunization drives Some 1.1 billion COVID-19 vaccines are likely to have been wasted since the global rollout began, according to new findings by Airfinity, a global health surveillance firm. Airfinity’s analysis, released Monday, assumed a 10% wastage rate from June 2021 when global dose sharing began. This rate is taken from confirmed wastage in the United States and factors in an average shelf life of six months. The team also collated all public reports of vaccine waste and expirations from around the world, totalling some 158 million doses. The majority of the reporting on wastage did not specify, however, which vaccine type was discarded. Of those which do name the manufacturer, Russia’s Sputnik V was the most squandered with over 25 million doses that are known to have been unused. This was followed by AstraZeneca’s reported 19 million wasted jabs. Wastage of COVID-19 vaccine doses under-reported, but within range of Gavi assumptions The new estimate means that around 8% of the 1.1 billion doses reportedly disbursed until now have gone unused. Those estimates are within the recommended range of Gavi, the Vaccine Alliance, which assumed the wastage rate for COVID vaccines could be as high as 10%. But the estimates also reflect a certain level of uncertainty toward the underreporting of vaccine wastage in terms of individual reports from nations’ public health systems. Airfinity’s Analytics Director Dr Matt Linley said some degree of wastage is inevitable despite countries’ best efforts. “Large multi-dose vials can make efficiencies more challenging, as well as cold chain storage and predicting daily demand or simply a vial being dropped or left out too long,” Linley said. “Vaccines in single-dose vials with a longer shelf life, which can be transported and stored more easily, will reduce wastage over time,” he said. “Pfizer/BioNTech’s most recent agreement with the U.S. includes single doses, a first for COVID-19 vaccines, and a stipulation we expect to be repeated by other nations.” Airfinity’s CEO Rasmus Bech Hansen said no one wants to waste doses in any amount, but it’s a byproduct of an unprecedented level of vaccine production that has saved millions of lives. “If we want a fast reacting global vaccine response system, we will have to accept some level of wasted doses,” he said. “But the less the better, and monitoring the wastage levels ongoing is an important piece of global health information.” Image Credits: Asian Development Bank/Flickr, Airfinity . European Medicines Agency Recommends Second COVID Booster for People Over 60 – as WHO Ponders Status of COVID Emergency 08/07/2022 Elaine Ruth Fletcher COVID vaccination of older people. The European Medicines Agency is now recommending boosters for people over 60, With cases of Omicron BA.4 and BA.5 soaring in Europe and around the world, the European Medicines Agency (EMA) recommends everyone 60 and older get a second COVID-19 booster shot. EMA’s recommendation came shortly before WHO reconvened its COVID Emergency Committee on Friday to reconsider its global recommendations for the pandemic – and if the state of global health emergency first declared on 30 January 2020, should be maintained. So far WHO recommendations on a second booster, provided by another expert group in May, are limited to immunocompromised people. Speaking at a press conference Thursday, EMA’s head of vaccines, Marco Cavaleri said a fourth booster for people over 60 and other vulnerable groups is now warranted due to a regional increase in COVID cases. He said projections show the BA.4 and BA.5 sub variants are expected to become dominant across all European countries, likely completely replacing all other variants by the end of July. Marco Cavaleri, head of vaccines for the European Medicines Agency “As this new wave is unfolding over the EU, it is essential to maintain protection of vulnerable groups and avoid any postponement of vaccination,” Cavaleri said. “Although there is no evidence of increased infection severity in the BA.4 and BA.5 compared to other sub variants, the increased transmission among older age groups is starting to translate into severe disease.” Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told a briefing on Wednesday. EMA and other regulators looking toward approval of “bivalent” COVID vaccines by September While current vaccines offer “good protection” against hospitalization, severe disease and death, EMA and other regulatory agencies around the world are now looking closely at new “bivalent” COVID vaccine formulations, Cavaleri said. EMA, the US Food and Drug Administration and other national regulatory authorities met last week under the auspices of the International Coalition of Regulatory Authorities (ICMRA) to examine available data on the new vaccines in light of the reduced protection that current vaccines offer against mild and moderate disease. “Preliminary data from clinical trials indicate that adapted messenger RNA (mRNA) vaccines which incorporate an Omicron variant strain can increase and extend protection, when used as a booster,” Cavaleri said of ICMRA’s conclusions. “Bivalent mRNA vaccines which combine two strains of SARS-CoV-2, one of which is an Omicron strain … appear to offer an even wider immune response.” But vaccines that include other variants or subvariants might also be considered for use as boosters, if clinical trial data demonstrate an adequate level of neutralization against Omicron and other variants of concern. Cavaleri said his agency is evaluating initial data that mRNA vaccines manufacturers have submitted for review and is in close contact with manufacturers of vaccines based on different platforms other than mRNA, especially adjuvanted protein vaccines. “Overall we expect to potentially have several vaccines to include … with an assortment of different platforms and technologies, and this is welcome,” he said. EMA also is working towards approval of adapted COVID-19 vaccines in September, with an eye towards what Cavaleri described as “plans for an even broader rollout of vaccination campaigns in the autumn.” Future Course of WHO Public Health Emergency Designation for COVID WHO hasn’t changed its designation of COVID-19 as a pandemic, and it was not expected to do so at Friday’s COVID Emergency Committee meeting – although as of Sunday afternoon no statement by the Commitee had yet been made, raising questions about what directives might yet be issued. Irregardless of current trends showing increased transmission in many parts of the world, there is growing acknowledgement that the COVID emergency is evolving into an endemic disease. That will likely mean further peaks and valleys, but be far less lethal than the initial waves of 2020. And sooner or later, that will prompt a re-evaluation of the status of COVID as a “Public Health Emergency of International Concern” (PHEIC), requiring countries to undertake special measures under the terms of International Health Regulations. At a press conference on Thursday, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed the real work needed to take place “at the national level.” In line with those trends, WHO and Gavi, the Vaccine Alliance acknowledged plans this week to “transition” the work of the Act Accelerator initiative for distributing COVID vaccines, tests and treatments into the work of key ACT-A partners and national health systems. Under the auspices of ACT-A, COVAX, the global vaccine facility has distributed hundreds of millions of doses of COVID vaccines to 92 low-income countries since March 2021 with the support of Gavi, UNICEF and WHO. Tthe vaccine facility was hampered early in the pandemic by severe vaccine supply shortages and later by widespread public uptake of vaccines as they became more available. -Updated 10 July 2022 Image Credits: Flickr: IMF/ Raphael Alves. First-Ever Cases of Marburg Virus Disease Reported in Ghana 08/07/2022 Editorial team Bats, captured from the Kitaka mine in Uganda were discovered to be the source of a Marburg virus outbreak in July 2007 in Uganda, where two infections were reported among miners. Ghana has reported two suspected cases of the rare and deadly Marburg virus disease – the first to ever be recorded within its borders. Marburg is a highly infectious viral haemorrhagic fever in the same family as the more well-known Ebola virus disease, said WHO’s Ghana Country Office in making the announcement. It has a fatality rate of up to 88%. Preliminary analysis of samples taken from two patients by the country’s Noguchi Memorial Institute for Medical Research indicated the cases were positive for Marburg. The samples have been sent to the Institut Pasteur in Senegal, a World Health Organization (WHO) Collaborating Centre, for confirmation. The two patients from the southern Ashanti region – both unrelated – showed symptoms including diarrhoea, fever, nausea and vomiting. They died after having been taken to a district hospital in Ashanti region. Preparations for a possible outbreak response are being set up swiftly as further investigations are underway, WHO said. “The health authorities are on the ground investigating the situation and preparing for a possible outbreak response. We are working closely with the country to ramp up detection, track contacts, be ready to control the spread of the virus,” said Dr Francis Kasolo, World Health Organization (WHO) Representative in Ghana. WHO is deploying experts to support Ghana’s health authorities by bolstering disease surveillance, testing, tracing contacts, preparing to treat patients and working with communities to alert and educate them about the risks and dangers of the disease and to collaborate with the emergency response teams. Geographic distribution of Marburg haemorrhagic fever outbreaks and fruit bats of Pteropodidae Family. Ghana cases outside of endemic zone The outbreak in Ghana is a source of concern not only because the virus is particularly deadly, but also because it has occurred outside of the central and southern African zone where most cases have been previously reported. Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda, according to WHO. Marburg has been detected in just one other West African country, Guinea. The country confirmed a single case in an outbreak that was declared over on 16 September 2021, five weeks after that case was detected. The deadly virus was first identified in 1967 after two outbreaks of cases simultaneously in Marburg and Frankfurt Germany and in Belgrade, Serbia – thus the naming of the disease. The outbreak was later raved to laboratory work with African green monkeys (Cercopithecus aethiops) that had been imported from Uganda. Marburg is transmitted to people from fruit bats and following that, it can spread person-to-person through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise, said WHO. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management. Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated. Image Credits: Chris Black/WHO, World Health Organization . African Innovation Gets Major Boost with New Pharma Technology Foundation 07/07/2022 Ochieng’ Ogodo Akinwumi Adesina, president of the African Development Bank, visits the ‘Mother and Child’ Hospital of Bingerville, Côte d’Ivoire, in 2020 The African Development Bank is establishing a foundation with the aim of spending at least $3 billion over the next decade to boost Africa’s access to technologies needed to make medicines, vaccines, and other pharmaceutical products. The bank’s board approved the establishment of the African Pharmaceutical Technology Foundation with an eye to towards creating what the bank described in a statement on June 27 as “a new groundbreaking institution” for Africa’s 1.3 billion citizens. AfDB President Akinwumi Adesina said Africa “must have a health defense system” that revamps its pharmaceutical industry while also building up its capacity to make vaccines and provide quality healthcare. “Africa can no longer outsource the healthcare security of its 1.3 billion citizens to the benevolence of others,” said Adesina, a Nigerian economist. AU priority to improve healthcare sector African Union Headquarters, Addis Ababa The need for a foundation featured prominently at the African Union summit in February at Addis Ababa, where leaders called on AfDB to help Africa’s health care sector become more independent in light of the challenges it has faced from several devastating diseases and the COVID-19 pandemic. WHO’s Dr Tedros Adhanom Ghebreyesus The foundation’s creation signals a major shift in efforts to address inadequacies in the sector, including limited capacity to produce its own medicines and vaccines in part due to the intellectual property barrier. Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said it “is a game changer on accelerating the access of African pharmaceutical companies to IP-protected technologies and know-how in Africa.” Medicines and vaccines gap The pandemic exposed Africa’s lack of capacity to manufacture and supply essential drugs and personal protective equipment (PPEs) needed to control the coronavirus. Soon after the pandemic began in early 2020, many of the world’s top scientists scrambled to find a vaccine but government and business leaders paid less attention to how it would be made and delivered to low- and middle-income countries. More focus was put on rapidly increasing supply to meet the surging demand, in a process largely driven by wealthier nations with greater purchasing power. In Africa, as in most other developing nations, citizens’ health care became dependent on the generosity of others. Nigerian pharmacist Ezinne Victoria Chinemerem Onwuekwe, who works as a public health fellow for the Africa Centres for Disease Control and Prevention, said the main problem is that Africa’s pharmaceutical industry lacks manufacturing capacity. “There are a few production companies here and there, and for it to be able to produce for these citizens, it will require the effort of public and private sector to bring together both the technical [and] financial support needed to push this forward,” she said. The shortage of medicines and other pharmaceutical products has been a challenge to effective delivering quality healthcare services in Africa. Pharmaceuticals are made in South Africa, Kenya, Morocco and Egypt, yet Africa spends US$16 billion to import 94% of its pharmaceutical and medicinal needs, according to the United Nations Economic Commission for Africa (UNECA). As of 2019, the continent had roughly 375 pharmaceutical manufacturers, compared to about 5,000 and 10,500, respectively, in China and India. And a 2019 study found many life-saving drugs are still inaccessible and unaffordable in low- and middle-income countries. Game changer for medicines Akinwumi Adesina, African Development Bank president, at the initiative launch, The new foundation, which will raise its own funds and operate independently of AfDB, will be hosted in Rwanda and deal with IP rights and health policy. One of its chief responsibilities will be mediating interests between Africa’s pharmaceutical sector and global companies with the aim of sharing IP-protected technologies, know-how and patented processes, according to documents on its establishment. It also is being asked to prioritize technologies, products and processes aimed primarily at diseases widely prevalent in Africa, or those that involve current and future pandemics. And it is expected to help build up the ranks of health care professionals and others who conduct research and development while upgrading manufacturing plant capacities and regulatory quality to meet WHO standards. Challenges in the healthcare sector Ezinne Onwuekwe Small fragmented markets and weak regulatory frameworks, inadequate human resource capacity, poor procurement and supply chain systems, and policy incoherencies in countries’ trade, industry, health, and finance departments are some of the impediments to the growth of Africa’s pharmaceutical sector. The continent is also burdened with fake and falsified medical drugs. In 2017, WHO revealed an estimated 116,000 additional deaths a year from malaria could be tied to substandard and falsified antimalarials. To counter that, the foundation is being asked to help local pharmaceutical companies boost home-grown production with better technology in their manufacturing plants and to work with governments, research and development centers to improve their innovation capacities. Onwuekwe said part of the problem is a lack of political will in some countries. “This is about finding African solutions to African problems. That is the new public heath order,” Onwuekwe told Health Policy Watch. “The leadership of the countries have to invest financially and politically for there to be any progress in the sector.” But the foundation, she said, also must become adept at negotiating with global pharmaceutical companies and must be “able to foster collaborations” with WHO, the African Union and other international organizations. Image Credits: AfDB Group, IAEA. WHO Concern as Monkeypox Cases Jump by 77% in a Week 07/07/2022 Kerry Cullinan With a 77% increase in new monkeypox cases in the past week, the World Health Organization’s (WHO) Emergency Committee is increasingly likely to declare the outbreak a public health emergency of international concern (PHEIC) when it reconvenes on or before 18 July. By Thursday, 59 countries had reported monkeypox cases, with Spain (1804 cases), UK (1351), Germany (1304) and the US (605) recording the highest caseloads. However, 10 countries have not reported new cases for over 21 days, which is the maximum duration of the incubation period of the disease, according to the WHO’s latest report. So far, there have been 6027 laboratory-confirmed cases of monkeypox and three deaths, but most countries are unable to test for the virus. However, the European Centre for Disease Prevention and Control (ECDC) reported on Wednesday that 5949 cases had been identified in 33 European countries alone through international health regulation mechanisms and public records. The vast majority of cases (99%) were male and aged between 31 and 40 (42%). “The majority of cases presented with a rash (96.1%) and systemic symptoms such as fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat or headache (69%). No cases were reported to have died. Some (15) cases were reported to be health workers. However, further investigation is ongoing to determine whether infection was due to occupational exposure,” according to the ECDC. Monkeypox cases, 6 July 2022 (Source: https://www.monkeypoxtally.info/) Lack of testing Expressing his concern about the scale and spread, WHO Director-General Dr Tedros Adhanom Ghebreyesus acknowledged that “testing remains a challenge and it’s highly probable that there are a significant number of cases not being picked up”. While most of the new cases have been identified in Europe and the US, Africa – where monkeypox was first identified in 1970 – has not recorded a huge jump in cases, and experts believe this could be due to a lack of proper testing. “I plan to reconvene the emergency committee so they are updated on the current epidemiology and evolution of the outbreak and implementation of countermeasures. I will bring them together during the week of 18 July or sooner if needed,” Tedros told the media briefing on Wednesday. The emergency committee decided not to declare monkeypox a PHEIC when it met in late June. Tedros also said that the WHO is working with countries and vaccine manufacturers to coordinate the sharing of “scarce” vaccines . Tedros added that the WHO is also working closely with civil society and LGBTQI+ community in particular to “break the stigma around the virus and spread information so people can protect themselves”, and commended those sharing their stories on social media to inform others. To share a little bit about my experience: I believe I was exposed to it around a week before symptoms manifested. Started off with just a couple bumps, then developed intense flu-like symptoms. Fever, chills, sweats, fatigue, etc. — Matt Ford (@JMatthiasFord) June 23, 2022 Child cases According to the WHO’s latest report, the outbreak “continues to primarily affect men who have sex with men who have reported recent sex with one or multiple male partners, suggesting no signal of sustained transmission beyond these networks for now.” However, WHO monkeypox expert Dr Rosamund Lewis confirmed that there were cases reported in children, about one-third of whom were under the age of 10. “For older children aged 18 or 19, the mode of transmission may still be an open question, but for younger children, one would assume that that would be from exposure in the household setting,” said Lewis. By Wednesday, 119 people had been diagnosed with monkeypox in New York City and city officials confirmed that the limited supplies of vaccines were usually snapped up in minutes by the group it was being offered to: men who have sex with men who had multiple sex partners, as well as close contacts of confirmed cases. Monkeypox cases continue to rise in NYC. Our supply of vaccine is wholly inadequate. Appts are gone within minutes of posting. (Yes even with the recent shipment.) We need the feds to send us far more doses ASAP. pic.twitter.com/HzqefaaIns — Mark D. Levine (@MarkLevineNYC) July 6, 2022 Image Credits: https://www.monkeypoxtally.info/. Long-Neglected Tuberculosis Could Be Stopped by 2030 – at a Cost of $250 Billion 07/07/2022 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. After year-long consultations, the Stop TB Partnership launched its global plan to end tuberculosis by 2030, which would involve the diagnosis and treatment of 50 million people at a cost of $250 billion. TB, the second biggest infectious disease killer in the world after COVID-19, has been neglected by donors in the past – yet if the plan’s budget was realised, every $1 invested would yield an economic return of at least $40. “If, instead, the status quo is maintained, TB is expected to continue to kill between 4,000-5,000 people every day, an additional 43 million people will develop TB and the cost in human life and disability would translate to a global economic loss of US$ 1 trillion,” according to Stop TB. “The COVID-19 pandemic delivered a crystal-clear wake-up call: that we cannot ignore a disease just because it has been relegated only to the poorest parts of the world,” said Dr. Paula Fujiwara, who led the task force in charge of the development of theplan. “With our attention diverted—along with the absence of financial commitments—TB has strengthened its grip on our planet. But we can regain control and meet our commitments to end TB by 2030 as long as we assert our political will now.” Today! @StopTB unveiled a costed plan to #endTB, the second leading infectious disease killers in the world, after #COVID19. The Global Plan to End TB 2023-2030 outlines the priority actions and estimated financial resources needed to end TB.👉Read here: https://t.co/HZLY4E9ous pic.twitter.com/gS2QbfBhzK — Stop TB Partnership (@StopTB) July 6, 2022 Tepid global response Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said that while the global response to COVID-19 was to “plough money and resources into developing diagnosis tools, treatments and vaccines at lightning speed”, the response to TB, which infects 10 million people every year and kills 1.5 million, “has been tepid at best”. “A similar airborne infectious disease, TB remains neglected, even though it is a health threat for every single person. It is in the interest of all of us to end TB,” added Ditiu. However, she added that she was optimistic that the war against tuberculosis could be won by 2030. “A lot of optimism comes from what we have seen happening during COVID—it is possible to mobilize the resources –it is possible that researchers will work together, and share data to be able to develop new tools in such a short amount of time and it is possible to deploy and to organize amazing efforts at the grassroots level.” The Global Plan highlights the need to invest in developing a new TB vaccine by 2025, and making sure that resources are available to reach adults and adolescents in countries where TB is most prevalent. The only TB vaccine currently available is the BCG vaccine, which was approved more than a century ago and has a very limited impact on disease prevention. Dr Lucica Ditiu, Executive Director of Stop TB Partnership “The proposed investment of $ 10 billion in new TB vaccines, a new tool we all are waiting for, is 10 times less than what was injected in the research and development for COVID-19 vaccines. It should be possible to have the TB vaccine,” said Ditiu. Previous reports from the Stop TB Partnership noted that COVID-19 had cost the world 12 years of progress against TB. “Currently, almost 30% of funding per TB case comes from out-of-pocket costs and on average individuals with TB and their households lose 50% of their annual incomes as they suffer from and get treatment for the disease, even in places where TB services are provided free of charge,” according to Paul Mahanna, USAID’s Director of the Office of Infectious Diseases, “We cannot drive change without addressing the significant funding gaps that exist within high TB burden countries that result in lack of access to life-saving services and drive individuals, families and communities further into poverty. Image Credits: Stop TB Partnership. World Sees ‘Unprecedented’ Hunger as Farm Subsidies Boost Unhealthy Foods 06/07/2022 Elaine Ruth Fletcher An African farmer collects leaves from a gourd plant – smallholders are critical to food security and nutritional diversity – and marginalized by global food systems. Between 702 million and 828 million people suffered from hunger in 2021, more than at any time since 2005, five UN agencies reported on Wednesday. The proportion of people affected by hunger had remained relatively unchanged since 2015, affecting 8% of the global population in 2019. Once the COVID-19 pandemic hit in early 2020, those numbers soared to 9.3% in 2020 and to 9.89% in 2021, according to the State of Food Security and Nutrition in the World 2022 report published by the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF, World Food Programme (WFP) and International Fund for Agricultural Development (IFAD). That represents an increase of about 46 million people since 2020 and 150 million people since the outbreak of the pandemic. At current rates, 8% of the global population will still face hunger in 2030, unchanged from when the UN’s 2030 Agenda for Sustainable Development launched. Among the key goals of that ambitious plan, adopted at the UN Sustainable Development Summit in September 2015, was a determination “to end poverty and hunger, in all their forms and dimensions, and to ensure that all human beings can fulfil their potential in dignity and equality and in a healthy environment.” Progress on hunger stalled: Numbers of people who are going hungry today is about the same, or even more, than in 2005. Botswana’s Collen Vixen Kelapile, President of the United Nations Economic and Social Council (ECOSOC) Almost 3.1 billion people couldn’t afford a healthy diet in 2020, the report says. Massive food subsidies behind the production and consumption of milk, rice, sugar and meat also are disincentivizing production and consumption of healthy fruits, vegetables and protein-rich legumes, the report finds. Critically, the report calls upon a restructuring of global and national food subsidies to encourage more consumption of healthier foods including fruits and vegetables – which would also reduce carbon emissions from agricultural production of livestock and products that contribute to climate change. “Transformed agro-food systems need to be part of the solution to climate change and biodiversity loss … our very existence depends on it. Hundreds of millions of hungry and malnourished fellow human beings depend on it,” said Botswana’s Collen Vixen Kelapile, president of the UN Economic and Social Council (ECOSOC), which hosted the report’s launch in New York City. ‘Starvation and mass migration on an ‘unprecedented’ scale Trends in hunger by region WFP’s Executive Director David Beasley noted the world already faced “a perfect storm from the combined effects of conflicts and climate change and COVID economic ripple effects and global inflation” as this year was getting started. David Beasley, WFP executive director “And just when you think it can’t get any worse,” he said, “because we had Ethiopia and Afghanistan, then boom, Ukraine happens, the breadbasket of the world. The impact this conflict is having on global food security means the number of chronically hungry people in the world is likely already much higher than the 828 million people outlined in this work.” Beasley said the latest analysis shows a record 345 million acutely hungry people are marching to the brink of starvation today, a huge increase 276 million at the start of 2022 and from 135 million in the pre-COVID era. “There’s a real danger it will climb even higher in the months ahead,” he warned. “The global price spikes in food, fuel and fertilizers that we are seeing as a result of the crisis in Ukraine threaten to push countries around the world,” Beasley said. “The result will be global destabilization – to starvation and mass migration on an unprecedented scale. We have to act, and we have to act today to avert this looming catastrophe.” Africa hardest hit by hunger – women suffer more than men Laotian children get a fresh and healthy meal; WHO has urged policymakers to prioritize the introduction of healthier foods at schools. The prevalence of hunger, childhood wasting and stunting is highest in Africa, with a substantial burden in Asia, Latin America and the Caribbean (LAC), the report says. Hunger affected 278 million people in Africa; 425 million people in Asia; and 56.5 million people in LAC in 2021. Women are more likely to go hungry across the developing world, the report stresses. Globally, 149.2 million children under the age of 5, or 22% of the total population, suffered from stunting, and 6.7% suffered from wasting. Both are nutrition indicators of low height and weight in proportion to age. Another 38.9 million children under the age of five, or 5.7% of babies and toddlers globally, are overweight, reflecting a rise in unhealthy diets. Healthy diets became even more unaffordable in 2021. Almost 3.1 billion people could not afford a healthy diet in 2020, up by 112 million people from 2019, reflecting what the report describes as the effects of inflation in consumer food prices stemming from the economic impacts of the pandemic and the measures put in place to contain it. The poor in Asia, Africa and Latin America are also among those least able to afford a healthy diet, with Asia seeing the highest surge in costs – 4% in just one year. Political solution to Ukraine among the most immediate measures The global food crisis is being exacerbated by Russia’s blockage of exports from Ukraine, the world’s breadbasket. An end to the Russian blockade of Ukrainian ports is an important first step in addressing the crisis but only the beginning, Beasley said, listing the top priorities as follows: “Firstly we urgently need a political solution to Ukrainian wheat and grain so they can re-enter global markets.. Open up the ports.. Let’s get it moving. “Number 2, humanitarian organizations need substantial new funding to deal with the skyrocketing levels of hunger that we’re seeing around the world. “Thirdly, governments have to resist protectionism and keep trade flowing across borders. And fourthly, we need to learn the lessons of this crisis and invest in resilience programmes to help the poorest communities protect themselves against hunger and against shocks. “If we had successfully threaded this needle in the past, the war in Ukraine wouldn’t be having such a disastrous global impact today.” Rewriting the rules on agricultural and food subsidies to promote healthier foods Shifting food and agriculture subsidies to production and consumption of healthier foods would both reduce climate emissions and average costs of a healthy diet. But some farmers invested in unhealthy foods production could lose out. Fundamentally, the report calls for a major restructuring of deeply embedded global and national subsidies that are currently driving a significant portion of agricultural production – and unhealthy consumption of meat, sugar and basic commodities such as rice – at the expense of other healthier and lower-carbon intensive alternatives. FAO chief economist Máximo Torero Cullen said overall support for agricultural production largely concentrates on staple foods such as dairy and other animal source protein-rich foods, especially in high and upper middle income countries. “Rice, sugar and meat of various types are the foods most incentivized worldwide, while producers of fruits and vegetables are less supported overall, and even penalized in some low-income countries,” he said. “This needs to change. We are doing the opposite of what we are talking about. We need to change abruptly what is happening.” FAO chief economist Máximo Torero Cullen. The new report offers scenarios through 2030 in which public support to all farmers is reallocated around priority foods needed for healthy diets. FAO says adjusting price incentives will also reduce the cost of nutritious foods, which can healthy diets more affordable. That would also lower greenhouse gas emissions, particularly with livestock production, which has a high carbon pricetag. Shifting certain kinds of subsidies could, however, also create negative impacts on some farmers – who would then need new kinds of support, he pointed out. Needed: new flexibilities in national and WTO subsidy rules Cullen said understanding the tradeoffs are key to mapping out the future, and come further into play with the World Trade Organization. “We need commitments and flexibilities, and we need to follow what we have agreed with the WTO rules,” he said. “It may be necessary to set up new fiscal subsidies to consumers or to use proper social protection systems. International development finance will be needed for low-income countries and upper lower middle income countries, given that they have smaller amount of mechanisms.” Agricultural subsidies rules, however, tend to penalize small farmers in low-income countries, delegates from Latin America, Africa and Asia told the ECOSOC meeting. Pakistan’s UN representative Munir Akram “Massive subsidies distort global markets and make it impossible for farmers from developing countries to produce food at competitive prices,” said Pakistan’s UN representative Munir Akram. Gilbert Houngbo, president of IFAD, said the report highlights ways to repurpose agricultural and food policies to support small-scale producers and to build their resilience. Gilbert F. Houngbo, president of IFAD “Policies on subsidies often fall short of reducing hunger or improving food security and inclusion,” he said. “Instead, they have promoted an overreliance on starches, sugars, high protein and processed foods, while not supporting the production of healthier fruits and vegetables, for example.” Image Credits: @veerajayanth03, The Future of Food , State of Food Security and Nutrition 2022, FAO, Flickr: Bart Verweij / World Bank, Joseph C. Okechukwu/Twitter . COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . 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. 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UN Human Rights Council’s Resolution on Access to Medicines and Vaccines Welcomed by Civil Society 11/07/2022 Elaine Ruth Fletcher COVID vaccine shipments to Africa began in February 2021, but subsequent shortfalls laid bare the acute access problems faced in many low-income countries. Citizens and NGOs welcomed the United Nations Human Rights Council’s adoption of a much-debated draft resolution that calls on nations to ensure everyone has access to medicines and vaccines. The resolution was adopted by consensus Friday shortly before the close of the HRC’s 50th session, sending what proponents called a “clear message” that access to medicines and diagnostics, including COVID-19 vaccines, tests, and treatments, is a human right. Opponents such as the European Union, United Kingdom and United States, all home to major pharmaceutical companies, said the World Health Organization should be managing access. “It is yet another rebuke to the rich countries and pharmaceutical companies that have chosen to uphold monopolies on life-saving medicines despite the human cost, which on one estimate is a preventable COVID-19 death every minute. That is a violation of human rights,” said a joint statement from Amnesty International, Human Rights Watch, Knowledge Ecology International, and the People’s Vaccine Alliance. The UN Human Rights Council meeting last week in its 50th session. Though the resolution is non-binding and may have little practical impact, it could influence similar debate at the World Trade Organization over a proposal by India, South Africa and some low- to middle-income countries to relax intellectual property rules for manufacturing COVID treatments and tests. At its meeting of trade ministers in June, the WTO approved a resolution on a “limited” waiver of IP rules around COVID vaccine production. The current surfeit of vaccines, however, means the resolution would have little practical impact. But the WTO is supposed to decide within the next six months whether to extend the waiver to COVID tests and treatments that are costlier or in short supply in many countries. Those talks have already begun in the WTO’s Council on Trade-related Aspects of Intellectual Property Rights (TRIPS), WTO’s Director General Ngozi Okonjo-Iweala said after an informal meeting with WTO heads of delegations in Geneva on Thursday. HRC resolution touches on wide range of topics The final draft of the Human Rights Council resolution, co-sponsored by Argentina, Brazil, China, Egypt, India, Indonesia and 10 other nations, includes ambitious calls to countries to ensure access to immunization as a “global public good.” It calls for the “de-linkage” of the costs of new research and development from medicines and vaccines prices to ensure their wider availability, in keeping with the wishes of citizens and NGOs. Countries are asked to promote research, build capacity, and take “all measures necesary to strengthen regional and local production.”\ Developing nations that sought the resolution and rich nations that opposed it engaged in heated, mostly backroom debates over the precedents it could set even from a rhetorical standpoint. After the United Kingdom said “securing” immunization as a “global public good” is not necessarily up to government, the final text was changed to refer to “access to immunization as a global public good.” And wealthy countries insisted on adding a caveat to the final text that says all transfers of technology and know-how to developing countries must be “on mutually agreed terms” rather than compulsory. ‘Commitment, where possible, to voluntary licensing’ The 47-nation Human Rights Council’s language linking the promotion of research and innovation to a “commitment, where possible, to voluntary licensing in all agreements in which public funding has been invested in research and development” is significant because of the way COVID vaccines and treatments were marketed under exclusive patents after being financed with public funds. But language calling for “a strong spirit of international solidarity” was changed to merely “a strong spirit of solidarity,” reportedly at the behest of the EU and the UK, according to an analysis by Knowledge Ecology International (KEI). “There were deliberate attempts from some states to water down the language of this resolution, and the United Kingdom and the European Union initially pushed back on the principle of international solidarity,” the analysis said. “Yet the final resolution clearly states that health is a human right and that international cooperation must be the world’s guiding principle for this pandemic and any future health crisis.” The analysis said governments must live up to their human rights obligations in several international human rights treaties, and that means “addressing the disproportionate impact of global health crises on marginalized groups, as well as fostering knowledge and technology transfer, and making full use of flexibilities in global intellectual property rules to adequately respond to and prepare for public health needs.” Image Credits: Bicanski on Pixnio, GovernmentZA/Flickr, European Union . Some 1.1 Billion COVID-19 Vaccine Doses Likely Wasted Since Rollout Began 11/07/2022 Editorial team Wasted COVID-19 vaccine doses since beginning of immunization drives Some 1.1 billion COVID-19 vaccines are likely to have been wasted since the global rollout began, according to new findings by Airfinity, a global health surveillance firm. Airfinity’s analysis, released Monday, assumed a 10% wastage rate from June 2021 when global dose sharing began. This rate is taken from confirmed wastage in the United States and factors in an average shelf life of six months. The team also collated all public reports of vaccine waste and expirations from around the world, totalling some 158 million doses. The majority of the reporting on wastage did not specify, however, which vaccine type was discarded. Of those which do name the manufacturer, Russia’s Sputnik V was the most squandered with over 25 million doses that are known to have been unused. This was followed by AstraZeneca’s reported 19 million wasted jabs. Wastage of COVID-19 vaccine doses under-reported, but within range of Gavi assumptions The new estimate means that around 8% of the 1.1 billion doses reportedly disbursed until now have gone unused. Those estimates are within the recommended range of Gavi, the Vaccine Alliance, which assumed the wastage rate for COVID vaccines could be as high as 10%. But the estimates also reflect a certain level of uncertainty toward the underreporting of vaccine wastage in terms of individual reports from nations’ public health systems. Airfinity’s Analytics Director Dr Matt Linley said some degree of wastage is inevitable despite countries’ best efforts. “Large multi-dose vials can make efficiencies more challenging, as well as cold chain storage and predicting daily demand or simply a vial being dropped or left out too long,” Linley said. “Vaccines in single-dose vials with a longer shelf life, which can be transported and stored more easily, will reduce wastage over time,” he said. “Pfizer/BioNTech’s most recent agreement with the U.S. includes single doses, a first for COVID-19 vaccines, and a stipulation we expect to be repeated by other nations.” Airfinity’s CEO Rasmus Bech Hansen said no one wants to waste doses in any amount, but it’s a byproduct of an unprecedented level of vaccine production that has saved millions of lives. “If we want a fast reacting global vaccine response system, we will have to accept some level of wasted doses,” he said. “But the less the better, and monitoring the wastage levels ongoing is an important piece of global health information.” Image Credits: Asian Development Bank/Flickr, Airfinity . European Medicines Agency Recommends Second COVID Booster for People Over 60 – as WHO Ponders Status of COVID Emergency 08/07/2022 Elaine Ruth Fletcher COVID vaccination of older people. The European Medicines Agency is now recommending boosters for people over 60, With cases of Omicron BA.4 and BA.5 soaring in Europe and around the world, the European Medicines Agency (EMA) recommends everyone 60 and older get a second COVID-19 booster shot. EMA’s recommendation came shortly before WHO reconvened its COVID Emergency Committee on Friday to reconsider its global recommendations for the pandemic – and if the state of global health emergency first declared on 30 January 2020, should be maintained. So far WHO recommendations on a second booster, provided by another expert group in May, are limited to immunocompromised people. Speaking at a press conference Thursday, EMA’s head of vaccines, Marco Cavaleri said a fourth booster for people over 60 and other vulnerable groups is now warranted due to a regional increase in COVID cases. He said projections show the BA.4 and BA.5 sub variants are expected to become dominant across all European countries, likely completely replacing all other variants by the end of July. Marco Cavaleri, head of vaccines for the European Medicines Agency “As this new wave is unfolding over the EU, it is essential to maintain protection of vulnerable groups and avoid any postponement of vaccination,” Cavaleri said. “Although there is no evidence of increased infection severity in the BA.4 and BA.5 compared to other sub variants, the increased transmission among older age groups is starting to translate into severe disease.” Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told a briefing on Wednesday. EMA and other regulators looking toward approval of “bivalent” COVID vaccines by September While current vaccines offer “good protection” against hospitalization, severe disease and death, EMA and other regulatory agencies around the world are now looking closely at new “bivalent” COVID vaccine formulations, Cavaleri said. EMA, the US Food and Drug Administration and other national regulatory authorities met last week under the auspices of the International Coalition of Regulatory Authorities (ICMRA) to examine available data on the new vaccines in light of the reduced protection that current vaccines offer against mild and moderate disease. “Preliminary data from clinical trials indicate that adapted messenger RNA (mRNA) vaccines which incorporate an Omicron variant strain can increase and extend protection, when used as a booster,” Cavaleri said of ICMRA’s conclusions. “Bivalent mRNA vaccines which combine two strains of SARS-CoV-2, one of which is an Omicron strain … appear to offer an even wider immune response.” But vaccines that include other variants or subvariants might also be considered for use as boosters, if clinical trial data demonstrate an adequate level of neutralization against Omicron and other variants of concern. Cavaleri said his agency is evaluating initial data that mRNA vaccines manufacturers have submitted for review and is in close contact with manufacturers of vaccines based on different platforms other than mRNA, especially adjuvanted protein vaccines. “Overall we expect to potentially have several vaccines to include … with an assortment of different platforms and technologies, and this is welcome,” he said. EMA also is working towards approval of adapted COVID-19 vaccines in September, with an eye towards what Cavaleri described as “plans for an even broader rollout of vaccination campaigns in the autumn.” Future Course of WHO Public Health Emergency Designation for COVID WHO hasn’t changed its designation of COVID-19 as a pandemic, and it was not expected to do so at Friday’s COVID Emergency Committee meeting – although as of Sunday afternoon no statement by the Commitee had yet been made, raising questions about what directives might yet be issued. Irregardless of current trends showing increased transmission in many parts of the world, there is growing acknowledgement that the COVID emergency is evolving into an endemic disease. That will likely mean further peaks and valleys, but be far less lethal than the initial waves of 2020. And sooner or later, that will prompt a re-evaluation of the status of COVID as a “Public Health Emergency of International Concern” (PHEIC), requiring countries to undertake special measures under the terms of International Health Regulations. At a press conference on Thursday, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed the real work needed to take place “at the national level.” In line with those trends, WHO and Gavi, the Vaccine Alliance acknowledged plans this week to “transition” the work of the Act Accelerator initiative for distributing COVID vaccines, tests and treatments into the work of key ACT-A partners and national health systems. Under the auspices of ACT-A, COVAX, the global vaccine facility has distributed hundreds of millions of doses of COVID vaccines to 92 low-income countries since March 2021 with the support of Gavi, UNICEF and WHO. Tthe vaccine facility was hampered early in the pandemic by severe vaccine supply shortages and later by widespread public uptake of vaccines as they became more available. -Updated 10 July 2022 Image Credits: Flickr: IMF/ Raphael Alves. First-Ever Cases of Marburg Virus Disease Reported in Ghana 08/07/2022 Editorial team Bats, captured from the Kitaka mine in Uganda were discovered to be the source of a Marburg virus outbreak in July 2007 in Uganda, where two infections were reported among miners. Ghana has reported two suspected cases of the rare and deadly Marburg virus disease – the first to ever be recorded within its borders. Marburg is a highly infectious viral haemorrhagic fever in the same family as the more well-known Ebola virus disease, said WHO’s Ghana Country Office in making the announcement. It has a fatality rate of up to 88%. Preliminary analysis of samples taken from two patients by the country’s Noguchi Memorial Institute for Medical Research indicated the cases were positive for Marburg. The samples have been sent to the Institut Pasteur in Senegal, a World Health Organization (WHO) Collaborating Centre, for confirmation. The two patients from the southern Ashanti region – both unrelated – showed symptoms including diarrhoea, fever, nausea and vomiting. They died after having been taken to a district hospital in Ashanti region. Preparations for a possible outbreak response are being set up swiftly as further investigations are underway, WHO said. “The health authorities are on the ground investigating the situation and preparing for a possible outbreak response. We are working closely with the country to ramp up detection, track contacts, be ready to control the spread of the virus,” said Dr Francis Kasolo, World Health Organization (WHO) Representative in Ghana. WHO is deploying experts to support Ghana’s health authorities by bolstering disease surveillance, testing, tracing contacts, preparing to treat patients and working with communities to alert and educate them about the risks and dangers of the disease and to collaborate with the emergency response teams. Geographic distribution of Marburg haemorrhagic fever outbreaks and fruit bats of Pteropodidae Family. Ghana cases outside of endemic zone The outbreak in Ghana is a source of concern not only because the virus is particularly deadly, but also because it has occurred outside of the central and southern African zone where most cases have been previously reported. Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda, according to WHO. Marburg has been detected in just one other West African country, Guinea. The country confirmed a single case in an outbreak that was declared over on 16 September 2021, five weeks after that case was detected. The deadly virus was first identified in 1967 after two outbreaks of cases simultaneously in Marburg and Frankfurt Germany and in Belgrade, Serbia – thus the naming of the disease. The outbreak was later raved to laboratory work with African green monkeys (Cercopithecus aethiops) that had been imported from Uganda. Marburg is transmitted to people from fruit bats and following that, it can spread person-to-person through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise, said WHO. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management. Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated. Image Credits: Chris Black/WHO, World Health Organization . African Innovation Gets Major Boost with New Pharma Technology Foundation 07/07/2022 Ochieng’ Ogodo Akinwumi Adesina, president of the African Development Bank, visits the ‘Mother and Child’ Hospital of Bingerville, Côte d’Ivoire, in 2020 The African Development Bank is establishing a foundation with the aim of spending at least $3 billion over the next decade to boost Africa’s access to technologies needed to make medicines, vaccines, and other pharmaceutical products. The bank’s board approved the establishment of the African Pharmaceutical Technology Foundation with an eye to towards creating what the bank described in a statement on June 27 as “a new groundbreaking institution” for Africa’s 1.3 billion citizens. AfDB President Akinwumi Adesina said Africa “must have a health defense system” that revamps its pharmaceutical industry while also building up its capacity to make vaccines and provide quality healthcare. “Africa can no longer outsource the healthcare security of its 1.3 billion citizens to the benevolence of others,” said Adesina, a Nigerian economist. AU priority to improve healthcare sector African Union Headquarters, Addis Ababa The need for a foundation featured prominently at the African Union summit in February at Addis Ababa, where leaders called on AfDB to help Africa’s health care sector become more independent in light of the challenges it has faced from several devastating diseases and the COVID-19 pandemic. WHO’s Dr Tedros Adhanom Ghebreyesus The foundation’s creation signals a major shift in efforts to address inadequacies in the sector, including limited capacity to produce its own medicines and vaccines in part due to the intellectual property barrier. Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said it “is a game changer on accelerating the access of African pharmaceutical companies to IP-protected technologies and know-how in Africa.” Medicines and vaccines gap The pandemic exposed Africa’s lack of capacity to manufacture and supply essential drugs and personal protective equipment (PPEs) needed to control the coronavirus. Soon after the pandemic began in early 2020, many of the world’s top scientists scrambled to find a vaccine but government and business leaders paid less attention to how it would be made and delivered to low- and middle-income countries. More focus was put on rapidly increasing supply to meet the surging demand, in a process largely driven by wealthier nations with greater purchasing power. In Africa, as in most other developing nations, citizens’ health care became dependent on the generosity of others. Nigerian pharmacist Ezinne Victoria Chinemerem Onwuekwe, who works as a public health fellow for the Africa Centres for Disease Control and Prevention, said the main problem is that Africa’s pharmaceutical industry lacks manufacturing capacity. “There are a few production companies here and there, and for it to be able to produce for these citizens, it will require the effort of public and private sector to bring together both the technical [and] financial support needed to push this forward,” she said. The shortage of medicines and other pharmaceutical products has been a challenge to effective delivering quality healthcare services in Africa. Pharmaceuticals are made in South Africa, Kenya, Morocco and Egypt, yet Africa spends US$16 billion to import 94% of its pharmaceutical and medicinal needs, according to the United Nations Economic Commission for Africa (UNECA). As of 2019, the continent had roughly 375 pharmaceutical manufacturers, compared to about 5,000 and 10,500, respectively, in China and India. And a 2019 study found many life-saving drugs are still inaccessible and unaffordable in low- and middle-income countries. Game changer for medicines Akinwumi Adesina, African Development Bank president, at the initiative launch, The new foundation, which will raise its own funds and operate independently of AfDB, will be hosted in Rwanda and deal with IP rights and health policy. One of its chief responsibilities will be mediating interests between Africa’s pharmaceutical sector and global companies with the aim of sharing IP-protected technologies, know-how and patented processes, according to documents on its establishment. It also is being asked to prioritize technologies, products and processes aimed primarily at diseases widely prevalent in Africa, or those that involve current and future pandemics. And it is expected to help build up the ranks of health care professionals and others who conduct research and development while upgrading manufacturing plant capacities and regulatory quality to meet WHO standards. Challenges in the healthcare sector Ezinne Onwuekwe Small fragmented markets and weak regulatory frameworks, inadequate human resource capacity, poor procurement and supply chain systems, and policy incoherencies in countries’ trade, industry, health, and finance departments are some of the impediments to the growth of Africa’s pharmaceutical sector. The continent is also burdened with fake and falsified medical drugs. In 2017, WHO revealed an estimated 116,000 additional deaths a year from malaria could be tied to substandard and falsified antimalarials. To counter that, the foundation is being asked to help local pharmaceutical companies boost home-grown production with better technology in their manufacturing plants and to work with governments, research and development centers to improve their innovation capacities. Onwuekwe said part of the problem is a lack of political will in some countries. “This is about finding African solutions to African problems. That is the new public heath order,” Onwuekwe told Health Policy Watch. “The leadership of the countries have to invest financially and politically for there to be any progress in the sector.” But the foundation, she said, also must become adept at negotiating with global pharmaceutical companies and must be “able to foster collaborations” with WHO, the African Union and other international organizations. Image Credits: AfDB Group, IAEA. WHO Concern as Monkeypox Cases Jump by 77% in a Week 07/07/2022 Kerry Cullinan With a 77% increase in new monkeypox cases in the past week, the World Health Organization’s (WHO) Emergency Committee is increasingly likely to declare the outbreak a public health emergency of international concern (PHEIC) when it reconvenes on or before 18 July. By Thursday, 59 countries had reported monkeypox cases, with Spain (1804 cases), UK (1351), Germany (1304) and the US (605) recording the highest caseloads. However, 10 countries have not reported new cases for over 21 days, which is the maximum duration of the incubation period of the disease, according to the WHO’s latest report. So far, there have been 6027 laboratory-confirmed cases of monkeypox and three deaths, but most countries are unable to test for the virus. However, the European Centre for Disease Prevention and Control (ECDC) reported on Wednesday that 5949 cases had been identified in 33 European countries alone through international health regulation mechanisms and public records. The vast majority of cases (99%) were male and aged between 31 and 40 (42%). “The majority of cases presented with a rash (96.1%) and systemic symptoms such as fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat or headache (69%). No cases were reported to have died. Some (15) cases were reported to be health workers. However, further investigation is ongoing to determine whether infection was due to occupational exposure,” according to the ECDC. Monkeypox cases, 6 July 2022 (Source: https://www.monkeypoxtally.info/) Lack of testing Expressing his concern about the scale and spread, WHO Director-General Dr Tedros Adhanom Ghebreyesus acknowledged that “testing remains a challenge and it’s highly probable that there are a significant number of cases not being picked up”. While most of the new cases have been identified in Europe and the US, Africa – where monkeypox was first identified in 1970 – has not recorded a huge jump in cases, and experts believe this could be due to a lack of proper testing. “I plan to reconvene the emergency committee so they are updated on the current epidemiology and evolution of the outbreak and implementation of countermeasures. I will bring them together during the week of 18 July or sooner if needed,” Tedros told the media briefing on Wednesday. The emergency committee decided not to declare monkeypox a PHEIC when it met in late June. Tedros also said that the WHO is working with countries and vaccine manufacturers to coordinate the sharing of “scarce” vaccines . Tedros added that the WHO is also working closely with civil society and LGBTQI+ community in particular to “break the stigma around the virus and spread information so people can protect themselves”, and commended those sharing their stories on social media to inform others. To share a little bit about my experience: I believe I was exposed to it around a week before symptoms manifested. Started off with just a couple bumps, then developed intense flu-like symptoms. Fever, chills, sweats, fatigue, etc. — Matt Ford (@JMatthiasFord) June 23, 2022 Child cases According to the WHO’s latest report, the outbreak “continues to primarily affect men who have sex with men who have reported recent sex with one or multiple male partners, suggesting no signal of sustained transmission beyond these networks for now.” However, WHO monkeypox expert Dr Rosamund Lewis confirmed that there were cases reported in children, about one-third of whom were under the age of 10. “For older children aged 18 or 19, the mode of transmission may still be an open question, but for younger children, one would assume that that would be from exposure in the household setting,” said Lewis. By Wednesday, 119 people had been diagnosed with monkeypox in New York City and city officials confirmed that the limited supplies of vaccines were usually snapped up in minutes by the group it was being offered to: men who have sex with men who had multiple sex partners, as well as close contacts of confirmed cases. Monkeypox cases continue to rise in NYC. Our supply of vaccine is wholly inadequate. Appts are gone within minutes of posting. (Yes even with the recent shipment.) We need the feds to send us far more doses ASAP. pic.twitter.com/HzqefaaIns — Mark D. Levine (@MarkLevineNYC) July 6, 2022 Image Credits: https://www.monkeypoxtally.info/. Long-Neglected Tuberculosis Could Be Stopped by 2030 – at a Cost of $250 Billion 07/07/2022 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. After year-long consultations, the Stop TB Partnership launched its global plan to end tuberculosis by 2030, which would involve the diagnosis and treatment of 50 million people at a cost of $250 billion. TB, the second biggest infectious disease killer in the world after COVID-19, has been neglected by donors in the past – yet if the plan’s budget was realised, every $1 invested would yield an economic return of at least $40. “If, instead, the status quo is maintained, TB is expected to continue to kill between 4,000-5,000 people every day, an additional 43 million people will develop TB and the cost in human life and disability would translate to a global economic loss of US$ 1 trillion,” according to Stop TB. “The COVID-19 pandemic delivered a crystal-clear wake-up call: that we cannot ignore a disease just because it has been relegated only to the poorest parts of the world,” said Dr. Paula Fujiwara, who led the task force in charge of the development of theplan. “With our attention diverted—along with the absence of financial commitments—TB has strengthened its grip on our planet. But we can regain control and meet our commitments to end TB by 2030 as long as we assert our political will now.” Today! @StopTB unveiled a costed plan to #endTB, the second leading infectious disease killers in the world, after #COVID19. The Global Plan to End TB 2023-2030 outlines the priority actions and estimated financial resources needed to end TB.👉Read here: https://t.co/HZLY4E9ous pic.twitter.com/gS2QbfBhzK — Stop TB Partnership (@StopTB) July 6, 2022 Tepid global response Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said that while the global response to COVID-19 was to “plough money and resources into developing diagnosis tools, treatments and vaccines at lightning speed”, the response to TB, which infects 10 million people every year and kills 1.5 million, “has been tepid at best”. “A similar airborne infectious disease, TB remains neglected, even though it is a health threat for every single person. It is in the interest of all of us to end TB,” added Ditiu. However, she added that she was optimistic that the war against tuberculosis could be won by 2030. “A lot of optimism comes from what we have seen happening during COVID—it is possible to mobilize the resources –it is possible that researchers will work together, and share data to be able to develop new tools in such a short amount of time and it is possible to deploy and to organize amazing efforts at the grassroots level.” The Global Plan highlights the need to invest in developing a new TB vaccine by 2025, and making sure that resources are available to reach adults and adolescents in countries where TB is most prevalent. The only TB vaccine currently available is the BCG vaccine, which was approved more than a century ago and has a very limited impact on disease prevention. Dr Lucica Ditiu, Executive Director of Stop TB Partnership “The proposed investment of $ 10 billion in new TB vaccines, a new tool we all are waiting for, is 10 times less than what was injected in the research and development for COVID-19 vaccines. It should be possible to have the TB vaccine,” said Ditiu. Previous reports from the Stop TB Partnership noted that COVID-19 had cost the world 12 years of progress against TB. “Currently, almost 30% of funding per TB case comes from out-of-pocket costs and on average individuals with TB and their households lose 50% of their annual incomes as they suffer from and get treatment for the disease, even in places where TB services are provided free of charge,” according to Paul Mahanna, USAID’s Director of the Office of Infectious Diseases, “We cannot drive change without addressing the significant funding gaps that exist within high TB burden countries that result in lack of access to life-saving services and drive individuals, families and communities further into poverty. Image Credits: Stop TB Partnership. World Sees ‘Unprecedented’ Hunger as Farm Subsidies Boost Unhealthy Foods 06/07/2022 Elaine Ruth Fletcher An African farmer collects leaves from a gourd plant – smallholders are critical to food security and nutritional diversity – and marginalized by global food systems. Between 702 million and 828 million people suffered from hunger in 2021, more than at any time since 2005, five UN agencies reported on Wednesday. The proportion of people affected by hunger had remained relatively unchanged since 2015, affecting 8% of the global population in 2019. Once the COVID-19 pandemic hit in early 2020, those numbers soared to 9.3% in 2020 and to 9.89% in 2021, according to the State of Food Security and Nutrition in the World 2022 report published by the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF, World Food Programme (WFP) and International Fund for Agricultural Development (IFAD). That represents an increase of about 46 million people since 2020 and 150 million people since the outbreak of the pandemic. At current rates, 8% of the global population will still face hunger in 2030, unchanged from when the UN’s 2030 Agenda for Sustainable Development launched. Among the key goals of that ambitious plan, adopted at the UN Sustainable Development Summit in September 2015, was a determination “to end poverty and hunger, in all their forms and dimensions, and to ensure that all human beings can fulfil their potential in dignity and equality and in a healthy environment.” Progress on hunger stalled: Numbers of people who are going hungry today is about the same, or even more, than in 2005. Botswana’s Collen Vixen Kelapile, President of the United Nations Economic and Social Council (ECOSOC) Almost 3.1 billion people couldn’t afford a healthy diet in 2020, the report says. Massive food subsidies behind the production and consumption of milk, rice, sugar and meat also are disincentivizing production and consumption of healthy fruits, vegetables and protein-rich legumes, the report finds. Critically, the report calls upon a restructuring of global and national food subsidies to encourage more consumption of healthier foods including fruits and vegetables – which would also reduce carbon emissions from agricultural production of livestock and products that contribute to climate change. “Transformed agro-food systems need to be part of the solution to climate change and biodiversity loss … our very existence depends on it. Hundreds of millions of hungry and malnourished fellow human beings depend on it,” said Botswana’s Collen Vixen Kelapile, president of the UN Economic and Social Council (ECOSOC), which hosted the report’s launch in New York City. ‘Starvation and mass migration on an ‘unprecedented’ scale Trends in hunger by region WFP’s Executive Director David Beasley noted the world already faced “a perfect storm from the combined effects of conflicts and climate change and COVID economic ripple effects and global inflation” as this year was getting started. David Beasley, WFP executive director “And just when you think it can’t get any worse,” he said, “because we had Ethiopia and Afghanistan, then boom, Ukraine happens, the breadbasket of the world. The impact this conflict is having on global food security means the number of chronically hungry people in the world is likely already much higher than the 828 million people outlined in this work.” Beasley said the latest analysis shows a record 345 million acutely hungry people are marching to the brink of starvation today, a huge increase 276 million at the start of 2022 and from 135 million in the pre-COVID era. “There’s a real danger it will climb even higher in the months ahead,” he warned. “The global price spikes in food, fuel and fertilizers that we are seeing as a result of the crisis in Ukraine threaten to push countries around the world,” Beasley said. “The result will be global destabilization – to starvation and mass migration on an unprecedented scale. We have to act, and we have to act today to avert this looming catastrophe.” Africa hardest hit by hunger – women suffer more than men Laotian children get a fresh and healthy meal; WHO has urged policymakers to prioritize the introduction of healthier foods at schools. The prevalence of hunger, childhood wasting and stunting is highest in Africa, with a substantial burden in Asia, Latin America and the Caribbean (LAC), the report says. Hunger affected 278 million people in Africa; 425 million people in Asia; and 56.5 million people in LAC in 2021. Women are more likely to go hungry across the developing world, the report stresses. Globally, 149.2 million children under the age of 5, or 22% of the total population, suffered from stunting, and 6.7% suffered from wasting. Both are nutrition indicators of low height and weight in proportion to age. Another 38.9 million children under the age of five, or 5.7% of babies and toddlers globally, are overweight, reflecting a rise in unhealthy diets. Healthy diets became even more unaffordable in 2021. Almost 3.1 billion people could not afford a healthy diet in 2020, up by 112 million people from 2019, reflecting what the report describes as the effects of inflation in consumer food prices stemming from the economic impacts of the pandemic and the measures put in place to contain it. The poor in Asia, Africa and Latin America are also among those least able to afford a healthy diet, with Asia seeing the highest surge in costs – 4% in just one year. Political solution to Ukraine among the most immediate measures The global food crisis is being exacerbated by Russia’s blockage of exports from Ukraine, the world’s breadbasket. An end to the Russian blockade of Ukrainian ports is an important first step in addressing the crisis but only the beginning, Beasley said, listing the top priorities as follows: “Firstly we urgently need a political solution to Ukrainian wheat and grain so they can re-enter global markets.. Open up the ports.. Let’s get it moving. “Number 2, humanitarian organizations need substantial new funding to deal with the skyrocketing levels of hunger that we’re seeing around the world. “Thirdly, governments have to resist protectionism and keep trade flowing across borders. And fourthly, we need to learn the lessons of this crisis and invest in resilience programmes to help the poorest communities protect themselves against hunger and against shocks. “If we had successfully threaded this needle in the past, the war in Ukraine wouldn’t be having such a disastrous global impact today.” Rewriting the rules on agricultural and food subsidies to promote healthier foods Shifting food and agriculture subsidies to production and consumption of healthier foods would both reduce climate emissions and average costs of a healthy diet. But some farmers invested in unhealthy foods production could lose out. Fundamentally, the report calls for a major restructuring of deeply embedded global and national subsidies that are currently driving a significant portion of agricultural production – and unhealthy consumption of meat, sugar and basic commodities such as rice – at the expense of other healthier and lower-carbon intensive alternatives. FAO chief economist Máximo Torero Cullen said overall support for agricultural production largely concentrates on staple foods such as dairy and other animal source protein-rich foods, especially in high and upper middle income countries. “Rice, sugar and meat of various types are the foods most incentivized worldwide, while producers of fruits and vegetables are less supported overall, and even penalized in some low-income countries,” he said. “This needs to change. We are doing the opposite of what we are talking about. We need to change abruptly what is happening.” FAO chief economist Máximo Torero Cullen. The new report offers scenarios through 2030 in which public support to all farmers is reallocated around priority foods needed for healthy diets. FAO says adjusting price incentives will also reduce the cost of nutritious foods, which can healthy diets more affordable. That would also lower greenhouse gas emissions, particularly with livestock production, which has a high carbon pricetag. Shifting certain kinds of subsidies could, however, also create negative impacts on some farmers – who would then need new kinds of support, he pointed out. Needed: new flexibilities in national and WTO subsidy rules Cullen said understanding the tradeoffs are key to mapping out the future, and come further into play with the World Trade Organization. “We need commitments and flexibilities, and we need to follow what we have agreed with the WTO rules,” he said. “It may be necessary to set up new fiscal subsidies to consumers or to use proper social protection systems. International development finance will be needed for low-income countries and upper lower middle income countries, given that they have smaller amount of mechanisms.” Agricultural subsidies rules, however, tend to penalize small farmers in low-income countries, delegates from Latin America, Africa and Asia told the ECOSOC meeting. Pakistan’s UN representative Munir Akram “Massive subsidies distort global markets and make it impossible for farmers from developing countries to produce food at competitive prices,” said Pakistan’s UN representative Munir Akram. Gilbert Houngbo, president of IFAD, said the report highlights ways to repurpose agricultural and food policies to support small-scale producers and to build their resilience. Gilbert F. Houngbo, president of IFAD “Policies on subsidies often fall short of reducing hunger or improving food security and inclusion,” he said. “Instead, they have promoted an overreliance on starches, sugars, high protein and processed foods, while not supporting the production of healthier fruits and vegetables, for example.” Image Credits: @veerajayanth03, The Future of Food , State of Food Security and Nutrition 2022, FAO, Flickr: Bart Verweij / World Bank, Joseph C. Okechukwu/Twitter . COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . 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. 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Some 1.1 Billion COVID-19 Vaccine Doses Likely Wasted Since Rollout Began 11/07/2022 Editorial team Wasted COVID-19 vaccine doses since beginning of immunization drives Some 1.1 billion COVID-19 vaccines are likely to have been wasted since the global rollout began, according to new findings by Airfinity, a global health surveillance firm. Airfinity’s analysis, released Monday, assumed a 10% wastage rate from June 2021 when global dose sharing began. This rate is taken from confirmed wastage in the United States and factors in an average shelf life of six months. The team also collated all public reports of vaccine waste and expirations from around the world, totalling some 158 million doses. The majority of the reporting on wastage did not specify, however, which vaccine type was discarded. Of those which do name the manufacturer, Russia’s Sputnik V was the most squandered with over 25 million doses that are known to have been unused. This was followed by AstraZeneca’s reported 19 million wasted jabs. Wastage of COVID-19 vaccine doses under-reported, but within range of Gavi assumptions The new estimate means that around 8% of the 1.1 billion doses reportedly disbursed until now have gone unused. Those estimates are within the recommended range of Gavi, the Vaccine Alliance, which assumed the wastage rate for COVID vaccines could be as high as 10%. But the estimates also reflect a certain level of uncertainty toward the underreporting of vaccine wastage in terms of individual reports from nations’ public health systems. Airfinity’s Analytics Director Dr Matt Linley said some degree of wastage is inevitable despite countries’ best efforts. “Large multi-dose vials can make efficiencies more challenging, as well as cold chain storage and predicting daily demand or simply a vial being dropped or left out too long,” Linley said. “Vaccines in single-dose vials with a longer shelf life, which can be transported and stored more easily, will reduce wastage over time,” he said. “Pfizer/BioNTech’s most recent agreement with the U.S. includes single doses, a first for COVID-19 vaccines, and a stipulation we expect to be repeated by other nations.” Airfinity’s CEO Rasmus Bech Hansen said no one wants to waste doses in any amount, but it’s a byproduct of an unprecedented level of vaccine production that has saved millions of lives. “If we want a fast reacting global vaccine response system, we will have to accept some level of wasted doses,” he said. “But the less the better, and monitoring the wastage levels ongoing is an important piece of global health information.” Image Credits: Asian Development Bank/Flickr, Airfinity . European Medicines Agency Recommends Second COVID Booster for People Over 60 – as WHO Ponders Status of COVID Emergency 08/07/2022 Elaine Ruth Fletcher COVID vaccination of older people. The European Medicines Agency is now recommending boosters for people over 60, With cases of Omicron BA.4 and BA.5 soaring in Europe and around the world, the European Medicines Agency (EMA) recommends everyone 60 and older get a second COVID-19 booster shot. EMA’s recommendation came shortly before WHO reconvened its COVID Emergency Committee on Friday to reconsider its global recommendations for the pandemic – and if the state of global health emergency first declared on 30 January 2020, should be maintained. So far WHO recommendations on a second booster, provided by another expert group in May, are limited to immunocompromised people. Speaking at a press conference Thursday, EMA’s head of vaccines, Marco Cavaleri said a fourth booster for people over 60 and other vulnerable groups is now warranted due to a regional increase in COVID cases. He said projections show the BA.4 and BA.5 sub variants are expected to become dominant across all European countries, likely completely replacing all other variants by the end of July. Marco Cavaleri, head of vaccines for the European Medicines Agency “As this new wave is unfolding over the EU, it is essential to maintain protection of vulnerable groups and avoid any postponement of vaccination,” Cavaleri said. “Although there is no evidence of increased infection severity in the BA.4 and BA.5 compared to other sub variants, the increased transmission among older age groups is starting to translate into severe disease.” Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told a briefing on Wednesday. EMA and other regulators looking toward approval of “bivalent” COVID vaccines by September While current vaccines offer “good protection” against hospitalization, severe disease and death, EMA and other regulatory agencies around the world are now looking closely at new “bivalent” COVID vaccine formulations, Cavaleri said. EMA, the US Food and Drug Administration and other national regulatory authorities met last week under the auspices of the International Coalition of Regulatory Authorities (ICMRA) to examine available data on the new vaccines in light of the reduced protection that current vaccines offer against mild and moderate disease. “Preliminary data from clinical trials indicate that adapted messenger RNA (mRNA) vaccines which incorporate an Omicron variant strain can increase and extend protection, when used as a booster,” Cavaleri said of ICMRA’s conclusions. “Bivalent mRNA vaccines which combine two strains of SARS-CoV-2, one of which is an Omicron strain … appear to offer an even wider immune response.” But vaccines that include other variants or subvariants might also be considered for use as boosters, if clinical trial data demonstrate an adequate level of neutralization against Omicron and other variants of concern. Cavaleri said his agency is evaluating initial data that mRNA vaccines manufacturers have submitted for review and is in close contact with manufacturers of vaccines based on different platforms other than mRNA, especially adjuvanted protein vaccines. “Overall we expect to potentially have several vaccines to include … with an assortment of different platforms and technologies, and this is welcome,” he said. EMA also is working towards approval of adapted COVID-19 vaccines in September, with an eye towards what Cavaleri described as “plans for an even broader rollout of vaccination campaigns in the autumn.” Future Course of WHO Public Health Emergency Designation for COVID WHO hasn’t changed its designation of COVID-19 as a pandemic, and it was not expected to do so at Friday’s COVID Emergency Committee meeting – although as of Sunday afternoon no statement by the Commitee had yet been made, raising questions about what directives might yet be issued. Irregardless of current trends showing increased transmission in many parts of the world, there is growing acknowledgement that the COVID emergency is evolving into an endemic disease. That will likely mean further peaks and valleys, but be far less lethal than the initial waves of 2020. And sooner or later, that will prompt a re-evaluation of the status of COVID as a “Public Health Emergency of International Concern” (PHEIC), requiring countries to undertake special measures under the terms of International Health Regulations. At a press conference on Thursday, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed the real work needed to take place “at the national level.” In line with those trends, WHO and Gavi, the Vaccine Alliance acknowledged plans this week to “transition” the work of the Act Accelerator initiative for distributing COVID vaccines, tests and treatments into the work of key ACT-A partners and national health systems. Under the auspices of ACT-A, COVAX, the global vaccine facility has distributed hundreds of millions of doses of COVID vaccines to 92 low-income countries since March 2021 with the support of Gavi, UNICEF and WHO. Tthe vaccine facility was hampered early in the pandemic by severe vaccine supply shortages and later by widespread public uptake of vaccines as they became more available. -Updated 10 July 2022 Image Credits: Flickr: IMF/ Raphael Alves. First-Ever Cases of Marburg Virus Disease Reported in Ghana 08/07/2022 Editorial team Bats, captured from the Kitaka mine in Uganda were discovered to be the source of a Marburg virus outbreak in July 2007 in Uganda, where two infections were reported among miners. Ghana has reported two suspected cases of the rare and deadly Marburg virus disease – the first to ever be recorded within its borders. Marburg is a highly infectious viral haemorrhagic fever in the same family as the more well-known Ebola virus disease, said WHO’s Ghana Country Office in making the announcement. It has a fatality rate of up to 88%. Preliminary analysis of samples taken from two patients by the country’s Noguchi Memorial Institute for Medical Research indicated the cases were positive for Marburg. The samples have been sent to the Institut Pasteur in Senegal, a World Health Organization (WHO) Collaborating Centre, for confirmation. The two patients from the southern Ashanti region – both unrelated – showed symptoms including diarrhoea, fever, nausea and vomiting. They died after having been taken to a district hospital in Ashanti region. Preparations for a possible outbreak response are being set up swiftly as further investigations are underway, WHO said. “The health authorities are on the ground investigating the situation and preparing for a possible outbreak response. We are working closely with the country to ramp up detection, track contacts, be ready to control the spread of the virus,” said Dr Francis Kasolo, World Health Organization (WHO) Representative in Ghana. WHO is deploying experts to support Ghana’s health authorities by bolstering disease surveillance, testing, tracing contacts, preparing to treat patients and working with communities to alert and educate them about the risks and dangers of the disease and to collaborate with the emergency response teams. Geographic distribution of Marburg haemorrhagic fever outbreaks and fruit bats of Pteropodidae Family. Ghana cases outside of endemic zone The outbreak in Ghana is a source of concern not only because the virus is particularly deadly, but also because it has occurred outside of the central and southern African zone where most cases have been previously reported. Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda, according to WHO. Marburg has been detected in just one other West African country, Guinea. The country confirmed a single case in an outbreak that was declared over on 16 September 2021, five weeks after that case was detected. The deadly virus was first identified in 1967 after two outbreaks of cases simultaneously in Marburg and Frankfurt Germany and in Belgrade, Serbia – thus the naming of the disease. The outbreak was later raved to laboratory work with African green monkeys (Cercopithecus aethiops) that had been imported from Uganda. Marburg is transmitted to people from fruit bats and following that, it can spread person-to-person through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise, said WHO. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management. Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated. Image Credits: Chris Black/WHO, World Health Organization . African Innovation Gets Major Boost with New Pharma Technology Foundation 07/07/2022 Ochieng’ Ogodo Akinwumi Adesina, president of the African Development Bank, visits the ‘Mother and Child’ Hospital of Bingerville, Côte d’Ivoire, in 2020 The African Development Bank is establishing a foundation with the aim of spending at least $3 billion over the next decade to boost Africa’s access to technologies needed to make medicines, vaccines, and other pharmaceutical products. The bank’s board approved the establishment of the African Pharmaceutical Technology Foundation with an eye to towards creating what the bank described in a statement on June 27 as “a new groundbreaking institution” for Africa’s 1.3 billion citizens. AfDB President Akinwumi Adesina said Africa “must have a health defense system” that revamps its pharmaceutical industry while also building up its capacity to make vaccines and provide quality healthcare. “Africa can no longer outsource the healthcare security of its 1.3 billion citizens to the benevolence of others,” said Adesina, a Nigerian economist. AU priority to improve healthcare sector African Union Headquarters, Addis Ababa The need for a foundation featured prominently at the African Union summit in February at Addis Ababa, where leaders called on AfDB to help Africa’s health care sector become more independent in light of the challenges it has faced from several devastating diseases and the COVID-19 pandemic. WHO’s Dr Tedros Adhanom Ghebreyesus The foundation’s creation signals a major shift in efforts to address inadequacies in the sector, including limited capacity to produce its own medicines and vaccines in part due to the intellectual property barrier. Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said it “is a game changer on accelerating the access of African pharmaceutical companies to IP-protected technologies and know-how in Africa.” Medicines and vaccines gap The pandemic exposed Africa’s lack of capacity to manufacture and supply essential drugs and personal protective equipment (PPEs) needed to control the coronavirus. Soon after the pandemic began in early 2020, many of the world’s top scientists scrambled to find a vaccine but government and business leaders paid less attention to how it would be made and delivered to low- and middle-income countries. More focus was put on rapidly increasing supply to meet the surging demand, in a process largely driven by wealthier nations with greater purchasing power. In Africa, as in most other developing nations, citizens’ health care became dependent on the generosity of others. Nigerian pharmacist Ezinne Victoria Chinemerem Onwuekwe, who works as a public health fellow for the Africa Centres for Disease Control and Prevention, said the main problem is that Africa’s pharmaceutical industry lacks manufacturing capacity. “There are a few production companies here and there, and for it to be able to produce for these citizens, it will require the effort of public and private sector to bring together both the technical [and] financial support needed to push this forward,” she said. The shortage of medicines and other pharmaceutical products has been a challenge to effective delivering quality healthcare services in Africa. Pharmaceuticals are made in South Africa, Kenya, Morocco and Egypt, yet Africa spends US$16 billion to import 94% of its pharmaceutical and medicinal needs, according to the United Nations Economic Commission for Africa (UNECA). As of 2019, the continent had roughly 375 pharmaceutical manufacturers, compared to about 5,000 and 10,500, respectively, in China and India. And a 2019 study found many life-saving drugs are still inaccessible and unaffordable in low- and middle-income countries. Game changer for medicines Akinwumi Adesina, African Development Bank president, at the initiative launch, The new foundation, which will raise its own funds and operate independently of AfDB, will be hosted in Rwanda and deal with IP rights and health policy. One of its chief responsibilities will be mediating interests between Africa’s pharmaceutical sector and global companies with the aim of sharing IP-protected technologies, know-how and patented processes, according to documents on its establishment. It also is being asked to prioritize technologies, products and processes aimed primarily at diseases widely prevalent in Africa, or those that involve current and future pandemics. And it is expected to help build up the ranks of health care professionals and others who conduct research and development while upgrading manufacturing plant capacities and regulatory quality to meet WHO standards. Challenges in the healthcare sector Ezinne Onwuekwe Small fragmented markets and weak regulatory frameworks, inadequate human resource capacity, poor procurement and supply chain systems, and policy incoherencies in countries’ trade, industry, health, and finance departments are some of the impediments to the growth of Africa’s pharmaceutical sector. The continent is also burdened with fake and falsified medical drugs. In 2017, WHO revealed an estimated 116,000 additional deaths a year from malaria could be tied to substandard and falsified antimalarials. To counter that, the foundation is being asked to help local pharmaceutical companies boost home-grown production with better technology in their manufacturing plants and to work with governments, research and development centers to improve their innovation capacities. Onwuekwe said part of the problem is a lack of political will in some countries. “This is about finding African solutions to African problems. That is the new public heath order,” Onwuekwe told Health Policy Watch. “The leadership of the countries have to invest financially and politically for there to be any progress in the sector.” But the foundation, she said, also must become adept at negotiating with global pharmaceutical companies and must be “able to foster collaborations” with WHO, the African Union and other international organizations. Image Credits: AfDB Group, IAEA. WHO Concern as Monkeypox Cases Jump by 77% in a Week 07/07/2022 Kerry Cullinan With a 77% increase in new monkeypox cases in the past week, the World Health Organization’s (WHO) Emergency Committee is increasingly likely to declare the outbreak a public health emergency of international concern (PHEIC) when it reconvenes on or before 18 July. By Thursday, 59 countries had reported monkeypox cases, with Spain (1804 cases), UK (1351), Germany (1304) and the US (605) recording the highest caseloads. However, 10 countries have not reported new cases for over 21 days, which is the maximum duration of the incubation period of the disease, according to the WHO’s latest report. So far, there have been 6027 laboratory-confirmed cases of monkeypox and three deaths, but most countries are unable to test for the virus. However, the European Centre for Disease Prevention and Control (ECDC) reported on Wednesday that 5949 cases had been identified in 33 European countries alone through international health regulation mechanisms and public records. The vast majority of cases (99%) were male and aged between 31 and 40 (42%). “The majority of cases presented with a rash (96.1%) and systemic symptoms such as fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat or headache (69%). No cases were reported to have died. Some (15) cases were reported to be health workers. However, further investigation is ongoing to determine whether infection was due to occupational exposure,” according to the ECDC. Monkeypox cases, 6 July 2022 (Source: https://www.monkeypoxtally.info/) Lack of testing Expressing his concern about the scale and spread, WHO Director-General Dr Tedros Adhanom Ghebreyesus acknowledged that “testing remains a challenge and it’s highly probable that there are a significant number of cases not being picked up”. While most of the new cases have been identified in Europe and the US, Africa – where monkeypox was first identified in 1970 – has not recorded a huge jump in cases, and experts believe this could be due to a lack of proper testing. “I plan to reconvene the emergency committee so they are updated on the current epidemiology and evolution of the outbreak and implementation of countermeasures. I will bring them together during the week of 18 July or sooner if needed,” Tedros told the media briefing on Wednesday. The emergency committee decided not to declare monkeypox a PHEIC when it met in late June. Tedros also said that the WHO is working with countries and vaccine manufacturers to coordinate the sharing of “scarce” vaccines . Tedros added that the WHO is also working closely with civil society and LGBTQI+ community in particular to “break the stigma around the virus and spread information so people can protect themselves”, and commended those sharing their stories on social media to inform others. To share a little bit about my experience: I believe I was exposed to it around a week before symptoms manifested. Started off with just a couple bumps, then developed intense flu-like symptoms. Fever, chills, sweats, fatigue, etc. — Matt Ford (@JMatthiasFord) June 23, 2022 Child cases According to the WHO’s latest report, the outbreak “continues to primarily affect men who have sex with men who have reported recent sex with one or multiple male partners, suggesting no signal of sustained transmission beyond these networks for now.” However, WHO monkeypox expert Dr Rosamund Lewis confirmed that there were cases reported in children, about one-third of whom were under the age of 10. “For older children aged 18 or 19, the mode of transmission may still be an open question, but for younger children, one would assume that that would be from exposure in the household setting,” said Lewis. By Wednesday, 119 people had been diagnosed with monkeypox in New York City and city officials confirmed that the limited supplies of vaccines were usually snapped up in minutes by the group it was being offered to: men who have sex with men who had multiple sex partners, as well as close contacts of confirmed cases. Monkeypox cases continue to rise in NYC. Our supply of vaccine is wholly inadequate. Appts are gone within minutes of posting. (Yes even with the recent shipment.) We need the feds to send us far more doses ASAP. pic.twitter.com/HzqefaaIns — Mark D. Levine (@MarkLevineNYC) July 6, 2022 Image Credits: https://www.monkeypoxtally.info/. Long-Neglected Tuberculosis Could Be Stopped by 2030 – at a Cost of $250 Billion 07/07/2022 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. After year-long consultations, the Stop TB Partnership launched its global plan to end tuberculosis by 2030, which would involve the diagnosis and treatment of 50 million people at a cost of $250 billion. TB, the second biggest infectious disease killer in the world after COVID-19, has been neglected by donors in the past – yet if the plan’s budget was realised, every $1 invested would yield an economic return of at least $40. “If, instead, the status quo is maintained, TB is expected to continue to kill between 4,000-5,000 people every day, an additional 43 million people will develop TB and the cost in human life and disability would translate to a global economic loss of US$ 1 trillion,” according to Stop TB. “The COVID-19 pandemic delivered a crystal-clear wake-up call: that we cannot ignore a disease just because it has been relegated only to the poorest parts of the world,” said Dr. Paula Fujiwara, who led the task force in charge of the development of theplan. “With our attention diverted—along with the absence of financial commitments—TB has strengthened its grip on our planet. But we can regain control and meet our commitments to end TB by 2030 as long as we assert our political will now.” Today! @StopTB unveiled a costed plan to #endTB, the second leading infectious disease killers in the world, after #COVID19. The Global Plan to End TB 2023-2030 outlines the priority actions and estimated financial resources needed to end TB.👉Read here: https://t.co/HZLY4E9ous pic.twitter.com/gS2QbfBhzK — Stop TB Partnership (@StopTB) July 6, 2022 Tepid global response Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said that while the global response to COVID-19 was to “plough money and resources into developing diagnosis tools, treatments and vaccines at lightning speed”, the response to TB, which infects 10 million people every year and kills 1.5 million, “has been tepid at best”. “A similar airborne infectious disease, TB remains neglected, even though it is a health threat for every single person. It is in the interest of all of us to end TB,” added Ditiu. However, she added that she was optimistic that the war against tuberculosis could be won by 2030. “A lot of optimism comes from what we have seen happening during COVID—it is possible to mobilize the resources –it is possible that researchers will work together, and share data to be able to develop new tools in such a short amount of time and it is possible to deploy and to organize amazing efforts at the grassroots level.” The Global Plan highlights the need to invest in developing a new TB vaccine by 2025, and making sure that resources are available to reach adults and adolescents in countries where TB is most prevalent. The only TB vaccine currently available is the BCG vaccine, which was approved more than a century ago and has a very limited impact on disease prevention. Dr Lucica Ditiu, Executive Director of Stop TB Partnership “The proposed investment of $ 10 billion in new TB vaccines, a new tool we all are waiting for, is 10 times less than what was injected in the research and development for COVID-19 vaccines. It should be possible to have the TB vaccine,” said Ditiu. Previous reports from the Stop TB Partnership noted that COVID-19 had cost the world 12 years of progress against TB. “Currently, almost 30% of funding per TB case comes from out-of-pocket costs and on average individuals with TB and their households lose 50% of their annual incomes as they suffer from and get treatment for the disease, even in places where TB services are provided free of charge,” according to Paul Mahanna, USAID’s Director of the Office of Infectious Diseases, “We cannot drive change without addressing the significant funding gaps that exist within high TB burden countries that result in lack of access to life-saving services and drive individuals, families and communities further into poverty. Image Credits: Stop TB Partnership. World Sees ‘Unprecedented’ Hunger as Farm Subsidies Boost Unhealthy Foods 06/07/2022 Elaine Ruth Fletcher An African farmer collects leaves from a gourd plant – smallholders are critical to food security and nutritional diversity – and marginalized by global food systems. Between 702 million and 828 million people suffered from hunger in 2021, more than at any time since 2005, five UN agencies reported on Wednesday. The proportion of people affected by hunger had remained relatively unchanged since 2015, affecting 8% of the global population in 2019. Once the COVID-19 pandemic hit in early 2020, those numbers soared to 9.3% in 2020 and to 9.89% in 2021, according to the State of Food Security and Nutrition in the World 2022 report published by the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF, World Food Programme (WFP) and International Fund for Agricultural Development (IFAD). That represents an increase of about 46 million people since 2020 and 150 million people since the outbreak of the pandemic. At current rates, 8% of the global population will still face hunger in 2030, unchanged from when the UN’s 2030 Agenda for Sustainable Development launched. Among the key goals of that ambitious plan, adopted at the UN Sustainable Development Summit in September 2015, was a determination “to end poverty and hunger, in all their forms and dimensions, and to ensure that all human beings can fulfil their potential in dignity and equality and in a healthy environment.” Progress on hunger stalled: Numbers of people who are going hungry today is about the same, or even more, than in 2005. Botswana’s Collen Vixen Kelapile, President of the United Nations Economic and Social Council (ECOSOC) Almost 3.1 billion people couldn’t afford a healthy diet in 2020, the report says. Massive food subsidies behind the production and consumption of milk, rice, sugar and meat also are disincentivizing production and consumption of healthy fruits, vegetables and protein-rich legumes, the report finds. Critically, the report calls upon a restructuring of global and national food subsidies to encourage more consumption of healthier foods including fruits and vegetables – which would also reduce carbon emissions from agricultural production of livestock and products that contribute to climate change. “Transformed agro-food systems need to be part of the solution to climate change and biodiversity loss … our very existence depends on it. Hundreds of millions of hungry and malnourished fellow human beings depend on it,” said Botswana’s Collen Vixen Kelapile, president of the UN Economic and Social Council (ECOSOC), which hosted the report’s launch in New York City. ‘Starvation and mass migration on an ‘unprecedented’ scale Trends in hunger by region WFP’s Executive Director David Beasley noted the world already faced “a perfect storm from the combined effects of conflicts and climate change and COVID economic ripple effects and global inflation” as this year was getting started. David Beasley, WFP executive director “And just when you think it can’t get any worse,” he said, “because we had Ethiopia and Afghanistan, then boom, Ukraine happens, the breadbasket of the world. The impact this conflict is having on global food security means the number of chronically hungry people in the world is likely already much higher than the 828 million people outlined in this work.” Beasley said the latest analysis shows a record 345 million acutely hungry people are marching to the brink of starvation today, a huge increase 276 million at the start of 2022 and from 135 million in the pre-COVID era. “There’s a real danger it will climb even higher in the months ahead,” he warned. “The global price spikes in food, fuel and fertilizers that we are seeing as a result of the crisis in Ukraine threaten to push countries around the world,” Beasley said. “The result will be global destabilization – to starvation and mass migration on an unprecedented scale. We have to act, and we have to act today to avert this looming catastrophe.” Africa hardest hit by hunger – women suffer more than men Laotian children get a fresh and healthy meal; WHO has urged policymakers to prioritize the introduction of healthier foods at schools. The prevalence of hunger, childhood wasting and stunting is highest in Africa, with a substantial burden in Asia, Latin America and the Caribbean (LAC), the report says. Hunger affected 278 million people in Africa; 425 million people in Asia; and 56.5 million people in LAC in 2021. Women are more likely to go hungry across the developing world, the report stresses. Globally, 149.2 million children under the age of 5, or 22% of the total population, suffered from stunting, and 6.7% suffered from wasting. Both are nutrition indicators of low height and weight in proportion to age. Another 38.9 million children under the age of five, or 5.7% of babies and toddlers globally, are overweight, reflecting a rise in unhealthy diets. Healthy diets became even more unaffordable in 2021. Almost 3.1 billion people could not afford a healthy diet in 2020, up by 112 million people from 2019, reflecting what the report describes as the effects of inflation in consumer food prices stemming from the economic impacts of the pandemic and the measures put in place to contain it. The poor in Asia, Africa and Latin America are also among those least able to afford a healthy diet, with Asia seeing the highest surge in costs – 4% in just one year. Political solution to Ukraine among the most immediate measures The global food crisis is being exacerbated by Russia’s blockage of exports from Ukraine, the world’s breadbasket. An end to the Russian blockade of Ukrainian ports is an important first step in addressing the crisis but only the beginning, Beasley said, listing the top priorities as follows: “Firstly we urgently need a political solution to Ukrainian wheat and grain so they can re-enter global markets.. Open up the ports.. Let’s get it moving. “Number 2, humanitarian organizations need substantial new funding to deal with the skyrocketing levels of hunger that we’re seeing around the world. “Thirdly, governments have to resist protectionism and keep trade flowing across borders. And fourthly, we need to learn the lessons of this crisis and invest in resilience programmes to help the poorest communities protect themselves against hunger and against shocks. “If we had successfully threaded this needle in the past, the war in Ukraine wouldn’t be having such a disastrous global impact today.” Rewriting the rules on agricultural and food subsidies to promote healthier foods Shifting food and agriculture subsidies to production and consumption of healthier foods would both reduce climate emissions and average costs of a healthy diet. But some farmers invested in unhealthy foods production could lose out. Fundamentally, the report calls for a major restructuring of deeply embedded global and national subsidies that are currently driving a significant portion of agricultural production – and unhealthy consumption of meat, sugar and basic commodities such as rice – at the expense of other healthier and lower-carbon intensive alternatives. FAO chief economist Máximo Torero Cullen said overall support for agricultural production largely concentrates on staple foods such as dairy and other animal source protein-rich foods, especially in high and upper middle income countries. “Rice, sugar and meat of various types are the foods most incentivized worldwide, while producers of fruits and vegetables are less supported overall, and even penalized in some low-income countries,” he said. “This needs to change. We are doing the opposite of what we are talking about. We need to change abruptly what is happening.” FAO chief economist Máximo Torero Cullen. The new report offers scenarios through 2030 in which public support to all farmers is reallocated around priority foods needed for healthy diets. FAO says adjusting price incentives will also reduce the cost of nutritious foods, which can healthy diets more affordable. That would also lower greenhouse gas emissions, particularly with livestock production, which has a high carbon pricetag. Shifting certain kinds of subsidies could, however, also create negative impacts on some farmers – who would then need new kinds of support, he pointed out. Needed: new flexibilities in national and WTO subsidy rules Cullen said understanding the tradeoffs are key to mapping out the future, and come further into play with the World Trade Organization. “We need commitments and flexibilities, and we need to follow what we have agreed with the WTO rules,” he said. “It may be necessary to set up new fiscal subsidies to consumers or to use proper social protection systems. International development finance will be needed for low-income countries and upper lower middle income countries, given that they have smaller amount of mechanisms.” Agricultural subsidies rules, however, tend to penalize small farmers in low-income countries, delegates from Latin America, Africa and Asia told the ECOSOC meeting. Pakistan’s UN representative Munir Akram “Massive subsidies distort global markets and make it impossible for farmers from developing countries to produce food at competitive prices,” said Pakistan’s UN representative Munir Akram. Gilbert Houngbo, president of IFAD, said the report highlights ways to repurpose agricultural and food policies to support small-scale producers and to build their resilience. Gilbert F. Houngbo, president of IFAD “Policies on subsidies often fall short of reducing hunger or improving food security and inclusion,” he said. “Instead, they have promoted an overreliance on starches, sugars, high protein and processed foods, while not supporting the production of healthier fruits and vegetables, for example.” Image Credits: @veerajayanth03, The Future of Food , State of Food Security and Nutrition 2022, FAO, Flickr: Bart Verweij / World Bank, Joseph C. Okechukwu/Twitter . COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . 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. 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European Medicines Agency Recommends Second COVID Booster for People Over 60 – as WHO Ponders Status of COVID Emergency 08/07/2022 Elaine Ruth Fletcher COVID vaccination of older people. The European Medicines Agency is now recommending boosters for people over 60, With cases of Omicron BA.4 and BA.5 soaring in Europe and around the world, the European Medicines Agency (EMA) recommends everyone 60 and older get a second COVID-19 booster shot. EMA’s recommendation came shortly before WHO reconvened its COVID Emergency Committee on Friday to reconsider its global recommendations for the pandemic – and if the state of global health emergency first declared on 30 January 2020, should be maintained. So far WHO recommendations on a second booster, provided by another expert group in May, are limited to immunocompromised people. Speaking at a press conference Thursday, EMA’s head of vaccines, Marco Cavaleri said a fourth booster for people over 60 and other vulnerable groups is now warranted due to a regional increase in COVID cases. He said projections show the BA.4 and BA.5 sub variants are expected to become dominant across all European countries, likely completely replacing all other variants by the end of July. Marco Cavaleri, head of vaccines for the European Medicines Agency “As this new wave is unfolding over the EU, it is essential to maintain protection of vulnerable groups and avoid any postponement of vaccination,” Cavaleri said. “Although there is no evidence of increased infection severity in the BA.4 and BA.5 compared to other sub variants, the increased transmission among older age groups is starting to translate into severe disease.” Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told a briefing on Wednesday. EMA and other regulators looking toward approval of “bivalent” COVID vaccines by September While current vaccines offer “good protection” against hospitalization, severe disease and death, EMA and other regulatory agencies around the world are now looking closely at new “bivalent” COVID vaccine formulations, Cavaleri said. EMA, the US Food and Drug Administration and other national regulatory authorities met last week under the auspices of the International Coalition of Regulatory Authorities (ICMRA) to examine available data on the new vaccines in light of the reduced protection that current vaccines offer against mild and moderate disease. “Preliminary data from clinical trials indicate that adapted messenger RNA (mRNA) vaccines which incorporate an Omicron variant strain can increase and extend protection, when used as a booster,” Cavaleri said of ICMRA’s conclusions. “Bivalent mRNA vaccines which combine two strains of SARS-CoV-2, one of which is an Omicron strain … appear to offer an even wider immune response.” But vaccines that include other variants or subvariants might also be considered for use as boosters, if clinical trial data demonstrate an adequate level of neutralization against Omicron and other variants of concern. Cavaleri said his agency is evaluating initial data that mRNA vaccines manufacturers have submitted for review and is in close contact with manufacturers of vaccines based on different platforms other than mRNA, especially adjuvanted protein vaccines. “Overall we expect to potentially have several vaccines to include … with an assortment of different platforms and technologies, and this is welcome,” he said. EMA also is working towards approval of adapted COVID-19 vaccines in September, with an eye towards what Cavaleri described as “plans for an even broader rollout of vaccination campaigns in the autumn.” Future Course of WHO Public Health Emergency Designation for COVID WHO hasn’t changed its designation of COVID-19 as a pandemic, and it was not expected to do so at Friday’s COVID Emergency Committee meeting – although as of Sunday afternoon no statement by the Commitee had yet been made, raising questions about what directives might yet be issued. Irregardless of current trends showing increased transmission in many parts of the world, there is growing acknowledgement that the COVID emergency is evolving into an endemic disease. That will likely mean further peaks and valleys, but be far less lethal than the initial waves of 2020. And sooner or later, that will prompt a re-evaluation of the status of COVID as a “Public Health Emergency of International Concern” (PHEIC), requiring countries to undertake special measures under the terms of International Health Regulations. At a press conference on Thursday, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed the real work needed to take place “at the national level.” In line with those trends, WHO and Gavi, the Vaccine Alliance acknowledged plans this week to “transition” the work of the Act Accelerator initiative for distributing COVID vaccines, tests and treatments into the work of key ACT-A partners and national health systems. Under the auspices of ACT-A, COVAX, the global vaccine facility has distributed hundreds of millions of doses of COVID vaccines to 92 low-income countries since March 2021 with the support of Gavi, UNICEF and WHO. Tthe vaccine facility was hampered early in the pandemic by severe vaccine supply shortages and later by widespread public uptake of vaccines as they became more available. -Updated 10 July 2022 Image Credits: Flickr: IMF/ Raphael Alves. First-Ever Cases of Marburg Virus Disease Reported in Ghana 08/07/2022 Editorial team Bats, captured from the Kitaka mine in Uganda were discovered to be the source of a Marburg virus outbreak in July 2007 in Uganda, where two infections were reported among miners. Ghana has reported two suspected cases of the rare and deadly Marburg virus disease – the first to ever be recorded within its borders. Marburg is a highly infectious viral haemorrhagic fever in the same family as the more well-known Ebola virus disease, said WHO’s Ghana Country Office in making the announcement. It has a fatality rate of up to 88%. Preliminary analysis of samples taken from two patients by the country’s Noguchi Memorial Institute for Medical Research indicated the cases were positive for Marburg. The samples have been sent to the Institut Pasteur in Senegal, a World Health Organization (WHO) Collaborating Centre, for confirmation. The two patients from the southern Ashanti region – both unrelated – showed symptoms including diarrhoea, fever, nausea and vomiting. They died after having been taken to a district hospital in Ashanti region. Preparations for a possible outbreak response are being set up swiftly as further investigations are underway, WHO said. “The health authorities are on the ground investigating the situation and preparing for a possible outbreak response. We are working closely with the country to ramp up detection, track contacts, be ready to control the spread of the virus,” said Dr Francis Kasolo, World Health Organization (WHO) Representative in Ghana. WHO is deploying experts to support Ghana’s health authorities by bolstering disease surveillance, testing, tracing contacts, preparing to treat patients and working with communities to alert and educate them about the risks and dangers of the disease and to collaborate with the emergency response teams. Geographic distribution of Marburg haemorrhagic fever outbreaks and fruit bats of Pteropodidae Family. Ghana cases outside of endemic zone The outbreak in Ghana is a source of concern not only because the virus is particularly deadly, but also because it has occurred outside of the central and southern African zone where most cases have been previously reported. Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda, according to WHO. Marburg has been detected in just one other West African country, Guinea. The country confirmed a single case in an outbreak that was declared over on 16 September 2021, five weeks after that case was detected. The deadly virus was first identified in 1967 after two outbreaks of cases simultaneously in Marburg and Frankfurt Germany and in Belgrade, Serbia – thus the naming of the disease. The outbreak was later raved to laboratory work with African green monkeys (Cercopithecus aethiops) that had been imported from Uganda. Marburg is transmitted to people from fruit bats and following that, it can spread person-to-person through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise, said WHO. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management. Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated. Image Credits: Chris Black/WHO, World Health Organization . African Innovation Gets Major Boost with New Pharma Technology Foundation 07/07/2022 Ochieng’ Ogodo Akinwumi Adesina, president of the African Development Bank, visits the ‘Mother and Child’ Hospital of Bingerville, Côte d’Ivoire, in 2020 The African Development Bank is establishing a foundation with the aim of spending at least $3 billion over the next decade to boost Africa’s access to technologies needed to make medicines, vaccines, and other pharmaceutical products. The bank’s board approved the establishment of the African Pharmaceutical Technology Foundation with an eye to towards creating what the bank described in a statement on June 27 as “a new groundbreaking institution” for Africa’s 1.3 billion citizens. AfDB President Akinwumi Adesina said Africa “must have a health defense system” that revamps its pharmaceutical industry while also building up its capacity to make vaccines and provide quality healthcare. “Africa can no longer outsource the healthcare security of its 1.3 billion citizens to the benevolence of others,” said Adesina, a Nigerian economist. AU priority to improve healthcare sector African Union Headquarters, Addis Ababa The need for a foundation featured prominently at the African Union summit in February at Addis Ababa, where leaders called on AfDB to help Africa’s health care sector become more independent in light of the challenges it has faced from several devastating diseases and the COVID-19 pandemic. WHO’s Dr Tedros Adhanom Ghebreyesus The foundation’s creation signals a major shift in efforts to address inadequacies in the sector, including limited capacity to produce its own medicines and vaccines in part due to the intellectual property barrier. Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said it “is a game changer on accelerating the access of African pharmaceutical companies to IP-protected technologies and know-how in Africa.” Medicines and vaccines gap The pandemic exposed Africa’s lack of capacity to manufacture and supply essential drugs and personal protective equipment (PPEs) needed to control the coronavirus. Soon after the pandemic began in early 2020, many of the world’s top scientists scrambled to find a vaccine but government and business leaders paid less attention to how it would be made and delivered to low- and middle-income countries. More focus was put on rapidly increasing supply to meet the surging demand, in a process largely driven by wealthier nations with greater purchasing power. In Africa, as in most other developing nations, citizens’ health care became dependent on the generosity of others. Nigerian pharmacist Ezinne Victoria Chinemerem Onwuekwe, who works as a public health fellow for the Africa Centres for Disease Control and Prevention, said the main problem is that Africa’s pharmaceutical industry lacks manufacturing capacity. “There are a few production companies here and there, and for it to be able to produce for these citizens, it will require the effort of public and private sector to bring together both the technical [and] financial support needed to push this forward,” she said. The shortage of medicines and other pharmaceutical products has been a challenge to effective delivering quality healthcare services in Africa. Pharmaceuticals are made in South Africa, Kenya, Morocco and Egypt, yet Africa spends US$16 billion to import 94% of its pharmaceutical and medicinal needs, according to the United Nations Economic Commission for Africa (UNECA). As of 2019, the continent had roughly 375 pharmaceutical manufacturers, compared to about 5,000 and 10,500, respectively, in China and India. And a 2019 study found many life-saving drugs are still inaccessible and unaffordable in low- and middle-income countries. Game changer for medicines Akinwumi Adesina, African Development Bank president, at the initiative launch, The new foundation, which will raise its own funds and operate independently of AfDB, will be hosted in Rwanda and deal with IP rights and health policy. One of its chief responsibilities will be mediating interests between Africa’s pharmaceutical sector and global companies with the aim of sharing IP-protected technologies, know-how and patented processes, according to documents on its establishment. It also is being asked to prioritize technologies, products and processes aimed primarily at diseases widely prevalent in Africa, or those that involve current and future pandemics. And it is expected to help build up the ranks of health care professionals and others who conduct research and development while upgrading manufacturing plant capacities and regulatory quality to meet WHO standards. Challenges in the healthcare sector Ezinne Onwuekwe Small fragmented markets and weak regulatory frameworks, inadequate human resource capacity, poor procurement and supply chain systems, and policy incoherencies in countries’ trade, industry, health, and finance departments are some of the impediments to the growth of Africa’s pharmaceutical sector. The continent is also burdened with fake and falsified medical drugs. In 2017, WHO revealed an estimated 116,000 additional deaths a year from malaria could be tied to substandard and falsified antimalarials. To counter that, the foundation is being asked to help local pharmaceutical companies boost home-grown production with better technology in their manufacturing plants and to work with governments, research and development centers to improve their innovation capacities. Onwuekwe said part of the problem is a lack of political will in some countries. “This is about finding African solutions to African problems. That is the new public heath order,” Onwuekwe told Health Policy Watch. “The leadership of the countries have to invest financially and politically for there to be any progress in the sector.” But the foundation, she said, also must become adept at negotiating with global pharmaceutical companies and must be “able to foster collaborations” with WHO, the African Union and other international organizations. Image Credits: AfDB Group, IAEA. WHO Concern as Monkeypox Cases Jump by 77% in a Week 07/07/2022 Kerry Cullinan With a 77% increase in new monkeypox cases in the past week, the World Health Organization’s (WHO) Emergency Committee is increasingly likely to declare the outbreak a public health emergency of international concern (PHEIC) when it reconvenes on or before 18 July. By Thursday, 59 countries had reported monkeypox cases, with Spain (1804 cases), UK (1351), Germany (1304) and the US (605) recording the highest caseloads. However, 10 countries have not reported new cases for over 21 days, which is the maximum duration of the incubation period of the disease, according to the WHO’s latest report. So far, there have been 6027 laboratory-confirmed cases of monkeypox and three deaths, but most countries are unable to test for the virus. However, the European Centre for Disease Prevention and Control (ECDC) reported on Wednesday that 5949 cases had been identified in 33 European countries alone through international health regulation mechanisms and public records. The vast majority of cases (99%) were male and aged between 31 and 40 (42%). “The majority of cases presented with a rash (96.1%) and systemic symptoms such as fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat or headache (69%). No cases were reported to have died. Some (15) cases were reported to be health workers. However, further investigation is ongoing to determine whether infection was due to occupational exposure,” according to the ECDC. Monkeypox cases, 6 July 2022 (Source: https://www.monkeypoxtally.info/) Lack of testing Expressing his concern about the scale and spread, WHO Director-General Dr Tedros Adhanom Ghebreyesus acknowledged that “testing remains a challenge and it’s highly probable that there are a significant number of cases not being picked up”. While most of the new cases have been identified in Europe and the US, Africa – where monkeypox was first identified in 1970 – has not recorded a huge jump in cases, and experts believe this could be due to a lack of proper testing. “I plan to reconvene the emergency committee so they are updated on the current epidemiology and evolution of the outbreak and implementation of countermeasures. I will bring them together during the week of 18 July or sooner if needed,” Tedros told the media briefing on Wednesday. The emergency committee decided not to declare monkeypox a PHEIC when it met in late June. Tedros also said that the WHO is working with countries and vaccine manufacturers to coordinate the sharing of “scarce” vaccines . Tedros added that the WHO is also working closely with civil society and LGBTQI+ community in particular to “break the stigma around the virus and spread information so people can protect themselves”, and commended those sharing their stories on social media to inform others. To share a little bit about my experience: I believe I was exposed to it around a week before symptoms manifested. Started off with just a couple bumps, then developed intense flu-like symptoms. Fever, chills, sweats, fatigue, etc. — Matt Ford (@JMatthiasFord) June 23, 2022 Child cases According to the WHO’s latest report, the outbreak “continues to primarily affect men who have sex with men who have reported recent sex with one or multiple male partners, suggesting no signal of sustained transmission beyond these networks for now.” However, WHO monkeypox expert Dr Rosamund Lewis confirmed that there were cases reported in children, about one-third of whom were under the age of 10. “For older children aged 18 or 19, the mode of transmission may still be an open question, but for younger children, one would assume that that would be from exposure in the household setting,” said Lewis. By Wednesday, 119 people had been diagnosed with monkeypox in New York City and city officials confirmed that the limited supplies of vaccines were usually snapped up in minutes by the group it was being offered to: men who have sex with men who had multiple sex partners, as well as close contacts of confirmed cases. Monkeypox cases continue to rise in NYC. Our supply of vaccine is wholly inadequate. Appts are gone within minutes of posting. (Yes even with the recent shipment.) We need the feds to send us far more doses ASAP. pic.twitter.com/HzqefaaIns — Mark D. Levine (@MarkLevineNYC) July 6, 2022 Image Credits: https://www.monkeypoxtally.info/. Long-Neglected Tuberculosis Could Be Stopped by 2030 – at a Cost of $250 Billion 07/07/2022 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. After year-long consultations, the Stop TB Partnership launched its global plan to end tuberculosis by 2030, which would involve the diagnosis and treatment of 50 million people at a cost of $250 billion. TB, the second biggest infectious disease killer in the world after COVID-19, has been neglected by donors in the past – yet if the plan’s budget was realised, every $1 invested would yield an economic return of at least $40. “If, instead, the status quo is maintained, TB is expected to continue to kill between 4,000-5,000 people every day, an additional 43 million people will develop TB and the cost in human life and disability would translate to a global economic loss of US$ 1 trillion,” according to Stop TB. “The COVID-19 pandemic delivered a crystal-clear wake-up call: that we cannot ignore a disease just because it has been relegated only to the poorest parts of the world,” said Dr. Paula Fujiwara, who led the task force in charge of the development of theplan. “With our attention diverted—along with the absence of financial commitments—TB has strengthened its grip on our planet. But we can regain control and meet our commitments to end TB by 2030 as long as we assert our political will now.” Today! @StopTB unveiled a costed plan to #endTB, the second leading infectious disease killers in the world, after #COVID19. The Global Plan to End TB 2023-2030 outlines the priority actions and estimated financial resources needed to end TB.👉Read here: https://t.co/HZLY4E9ous pic.twitter.com/gS2QbfBhzK — Stop TB Partnership (@StopTB) July 6, 2022 Tepid global response Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said that while the global response to COVID-19 was to “plough money and resources into developing diagnosis tools, treatments and vaccines at lightning speed”, the response to TB, which infects 10 million people every year and kills 1.5 million, “has been tepid at best”. “A similar airborne infectious disease, TB remains neglected, even though it is a health threat for every single person. It is in the interest of all of us to end TB,” added Ditiu. However, she added that she was optimistic that the war against tuberculosis could be won by 2030. “A lot of optimism comes from what we have seen happening during COVID—it is possible to mobilize the resources –it is possible that researchers will work together, and share data to be able to develop new tools in such a short amount of time and it is possible to deploy and to organize amazing efforts at the grassroots level.” The Global Plan highlights the need to invest in developing a new TB vaccine by 2025, and making sure that resources are available to reach adults and adolescents in countries where TB is most prevalent. The only TB vaccine currently available is the BCG vaccine, which was approved more than a century ago and has a very limited impact on disease prevention. Dr Lucica Ditiu, Executive Director of Stop TB Partnership “The proposed investment of $ 10 billion in new TB vaccines, a new tool we all are waiting for, is 10 times less than what was injected in the research and development for COVID-19 vaccines. It should be possible to have the TB vaccine,” said Ditiu. Previous reports from the Stop TB Partnership noted that COVID-19 had cost the world 12 years of progress against TB. “Currently, almost 30% of funding per TB case comes from out-of-pocket costs and on average individuals with TB and their households lose 50% of their annual incomes as they suffer from and get treatment for the disease, even in places where TB services are provided free of charge,” according to Paul Mahanna, USAID’s Director of the Office of Infectious Diseases, “We cannot drive change without addressing the significant funding gaps that exist within high TB burden countries that result in lack of access to life-saving services and drive individuals, families and communities further into poverty. Image Credits: Stop TB Partnership. World Sees ‘Unprecedented’ Hunger as Farm Subsidies Boost Unhealthy Foods 06/07/2022 Elaine Ruth Fletcher An African farmer collects leaves from a gourd plant – smallholders are critical to food security and nutritional diversity – and marginalized by global food systems. Between 702 million and 828 million people suffered from hunger in 2021, more than at any time since 2005, five UN agencies reported on Wednesday. The proportion of people affected by hunger had remained relatively unchanged since 2015, affecting 8% of the global population in 2019. Once the COVID-19 pandemic hit in early 2020, those numbers soared to 9.3% in 2020 and to 9.89% in 2021, according to the State of Food Security and Nutrition in the World 2022 report published by the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF, World Food Programme (WFP) and International Fund for Agricultural Development (IFAD). That represents an increase of about 46 million people since 2020 and 150 million people since the outbreak of the pandemic. At current rates, 8% of the global population will still face hunger in 2030, unchanged from when the UN’s 2030 Agenda for Sustainable Development launched. Among the key goals of that ambitious plan, adopted at the UN Sustainable Development Summit in September 2015, was a determination “to end poverty and hunger, in all their forms and dimensions, and to ensure that all human beings can fulfil their potential in dignity and equality and in a healthy environment.” Progress on hunger stalled: Numbers of people who are going hungry today is about the same, or even more, than in 2005. Botswana’s Collen Vixen Kelapile, President of the United Nations Economic and Social Council (ECOSOC) Almost 3.1 billion people couldn’t afford a healthy diet in 2020, the report says. Massive food subsidies behind the production and consumption of milk, rice, sugar and meat also are disincentivizing production and consumption of healthy fruits, vegetables and protein-rich legumes, the report finds. Critically, the report calls upon a restructuring of global and national food subsidies to encourage more consumption of healthier foods including fruits and vegetables – which would also reduce carbon emissions from agricultural production of livestock and products that contribute to climate change. “Transformed agro-food systems need to be part of the solution to climate change and biodiversity loss … our very existence depends on it. Hundreds of millions of hungry and malnourished fellow human beings depend on it,” said Botswana’s Collen Vixen Kelapile, president of the UN Economic and Social Council (ECOSOC), which hosted the report’s launch in New York City. ‘Starvation and mass migration on an ‘unprecedented’ scale Trends in hunger by region WFP’s Executive Director David Beasley noted the world already faced “a perfect storm from the combined effects of conflicts and climate change and COVID economic ripple effects and global inflation” as this year was getting started. David Beasley, WFP executive director “And just when you think it can’t get any worse,” he said, “because we had Ethiopia and Afghanistan, then boom, Ukraine happens, the breadbasket of the world. The impact this conflict is having on global food security means the number of chronically hungry people in the world is likely already much higher than the 828 million people outlined in this work.” Beasley said the latest analysis shows a record 345 million acutely hungry people are marching to the brink of starvation today, a huge increase 276 million at the start of 2022 and from 135 million in the pre-COVID era. “There’s a real danger it will climb even higher in the months ahead,” he warned. “The global price spikes in food, fuel and fertilizers that we are seeing as a result of the crisis in Ukraine threaten to push countries around the world,” Beasley said. “The result will be global destabilization – to starvation and mass migration on an unprecedented scale. We have to act, and we have to act today to avert this looming catastrophe.” Africa hardest hit by hunger – women suffer more than men Laotian children get a fresh and healthy meal; WHO has urged policymakers to prioritize the introduction of healthier foods at schools. The prevalence of hunger, childhood wasting and stunting is highest in Africa, with a substantial burden in Asia, Latin America and the Caribbean (LAC), the report says. Hunger affected 278 million people in Africa; 425 million people in Asia; and 56.5 million people in LAC in 2021. Women are more likely to go hungry across the developing world, the report stresses. Globally, 149.2 million children under the age of 5, or 22% of the total population, suffered from stunting, and 6.7% suffered from wasting. Both are nutrition indicators of low height and weight in proportion to age. Another 38.9 million children under the age of five, or 5.7% of babies and toddlers globally, are overweight, reflecting a rise in unhealthy diets. Healthy diets became even more unaffordable in 2021. Almost 3.1 billion people could not afford a healthy diet in 2020, up by 112 million people from 2019, reflecting what the report describes as the effects of inflation in consumer food prices stemming from the economic impacts of the pandemic and the measures put in place to contain it. The poor in Asia, Africa and Latin America are also among those least able to afford a healthy diet, with Asia seeing the highest surge in costs – 4% in just one year. Political solution to Ukraine among the most immediate measures The global food crisis is being exacerbated by Russia’s blockage of exports from Ukraine, the world’s breadbasket. An end to the Russian blockade of Ukrainian ports is an important first step in addressing the crisis but only the beginning, Beasley said, listing the top priorities as follows: “Firstly we urgently need a political solution to Ukrainian wheat and grain so they can re-enter global markets.. Open up the ports.. Let’s get it moving. “Number 2, humanitarian organizations need substantial new funding to deal with the skyrocketing levels of hunger that we’re seeing around the world. “Thirdly, governments have to resist protectionism and keep trade flowing across borders. And fourthly, we need to learn the lessons of this crisis and invest in resilience programmes to help the poorest communities protect themselves against hunger and against shocks. “If we had successfully threaded this needle in the past, the war in Ukraine wouldn’t be having such a disastrous global impact today.” Rewriting the rules on agricultural and food subsidies to promote healthier foods Shifting food and agriculture subsidies to production and consumption of healthier foods would both reduce climate emissions and average costs of a healthy diet. But some farmers invested in unhealthy foods production could lose out. Fundamentally, the report calls for a major restructuring of deeply embedded global and national subsidies that are currently driving a significant portion of agricultural production – and unhealthy consumption of meat, sugar and basic commodities such as rice – at the expense of other healthier and lower-carbon intensive alternatives. FAO chief economist Máximo Torero Cullen said overall support for agricultural production largely concentrates on staple foods such as dairy and other animal source protein-rich foods, especially in high and upper middle income countries. “Rice, sugar and meat of various types are the foods most incentivized worldwide, while producers of fruits and vegetables are less supported overall, and even penalized in some low-income countries,” he said. “This needs to change. We are doing the opposite of what we are talking about. We need to change abruptly what is happening.” FAO chief economist Máximo Torero Cullen. The new report offers scenarios through 2030 in which public support to all farmers is reallocated around priority foods needed for healthy diets. FAO says adjusting price incentives will also reduce the cost of nutritious foods, which can healthy diets more affordable. That would also lower greenhouse gas emissions, particularly with livestock production, which has a high carbon pricetag. Shifting certain kinds of subsidies could, however, also create negative impacts on some farmers – who would then need new kinds of support, he pointed out. Needed: new flexibilities in national and WTO subsidy rules Cullen said understanding the tradeoffs are key to mapping out the future, and come further into play with the World Trade Organization. “We need commitments and flexibilities, and we need to follow what we have agreed with the WTO rules,” he said. “It may be necessary to set up new fiscal subsidies to consumers or to use proper social protection systems. International development finance will be needed for low-income countries and upper lower middle income countries, given that they have smaller amount of mechanisms.” Agricultural subsidies rules, however, tend to penalize small farmers in low-income countries, delegates from Latin America, Africa and Asia told the ECOSOC meeting. Pakistan’s UN representative Munir Akram “Massive subsidies distort global markets and make it impossible for farmers from developing countries to produce food at competitive prices,” said Pakistan’s UN representative Munir Akram. Gilbert Houngbo, president of IFAD, said the report highlights ways to repurpose agricultural and food policies to support small-scale producers and to build their resilience. Gilbert F. Houngbo, president of IFAD “Policies on subsidies often fall short of reducing hunger or improving food security and inclusion,” he said. “Instead, they have promoted an overreliance on starches, sugars, high protein and processed foods, while not supporting the production of healthier fruits and vegetables, for example.” Image Credits: @veerajayanth03, The Future of Food , State of Food Security and Nutrition 2022, FAO, Flickr: Bart Verweij / World Bank, Joseph C. Okechukwu/Twitter . COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . 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. 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First-Ever Cases of Marburg Virus Disease Reported in Ghana 08/07/2022 Editorial team Bats, captured from the Kitaka mine in Uganda were discovered to be the source of a Marburg virus outbreak in July 2007 in Uganda, where two infections were reported among miners. Ghana has reported two suspected cases of the rare and deadly Marburg virus disease – the first to ever be recorded within its borders. Marburg is a highly infectious viral haemorrhagic fever in the same family as the more well-known Ebola virus disease, said WHO’s Ghana Country Office in making the announcement. It has a fatality rate of up to 88%. Preliminary analysis of samples taken from two patients by the country’s Noguchi Memorial Institute for Medical Research indicated the cases were positive for Marburg. The samples have been sent to the Institut Pasteur in Senegal, a World Health Organization (WHO) Collaborating Centre, for confirmation. The two patients from the southern Ashanti region – both unrelated – showed symptoms including diarrhoea, fever, nausea and vomiting. They died after having been taken to a district hospital in Ashanti region. Preparations for a possible outbreak response are being set up swiftly as further investigations are underway, WHO said. “The health authorities are on the ground investigating the situation and preparing for a possible outbreak response. We are working closely with the country to ramp up detection, track contacts, be ready to control the spread of the virus,” said Dr Francis Kasolo, World Health Organization (WHO) Representative in Ghana. WHO is deploying experts to support Ghana’s health authorities by bolstering disease surveillance, testing, tracing contacts, preparing to treat patients and working with communities to alert and educate them about the risks and dangers of the disease and to collaborate with the emergency response teams. Geographic distribution of Marburg haemorrhagic fever outbreaks and fruit bats of Pteropodidae Family. Ghana cases outside of endemic zone The outbreak in Ghana is a source of concern not only because the virus is particularly deadly, but also because it has occurred outside of the central and southern African zone where most cases have been previously reported. Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda, according to WHO. Marburg has been detected in just one other West African country, Guinea. The country confirmed a single case in an outbreak that was declared over on 16 September 2021, five weeks after that case was detected. The deadly virus was first identified in 1967 after two outbreaks of cases simultaneously in Marburg and Frankfurt Germany and in Belgrade, Serbia – thus the naming of the disease. The outbreak was later raved to laboratory work with African green monkeys (Cercopithecus aethiops) that had been imported from Uganda. Marburg is transmitted to people from fruit bats and following that, it can spread person-to-person through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise, said WHO. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management. Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated. Image Credits: Chris Black/WHO, World Health Organization . African Innovation Gets Major Boost with New Pharma Technology Foundation 07/07/2022 Ochieng’ Ogodo Akinwumi Adesina, president of the African Development Bank, visits the ‘Mother and Child’ Hospital of Bingerville, Côte d’Ivoire, in 2020 The African Development Bank is establishing a foundation with the aim of spending at least $3 billion over the next decade to boost Africa’s access to technologies needed to make medicines, vaccines, and other pharmaceutical products. The bank’s board approved the establishment of the African Pharmaceutical Technology Foundation with an eye to towards creating what the bank described in a statement on June 27 as “a new groundbreaking institution” for Africa’s 1.3 billion citizens. AfDB President Akinwumi Adesina said Africa “must have a health defense system” that revamps its pharmaceutical industry while also building up its capacity to make vaccines and provide quality healthcare. “Africa can no longer outsource the healthcare security of its 1.3 billion citizens to the benevolence of others,” said Adesina, a Nigerian economist. AU priority to improve healthcare sector African Union Headquarters, Addis Ababa The need for a foundation featured prominently at the African Union summit in February at Addis Ababa, where leaders called on AfDB to help Africa’s health care sector become more independent in light of the challenges it has faced from several devastating diseases and the COVID-19 pandemic. WHO’s Dr Tedros Adhanom Ghebreyesus The foundation’s creation signals a major shift in efforts to address inadequacies in the sector, including limited capacity to produce its own medicines and vaccines in part due to the intellectual property barrier. Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said it “is a game changer on accelerating the access of African pharmaceutical companies to IP-protected technologies and know-how in Africa.” Medicines and vaccines gap The pandemic exposed Africa’s lack of capacity to manufacture and supply essential drugs and personal protective equipment (PPEs) needed to control the coronavirus. Soon after the pandemic began in early 2020, many of the world’s top scientists scrambled to find a vaccine but government and business leaders paid less attention to how it would be made and delivered to low- and middle-income countries. More focus was put on rapidly increasing supply to meet the surging demand, in a process largely driven by wealthier nations with greater purchasing power. In Africa, as in most other developing nations, citizens’ health care became dependent on the generosity of others. Nigerian pharmacist Ezinne Victoria Chinemerem Onwuekwe, who works as a public health fellow for the Africa Centres for Disease Control and Prevention, said the main problem is that Africa’s pharmaceutical industry lacks manufacturing capacity. “There are a few production companies here and there, and for it to be able to produce for these citizens, it will require the effort of public and private sector to bring together both the technical [and] financial support needed to push this forward,” she said. The shortage of medicines and other pharmaceutical products has been a challenge to effective delivering quality healthcare services in Africa. Pharmaceuticals are made in South Africa, Kenya, Morocco and Egypt, yet Africa spends US$16 billion to import 94% of its pharmaceutical and medicinal needs, according to the United Nations Economic Commission for Africa (UNECA). As of 2019, the continent had roughly 375 pharmaceutical manufacturers, compared to about 5,000 and 10,500, respectively, in China and India. And a 2019 study found many life-saving drugs are still inaccessible and unaffordable in low- and middle-income countries. Game changer for medicines Akinwumi Adesina, African Development Bank president, at the initiative launch, The new foundation, which will raise its own funds and operate independently of AfDB, will be hosted in Rwanda and deal with IP rights and health policy. One of its chief responsibilities will be mediating interests between Africa’s pharmaceutical sector and global companies with the aim of sharing IP-protected technologies, know-how and patented processes, according to documents on its establishment. It also is being asked to prioritize technologies, products and processes aimed primarily at diseases widely prevalent in Africa, or those that involve current and future pandemics. And it is expected to help build up the ranks of health care professionals and others who conduct research and development while upgrading manufacturing plant capacities and regulatory quality to meet WHO standards. Challenges in the healthcare sector Ezinne Onwuekwe Small fragmented markets and weak regulatory frameworks, inadequate human resource capacity, poor procurement and supply chain systems, and policy incoherencies in countries’ trade, industry, health, and finance departments are some of the impediments to the growth of Africa’s pharmaceutical sector. The continent is also burdened with fake and falsified medical drugs. In 2017, WHO revealed an estimated 116,000 additional deaths a year from malaria could be tied to substandard and falsified antimalarials. To counter that, the foundation is being asked to help local pharmaceutical companies boost home-grown production with better technology in their manufacturing plants and to work with governments, research and development centers to improve their innovation capacities. Onwuekwe said part of the problem is a lack of political will in some countries. “This is about finding African solutions to African problems. That is the new public heath order,” Onwuekwe told Health Policy Watch. “The leadership of the countries have to invest financially and politically for there to be any progress in the sector.” But the foundation, she said, also must become adept at negotiating with global pharmaceutical companies and must be “able to foster collaborations” with WHO, the African Union and other international organizations. Image Credits: AfDB Group, IAEA. WHO Concern as Monkeypox Cases Jump by 77% in a Week 07/07/2022 Kerry Cullinan With a 77% increase in new monkeypox cases in the past week, the World Health Organization’s (WHO) Emergency Committee is increasingly likely to declare the outbreak a public health emergency of international concern (PHEIC) when it reconvenes on or before 18 July. By Thursday, 59 countries had reported monkeypox cases, with Spain (1804 cases), UK (1351), Germany (1304) and the US (605) recording the highest caseloads. However, 10 countries have not reported new cases for over 21 days, which is the maximum duration of the incubation period of the disease, according to the WHO’s latest report. So far, there have been 6027 laboratory-confirmed cases of monkeypox and three deaths, but most countries are unable to test for the virus. However, the European Centre for Disease Prevention and Control (ECDC) reported on Wednesday that 5949 cases had been identified in 33 European countries alone through international health regulation mechanisms and public records. The vast majority of cases (99%) were male and aged between 31 and 40 (42%). “The majority of cases presented with a rash (96.1%) and systemic symptoms such as fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat or headache (69%). No cases were reported to have died. Some (15) cases were reported to be health workers. However, further investigation is ongoing to determine whether infection was due to occupational exposure,” according to the ECDC. Monkeypox cases, 6 July 2022 (Source: https://www.monkeypoxtally.info/) Lack of testing Expressing his concern about the scale and spread, WHO Director-General Dr Tedros Adhanom Ghebreyesus acknowledged that “testing remains a challenge and it’s highly probable that there are a significant number of cases not being picked up”. While most of the new cases have been identified in Europe and the US, Africa – where monkeypox was first identified in 1970 – has not recorded a huge jump in cases, and experts believe this could be due to a lack of proper testing. “I plan to reconvene the emergency committee so they are updated on the current epidemiology and evolution of the outbreak and implementation of countermeasures. I will bring them together during the week of 18 July or sooner if needed,” Tedros told the media briefing on Wednesday. The emergency committee decided not to declare monkeypox a PHEIC when it met in late June. Tedros also said that the WHO is working with countries and vaccine manufacturers to coordinate the sharing of “scarce” vaccines . Tedros added that the WHO is also working closely with civil society and LGBTQI+ community in particular to “break the stigma around the virus and spread information so people can protect themselves”, and commended those sharing their stories on social media to inform others. To share a little bit about my experience: I believe I was exposed to it around a week before symptoms manifested. Started off with just a couple bumps, then developed intense flu-like symptoms. Fever, chills, sweats, fatigue, etc. — Matt Ford (@JMatthiasFord) June 23, 2022 Child cases According to the WHO’s latest report, the outbreak “continues to primarily affect men who have sex with men who have reported recent sex with one or multiple male partners, suggesting no signal of sustained transmission beyond these networks for now.” However, WHO monkeypox expert Dr Rosamund Lewis confirmed that there were cases reported in children, about one-third of whom were under the age of 10. “For older children aged 18 or 19, the mode of transmission may still be an open question, but for younger children, one would assume that that would be from exposure in the household setting,” said Lewis. By Wednesday, 119 people had been diagnosed with monkeypox in New York City and city officials confirmed that the limited supplies of vaccines were usually snapped up in minutes by the group it was being offered to: men who have sex with men who had multiple sex partners, as well as close contacts of confirmed cases. Monkeypox cases continue to rise in NYC. Our supply of vaccine is wholly inadequate. Appts are gone within minutes of posting. (Yes even with the recent shipment.) We need the feds to send us far more doses ASAP. pic.twitter.com/HzqefaaIns — Mark D. Levine (@MarkLevineNYC) July 6, 2022 Image Credits: https://www.monkeypoxtally.info/. Long-Neglected Tuberculosis Could Be Stopped by 2030 – at a Cost of $250 Billion 07/07/2022 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. After year-long consultations, the Stop TB Partnership launched its global plan to end tuberculosis by 2030, which would involve the diagnosis and treatment of 50 million people at a cost of $250 billion. TB, the second biggest infectious disease killer in the world after COVID-19, has been neglected by donors in the past – yet if the plan’s budget was realised, every $1 invested would yield an economic return of at least $40. “If, instead, the status quo is maintained, TB is expected to continue to kill between 4,000-5,000 people every day, an additional 43 million people will develop TB and the cost in human life and disability would translate to a global economic loss of US$ 1 trillion,” according to Stop TB. “The COVID-19 pandemic delivered a crystal-clear wake-up call: that we cannot ignore a disease just because it has been relegated only to the poorest parts of the world,” said Dr. Paula Fujiwara, who led the task force in charge of the development of theplan. “With our attention diverted—along with the absence of financial commitments—TB has strengthened its grip on our planet. But we can regain control and meet our commitments to end TB by 2030 as long as we assert our political will now.” Today! @StopTB unveiled a costed plan to #endTB, the second leading infectious disease killers in the world, after #COVID19. The Global Plan to End TB 2023-2030 outlines the priority actions and estimated financial resources needed to end TB.👉Read here: https://t.co/HZLY4E9ous pic.twitter.com/gS2QbfBhzK — Stop TB Partnership (@StopTB) July 6, 2022 Tepid global response Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said that while the global response to COVID-19 was to “plough money and resources into developing diagnosis tools, treatments and vaccines at lightning speed”, the response to TB, which infects 10 million people every year and kills 1.5 million, “has been tepid at best”. “A similar airborne infectious disease, TB remains neglected, even though it is a health threat for every single person. It is in the interest of all of us to end TB,” added Ditiu. However, she added that she was optimistic that the war against tuberculosis could be won by 2030. “A lot of optimism comes from what we have seen happening during COVID—it is possible to mobilize the resources –it is possible that researchers will work together, and share data to be able to develop new tools in such a short amount of time and it is possible to deploy and to organize amazing efforts at the grassroots level.” The Global Plan highlights the need to invest in developing a new TB vaccine by 2025, and making sure that resources are available to reach adults and adolescents in countries where TB is most prevalent. The only TB vaccine currently available is the BCG vaccine, which was approved more than a century ago and has a very limited impact on disease prevention. Dr Lucica Ditiu, Executive Director of Stop TB Partnership “The proposed investment of $ 10 billion in new TB vaccines, a new tool we all are waiting for, is 10 times less than what was injected in the research and development for COVID-19 vaccines. It should be possible to have the TB vaccine,” said Ditiu. Previous reports from the Stop TB Partnership noted that COVID-19 had cost the world 12 years of progress against TB. “Currently, almost 30% of funding per TB case comes from out-of-pocket costs and on average individuals with TB and their households lose 50% of their annual incomes as they suffer from and get treatment for the disease, even in places where TB services are provided free of charge,” according to Paul Mahanna, USAID’s Director of the Office of Infectious Diseases, “We cannot drive change without addressing the significant funding gaps that exist within high TB burden countries that result in lack of access to life-saving services and drive individuals, families and communities further into poverty. Image Credits: Stop TB Partnership. World Sees ‘Unprecedented’ Hunger as Farm Subsidies Boost Unhealthy Foods 06/07/2022 Elaine Ruth Fletcher An African farmer collects leaves from a gourd plant – smallholders are critical to food security and nutritional diversity – and marginalized by global food systems. Between 702 million and 828 million people suffered from hunger in 2021, more than at any time since 2005, five UN agencies reported on Wednesday. The proportion of people affected by hunger had remained relatively unchanged since 2015, affecting 8% of the global population in 2019. Once the COVID-19 pandemic hit in early 2020, those numbers soared to 9.3% in 2020 and to 9.89% in 2021, according to the State of Food Security and Nutrition in the World 2022 report published by the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF, World Food Programme (WFP) and International Fund for Agricultural Development (IFAD). That represents an increase of about 46 million people since 2020 and 150 million people since the outbreak of the pandemic. At current rates, 8% of the global population will still face hunger in 2030, unchanged from when the UN’s 2030 Agenda for Sustainable Development launched. Among the key goals of that ambitious plan, adopted at the UN Sustainable Development Summit in September 2015, was a determination “to end poverty and hunger, in all their forms and dimensions, and to ensure that all human beings can fulfil their potential in dignity and equality and in a healthy environment.” Progress on hunger stalled: Numbers of people who are going hungry today is about the same, or even more, than in 2005. Botswana’s Collen Vixen Kelapile, President of the United Nations Economic and Social Council (ECOSOC) Almost 3.1 billion people couldn’t afford a healthy diet in 2020, the report says. Massive food subsidies behind the production and consumption of milk, rice, sugar and meat also are disincentivizing production and consumption of healthy fruits, vegetables and protein-rich legumes, the report finds. Critically, the report calls upon a restructuring of global and national food subsidies to encourage more consumption of healthier foods including fruits and vegetables – which would also reduce carbon emissions from agricultural production of livestock and products that contribute to climate change. “Transformed agro-food systems need to be part of the solution to climate change and biodiversity loss … our very existence depends on it. Hundreds of millions of hungry and malnourished fellow human beings depend on it,” said Botswana’s Collen Vixen Kelapile, president of the UN Economic and Social Council (ECOSOC), which hosted the report’s launch in New York City. ‘Starvation and mass migration on an ‘unprecedented’ scale Trends in hunger by region WFP’s Executive Director David Beasley noted the world already faced “a perfect storm from the combined effects of conflicts and climate change and COVID economic ripple effects and global inflation” as this year was getting started. David Beasley, WFP executive director “And just when you think it can’t get any worse,” he said, “because we had Ethiopia and Afghanistan, then boom, Ukraine happens, the breadbasket of the world. The impact this conflict is having on global food security means the number of chronically hungry people in the world is likely already much higher than the 828 million people outlined in this work.” Beasley said the latest analysis shows a record 345 million acutely hungry people are marching to the brink of starvation today, a huge increase 276 million at the start of 2022 and from 135 million in the pre-COVID era. “There’s a real danger it will climb even higher in the months ahead,” he warned. “The global price spikes in food, fuel and fertilizers that we are seeing as a result of the crisis in Ukraine threaten to push countries around the world,” Beasley said. “The result will be global destabilization – to starvation and mass migration on an unprecedented scale. We have to act, and we have to act today to avert this looming catastrophe.” Africa hardest hit by hunger – women suffer more than men Laotian children get a fresh and healthy meal; WHO has urged policymakers to prioritize the introduction of healthier foods at schools. The prevalence of hunger, childhood wasting and stunting is highest in Africa, with a substantial burden in Asia, Latin America and the Caribbean (LAC), the report says. Hunger affected 278 million people in Africa; 425 million people in Asia; and 56.5 million people in LAC in 2021. Women are more likely to go hungry across the developing world, the report stresses. Globally, 149.2 million children under the age of 5, or 22% of the total population, suffered from stunting, and 6.7% suffered from wasting. Both are nutrition indicators of low height and weight in proportion to age. Another 38.9 million children under the age of five, or 5.7% of babies and toddlers globally, are overweight, reflecting a rise in unhealthy diets. Healthy diets became even more unaffordable in 2021. Almost 3.1 billion people could not afford a healthy diet in 2020, up by 112 million people from 2019, reflecting what the report describes as the effects of inflation in consumer food prices stemming from the economic impacts of the pandemic and the measures put in place to contain it. The poor in Asia, Africa and Latin America are also among those least able to afford a healthy diet, with Asia seeing the highest surge in costs – 4% in just one year. Political solution to Ukraine among the most immediate measures The global food crisis is being exacerbated by Russia’s blockage of exports from Ukraine, the world’s breadbasket. An end to the Russian blockade of Ukrainian ports is an important first step in addressing the crisis but only the beginning, Beasley said, listing the top priorities as follows: “Firstly we urgently need a political solution to Ukrainian wheat and grain so they can re-enter global markets.. Open up the ports.. Let’s get it moving. “Number 2, humanitarian organizations need substantial new funding to deal with the skyrocketing levels of hunger that we’re seeing around the world. “Thirdly, governments have to resist protectionism and keep trade flowing across borders. And fourthly, we need to learn the lessons of this crisis and invest in resilience programmes to help the poorest communities protect themselves against hunger and against shocks. “If we had successfully threaded this needle in the past, the war in Ukraine wouldn’t be having such a disastrous global impact today.” Rewriting the rules on agricultural and food subsidies to promote healthier foods Shifting food and agriculture subsidies to production and consumption of healthier foods would both reduce climate emissions and average costs of a healthy diet. But some farmers invested in unhealthy foods production could lose out. Fundamentally, the report calls for a major restructuring of deeply embedded global and national subsidies that are currently driving a significant portion of agricultural production – and unhealthy consumption of meat, sugar and basic commodities such as rice – at the expense of other healthier and lower-carbon intensive alternatives. FAO chief economist Máximo Torero Cullen said overall support for agricultural production largely concentrates on staple foods such as dairy and other animal source protein-rich foods, especially in high and upper middle income countries. “Rice, sugar and meat of various types are the foods most incentivized worldwide, while producers of fruits and vegetables are less supported overall, and even penalized in some low-income countries,” he said. “This needs to change. We are doing the opposite of what we are talking about. We need to change abruptly what is happening.” FAO chief economist Máximo Torero Cullen. The new report offers scenarios through 2030 in which public support to all farmers is reallocated around priority foods needed for healthy diets. FAO says adjusting price incentives will also reduce the cost of nutritious foods, which can healthy diets more affordable. That would also lower greenhouse gas emissions, particularly with livestock production, which has a high carbon pricetag. Shifting certain kinds of subsidies could, however, also create negative impacts on some farmers – who would then need new kinds of support, he pointed out. Needed: new flexibilities in national and WTO subsidy rules Cullen said understanding the tradeoffs are key to mapping out the future, and come further into play with the World Trade Organization. “We need commitments and flexibilities, and we need to follow what we have agreed with the WTO rules,” he said. “It may be necessary to set up new fiscal subsidies to consumers or to use proper social protection systems. International development finance will be needed for low-income countries and upper lower middle income countries, given that they have smaller amount of mechanisms.” Agricultural subsidies rules, however, tend to penalize small farmers in low-income countries, delegates from Latin America, Africa and Asia told the ECOSOC meeting. Pakistan’s UN representative Munir Akram “Massive subsidies distort global markets and make it impossible for farmers from developing countries to produce food at competitive prices,” said Pakistan’s UN representative Munir Akram. Gilbert Houngbo, president of IFAD, said the report highlights ways to repurpose agricultural and food policies to support small-scale producers and to build their resilience. Gilbert F. Houngbo, president of IFAD “Policies on subsidies often fall short of reducing hunger or improving food security and inclusion,” he said. “Instead, they have promoted an overreliance on starches, sugars, high protein and processed foods, while not supporting the production of healthier fruits and vegetables, for example.” Image Credits: @veerajayanth03, The Future of Food , State of Food Security and Nutrition 2022, FAO, Flickr: Bart Verweij / World Bank, Joseph C. Okechukwu/Twitter . COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . 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. 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African Innovation Gets Major Boost with New Pharma Technology Foundation 07/07/2022 Ochieng’ Ogodo Akinwumi Adesina, president of the African Development Bank, visits the ‘Mother and Child’ Hospital of Bingerville, Côte d’Ivoire, in 2020 The African Development Bank is establishing a foundation with the aim of spending at least $3 billion over the next decade to boost Africa’s access to technologies needed to make medicines, vaccines, and other pharmaceutical products. The bank’s board approved the establishment of the African Pharmaceutical Technology Foundation with an eye to towards creating what the bank described in a statement on June 27 as “a new groundbreaking institution” for Africa’s 1.3 billion citizens. AfDB President Akinwumi Adesina said Africa “must have a health defense system” that revamps its pharmaceutical industry while also building up its capacity to make vaccines and provide quality healthcare. “Africa can no longer outsource the healthcare security of its 1.3 billion citizens to the benevolence of others,” said Adesina, a Nigerian economist. AU priority to improve healthcare sector African Union Headquarters, Addis Ababa The need for a foundation featured prominently at the African Union summit in February at Addis Ababa, where leaders called on AfDB to help Africa’s health care sector become more independent in light of the challenges it has faced from several devastating diseases and the COVID-19 pandemic. WHO’s Dr Tedros Adhanom Ghebreyesus The foundation’s creation signals a major shift in efforts to address inadequacies in the sector, including limited capacity to produce its own medicines and vaccines in part due to the intellectual property barrier. Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said it “is a game changer on accelerating the access of African pharmaceutical companies to IP-protected technologies and know-how in Africa.” Medicines and vaccines gap The pandemic exposed Africa’s lack of capacity to manufacture and supply essential drugs and personal protective equipment (PPEs) needed to control the coronavirus. Soon after the pandemic began in early 2020, many of the world’s top scientists scrambled to find a vaccine but government and business leaders paid less attention to how it would be made and delivered to low- and middle-income countries. More focus was put on rapidly increasing supply to meet the surging demand, in a process largely driven by wealthier nations with greater purchasing power. In Africa, as in most other developing nations, citizens’ health care became dependent on the generosity of others. Nigerian pharmacist Ezinne Victoria Chinemerem Onwuekwe, who works as a public health fellow for the Africa Centres for Disease Control and Prevention, said the main problem is that Africa’s pharmaceutical industry lacks manufacturing capacity. “There are a few production companies here and there, and for it to be able to produce for these citizens, it will require the effort of public and private sector to bring together both the technical [and] financial support needed to push this forward,” she said. The shortage of medicines and other pharmaceutical products has been a challenge to effective delivering quality healthcare services in Africa. Pharmaceuticals are made in South Africa, Kenya, Morocco and Egypt, yet Africa spends US$16 billion to import 94% of its pharmaceutical and medicinal needs, according to the United Nations Economic Commission for Africa (UNECA). As of 2019, the continent had roughly 375 pharmaceutical manufacturers, compared to about 5,000 and 10,500, respectively, in China and India. And a 2019 study found many life-saving drugs are still inaccessible and unaffordable in low- and middle-income countries. Game changer for medicines Akinwumi Adesina, African Development Bank president, at the initiative launch, The new foundation, which will raise its own funds and operate independently of AfDB, will be hosted in Rwanda and deal with IP rights and health policy. One of its chief responsibilities will be mediating interests between Africa’s pharmaceutical sector and global companies with the aim of sharing IP-protected technologies, know-how and patented processes, according to documents on its establishment. It also is being asked to prioritize technologies, products and processes aimed primarily at diseases widely prevalent in Africa, or those that involve current and future pandemics. And it is expected to help build up the ranks of health care professionals and others who conduct research and development while upgrading manufacturing plant capacities and regulatory quality to meet WHO standards. Challenges in the healthcare sector Ezinne Onwuekwe Small fragmented markets and weak regulatory frameworks, inadequate human resource capacity, poor procurement and supply chain systems, and policy incoherencies in countries’ trade, industry, health, and finance departments are some of the impediments to the growth of Africa’s pharmaceutical sector. The continent is also burdened with fake and falsified medical drugs. In 2017, WHO revealed an estimated 116,000 additional deaths a year from malaria could be tied to substandard and falsified antimalarials. To counter that, the foundation is being asked to help local pharmaceutical companies boost home-grown production with better technology in their manufacturing plants and to work with governments, research and development centers to improve their innovation capacities. Onwuekwe said part of the problem is a lack of political will in some countries. “This is about finding African solutions to African problems. That is the new public heath order,” Onwuekwe told Health Policy Watch. “The leadership of the countries have to invest financially and politically for there to be any progress in the sector.” But the foundation, she said, also must become adept at negotiating with global pharmaceutical companies and must be “able to foster collaborations” with WHO, the African Union and other international organizations. Image Credits: AfDB Group, IAEA. WHO Concern as Monkeypox Cases Jump by 77% in a Week 07/07/2022 Kerry Cullinan With a 77% increase in new monkeypox cases in the past week, the World Health Organization’s (WHO) Emergency Committee is increasingly likely to declare the outbreak a public health emergency of international concern (PHEIC) when it reconvenes on or before 18 July. By Thursday, 59 countries had reported monkeypox cases, with Spain (1804 cases), UK (1351), Germany (1304) and the US (605) recording the highest caseloads. However, 10 countries have not reported new cases for over 21 days, which is the maximum duration of the incubation period of the disease, according to the WHO’s latest report. So far, there have been 6027 laboratory-confirmed cases of monkeypox and three deaths, but most countries are unable to test for the virus. However, the European Centre for Disease Prevention and Control (ECDC) reported on Wednesday that 5949 cases had been identified in 33 European countries alone through international health regulation mechanisms and public records. The vast majority of cases (99%) were male and aged between 31 and 40 (42%). “The majority of cases presented with a rash (96.1%) and systemic symptoms such as fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat or headache (69%). No cases were reported to have died. Some (15) cases were reported to be health workers. However, further investigation is ongoing to determine whether infection was due to occupational exposure,” according to the ECDC. Monkeypox cases, 6 July 2022 (Source: https://www.monkeypoxtally.info/) Lack of testing Expressing his concern about the scale and spread, WHO Director-General Dr Tedros Adhanom Ghebreyesus acknowledged that “testing remains a challenge and it’s highly probable that there are a significant number of cases not being picked up”. While most of the new cases have been identified in Europe and the US, Africa – where monkeypox was first identified in 1970 – has not recorded a huge jump in cases, and experts believe this could be due to a lack of proper testing. “I plan to reconvene the emergency committee so they are updated on the current epidemiology and evolution of the outbreak and implementation of countermeasures. I will bring them together during the week of 18 July or sooner if needed,” Tedros told the media briefing on Wednesday. The emergency committee decided not to declare monkeypox a PHEIC when it met in late June. Tedros also said that the WHO is working with countries and vaccine manufacturers to coordinate the sharing of “scarce” vaccines . Tedros added that the WHO is also working closely with civil society and LGBTQI+ community in particular to “break the stigma around the virus and spread information so people can protect themselves”, and commended those sharing their stories on social media to inform others. To share a little bit about my experience: I believe I was exposed to it around a week before symptoms manifested. Started off with just a couple bumps, then developed intense flu-like symptoms. Fever, chills, sweats, fatigue, etc. — Matt Ford (@JMatthiasFord) June 23, 2022 Child cases According to the WHO’s latest report, the outbreak “continues to primarily affect men who have sex with men who have reported recent sex with one or multiple male partners, suggesting no signal of sustained transmission beyond these networks for now.” However, WHO monkeypox expert Dr Rosamund Lewis confirmed that there were cases reported in children, about one-third of whom were under the age of 10. “For older children aged 18 or 19, the mode of transmission may still be an open question, but for younger children, one would assume that that would be from exposure in the household setting,” said Lewis. By Wednesday, 119 people had been diagnosed with monkeypox in New York City and city officials confirmed that the limited supplies of vaccines were usually snapped up in minutes by the group it was being offered to: men who have sex with men who had multiple sex partners, as well as close contacts of confirmed cases. Monkeypox cases continue to rise in NYC. Our supply of vaccine is wholly inadequate. Appts are gone within minutes of posting. (Yes even with the recent shipment.) We need the feds to send us far more doses ASAP. pic.twitter.com/HzqefaaIns — Mark D. Levine (@MarkLevineNYC) July 6, 2022 Image Credits: https://www.monkeypoxtally.info/. Long-Neglected Tuberculosis Could Be Stopped by 2030 – at a Cost of $250 Billion 07/07/2022 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. After year-long consultations, the Stop TB Partnership launched its global plan to end tuberculosis by 2030, which would involve the diagnosis and treatment of 50 million people at a cost of $250 billion. TB, the second biggest infectious disease killer in the world after COVID-19, has been neglected by donors in the past – yet if the plan’s budget was realised, every $1 invested would yield an economic return of at least $40. “If, instead, the status quo is maintained, TB is expected to continue to kill between 4,000-5,000 people every day, an additional 43 million people will develop TB and the cost in human life and disability would translate to a global economic loss of US$ 1 trillion,” according to Stop TB. “The COVID-19 pandemic delivered a crystal-clear wake-up call: that we cannot ignore a disease just because it has been relegated only to the poorest parts of the world,” said Dr. Paula Fujiwara, who led the task force in charge of the development of theplan. “With our attention diverted—along with the absence of financial commitments—TB has strengthened its grip on our planet. But we can regain control and meet our commitments to end TB by 2030 as long as we assert our political will now.” Today! @StopTB unveiled a costed plan to #endTB, the second leading infectious disease killers in the world, after #COVID19. The Global Plan to End TB 2023-2030 outlines the priority actions and estimated financial resources needed to end TB.👉Read here: https://t.co/HZLY4E9ous pic.twitter.com/gS2QbfBhzK — Stop TB Partnership (@StopTB) July 6, 2022 Tepid global response Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said that while the global response to COVID-19 was to “plough money and resources into developing diagnosis tools, treatments and vaccines at lightning speed”, the response to TB, which infects 10 million people every year and kills 1.5 million, “has been tepid at best”. “A similar airborne infectious disease, TB remains neglected, even though it is a health threat for every single person. It is in the interest of all of us to end TB,” added Ditiu. However, she added that she was optimistic that the war against tuberculosis could be won by 2030. “A lot of optimism comes from what we have seen happening during COVID—it is possible to mobilize the resources –it is possible that researchers will work together, and share data to be able to develop new tools in such a short amount of time and it is possible to deploy and to organize amazing efforts at the grassroots level.” The Global Plan highlights the need to invest in developing a new TB vaccine by 2025, and making sure that resources are available to reach adults and adolescents in countries where TB is most prevalent. The only TB vaccine currently available is the BCG vaccine, which was approved more than a century ago and has a very limited impact on disease prevention. Dr Lucica Ditiu, Executive Director of Stop TB Partnership “The proposed investment of $ 10 billion in new TB vaccines, a new tool we all are waiting for, is 10 times less than what was injected in the research and development for COVID-19 vaccines. It should be possible to have the TB vaccine,” said Ditiu. Previous reports from the Stop TB Partnership noted that COVID-19 had cost the world 12 years of progress against TB. “Currently, almost 30% of funding per TB case comes from out-of-pocket costs and on average individuals with TB and their households lose 50% of their annual incomes as they suffer from and get treatment for the disease, even in places where TB services are provided free of charge,” according to Paul Mahanna, USAID’s Director of the Office of Infectious Diseases, “We cannot drive change without addressing the significant funding gaps that exist within high TB burden countries that result in lack of access to life-saving services and drive individuals, families and communities further into poverty. Image Credits: Stop TB Partnership. World Sees ‘Unprecedented’ Hunger as Farm Subsidies Boost Unhealthy Foods 06/07/2022 Elaine Ruth Fletcher An African farmer collects leaves from a gourd plant – smallholders are critical to food security and nutritional diversity – and marginalized by global food systems. Between 702 million and 828 million people suffered from hunger in 2021, more than at any time since 2005, five UN agencies reported on Wednesday. The proportion of people affected by hunger had remained relatively unchanged since 2015, affecting 8% of the global population in 2019. Once the COVID-19 pandemic hit in early 2020, those numbers soared to 9.3% in 2020 and to 9.89% in 2021, according to the State of Food Security and Nutrition in the World 2022 report published by the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF, World Food Programme (WFP) and International Fund for Agricultural Development (IFAD). That represents an increase of about 46 million people since 2020 and 150 million people since the outbreak of the pandemic. At current rates, 8% of the global population will still face hunger in 2030, unchanged from when the UN’s 2030 Agenda for Sustainable Development launched. Among the key goals of that ambitious plan, adopted at the UN Sustainable Development Summit in September 2015, was a determination “to end poverty and hunger, in all their forms and dimensions, and to ensure that all human beings can fulfil their potential in dignity and equality and in a healthy environment.” Progress on hunger stalled: Numbers of people who are going hungry today is about the same, or even more, than in 2005. Botswana’s Collen Vixen Kelapile, President of the United Nations Economic and Social Council (ECOSOC) Almost 3.1 billion people couldn’t afford a healthy diet in 2020, the report says. Massive food subsidies behind the production and consumption of milk, rice, sugar and meat also are disincentivizing production and consumption of healthy fruits, vegetables and protein-rich legumes, the report finds. Critically, the report calls upon a restructuring of global and national food subsidies to encourage more consumption of healthier foods including fruits and vegetables – which would also reduce carbon emissions from agricultural production of livestock and products that contribute to climate change. “Transformed agro-food systems need to be part of the solution to climate change and biodiversity loss … our very existence depends on it. Hundreds of millions of hungry and malnourished fellow human beings depend on it,” said Botswana’s Collen Vixen Kelapile, president of the UN Economic and Social Council (ECOSOC), which hosted the report’s launch in New York City. ‘Starvation and mass migration on an ‘unprecedented’ scale Trends in hunger by region WFP’s Executive Director David Beasley noted the world already faced “a perfect storm from the combined effects of conflicts and climate change and COVID economic ripple effects and global inflation” as this year was getting started. David Beasley, WFP executive director “And just when you think it can’t get any worse,” he said, “because we had Ethiopia and Afghanistan, then boom, Ukraine happens, the breadbasket of the world. The impact this conflict is having on global food security means the number of chronically hungry people in the world is likely already much higher than the 828 million people outlined in this work.” Beasley said the latest analysis shows a record 345 million acutely hungry people are marching to the brink of starvation today, a huge increase 276 million at the start of 2022 and from 135 million in the pre-COVID era. “There’s a real danger it will climb even higher in the months ahead,” he warned. “The global price spikes in food, fuel and fertilizers that we are seeing as a result of the crisis in Ukraine threaten to push countries around the world,” Beasley said. “The result will be global destabilization – to starvation and mass migration on an unprecedented scale. We have to act, and we have to act today to avert this looming catastrophe.” Africa hardest hit by hunger – women suffer more than men Laotian children get a fresh and healthy meal; WHO has urged policymakers to prioritize the introduction of healthier foods at schools. The prevalence of hunger, childhood wasting and stunting is highest in Africa, with a substantial burden in Asia, Latin America and the Caribbean (LAC), the report says. Hunger affected 278 million people in Africa; 425 million people in Asia; and 56.5 million people in LAC in 2021. Women are more likely to go hungry across the developing world, the report stresses. Globally, 149.2 million children under the age of 5, or 22% of the total population, suffered from stunting, and 6.7% suffered from wasting. Both are nutrition indicators of low height and weight in proportion to age. Another 38.9 million children under the age of five, or 5.7% of babies and toddlers globally, are overweight, reflecting a rise in unhealthy diets. Healthy diets became even more unaffordable in 2021. Almost 3.1 billion people could not afford a healthy diet in 2020, up by 112 million people from 2019, reflecting what the report describes as the effects of inflation in consumer food prices stemming from the economic impacts of the pandemic and the measures put in place to contain it. The poor in Asia, Africa and Latin America are also among those least able to afford a healthy diet, with Asia seeing the highest surge in costs – 4% in just one year. Political solution to Ukraine among the most immediate measures The global food crisis is being exacerbated by Russia’s blockage of exports from Ukraine, the world’s breadbasket. An end to the Russian blockade of Ukrainian ports is an important first step in addressing the crisis but only the beginning, Beasley said, listing the top priorities as follows: “Firstly we urgently need a political solution to Ukrainian wheat and grain so they can re-enter global markets.. Open up the ports.. Let’s get it moving. “Number 2, humanitarian organizations need substantial new funding to deal with the skyrocketing levels of hunger that we’re seeing around the world. “Thirdly, governments have to resist protectionism and keep trade flowing across borders. And fourthly, we need to learn the lessons of this crisis and invest in resilience programmes to help the poorest communities protect themselves against hunger and against shocks. “If we had successfully threaded this needle in the past, the war in Ukraine wouldn’t be having such a disastrous global impact today.” Rewriting the rules on agricultural and food subsidies to promote healthier foods Shifting food and agriculture subsidies to production and consumption of healthier foods would both reduce climate emissions and average costs of a healthy diet. But some farmers invested in unhealthy foods production could lose out. Fundamentally, the report calls for a major restructuring of deeply embedded global and national subsidies that are currently driving a significant portion of agricultural production – and unhealthy consumption of meat, sugar and basic commodities such as rice – at the expense of other healthier and lower-carbon intensive alternatives. FAO chief economist Máximo Torero Cullen said overall support for agricultural production largely concentrates on staple foods such as dairy and other animal source protein-rich foods, especially in high and upper middle income countries. “Rice, sugar and meat of various types are the foods most incentivized worldwide, while producers of fruits and vegetables are less supported overall, and even penalized in some low-income countries,” he said. “This needs to change. We are doing the opposite of what we are talking about. We need to change abruptly what is happening.” FAO chief economist Máximo Torero Cullen. The new report offers scenarios through 2030 in which public support to all farmers is reallocated around priority foods needed for healthy diets. FAO says adjusting price incentives will also reduce the cost of nutritious foods, which can healthy diets more affordable. That would also lower greenhouse gas emissions, particularly with livestock production, which has a high carbon pricetag. Shifting certain kinds of subsidies could, however, also create negative impacts on some farmers – who would then need new kinds of support, he pointed out. Needed: new flexibilities in national and WTO subsidy rules Cullen said understanding the tradeoffs are key to mapping out the future, and come further into play with the World Trade Organization. “We need commitments and flexibilities, and we need to follow what we have agreed with the WTO rules,” he said. “It may be necessary to set up new fiscal subsidies to consumers or to use proper social protection systems. International development finance will be needed for low-income countries and upper lower middle income countries, given that they have smaller amount of mechanisms.” Agricultural subsidies rules, however, tend to penalize small farmers in low-income countries, delegates from Latin America, Africa and Asia told the ECOSOC meeting. Pakistan’s UN representative Munir Akram “Massive subsidies distort global markets and make it impossible for farmers from developing countries to produce food at competitive prices,” said Pakistan’s UN representative Munir Akram. Gilbert Houngbo, president of IFAD, said the report highlights ways to repurpose agricultural and food policies to support small-scale producers and to build their resilience. Gilbert F. Houngbo, president of IFAD “Policies on subsidies often fall short of reducing hunger or improving food security and inclusion,” he said. “Instead, they have promoted an overreliance on starches, sugars, high protein and processed foods, while not supporting the production of healthier fruits and vegetables, for example.” Image Credits: @veerajayanth03, The Future of Food , State of Food Security and Nutrition 2022, FAO, Flickr: Bart Verweij / World Bank, Joseph C. Okechukwu/Twitter . COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . 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. 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WHO Concern as Monkeypox Cases Jump by 77% in a Week 07/07/2022 Kerry Cullinan With a 77% increase in new monkeypox cases in the past week, the World Health Organization’s (WHO) Emergency Committee is increasingly likely to declare the outbreak a public health emergency of international concern (PHEIC) when it reconvenes on or before 18 July. By Thursday, 59 countries had reported monkeypox cases, with Spain (1804 cases), UK (1351), Germany (1304) and the US (605) recording the highest caseloads. However, 10 countries have not reported new cases for over 21 days, which is the maximum duration of the incubation period of the disease, according to the WHO’s latest report. So far, there have been 6027 laboratory-confirmed cases of monkeypox and three deaths, but most countries are unable to test for the virus. However, the European Centre for Disease Prevention and Control (ECDC) reported on Wednesday that 5949 cases had been identified in 33 European countries alone through international health regulation mechanisms and public records. The vast majority of cases (99%) were male and aged between 31 and 40 (42%). “The majority of cases presented with a rash (96.1%) and systemic symptoms such as fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat or headache (69%). No cases were reported to have died. Some (15) cases were reported to be health workers. However, further investigation is ongoing to determine whether infection was due to occupational exposure,” according to the ECDC. Monkeypox cases, 6 July 2022 (Source: https://www.monkeypoxtally.info/) Lack of testing Expressing his concern about the scale and spread, WHO Director-General Dr Tedros Adhanom Ghebreyesus acknowledged that “testing remains a challenge and it’s highly probable that there are a significant number of cases not being picked up”. While most of the new cases have been identified in Europe and the US, Africa – where monkeypox was first identified in 1970 – has not recorded a huge jump in cases, and experts believe this could be due to a lack of proper testing. “I plan to reconvene the emergency committee so they are updated on the current epidemiology and evolution of the outbreak and implementation of countermeasures. I will bring them together during the week of 18 July or sooner if needed,” Tedros told the media briefing on Wednesday. The emergency committee decided not to declare monkeypox a PHEIC when it met in late June. Tedros also said that the WHO is working with countries and vaccine manufacturers to coordinate the sharing of “scarce” vaccines . Tedros added that the WHO is also working closely with civil society and LGBTQI+ community in particular to “break the stigma around the virus and spread information so people can protect themselves”, and commended those sharing their stories on social media to inform others. To share a little bit about my experience: I believe I was exposed to it around a week before symptoms manifested. Started off with just a couple bumps, then developed intense flu-like symptoms. Fever, chills, sweats, fatigue, etc. — Matt Ford (@JMatthiasFord) June 23, 2022 Child cases According to the WHO’s latest report, the outbreak “continues to primarily affect men who have sex with men who have reported recent sex with one or multiple male partners, suggesting no signal of sustained transmission beyond these networks for now.” However, WHO monkeypox expert Dr Rosamund Lewis confirmed that there were cases reported in children, about one-third of whom were under the age of 10. “For older children aged 18 or 19, the mode of transmission may still be an open question, but for younger children, one would assume that that would be from exposure in the household setting,” said Lewis. By Wednesday, 119 people had been diagnosed with monkeypox in New York City and city officials confirmed that the limited supplies of vaccines were usually snapped up in minutes by the group it was being offered to: men who have sex with men who had multiple sex partners, as well as close contacts of confirmed cases. Monkeypox cases continue to rise in NYC. Our supply of vaccine is wholly inadequate. Appts are gone within minutes of posting. (Yes even with the recent shipment.) We need the feds to send us far more doses ASAP. pic.twitter.com/HzqefaaIns — Mark D. Levine (@MarkLevineNYC) July 6, 2022 Image Credits: https://www.monkeypoxtally.info/. Long-Neglected Tuberculosis Could Be Stopped by 2030 – at a Cost of $250 Billion 07/07/2022 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. After year-long consultations, the Stop TB Partnership launched its global plan to end tuberculosis by 2030, which would involve the diagnosis and treatment of 50 million people at a cost of $250 billion. TB, the second biggest infectious disease killer in the world after COVID-19, has been neglected by donors in the past – yet if the plan’s budget was realised, every $1 invested would yield an economic return of at least $40. “If, instead, the status quo is maintained, TB is expected to continue to kill between 4,000-5,000 people every day, an additional 43 million people will develop TB and the cost in human life and disability would translate to a global economic loss of US$ 1 trillion,” according to Stop TB. “The COVID-19 pandemic delivered a crystal-clear wake-up call: that we cannot ignore a disease just because it has been relegated only to the poorest parts of the world,” said Dr. Paula Fujiwara, who led the task force in charge of the development of theplan. “With our attention diverted—along with the absence of financial commitments—TB has strengthened its grip on our planet. But we can regain control and meet our commitments to end TB by 2030 as long as we assert our political will now.” Today! @StopTB unveiled a costed plan to #endTB, the second leading infectious disease killers in the world, after #COVID19. The Global Plan to End TB 2023-2030 outlines the priority actions and estimated financial resources needed to end TB.👉Read here: https://t.co/HZLY4E9ous pic.twitter.com/gS2QbfBhzK — Stop TB Partnership (@StopTB) July 6, 2022 Tepid global response Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said that while the global response to COVID-19 was to “plough money and resources into developing diagnosis tools, treatments and vaccines at lightning speed”, the response to TB, which infects 10 million people every year and kills 1.5 million, “has been tepid at best”. “A similar airborne infectious disease, TB remains neglected, even though it is a health threat for every single person. It is in the interest of all of us to end TB,” added Ditiu. However, she added that she was optimistic that the war against tuberculosis could be won by 2030. “A lot of optimism comes from what we have seen happening during COVID—it is possible to mobilize the resources –it is possible that researchers will work together, and share data to be able to develop new tools in such a short amount of time and it is possible to deploy and to organize amazing efforts at the grassroots level.” The Global Plan highlights the need to invest in developing a new TB vaccine by 2025, and making sure that resources are available to reach adults and adolescents in countries where TB is most prevalent. The only TB vaccine currently available is the BCG vaccine, which was approved more than a century ago and has a very limited impact on disease prevention. Dr Lucica Ditiu, Executive Director of Stop TB Partnership “The proposed investment of $ 10 billion in new TB vaccines, a new tool we all are waiting for, is 10 times less than what was injected in the research and development for COVID-19 vaccines. It should be possible to have the TB vaccine,” said Ditiu. Previous reports from the Stop TB Partnership noted that COVID-19 had cost the world 12 years of progress against TB. “Currently, almost 30% of funding per TB case comes from out-of-pocket costs and on average individuals with TB and their households lose 50% of their annual incomes as they suffer from and get treatment for the disease, even in places where TB services are provided free of charge,” according to Paul Mahanna, USAID’s Director of the Office of Infectious Diseases, “We cannot drive change without addressing the significant funding gaps that exist within high TB burden countries that result in lack of access to life-saving services and drive individuals, families and communities further into poverty. Image Credits: Stop TB Partnership. World Sees ‘Unprecedented’ Hunger as Farm Subsidies Boost Unhealthy Foods 06/07/2022 Elaine Ruth Fletcher An African farmer collects leaves from a gourd plant – smallholders are critical to food security and nutritional diversity – and marginalized by global food systems. Between 702 million and 828 million people suffered from hunger in 2021, more than at any time since 2005, five UN agencies reported on Wednesday. The proportion of people affected by hunger had remained relatively unchanged since 2015, affecting 8% of the global population in 2019. Once the COVID-19 pandemic hit in early 2020, those numbers soared to 9.3% in 2020 and to 9.89% in 2021, according to the State of Food Security and Nutrition in the World 2022 report published by the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF, World Food Programme (WFP) and International Fund for Agricultural Development (IFAD). That represents an increase of about 46 million people since 2020 and 150 million people since the outbreak of the pandemic. At current rates, 8% of the global population will still face hunger in 2030, unchanged from when the UN’s 2030 Agenda for Sustainable Development launched. Among the key goals of that ambitious plan, adopted at the UN Sustainable Development Summit in September 2015, was a determination “to end poverty and hunger, in all their forms and dimensions, and to ensure that all human beings can fulfil their potential in dignity and equality and in a healthy environment.” Progress on hunger stalled: Numbers of people who are going hungry today is about the same, or even more, than in 2005. Botswana’s Collen Vixen Kelapile, President of the United Nations Economic and Social Council (ECOSOC) Almost 3.1 billion people couldn’t afford a healthy diet in 2020, the report says. Massive food subsidies behind the production and consumption of milk, rice, sugar and meat also are disincentivizing production and consumption of healthy fruits, vegetables and protein-rich legumes, the report finds. Critically, the report calls upon a restructuring of global and national food subsidies to encourage more consumption of healthier foods including fruits and vegetables – which would also reduce carbon emissions from agricultural production of livestock and products that contribute to climate change. “Transformed agro-food systems need to be part of the solution to climate change and biodiversity loss … our very existence depends on it. Hundreds of millions of hungry and malnourished fellow human beings depend on it,” said Botswana’s Collen Vixen Kelapile, president of the UN Economic and Social Council (ECOSOC), which hosted the report’s launch in New York City. ‘Starvation and mass migration on an ‘unprecedented’ scale Trends in hunger by region WFP’s Executive Director David Beasley noted the world already faced “a perfect storm from the combined effects of conflicts and climate change and COVID economic ripple effects and global inflation” as this year was getting started. David Beasley, WFP executive director “And just when you think it can’t get any worse,” he said, “because we had Ethiopia and Afghanistan, then boom, Ukraine happens, the breadbasket of the world. The impact this conflict is having on global food security means the number of chronically hungry people in the world is likely already much higher than the 828 million people outlined in this work.” Beasley said the latest analysis shows a record 345 million acutely hungry people are marching to the brink of starvation today, a huge increase 276 million at the start of 2022 and from 135 million in the pre-COVID era. “There’s a real danger it will climb even higher in the months ahead,” he warned. “The global price spikes in food, fuel and fertilizers that we are seeing as a result of the crisis in Ukraine threaten to push countries around the world,” Beasley said. “The result will be global destabilization – to starvation and mass migration on an unprecedented scale. We have to act, and we have to act today to avert this looming catastrophe.” Africa hardest hit by hunger – women suffer more than men Laotian children get a fresh and healthy meal; WHO has urged policymakers to prioritize the introduction of healthier foods at schools. The prevalence of hunger, childhood wasting and stunting is highest in Africa, with a substantial burden in Asia, Latin America and the Caribbean (LAC), the report says. Hunger affected 278 million people in Africa; 425 million people in Asia; and 56.5 million people in LAC in 2021. Women are more likely to go hungry across the developing world, the report stresses. Globally, 149.2 million children under the age of 5, or 22% of the total population, suffered from stunting, and 6.7% suffered from wasting. Both are nutrition indicators of low height and weight in proportion to age. Another 38.9 million children under the age of five, or 5.7% of babies and toddlers globally, are overweight, reflecting a rise in unhealthy diets. Healthy diets became even more unaffordable in 2021. Almost 3.1 billion people could not afford a healthy diet in 2020, up by 112 million people from 2019, reflecting what the report describes as the effects of inflation in consumer food prices stemming from the economic impacts of the pandemic and the measures put in place to contain it. The poor in Asia, Africa and Latin America are also among those least able to afford a healthy diet, with Asia seeing the highest surge in costs – 4% in just one year. Political solution to Ukraine among the most immediate measures The global food crisis is being exacerbated by Russia’s blockage of exports from Ukraine, the world’s breadbasket. An end to the Russian blockade of Ukrainian ports is an important first step in addressing the crisis but only the beginning, Beasley said, listing the top priorities as follows: “Firstly we urgently need a political solution to Ukrainian wheat and grain so they can re-enter global markets.. Open up the ports.. Let’s get it moving. “Number 2, humanitarian organizations need substantial new funding to deal with the skyrocketing levels of hunger that we’re seeing around the world. “Thirdly, governments have to resist protectionism and keep trade flowing across borders. And fourthly, we need to learn the lessons of this crisis and invest in resilience programmes to help the poorest communities protect themselves against hunger and against shocks. “If we had successfully threaded this needle in the past, the war in Ukraine wouldn’t be having such a disastrous global impact today.” Rewriting the rules on agricultural and food subsidies to promote healthier foods Shifting food and agriculture subsidies to production and consumption of healthier foods would both reduce climate emissions and average costs of a healthy diet. But some farmers invested in unhealthy foods production could lose out. Fundamentally, the report calls for a major restructuring of deeply embedded global and national subsidies that are currently driving a significant portion of agricultural production – and unhealthy consumption of meat, sugar and basic commodities such as rice – at the expense of other healthier and lower-carbon intensive alternatives. FAO chief economist Máximo Torero Cullen said overall support for agricultural production largely concentrates on staple foods such as dairy and other animal source protein-rich foods, especially in high and upper middle income countries. “Rice, sugar and meat of various types are the foods most incentivized worldwide, while producers of fruits and vegetables are less supported overall, and even penalized in some low-income countries,” he said. “This needs to change. We are doing the opposite of what we are talking about. We need to change abruptly what is happening.” FAO chief economist Máximo Torero Cullen. The new report offers scenarios through 2030 in which public support to all farmers is reallocated around priority foods needed for healthy diets. FAO says adjusting price incentives will also reduce the cost of nutritious foods, which can healthy diets more affordable. That would also lower greenhouse gas emissions, particularly with livestock production, which has a high carbon pricetag. Shifting certain kinds of subsidies could, however, also create negative impacts on some farmers – who would then need new kinds of support, he pointed out. Needed: new flexibilities in national and WTO subsidy rules Cullen said understanding the tradeoffs are key to mapping out the future, and come further into play with the World Trade Organization. “We need commitments and flexibilities, and we need to follow what we have agreed with the WTO rules,” he said. “It may be necessary to set up new fiscal subsidies to consumers or to use proper social protection systems. International development finance will be needed for low-income countries and upper lower middle income countries, given that they have smaller amount of mechanisms.” Agricultural subsidies rules, however, tend to penalize small farmers in low-income countries, delegates from Latin America, Africa and Asia told the ECOSOC meeting. Pakistan’s UN representative Munir Akram “Massive subsidies distort global markets and make it impossible for farmers from developing countries to produce food at competitive prices,” said Pakistan’s UN representative Munir Akram. Gilbert Houngbo, president of IFAD, said the report highlights ways to repurpose agricultural and food policies to support small-scale producers and to build their resilience. Gilbert F. Houngbo, president of IFAD “Policies on subsidies often fall short of reducing hunger or improving food security and inclusion,” he said. “Instead, they have promoted an overreliance on starches, sugars, high protein and processed foods, while not supporting the production of healthier fruits and vegetables, for example.” Image Credits: @veerajayanth03, The Future of Food , State of Food Security and Nutrition 2022, FAO, Flickr: Bart Verweij / World Bank, Joseph C. Okechukwu/Twitter . COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . 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. 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Long-Neglected Tuberculosis Could Be Stopped by 2030 – at a Cost of $250 Billion 07/07/2022 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. After year-long consultations, the Stop TB Partnership launched its global plan to end tuberculosis by 2030, which would involve the diagnosis and treatment of 50 million people at a cost of $250 billion. TB, the second biggest infectious disease killer in the world after COVID-19, has been neglected by donors in the past – yet if the plan’s budget was realised, every $1 invested would yield an economic return of at least $40. “If, instead, the status quo is maintained, TB is expected to continue to kill between 4,000-5,000 people every day, an additional 43 million people will develop TB and the cost in human life and disability would translate to a global economic loss of US$ 1 trillion,” according to Stop TB. “The COVID-19 pandemic delivered a crystal-clear wake-up call: that we cannot ignore a disease just because it has been relegated only to the poorest parts of the world,” said Dr. Paula Fujiwara, who led the task force in charge of the development of theplan. “With our attention diverted—along with the absence of financial commitments—TB has strengthened its grip on our planet. But we can regain control and meet our commitments to end TB by 2030 as long as we assert our political will now.” Today! @StopTB unveiled a costed plan to #endTB, the second leading infectious disease killers in the world, after #COVID19. The Global Plan to End TB 2023-2030 outlines the priority actions and estimated financial resources needed to end TB.👉Read here: https://t.co/HZLY4E9ous pic.twitter.com/gS2QbfBhzK — Stop TB Partnership (@StopTB) July 6, 2022 Tepid global response Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said that while the global response to COVID-19 was to “plough money and resources into developing diagnosis tools, treatments and vaccines at lightning speed”, the response to TB, which infects 10 million people every year and kills 1.5 million, “has been tepid at best”. “A similar airborne infectious disease, TB remains neglected, even though it is a health threat for every single person. It is in the interest of all of us to end TB,” added Ditiu. However, she added that she was optimistic that the war against tuberculosis could be won by 2030. “A lot of optimism comes from what we have seen happening during COVID—it is possible to mobilize the resources –it is possible that researchers will work together, and share data to be able to develop new tools in such a short amount of time and it is possible to deploy and to organize amazing efforts at the grassroots level.” The Global Plan highlights the need to invest in developing a new TB vaccine by 2025, and making sure that resources are available to reach adults and adolescents in countries where TB is most prevalent. The only TB vaccine currently available is the BCG vaccine, which was approved more than a century ago and has a very limited impact on disease prevention. Dr Lucica Ditiu, Executive Director of Stop TB Partnership “The proposed investment of $ 10 billion in new TB vaccines, a new tool we all are waiting for, is 10 times less than what was injected in the research and development for COVID-19 vaccines. It should be possible to have the TB vaccine,” said Ditiu. Previous reports from the Stop TB Partnership noted that COVID-19 had cost the world 12 years of progress against TB. “Currently, almost 30% of funding per TB case comes from out-of-pocket costs and on average individuals with TB and their households lose 50% of their annual incomes as they suffer from and get treatment for the disease, even in places where TB services are provided free of charge,” according to Paul Mahanna, USAID’s Director of the Office of Infectious Diseases, “We cannot drive change without addressing the significant funding gaps that exist within high TB burden countries that result in lack of access to life-saving services and drive individuals, families and communities further into poverty. Image Credits: Stop TB Partnership. World Sees ‘Unprecedented’ Hunger as Farm Subsidies Boost Unhealthy Foods 06/07/2022 Elaine Ruth Fletcher An African farmer collects leaves from a gourd plant – smallholders are critical to food security and nutritional diversity – and marginalized by global food systems. Between 702 million and 828 million people suffered from hunger in 2021, more than at any time since 2005, five UN agencies reported on Wednesday. The proportion of people affected by hunger had remained relatively unchanged since 2015, affecting 8% of the global population in 2019. Once the COVID-19 pandemic hit in early 2020, those numbers soared to 9.3% in 2020 and to 9.89% in 2021, according to the State of Food Security and Nutrition in the World 2022 report published by the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF, World Food Programme (WFP) and International Fund for Agricultural Development (IFAD). That represents an increase of about 46 million people since 2020 and 150 million people since the outbreak of the pandemic. At current rates, 8% of the global population will still face hunger in 2030, unchanged from when the UN’s 2030 Agenda for Sustainable Development launched. Among the key goals of that ambitious plan, adopted at the UN Sustainable Development Summit in September 2015, was a determination “to end poverty and hunger, in all their forms and dimensions, and to ensure that all human beings can fulfil their potential in dignity and equality and in a healthy environment.” Progress on hunger stalled: Numbers of people who are going hungry today is about the same, or even more, than in 2005. Botswana’s Collen Vixen Kelapile, President of the United Nations Economic and Social Council (ECOSOC) Almost 3.1 billion people couldn’t afford a healthy diet in 2020, the report says. Massive food subsidies behind the production and consumption of milk, rice, sugar and meat also are disincentivizing production and consumption of healthy fruits, vegetables and protein-rich legumes, the report finds. Critically, the report calls upon a restructuring of global and national food subsidies to encourage more consumption of healthier foods including fruits and vegetables – which would also reduce carbon emissions from agricultural production of livestock and products that contribute to climate change. “Transformed agro-food systems need to be part of the solution to climate change and biodiversity loss … our very existence depends on it. Hundreds of millions of hungry and malnourished fellow human beings depend on it,” said Botswana’s Collen Vixen Kelapile, president of the UN Economic and Social Council (ECOSOC), which hosted the report’s launch in New York City. ‘Starvation and mass migration on an ‘unprecedented’ scale Trends in hunger by region WFP’s Executive Director David Beasley noted the world already faced “a perfect storm from the combined effects of conflicts and climate change and COVID economic ripple effects and global inflation” as this year was getting started. David Beasley, WFP executive director “And just when you think it can’t get any worse,” he said, “because we had Ethiopia and Afghanistan, then boom, Ukraine happens, the breadbasket of the world. The impact this conflict is having on global food security means the number of chronically hungry people in the world is likely already much higher than the 828 million people outlined in this work.” Beasley said the latest analysis shows a record 345 million acutely hungry people are marching to the brink of starvation today, a huge increase 276 million at the start of 2022 and from 135 million in the pre-COVID era. “There’s a real danger it will climb even higher in the months ahead,” he warned. “The global price spikes in food, fuel and fertilizers that we are seeing as a result of the crisis in Ukraine threaten to push countries around the world,” Beasley said. “The result will be global destabilization – to starvation and mass migration on an unprecedented scale. We have to act, and we have to act today to avert this looming catastrophe.” Africa hardest hit by hunger – women suffer more than men Laotian children get a fresh and healthy meal; WHO has urged policymakers to prioritize the introduction of healthier foods at schools. The prevalence of hunger, childhood wasting and stunting is highest in Africa, with a substantial burden in Asia, Latin America and the Caribbean (LAC), the report says. Hunger affected 278 million people in Africa; 425 million people in Asia; and 56.5 million people in LAC in 2021. Women are more likely to go hungry across the developing world, the report stresses. Globally, 149.2 million children under the age of 5, or 22% of the total population, suffered from stunting, and 6.7% suffered from wasting. Both are nutrition indicators of low height and weight in proportion to age. Another 38.9 million children under the age of five, or 5.7% of babies and toddlers globally, are overweight, reflecting a rise in unhealthy diets. Healthy diets became even more unaffordable in 2021. Almost 3.1 billion people could not afford a healthy diet in 2020, up by 112 million people from 2019, reflecting what the report describes as the effects of inflation in consumer food prices stemming from the economic impacts of the pandemic and the measures put in place to contain it. The poor in Asia, Africa and Latin America are also among those least able to afford a healthy diet, with Asia seeing the highest surge in costs – 4% in just one year. Political solution to Ukraine among the most immediate measures The global food crisis is being exacerbated by Russia’s blockage of exports from Ukraine, the world’s breadbasket. An end to the Russian blockade of Ukrainian ports is an important first step in addressing the crisis but only the beginning, Beasley said, listing the top priorities as follows: “Firstly we urgently need a political solution to Ukrainian wheat and grain so they can re-enter global markets.. Open up the ports.. Let’s get it moving. “Number 2, humanitarian organizations need substantial new funding to deal with the skyrocketing levels of hunger that we’re seeing around the world. “Thirdly, governments have to resist protectionism and keep trade flowing across borders. And fourthly, we need to learn the lessons of this crisis and invest in resilience programmes to help the poorest communities protect themselves against hunger and against shocks. “If we had successfully threaded this needle in the past, the war in Ukraine wouldn’t be having such a disastrous global impact today.” Rewriting the rules on agricultural and food subsidies to promote healthier foods Shifting food and agriculture subsidies to production and consumption of healthier foods would both reduce climate emissions and average costs of a healthy diet. But some farmers invested in unhealthy foods production could lose out. Fundamentally, the report calls for a major restructuring of deeply embedded global and national subsidies that are currently driving a significant portion of agricultural production – and unhealthy consumption of meat, sugar and basic commodities such as rice – at the expense of other healthier and lower-carbon intensive alternatives. FAO chief economist Máximo Torero Cullen said overall support for agricultural production largely concentrates on staple foods such as dairy and other animal source protein-rich foods, especially in high and upper middle income countries. “Rice, sugar and meat of various types are the foods most incentivized worldwide, while producers of fruits and vegetables are less supported overall, and even penalized in some low-income countries,” he said. “This needs to change. We are doing the opposite of what we are talking about. We need to change abruptly what is happening.” FAO chief economist Máximo Torero Cullen. The new report offers scenarios through 2030 in which public support to all farmers is reallocated around priority foods needed for healthy diets. FAO says adjusting price incentives will also reduce the cost of nutritious foods, which can healthy diets more affordable. That would also lower greenhouse gas emissions, particularly with livestock production, which has a high carbon pricetag. Shifting certain kinds of subsidies could, however, also create negative impacts on some farmers – who would then need new kinds of support, he pointed out. Needed: new flexibilities in national and WTO subsidy rules Cullen said understanding the tradeoffs are key to mapping out the future, and come further into play with the World Trade Organization. “We need commitments and flexibilities, and we need to follow what we have agreed with the WTO rules,” he said. “It may be necessary to set up new fiscal subsidies to consumers or to use proper social protection systems. International development finance will be needed for low-income countries and upper lower middle income countries, given that they have smaller amount of mechanisms.” Agricultural subsidies rules, however, tend to penalize small farmers in low-income countries, delegates from Latin America, Africa and Asia told the ECOSOC meeting. Pakistan’s UN representative Munir Akram “Massive subsidies distort global markets and make it impossible for farmers from developing countries to produce food at competitive prices,” said Pakistan’s UN representative Munir Akram. Gilbert Houngbo, president of IFAD, said the report highlights ways to repurpose agricultural and food policies to support small-scale producers and to build their resilience. Gilbert F. Houngbo, president of IFAD “Policies on subsidies often fall short of reducing hunger or improving food security and inclusion,” he said. “Instead, they have promoted an overreliance on starches, sugars, high protein and processed foods, while not supporting the production of healthier fruits and vegetables, for example.” Image Credits: @veerajayanth03, The Future of Food , State of Food Security and Nutrition 2022, FAO, Flickr: Bart Verweij / World Bank, Joseph C. Okechukwu/Twitter . COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . 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. 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World Sees ‘Unprecedented’ Hunger as Farm Subsidies Boost Unhealthy Foods 06/07/2022 Elaine Ruth Fletcher An African farmer collects leaves from a gourd plant – smallholders are critical to food security and nutritional diversity – and marginalized by global food systems. Between 702 million and 828 million people suffered from hunger in 2021, more than at any time since 2005, five UN agencies reported on Wednesday. The proportion of people affected by hunger had remained relatively unchanged since 2015, affecting 8% of the global population in 2019. Once the COVID-19 pandemic hit in early 2020, those numbers soared to 9.3% in 2020 and to 9.89% in 2021, according to the State of Food Security and Nutrition in the World 2022 report published by the Food and Agriculture Organization (FAO), World Health Organization (WHO), UNICEF, World Food Programme (WFP) and International Fund for Agricultural Development (IFAD). That represents an increase of about 46 million people since 2020 and 150 million people since the outbreak of the pandemic. At current rates, 8% of the global population will still face hunger in 2030, unchanged from when the UN’s 2030 Agenda for Sustainable Development launched. Among the key goals of that ambitious plan, adopted at the UN Sustainable Development Summit in September 2015, was a determination “to end poverty and hunger, in all their forms and dimensions, and to ensure that all human beings can fulfil their potential in dignity and equality and in a healthy environment.” Progress on hunger stalled: Numbers of people who are going hungry today is about the same, or even more, than in 2005. Botswana’s Collen Vixen Kelapile, President of the United Nations Economic and Social Council (ECOSOC) Almost 3.1 billion people couldn’t afford a healthy diet in 2020, the report says. Massive food subsidies behind the production and consumption of milk, rice, sugar and meat also are disincentivizing production and consumption of healthy fruits, vegetables and protein-rich legumes, the report finds. Critically, the report calls upon a restructuring of global and national food subsidies to encourage more consumption of healthier foods including fruits and vegetables – which would also reduce carbon emissions from agricultural production of livestock and products that contribute to climate change. “Transformed agro-food systems need to be part of the solution to climate change and biodiversity loss … our very existence depends on it. Hundreds of millions of hungry and malnourished fellow human beings depend on it,” said Botswana’s Collen Vixen Kelapile, president of the UN Economic and Social Council (ECOSOC), which hosted the report’s launch in New York City. ‘Starvation and mass migration on an ‘unprecedented’ scale Trends in hunger by region WFP’s Executive Director David Beasley noted the world already faced “a perfect storm from the combined effects of conflicts and climate change and COVID economic ripple effects and global inflation” as this year was getting started. David Beasley, WFP executive director “And just when you think it can’t get any worse,” he said, “because we had Ethiopia and Afghanistan, then boom, Ukraine happens, the breadbasket of the world. The impact this conflict is having on global food security means the number of chronically hungry people in the world is likely already much higher than the 828 million people outlined in this work.” Beasley said the latest analysis shows a record 345 million acutely hungry people are marching to the brink of starvation today, a huge increase 276 million at the start of 2022 and from 135 million in the pre-COVID era. “There’s a real danger it will climb even higher in the months ahead,” he warned. “The global price spikes in food, fuel and fertilizers that we are seeing as a result of the crisis in Ukraine threaten to push countries around the world,” Beasley said. “The result will be global destabilization – to starvation and mass migration on an unprecedented scale. We have to act, and we have to act today to avert this looming catastrophe.” Africa hardest hit by hunger – women suffer more than men Laotian children get a fresh and healthy meal; WHO has urged policymakers to prioritize the introduction of healthier foods at schools. The prevalence of hunger, childhood wasting and stunting is highest in Africa, with a substantial burden in Asia, Latin America and the Caribbean (LAC), the report says. Hunger affected 278 million people in Africa; 425 million people in Asia; and 56.5 million people in LAC in 2021. Women are more likely to go hungry across the developing world, the report stresses. Globally, 149.2 million children under the age of 5, or 22% of the total population, suffered from stunting, and 6.7% suffered from wasting. Both are nutrition indicators of low height and weight in proportion to age. Another 38.9 million children under the age of five, or 5.7% of babies and toddlers globally, are overweight, reflecting a rise in unhealthy diets. Healthy diets became even more unaffordable in 2021. Almost 3.1 billion people could not afford a healthy diet in 2020, up by 112 million people from 2019, reflecting what the report describes as the effects of inflation in consumer food prices stemming from the economic impacts of the pandemic and the measures put in place to contain it. The poor in Asia, Africa and Latin America are also among those least able to afford a healthy diet, with Asia seeing the highest surge in costs – 4% in just one year. Political solution to Ukraine among the most immediate measures The global food crisis is being exacerbated by Russia’s blockage of exports from Ukraine, the world’s breadbasket. An end to the Russian blockade of Ukrainian ports is an important first step in addressing the crisis but only the beginning, Beasley said, listing the top priorities as follows: “Firstly we urgently need a political solution to Ukrainian wheat and grain so they can re-enter global markets.. Open up the ports.. Let’s get it moving. “Number 2, humanitarian organizations need substantial new funding to deal with the skyrocketing levels of hunger that we’re seeing around the world. “Thirdly, governments have to resist protectionism and keep trade flowing across borders. And fourthly, we need to learn the lessons of this crisis and invest in resilience programmes to help the poorest communities protect themselves against hunger and against shocks. “If we had successfully threaded this needle in the past, the war in Ukraine wouldn’t be having such a disastrous global impact today.” Rewriting the rules on agricultural and food subsidies to promote healthier foods Shifting food and agriculture subsidies to production and consumption of healthier foods would both reduce climate emissions and average costs of a healthy diet. But some farmers invested in unhealthy foods production could lose out. Fundamentally, the report calls for a major restructuring of deeply embedded global and national subsidies that are currently driving a significant portion of agricultural production – and unhealthy consumption of meat, sugar and basic commodities such as rice – at the expense of other healthier and lower-carbon intensive alternatives. FAO chief economist Máximo Torero Cullen said overall support for agricultural production largely concentrates on staple foods such as dairy and other animal source protein-rich foods, especially in high and upper middle income countries. “Rice, sugar and meat of various types are the foods most incentivized worldwide, while producers of fruits and vegetables are less supported overall, and even penalized in some low-income countries,” he said. “This needs to change. We are doing the opposite of what we are talking about. We need to change abruptly what is happening.” FAO chief economist Máximo Torero Cullen. The new report offers scenarios through 2030 in which public support to all farmers is reallocated around priority foods needed for healthy diets. FAO says adjusting price incentives will also reduce the cost of nutritious foods, which can healthy diets more affordable. That would also lower greenhouse gas emissions, particularly with livestock production, which has a high carbon pricetag. Shifting certain kinds of subsidies could, however, also create negative impacts on some farmers – who would then need new kinds of support, he pointed out. Needed: new flexibilities in national and WTO subsidy rules Cullen said understanding the tradeoffs are key to mapping out the future, and come further into play with the World Trade Organization. “We need commitments and flexibilities, and we need to follow what we have agreed with the WTO rules,” he said. “It may be necessary to set up new fiscal subsidies to consumers or to use proper social protection systems. International development finance will be needed for low-income countries and upper lower middle income countries, given that they have smaller amount of mechanisms.” Agricultural subsidies rules, however, tend to penalize small farmers in low-income countries, delegates from Latin America, Africa and Asia told the ECOSOC meeting. Pakistan’s UN representative Munir Akram “Massive subsidies distort global markets and make it impossible for farmers from developing countries to produce food at competitive prices,” said Pakistan’s UN representative Munir Akram. Gilbert Houngbo, president of IFAD, said the report highlights ways to repurpose agricultural and food policies to support small-scale producers and to build their resilience. Gilbert F. Houngbo, president of IFAD “Policies on subsidies often fall short of reducing hunger or improving food security and inclusion,” he said. “Instead, they have promoted an overreliance on starches, sugars, high protein and processed foods, while not supporting the production of healthier fruits and vegetables, for example.” Image Credits: @veerajayanth03, The Future of Food , State of Food Security and Nutrition 2022, FAO, Flickr: Bart Verweij / World Bank, Joseph C. Okechukwu/Twitter . COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . 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
COVID-19 Support Steady Despite Global Partnership’s ‘Transition’ 06/07/2022 Kerry Cullinan COVAX, the best-known part of the ACT-Accelerator, has delivered over a billion vaccines globally. Organizers say they have no plans to “sunset” the support they offer countries through the Access to COVID-19 Tools (ACT) Accelerator, the global partnership to facilitate equitable access to COVID-19 tests, treatments, and vaccines. The ACT-A, however, will undergo a “transition” when its strategic plan and budget ends in September, according to the World Health Organization’s (WHO) Dr Bruce Aylward, who represents the global body at the ACT-A. Its COVID-19 response will likely be incorporated into the usual work of key ACT-A partners, including Gavi, the global vaccine alliance, which is a co-leader of COVAX, the vaccine arm of the ACT-A. COVAX also is co-led by WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), alongside key delivery partner UNICEF. Dr Bruce Aylward Aylward told a media briefing on Wednesday that ACT-A’s work to enhance equitable access to COVID-19 tools will continue, since the pandemic hasn’t ended. “As countries are moving from managing COVID-19 as an acute emergency to integration into longer-term disease control programmes, the ACT-Accelerator partnership is adjusting its ways of working,” he said. A Gavi spokesperson told Health Policy Watch that COVAX partners and other ACT-Accelerator organizations, mindful of the need to prepare the global health response for future pandemics, “are looking at how to transition temporary emergency response structures into an integrated approach that builds COVID-19 and pandemic preparedness and response capacity into existing global health architecture”. Though WHO hasn’t changed its designation of COVID-19 as a pandemic, Dr Mike Ryan, WHO’s head of health emergencies, described it as more of “a series of national epidemics” and stressed that the real work needed to take place at the national level. Globally, COVID-19 cases have increased by at least 30%, driven by variants BA.4 and BA.5 in Europe and the US, while a new sub-lineage of BA.2.75 is rising in India, WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing. ACT-A transition plan Aylward indicated there is little appetite among ACT-A partners to develop another strategic plan. Therefore the focus is on a “transition plan,” he said, to “make sure that this extraordinary collaboration that we’ve put together can continue to operate but in a mode and in a manner that allows us to make sure the core business of the [partner] organisations also gets attention”. The pandemic’s strain on nations’ resources, financial markets and global supply chains have caused setbacks in key global health programmes, particularly childhood vaccinations and tuberculosis diagnosis and care. “The ACT-A agencies will not sunset their support to the countries that rely on them for equitable access to these tools,” stressed Aylward. “What we will do is make sure that we work efficiently and effectively to deliver right across our mandates in the longer term.” At the ACT-A’s Council Meeting, also held on Wednesday, some countries offered their views of what form this transition could take. India’s Dr Vinod Paul, for example, called for ACT-A to become “a long-term institutional mechanism to support countries in future health emergencies”. Indonesia and South Africa called ACT-A’s evaluation to feed into international discussions on pandemic preparedness. France’s John Valadou, meanwhile, called for an assessment of ACT-A before any decisions were made about its future. “We should avoid two risks when it comes to global governance,” Valadou said. “We shouldn’t make the existing architecture too complex, and secondly, we should not weaken the central role that should be played by WHO.” Dr Fifa Rahman Dr Fifa Rahman, a civil society representative on ACT-A, told the council that her sector looked forward to seeing the transition plans. She endorsed Germany’s call for “some kind of mechanism for coordinating and evaluating the global risk response to COVID”, describing this as essential. Rahman also called for resources to build more resilient health systems, including community health systems, pointing out that only 14% of community health workers in Africa were paid, while health workers in many countries were grossly underpaid. She also called for transparency in government procurement of COVID-19 goods during this transition phase. Norway’s Ambassador and ACT-A council co-chair John-Arne Rottingen closed the council meeting by noting that “members support a gradual transitioning” of ACT-A. “We cannot go back to where we were before the pandemic,” he said. “We need to continue coordination and collaboration across the implementing agencies and ACT-A actors. And we also need to use the evaluation and other learning efforts to learn for the future both on the countermeasure side as well as long-term strengthening of health systems, primary health care capacities and supporting the health care workforce.” Goodwill COVID-19 support does not mean equity Reflecting on ACT-A’s future, Aylward said “what we’ve learned in this pandemic is that goodwill alone is not enough to get to equity”, which is why a pandemic accord or instrument is important. And to address future pandemics, he said, more financing is needed to prepare so that low-and middle-income countries can purchase what they need, manufacturers are included, and supply chains keep flowing with the free trade of raw materials and finished products. “All of this needs to be captured under something like a pandemic accord,” Aylward said. “This is not charity. This is not handouts. This is in everyone’s interest to end pandemics, like the one we’re in the midst of now has been going on much longer than it should have given the science that we had so early in this in this pandemic.” Image Credits: UNICEF, Gavi . Posts navigation Older postsNewer posts